• 한국의학물리학회지:의학물리
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• 제24권3호
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• pp.154-161
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• 2013

본 연구는 총 10명의 전립선 암 환자를 대상으로 세기조절방사선치료(IMRT), 균일스캐닝양성자치료(USPT), 그리고 세기조절양성자치료(IMPT)기술을 이용한 치료계획의 결과를 비교, 평가 하였다. 각 치료 계획은 타깃 체적의 95%에 70 Gy가 28회 분할 조사되도록 하였으며 세기조절방사선치료(IMRT)에서는 step-and-shoot 기법을 이용하여 총 7개의 빔을 사용하여 방사선을 조사하였고, 균일세기양성자치료(USPT)와 세기조절양성자치료(IMPT)에서는 동일한 방사선 가중치의 측방향대향조사면(lateral opposing field)를 사용하여 타깃에 처방선량이 전달되도록 하였다. 한편, 세기조절양성자치료(IMPT)의 최적화를 위해 IMRT치료와 유사한 Inverse planning을 수행하였다. 결과 비교를 위해 타깃의 균질성지수(homogeneity index) 및 동형지수(conformity index)와 정상조직의 정상조직합병증확률(NTCP)을 계산하였다. 비록 치료기법간에 균질성지수(homogeneity index), 동형지수(conformity index)차이가 크지 않았지만, 직장의 경우 각 세기조절방사선치료(IMRT), 균일스캐닝 양성자치료(USPT) 및 세기조절양성자치료(IMPT)에서 2.233, 3.326 및 1.707로 계산되었다. 또한 방광의 정상조직합병증확률(NTCP)는 0.008, 0.003, 및 0.002를 나타내었다. 직장과 방광의 NTCP 값이 IMPT을 사용할 때 유의하게 낮은 값을 보이는 것을 확인하였다. 본 연구를 통해 전립선 암의 방사선 치료 시 세기조절방사선치료(IMRT)보다 양성자를 이용한 방사선 치료, 특히 최적화된 세기조절양성자치료(IMPT)가 치료 효과를 높일 수 있는 치료계획이 될 수 있음을 확인할 수 있었다.

• 한국사회복지학
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• 제68권2호
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• pp.161-184
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• 2016

본 연구는 ADHD 아동을 양육하는 어머니들의 체험을 통한 ADHD 아동에 대한 치료와 서비스 본질 의미를 탐구하고자 하였다. 본질을 탐색하기 위해 ADHD 아동에게 실시한 치료와 서비스의 경험을 Giorgi 4단계를 토대로 단계별 치료와 서비스 경험의 의미와 정보 채널의 과정을 연구문제 내용으로 기술하였다. 연구문제는 ADHD 아동 어머니들이 경험한 ADHD 치료 및 서비스 경험의 실태는 무엇인가?, ADHD 아동 어머니들이 경험한 ADHD 치료 및 서비스의 본질적 의미는 무엇인가? ADHD 아동 어머니들이 경험한 ADHD 치료 및 서비스 경험의 구조는 어떠한가?로 구성되었다. 이를 위해 2014년 6월부터 전화면접을 통한 접촉을 시작하였으며, 인터뷰는 2014년 12월부터 2015년 2월까지 실시되었다. 13명의 ADHD 아동 어머니를 대상으로 2~3회에 걸쳐 현상학적 연구로 진행되었다. 그 결과 ADHD 아동 어머니들이 경험한 ADHD 치료 및 서비스 경험의 본질적 의미를 통한 질적 구조는 '내가 변해야 우리 아이가 산다'는 것으로 인지의 변화를 가져온 '인식변화를 위한 동행과정'이었다. 이러한 과정은 '무지와 혼란 속에서 자기결정의 부재'를 가져온 경험을 통해 '지각한 현실과 불안에 대처하며 변화에의 욕구'를 가진 후 '변화를 시도하지만 아직 남은 미결의 과제'를 지닌 채 '긍정적 변화의 주체로' 맞서 나아가는 과정이었다. 이 연구결과를 통해 병합치료의 필요성과 치료를 지속하는데 있어 부모의 올바른 인식에 의한 치료 참여는 주요한 변인이 된다는 것을 알 수 있었다. 아울러 아동의 변화를 위한 어머니의 변화가 중요하지만 삶에 대한 어머니의 태도가 긍정적으로 변화될 때만이 이루어질 수 있는, 어머니의 인지의 변화 과정이었다는 것이다.

