• Radiation Oncology Journal
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• v.26 no.1
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• pp.35-44
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• 2008

Purpose: To evaluate the incidence and prognostic factors of treatment-related pneumonitis in non-small-cell lung cancer(NSCLC) patients treated with intensity modulated radiation therapy(IMRT). Materials and Methods: One-hundred-five patients with NSCLC treated with IMRT between 1 August 2004 and 30 November 2006 were analyzed retrospectively. The mean age of patients was 62.9 years, and squamous carcinomas were confirmed in 81 patients(77%). Sixty-six patients(62.9%) were classified as stage III, and 59 patients had lesions in the right lung. Twenty-seven patients were treated with a dose of 3,060 cGy preoperatively, and 10 patients were given a dose of 5,040 cGy postoperatively. Sixty-eight patients received a dose of 7,020 cGy for curative intent. Sixty-eight patients were treated with the use of the CORVUS planning system and 37 patients were treated with the use of the ECLIPSE planning system. Results: Of 105 patients, 21 patients(20%) had abnormal radiological findings, but only seven patients(6.7%) required treatment for radiation pneumonitis. Six of the seven patients had other serious lesions, including a bronchioesophageal fistula(one patient), recurrence in the treatment field(two patients), brain metastasis(one patient) and lung-to-lung metastasis(two patients); all of these patients died within 19 months after radiation treatment. Sixteen patients(23.5%) that received planning with the CORVUS system had abnormal lung findings. Five patients(13.5%) had abnormal lung findings with the use of the ECLIPSE planning system. Other prognostic factors such as perioperative radiation therapy, a volume over 10% of the V20 volume in the right lung, were also statistically significant. Conclusion: This retrospective analysis suggests that IMRT could be a beneficial treatment modality for the reduction of radiation pneumonitis in NSCLC patients. However, the higher incidence of abnormal radiological findings in perioperative patients treated with relatively lower doses($3,060{\sim}5,040$ cGy) suggest the need for judicious treatment planning in preoperative or postoperative treatment.

• Tuberculosis and Respiratory Diseases
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• v.42 no.4
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• pp.555-568
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• 1995

Background: It is most physiologic to measure the diffusing capacity of the lung by using oxygen, but it is so difficult to measure partial pressure of oxygen in the capillary blood of the lung that in clinical practice it is measured by using carbon monoxide, and single-breath diffusing capacity method is used most widely. However, since the process of withholding the breath for 10 seconds after inspiration to the total lung capacity is very hard to practice for patients who suffer from cough, dyspnea, etc, the intra-breath lung diffusing capacity method which requires a single exhalation of low-flow rate without such process was devised. In this study, we want to know whether or not there is any significant difference in the diffusing capacity of the lung measured by the single-breath and intra-breath methods, and if any, which factors have any influence. Methods: We chose randomly 73 persons without regarding specific disease, and after conducting 3 times the flow-volume curve test, we selected forced vital capacity(FVC), percent of predicted forced vital capacity, forced expiratory volume within 1 second($FEV_1$), percent of forced expiratory volume within 1 second, the ratio of forced expiratory volume within 1 second against forced vital capacity($FEV_1$/FVC) in test which the sum of FVC and $FEV_1$ is biggest. We measured the diffusing capacity of the lung 3 times in each of the single-breath and intra-breath methods at intervals of 5 minutes, and we evaluated which factors have any influence on the difference of the diffusing capacity of the lung between two methods[the mean values(ml/min/mmHg) of difference between two diffusing capacity measured by two methods] by means of the linear regression method, and obtained the following results: Results: 1) Intra-test reproducibility in the single-breath and intra-breath methods was excellent. 2) There was in general a good correlation between the diffusing capacity of the lung measured by a single-breath method and that measured by the intra-breath method, but there was a significant difference between values measured by both methods($1.01{\pm}0.35ml/min/mmHg$, p<0.01) 3) The difference between the diffusing capacity of the lung measured by both methods was not correlated to FVC, but was correlated to $FEV_1$, percent of $FEV_1$, $FEV_1$/FVC and the gradient of methane concentration which is an indicator of distribution of ventilation, and it was found as a result of the multiple regression test, that the effect of $FEV_1$/FVC was most strong(r=-0.4725, p<0.01) 4) In a graphic view of the difference of diffusing capacity measured by single-breath and intra-breath method and $FEV_1$/FVC, it was found that the former was divided into two groups in section where $FEV_1$/FVC is 50~60%, and that there was no significant difference between two methods in the section where $FEV_1$/FVC is equal or more than 60% ($0.05{\pm}0.24ml/min/mmHg$, p>0.1), but there was significant difference in the section, less than 60%($-4.5{\pm}0.34ml/min/mmHg$, p<0.01). 5. The diffusing capacity of the lung measured by the single-breath and intra-breath method was the same in value($24.3{\pm}0.68ml/min/mmHg$) within the normal range(2%/L) of the methane gas gradient, and there was no difference depending on the measuring method, but if the methane concentration gradients exceed 2%/L, the diffusing capacity of the lung measured by single-breath method became $15.0{\pm}0.44ml/min/mmHg$, and that measured by intra-breath method, $11.9{\pm}0.51ml/min/mmHg$, and there was a significant difference between them(p<0.01). Conclusion: Therefore, in case where $FEV_1$/FVC was less than 60%, the diffusing capacity of the lung measured by intra-breath method represented significantly lower value than that by single-breath method, and it was presumed to be caused largely by a defect of ventilation-distribution, but the possibility could not be excluded that the diffusing capacity of the lung might be overestimated in the single-breath method, or the actual reduction of the diffusing capacity of the lung appeared more sensitively in the intra-breath method.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.8
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• pp.3257-3265
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• 2015

