• Progress in Medical Physics
• /
• v.19 no.1
• /
• pp.35-41
• /
• 2008

The main benefit of proton therapy over photon beam radiotherapy is the absence of exit dose, which offers the opportunity for highly conformal dose distributions to target volume while simultaneously irradiating less normal tissue. For proton beam therapy two patient specific beam modifying devices are used. The aperture is used to shape the transverse extension of the proton beam to the shape of the tumor target and a patient-specific compensator attached to the block aperture when required and used to modify the beam range as required by the treatment plan for the patient. A block of range shifting material, shaped on one face in such a way that the distal end of the proton field in the patient takes the shape of the distal end of the target volume. The mechanical quality assurance of range compensator is an essential procedure to confirm the 3 dimensional patient-specific dose distributions. We proposed a new quality assurance method for range compensator based on image processing using X-ray tube of proton therapy treatment room. The depth information, boundaries of each depth of plan compensatorfile and x-ray image of compensator were analyzed and presented over 80% matching results with proposed QA program.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.1
• /
• pp.307-314
• /
• 2015

Background: Bladder cancer is among the five most common malignancies worldwide. Altered expression of suppressor of cytokine signaling -3 (SOCS-3) has been implicated in various types of human cancers; however, its role in bladder cancer is not well established. Aim: The present study was undertaken to investigate the mRNA expression of SOCS-3 in normal and cancerous bladder tissue and to explore its correlation with urinary levels of some proinflammatory cytokines, cytokeratin-18 (CK -18) and with tumor histopathological grading, in order to evaluate their role as potential diagnostic markers. Materials and Methods: SOCS3 mRNA expression levels were evaluated using quantitative real time PCR. Urinary levels of interleukins 6 and 8 were estimated by enzyme linked immunosorbent assay (ELISA). Cytokeratin-18 expression was analyzed by immuunohistochemistry then validated by ELISA. Results: SOC3 m RNA expression levels were significantly lower in high grade urothelial carcinoma ($0.36{\pm}0.12$) compared to low grade carcinoma ($1.22{\pm}0.38$) and controls ($4.08{\pm}0.88$), (p<0.001). However, in high grade urothelial carcinoma the urinary levels of IL-6, IL-8, total CK-18($221.33{\pm}22.84pg/ml$, $325.2{\pm}53.6pg/ml$, $466.7{\pm}57.40U/L$ respectively) were significantly higher than their levels in low grade carcinoma ($58.6{\pm}18.6pg/ml$, $58.3{\pm}50.2pg/ml$, $185.5{\pm}60.3U/L$ respectively) and controls ($50.9{\pm}23.0pg/ml$, $7.12{\pm}2.74pg/ml$, $106.7{\pm}47.3U/L$ respectively), (p<0.001). Conclusions: Advanced grade of urothelial bladder carcinoma is significantly associated with lowered mRNA expression of SOC3 as well as elevated urinary levels of proinflammatory cytokines and CK-18. Furthermore, our results suggested that urinary IL-8, IL-6 and CK-18 may benefit as noninvasive biomarkers for early detection as well as histopathological subtyping of urothelial carcinoma.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.3
• /
• pp.1241-1245
• /
• 2015

Background: Thyroid carcinoma is the most common malignancy of the endocrine organs. Although the majority of thyroid cancer patients experience positive outcomes, anaplastic thyroid carcinoma is considered one of the most aggressive malignancies. Current therapeutic regimens do not confer a significant survival benefit, and new therapies are urgently needed. Oncolytic herpes simplex virus (oHSV) may represent a promising therapy for cancer. In the present study, we investigated the therapeutic effects of a third-generation HSV vector, $G47{\Delta}$, on various human thyroid carcinoma cell lines in vitro. Two subcutaneous (s.c.) models of anaplastic thyroid carcinoma were also established to evaluate the in vivo anti-tumor efficacy of $G47{\Delta}$. Materials and Methods: The human thyroid carcinoma cell line ARO, FRO, WRO, and KAT-5, were infected with $G47{\Delta}$ at different multiplicities of infection (MOIs) in vitro. The survival rates of infected cells were calculated each day. Two s.c. tumor models were established using ARO and FRO cells in Balb/c nude mice, which were intratumorally (i.t.) treated with either $G47{\Delta}$ or mock. Tumor volumes and mouse survival times were documented. Results: $G47{\Delta}$ was highly cytotoxic to different types of thyroid carcinomas. For ARO, FRO, and KAT-5, greater than 30% and 80% of cells were killed at MOI=0.01 and MOI=0.1, respectively on day 5. WRO cells displayed modest sensitivity to $G47{\Delta}$, with only 21% and 38% of cells killed. In the s.c. tumor model, both of the anaplastic thyroid carcinoma cell lines (ARO and FRO) were highly sensitive to $G47{\Delta}$; $G47{\Delta}$ significantly inhibited tumor growth and prolonged the survival of mice bearing s.c. ARO and FRO tumors. Conclusions: The oHSV $G47{\Delta}$ can effectively kill different types of human thyroid carcinomas in vitro. $G47{\Delta}$ significantly inhibited growth of anaplastic thyroid carcinoma in vivo and prolonged animal survival. Therefore, $G47{\Delta}$ may hold great promise for thyroid cancer patients.