• Archives of Plastic Surgery
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• 제36권4호
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• pp.432-436
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• 2009

Purpose: Negative pressure therapy has been used in various conditions to promote wound healing. It has also been used to secure a skin graft by improving microcirculation and improving tight adhesion between the graft and the recipient bed. To reduce post burn scar contracture and improve aesthetical result, many types of dermal substitutes have been invented and used widely. The goal of this study was evaluate usefulness of the VAC (Kinetic concepts Inc., San Antonio, TX) in improving the take rate and time to incorporation of Integra$^{(R)}$ in reconstruction of burn scar contracture. Methods: A retrospective study was performed from October, 2006 to December, 2008. The VAC was utilized for 11 patients. The average patient's age was 19.7 years (range 5 - 27) and average surface area was $785cm^2$ (range 24 - 1600). The burn scars were excised deep into normal subcutaneous tissue to achieve complete release of the scar, Integra$^{(R)}$ was sutured in place with skin staple와 Steri - strip$^{(R)}$. Then slit incisions were made on silicone sheet only with No.11 blade for effective drainage. The VAC was used as a bolster dressing over Integra$^{(R)}$. Negative - Pressure ranging from 100 to 125 mm Hg was applied to black polyurethane foam sponge trimmed to the appropriate wound size. An occlusive seal over the black polyurethane foam sponge was maintained by a combination of the occlusive dressing, OP - site$^{(R)}$. The VAC dressing changes were performed every 3 or 4 days until adequate incorporation was obtained. The neodermis appeared slightly yellow to orange color. When the Integra$^{(R)}$ deemed clinically incorporated, The VAC was removed and take was estimated with visual inspection. Very thin STSG(0.006 ~ 0.008 inches) was performed after silicone sheet removal. Result: The mean time for clinically assessed incorporation of Integra$^{(R)}$ was 10.00 days (range 9 - 12). The mean dressing change was 3.5 times until take was obtained. In All patients, Integra$^{(R)}$ had successful incorporation in tissue without serious complications. Conclusion: Integra$^{(R)}$ in combination with Vacuum - Assisted Closure(VAC) may be incorporated earlier than conventional dressing method.

• Radiation Oncology Journal
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• 제9권1호
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• pp.143-152
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• 1991

본 논문에서는 소조사면에 대한 X-선의 선량분포를 일반실험식으로 계산될 수 있도록 beam 측정 데이타를 종합 처리하는 방법에 대하여 기술하고 있다. Beam 데이타는 philips LINAC 6 MV, 8 MV X-ray에 대하여 측정 되었으며, 측정된 요소는 tissue maximum ratio (TMR), off-axis-ratio (OAH), 그리고 relative output factor (ROF)를 포함한다. 소조사면에 의한 방사선 치료를 위하여 isocenter에서 지름이 1 내지 3cm되도록 실린더 형태의 특수 collimator가 2 mm 간격으로 제작되었다. 본 측정을 위하여 다이오드 detector가 이용되었으며 Film 및 TLO 측정기로 측정된 값과 비교검토 되었다. 제한된 조사면으로 측정된 TMR, OAR data로부터 beam 데이타를 나타내는 실험식을 유도하였으며 이 실험식은 임의의 Set-UP조건에 따른 측정값을 예상할 수 있는 일반 실험식으로 확장되었고 측정된 TMR과 OAR 값들은 잘 일치되었다.