Background: Radiotherapy is an important treatment of choice for breast cancer patients after breast-conserving surgery, and we compare the feasibility of using dual arc volumetric modulated arc therapy (VMAT2), single arc volumetric modulated arc therapy (VMAT1) and Multi-beam Intensity Modulated Radiotherapy (M-IMRT) on patients after breast-conserving surgery. Materials and Methods: Thirty patients with breast cancer (half right-sided and half left-sided) treated by conservative lumpectomy and requiring whole breast radiotherapy with tumor bed boost were planned with three different radiotherapy techniques: 1) VMAT1; 2) VMAT2; 3) M-IMRT. The distributions for the planning target volume (PTV) and organs at risk (OARs) were compared. Dosimetries for all the techniques were compared. Results: All three techniques satisfied the dose constraint well. VMAT2 showed no obvious difference in the homogeneity index (HI) and conformity index (CI) of the PTV with respect to M-IMRT and VMAT1. VMAT2 clearly improved the treatment efficiency and can also decrease the mean dose and V5Gy of the contralateral lung. The mean dose and maximum dose of the spinal cord and contralateral breast were lower for VMAT2 than the other two techniques. The very low dose distribution (V1Gy) of the contralateral breast also showed great reduction in VMAT2 compared with the other two techniques. For the ipsilateral lung of right-sided breast cancer, the mean dose was decreased significantly in VMAT2 compared with VMAT1 and M-IMRT. The V20Gy and V30Gy of the ipsilateral lung of the left-sided breast cancer for VMAT2 showed obvious reduction compared with the other two techniques. The heart statistics of VMAT2 also decreased considerably compared to VMAT1 and M-IMRT. Conclusions: Compared to the other two techniques, the dual arc volumetric modulated arc therapy technique reduced radiation dose exposure to the organs at risk and maintained a reasonable target dose distribution.

• Journal of the Korean Society of Radiology
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• v.6 no.5
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• pp.395-402
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• 2012

4D-Radiation Therapy is the optimal treatment to track moving organs(tumor) and give the appropriate prescription dose to tumor and low radiation dose to normal tissue surrounding tumor volume. The ABCHES is a 4DRT devices maintaining shallow breathing to patients. It allows the tumor's movement was minimize. Meanwhile, Abdominal compression device is limited the breath compressing abdomen on patients. In this paper we will quantitative analysis the movement of tumor on only ABCHES versus ABCHES with Abdomal compression device and Analysis tumor dose and normal tissue's dose by Dose Volume Histogram on two parts. The result of Comparision ABCHES and ABCHES with Abdominal compression device, SI(Superior-Inferior) direction, AP(Anterior-Posterior) direction and LR(Left-Right) direction was limited 1.0 mm, 0.2 mm, 0.2 mm(average). and also reduction rate of voluume in HPTV was $16{\pm}2%$, and LPTV was $15.8{\pm}0.8%$ under only using ABCHES and ABCHES with compression. The analysis dose volume histogram was more radiation dose in ABCHES and abdominal compression device than only using ABCHES, and less normal tissue-ipsilateral lung, whole lung, kidney-dose in ABCHES and abdominal compression device than only using ABCHES. The overall analysis was ABCHES with abdominal compression better than only using ABCHES method. In hereafter it will be studies that limitation of ABCHES and abdomonal compression device. In other words, patient's discomfort on compression intensity, method of application on patient with inaccurate respiration cycle.

• Journal of Chest Surgery
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• v.16 no.4
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• pp.539-546
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• 1983

Maximal expiratory flow-volume [MEFV] curves were studied in 22 patients who underwent pneumonectomy with various pulmonary lesions, such as lung cancer, bronchiectasis and tuberculosis etc, at the preoperative stage and 3 week, 4 month and 12 month after pneumonectomy for the analysis of the reduction and progressive improvement of postoperative ventilatory function. And the factors affecting them like as age difference and the site of pneumonectomy were also analyzed. From these curves peak flow rate [PF R], maximal expiratory flows at 25% and 50% of expired forced vital capacity [V25, V50] and forced vital capacity [FVC] were obtained. In addition, partial pressure of oxygen and carbon dioxide in arterial blood were measured. The results were as follows; 1. The mixed type, especially obstructive type of ventilatory impairment was observed at 3 week after operation. For 1 year of postpneumonectomy FVC was increased by 12.3% of predicted compared to 2.6% of predicted V50. 2. The improvement of FVC during 1 year of postpneumonectomy showed decreasing tendency with the increase of age but the changes of V25 and V50 were unremarkable. 3. The differences of immediate postoperative reduction and progressive improvement of ventilatory capacity after right and left pneumonectomy were analyzed. The reduction of V50, V25 and FVC at 3 week of postoperation were greater in patients with right pneumonectomy [20.9%, 18.2% and 26.2% of predicted] than in patients with left pneumonectomy 16.5%, 18.2% and 18.1%]. But there was no significant difference of these values at 12 month after pneumonectomy. 4. The partial pressure of oxygen in arterial blood [$PaO_2$] was decreased by 13.6 mmHg at 3 week after pneumonectomy compared to the preoperative stage but returned to the normal range within 4 month after pneumonectomy. However, TEX>$PaCO_2$ was within the normal range during 1 year of postoperation.

• Journal of Pharmacopuncture
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• v.5 no.2
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• pp.120-136
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• 2002