• BMB Reports
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• 제34권2호
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• pp.176-181
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• 2001

Using a retrovirus, foreign genes can be introduced into mammalian cells. The purpose of this study is to produce a retrovirus that can make the infected cells express two genes; the human multidrug resistance gene (MDR1) and the HLA-B7 gene, which is one of the major human histocompatibility complex (MHC) class I genes. For the expression of these genes, the internal ribosome entry site (IRES) was used, which was derived from the encephalomyocarditis (EMC) virus. In order to produce retroviruses, a retroviral vector was transfected into a packaging cell line and the transfected cells were treated with vincristine, which is an anti-cancer drug and a substrate for the MDRI gene product. This study revealed that two genes were incorporated into chromosomes of selected cells and expressed in the same cells. The production of the retrovirus was confirmed by the reverse transcription (RT)-PCR of the viral RNA. The retrovirus that was produced infected mouse fibroblast cells as well as the human U937. This study showed that packaging cells produced the retroviruses, which can infect the target cells. Once the conditions for the high infectivity of retrovirus into human cells are optimized, thus virus will be used to infect hematopoietic stem cells to co-express MDRl and HLA-B7 genes, and develop the lymphocytes that can be used for the immnogene therapy.

• Journal of Pharmaceutical Investigation
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• 제36권6호
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• pp.355-361
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• 2006

Intraarticular corticosteroid injections for therapy of rheumatic arthritis are administered with the aim of optimal local anti-inflammatory effect at the injection site. Since the side effects of corticosteroidal drug, dexamethasone(DEX), administered at hish dose limited the therapeutic efficacy, there was a need to design a new drug delivery system for controlled release of dexamethasone. As a prodrug for continuous therapeutic efficacy, dexamethasone-21-palmitate(DEX-PAL) was prepared via esterification of palmitoyl chloride and dexamethasone. DEX-PAL was identified by NMR and MASS analysis. DEX-PAL or DEX was entrapped in lipid nanosphere which could be prepared by using a self emulsification-solvent evaporation method. Physicochemical characteristics such as mean particle diameter, zeta potential and drug loading efficiency of the lipid nanospheres were investigated with variation of either the kind of lipid or the lipid composition. The lipid nanospheres had a mean diameter $83{\sim}95$ nm and DEX-PAL loading efficiency of up to 95%. The drug loading efficiency increased with the increase of aliphatic chain length attached to the phospholipid. The incorporation of cationic lipid was very efficient for both reducing particle size of lipid nanospheres and enhancing drug loading efficiency. The lipid nanospheres containing DEX-PAL may be a promising novel drug carrier for the controlled release of the poorly water-soluble drugs.

• Journal of Pharmaceutical Investigation
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• 제34권5호
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• pp.401-406
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• 2004

To develop an intravenous delivery system of all-trans retinoic acid (ATRA) for the cancer therapy, poly(L-lactic acid) nanoparticles were prepared and characterized. Emulsification-solvent evaporation method was chosen to prepare submicron sized nanoparticles. Spherical nanoparticles less than 200 nm in diameter with narrow size distribution were prepared, and the entrapment efficiency of drug was more than 95%. The endothermic peak at $183^{\circ}C$ and X-ray crystallographic peak of ATRA appeared in the nanoparticle system, suggesting the inhibition of crystallization of ATRA by polymer adsorption during the precipitation process. ATRA was released at $37^{\circ}C$ for 60 days and the release rate was dependent on the concentration of drug incorporated in the nanoparticles. While ATRA was unstable in the light, it was very stable at $4^{\circ}C$. These results suggest the usefulness of PLA nanoparticles as a sustained and prolonged release carrier for ATRA.

• 대한핵의학회지
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• 제38권2호
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• pp.198-204
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• 2004