Objectives : The purpose of this study is to investigate Acute and Subacute Toxicity, and Anti-cancer Effect of H Herbal-acupuncture on mice and rats. Methods : Balb/c mice were injected intraperitoneally with H Herbal-acupuncture for $LD_{50}$ and acute toxicity test. Sprague-Dawley rats were experimented in the same way for subacute toxicity test. H Herbal-acupuncture was injected into abdomen of mice having S-180 cancer cell line. Result : 1. During the test, $LD_{50}$ could not be counted since there was no expired subjects. 2. In an acute toxicity test, the loss of motility and reflex action was observed, but weight increased in the treatment group, compared with those in the normal group (P<0.05). 3. In an acute toxicity test of serum biochemical values of mice, glucose increased in the treatment group II while total cholesterol was increased in the all treatment groups (P<0.05). 4. In a subacute toxicity test, a little loss of motility and reflex action was observed in the treatment group. Weight of mice in the treatment group decreased on the 28th day. 5. In a subacute toxicity test, liver weight was decreased but lung weight of mice increased in the all treatment groups (P<0.05). 6. As a result of measuring Complete Blood Count test (CBC) of rat, HCT was decreased in treatments even though it was not significant, compared with the normal group (P<0.05). 7. In a serum biochemical value test of subacute toxicity, total protein and albumin decreased in the all treatment groups. Creatinine, glucose, GOT increased in the treatment group I compared with the control group. Alkaline phos-phatase decreased in treatment II group, compared with the control group (P<0.05). 8. Median survival time that was measured in the rats treated with sarcoma-180 cancer cell Median decreased in the treatment group, compared with the control group (P<0.05). 9. Natural killer cell activity showed significant reduction at 100:1 and 10:1 E/T ratio while it increased at 50:1 E/T ratio. It is inferred that there was an error in the experiment (P<0.05). 10. In an interleukin-2 productivity test, even though it decreased in lung cancer, and increased in abdomen cancer, but it was only a small difference (P<0.005). 11. After injecting B16F10 cell into a capillary vessel of C57BL/6 mice and generating metastasized lung cancer, the lung was examined with the naked eye. It was not possible to see metastasized cancer in the all groups on the seventh day but the cancer was viewed on the fourteenth day. The number and volume of metastasized cancer in the treatment group enlarged in the treatment group, compared with the control group. Conclusion : According to the results, H herbal-acupuncture took no effects in cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.2
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• pp.741-746
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• 2015

Purpose: To investigate the influence of exogenous p53 upregulated modulator of apoptosis (PUMA) expression on cell proliferation and apoptosis in human non-small cell lung cancer A549 cells and transplanted tumor cell growth in nude mice. Materials and Methods: A549 cells were divided into the following groups: control, non-carrier (NC), PUMA (transfected with pCEP4-(HA) 2-PUMA plasmid), DDP ($10{\mu}g/mL$ cisplatin treatment) and PUMA+DDP (transfected with pCEP4-(HA)2-PUMA plasmid and $10{\mu}g/mL$ cisplatin treatment). The MTT method was used to detect the cell survival rate. Cell apoptosis rates were measured by flow cytometry, and PUMA, Bax and Bcl-2 protein expression levels were measured by Western blotting. Results: Compared to the control group, the PUMA, DDP and PUMA+DDP groups all had significantly decreased A549 cell proliferation (p<0.01), with the largest reduction in the PUMA+DDP group. Conversely, the apoptosis rates of the three groups were significantly increased (P<0.01), and the PUMA and DDP treatments were synergistic. Moreover, Bax protein levels significantly increased (p<0.01), while Bcl-2 protein levels significantly decreased (p<0.01). Finally, both the volume and the weights of transplanted tumors were significantly reduced (p<0.01), and the inhibition ratio of the PUMA+DDP group was significantly higher than in the single DDP or PUMA groups. Conclusions: Exogenous PUMA effectively inhibited lung cancer A549 cell proliferation and transplanted tumor growth by increasing Bax protein levels and reducing Bcl-2 protein levels.

• Journal of Power Electronics
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• v.15 no.2
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• pp.309-318
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• 2015

This study proposes a dual-output single-stage bridgeless single-ended primary-inductor converter (DOSSBS) that can completely remove the front-end full-bridge alternating current-direct current rectifier to accomplish power factor correction for universal line input. Without the need for bridge diodes, the proposed converter has the advantages of low component count and simple structure, and can thus significantly reduce power loss. DOSSBS has two uncommon output ports to provide different voltage levels to loads, instead of using two separate power factor correctors or multi-stage configurations in a single stage. Therefore, this proposed converter is cost-effective and compact. A magnetically coupled inductor is introduced in DOSSBS to replace two separate inductors to decrease volume and cost. Energy stored in the leakage inductance of the coupled inductor can be completely recycled. In each line cycle, the two active switches in DOSSBS are operated in either high-frequency pulse-width modulation pattern or low-frequency rectifying mode for switching loss reduction. A prototype for dealing with an $85-265V_{rms}$ universal line is designed, analyzed, and built. Practical measurements demonstrate the feasibility and functionality of the proposed converter.

• The Journal of Korean Medicine
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• v.31 no.3
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• pp.34-46
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• 2010

Objective: This experimental study was performed to examine if Hang-Am-Dan non-boiled water extracts (HAD-N) induce apoptosis in human lung carcinoma NCI-H460 cells in vitro and inhibits the growth of NCI-H460 cell-transplanted solid tumor in vivo. Materials and Methods: We cultured NCI-H460 cell lines and xenografted them to nude mice. The mice were divided into 3 groups, NCI-H460 cell alone, NCI-H460 + 90 mg/kg HAD-N treated group, and NCI-H460 + 180 mg/kg HAD-N treated group, with seven mice per group. HAD-N was orally administrated every day for four weeks. We checked their body weight and tumor weight and volumes two times a week and their absolute organ weight and biochemical blood analysis at the final day by sacrificing them. We also calculated their tumor inhibition rate (IR), mean survival time and percent increase in life span (% ILS). Results: In this study, we observed that all of the HAD-N treated mice got smaller tumors. The more doses of HAD-N used, the less IR showed at the 8th day after starting this experiment. Tumor weight and volume of HAD-N treatment groups also decreased. Mean survival time and percent increase in life span (% ILS) in the high-dose HAD-N treatment groups were higher than those of other groups. The test substances in the blood level UN results showed reduction in the significance in both HAD-N 90 mg/kg and HAD-N 180 mg/kg (p<0.01). The blood level phosphatase results in HAD-N 90 mg/kg group compared to NCI-H460 cell alone group showed a reduction in significance (p<0.05). AST levels HAD-N 180 mg/kg group compared to NCI-H460 cell alone group significance as well (p<0.05). Conclusion: We suggest that the results of the in vivo study showed that HAD-N may have potential as a growth inhibitor of tumor-induced NCI-H460 of nude mice in spite of the shortcomings of this study. More studies to overcome those shortcomings and to find out significant antitumor mechanism will be needed.

• Progress in Medical Physics
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• v.24 no.4
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• pp.278-283
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• 2013

Breast cancer is the leading cause of cancer death in women worldwide and the number of women breast cancer patient was increased continuously. Most of breast cancer patient has suffered from unnecessary radiation exposure to heart, lung. Low radiation dose to the heart could lead to the worsening of preexisting cardiovascular lesions caused by radiation induced pneumonitis. Also, several statistical reports demonstrated that left-sided breast cancer patient showed higher mortality than right-sided breast cancer patient because of heart disease. In radiation therapy, Deep Inspiration Breath Hold (DIBH) technique which the patient takes a deep inspiration and holds during treatment and could move the heart away from the chest wall and lung, has showed to lead to reduction in cardiac volume and to minimize the unnecessary radiation exposure to heart during treatment. In this study, we investigated the displacement of heart using DIBH CT data compared to free-breathing (FB) CT data and radiation exposure to heart. Treatment planning was performed on the computed tomography (CT) datasets of 10 patients who had received lumpectomy treatments. Heart, lung and both breasts were outlined. The prescribed dose was 50 Gy divided into 28 fractions. The dose distributions in all the plans were required to fulfill the International Commission on Radiation Units and Measurement specifications that include 100% coverage of the CTV with ${\geq}95%$ of the prescribed dose and that the volume inside the CTV receiving >107% of the prescribed dose should be minimized. Scar boost irradiation was not performed in this study. Displacement of heart was measured by calculating the distance between center of heart and left breast. For the evaluation of radiation dose to heart, minimum, maximum and mean dose to heart were calculated. The present study demonstrates that cardiac dose during left-sided breast radiotherapy can be reduced by applying DIBH breathing control technique.