Tumor cell proliferation is considered to be a useful prognostic indicator of tumor aggressiveness and tumor response to therapy but in vitro measurement of individual proliferation is complex and tedious work. PET imaging provides a noninvasive approach to measure tumor growth rate in situ. Early approaches have used $^{18}F$-FDG or methionine to monitor proliferation status. These 2 tracers detect changes in glucose and amino acid metabolism, respectively, and therefore provide only an indirect measure of proliferation status. More recent studies have focused on DNA synthesis itself as a marker of cell proliferation. Cell lines and tissues with a high proliferation rate require high rates of DNA synthesis. $[^{11}C]Thymidine$ was the first radiotracer for noninvasive imaging of tumor proliferation. The short half-life of $^{11}C$ and rapid metabolism of $[^{11}C]Thymidine$ in vivo make the radiotracer less suitable for routing use. Halogenated thymidine analogs such as 5-iodo-2-deoxyuridine (IUdR) can be successfully used as cell proliferation markers for in vitro studies because these compounds are rapidly incorporated into newly synthesized DNA. IUdR has been evaluated as a potential in vivo tracer in nuclear medicing but the image qualify and the calculation of proliferation rates are impaired by its rapid in vivo degradation. Hence, the thymidine analog $3'-deoxy-3'-^{18}F-fluorothymidine$ (FLT) was recently introduced as a stable proliferation marker with a suitable nuclide half-life and stable in vivo. $[^{18}F]FLT$ is phosphorylated to 3-fluorothymidine monophosphate by thymidine kinase 1 and reflects thymidine kinase 1 activity in proliferating cell. $[^{18}F]FLT$ PET is feasible in clincal use and well correlates with cellular proliferation. Choline is a precursor for the biosynthesis of phospholipids (in particular, phosphatidylcholine), which is the essential component of all eukaryotic cell membranes and $[^{11}C]choline$, which is a new marker for cellular proliferation.

• 융합정보논문지
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• 제10권6호
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• pp.164-176
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• 2020

인체 적응 면역 반응을 일으키는데 중요한 항원 특이적 T 세포를 활용한 면역 세포 치료에서 T 세포를 체외에서 배양하고 클론 확장시키는 과정은 매우 섬세하고 복잡하여 조절하기가 쉽지 않아 T 세포의 활성화와 클론 확장을 유도하면서도 조절 및 취급이 용이한 인공 항원제시세포 개발의 필요성이 대두되고 있다. 인공 항원제시세포는 인체의 항원제시세포의 세포 표면 분자와 작용을 모방하게 되는데, 기본적인 신호 분자인 MHC-항원 복합체, 공동 자극 분자, 그리고 용해성 면역 조절 분자를 필수적으로 발현하여야 한다. 또한 T 세포가 항원과 접촉할 때, 이들 분자들이 잘 조직화되어 작용하는 것이 효과적인 T 세포 활성화에 중요하다. 본 논문에서는 여러 인공 항원제시세포 제작 방법과 세포 표면 분자들의 결합 방법과 물리적인 특성이 T 세포와의 상호작용에 중요함을 고찰하였으며, 효과적인 T 세포 활성화를 유도하며 면역세포치료에 적용 가능한 인공항원제세세포의 제작 방법을 살펴보았다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제40권
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• pp.34.1-34.8
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• 2018

Background: Radiation therapy is widely employed in the treatment of head and neck cancer. Adverse effects of therapeutic irradiation include delayed bone healing after dental extraction or impaired bone regeneration at the irradiated bony defect. Development of a reliable experimental model may be beneficial to study tissue regeneration in the irradiated field. The current study aimed to develop a relevant animal model of post-radiation cranial bone defect. Methods: A lead shielding block was designed for selective external irradiation of the mouse calvaria. Critical-size calvarial defect was created 2 weeks after the irradiation. The defect was filled with a collagen scaffold, with or without incorporation of bone morphogenetic protein 2 (BMP-2) (1 ㎍/ml). The non-irradiated mice treated with or without BMP-2-included scaffold served as control. Four weeks after the surgery, the specimens were harvested and the degree of bone formation was evaluated by histological and radiographical examinations. Results: BMP-2-treated scaffold yielded significant bone regeneration in the mice calvarial defects. However, a single fraction of external irradiation was observed to eliminate the bone regeneration capacity of the BMP-2-incorporated scaffold without influencing the survival of the animals. Conclusion: The current study established an efficient model for post-radiation cranial bone regeneration and can be applied for evaluating the robust bone formation system using various chemokines or agents in unfavorable, demanding radiation-related bone defect models.