• Journal of Distribution Science
• /
• v.15 no.3
• /
• pp.73-80
• /
• 2017

Purpose - Since Korean distribution market was opened, the domestic environment in department stores has been changed by the pattern of consumption and consumer need based on income classes. As multilateral Free Trade Agreement (FTA) accelerates opening markets, the scale of circulating capital has become bigger. Large-scale commercial facilities have developed quickly as a form of a large shopping center, thus, the matter of choice and securing market area became an important valuable in this trend. Moreover, multi-complex space has been proposed as the goal of successful business with promoting the public benefit. Research design, data, and methodology - This research studied consumer behavior using data about the life style and sales of consumers, not statistical data or survey as previous studies. This research tried to find the differentiation in complex cultural space with consumption behavior of department store. Results - As the structure of society and culture was getting diverse and complex, economic growth and development with such diversity and complexity improved consumers' quality of life. The changes of consumer life style are quite natural like human instinct. Department stores have activated retail business with the products of accumulated technology. Moreover, they have created the space of consumption and culture. Because of these social and environmental changes, department stores are being developed as Multi-functional spaces as well as sale places considering the strategies of department and the changes of consumers' purchasing behaviors. Conclusions - Urban culture complex is a landmark standing for the culture era of 21st century. It has provided an opportunity for consumers to enjoy culture, and has been an important factor to improve company images. Based on these roles and needs, expectancy effects are related with consumer preference and space preference, and the attitude toward companies. Moreover, the expectancy effects from those relationships are getting bigger and bigger. We should respect nature, a characteristic of Korean architecture, maintain visual continuity that harmonies with nature in the development of the complex space of the domestic department stores, and should take significance in the development of the complex cultural space in the direction of feeling the hierarchy of the space to obtain the visual pleasure with the artificial structure.

• Safety and Health at Work
• /
• v.11 no.1
• /
• pp.33-40
• /
• 2020

Background: Exploratory study to investigate whether co-exposure to physical wrist stressors and chemicals is associated with carpal tunnel syndrome (CTS) in French male farmers and agricultural workers. Methods: Cross-sectional study of 711 men aged 30-65 years and working as either farmers or agricultural workers in 2009-2010 within a cohort covered by the French Agricultural Workers' and Farmers' Mutual Benefit Fund. CTS and exposure to physical wrist stressors and chemicals were assessed using a self-administered questionnaire. Associations between CTS and personal/medical factors, exposure to physical wrist stressors, exposure to chemicals, and co-exposure to physical wrist stressors and chemicals were studied using multivariate logistic regression models. Results: Forty-four men {5.6% [95% confidence interval (CI) 4.0-7.7]} reported that they had suffered from unilateral/bilateral CTS during the last 12 months. CTS was associated with age, current smoking [odds ratio (OR) = 2.1 (1.0-4.5)], and exposure to physical wrist stressors [OR = 2.6 (1.1-5.9)]. An association was found between CTS and co-exposure to physical wrist stressors and chemicals [OR = 3.3 (0.8-14.3), p = 0.044] in comparison with the no-exposure group. Conclusions: This exploratory study shows an association of CTS with exposure to biomechanical wrist stressors in male farmers and agricultural workers and suggests an association of CTS with co-exposure to physical wrist stressors and chemicals. Owing to the limitations of the study, this result must be confirmed by a prospective study with objective assessments of the outcome and exposure before drawing conclusions on the possible synergistic effects of mechanical stressors and chemicals on the impairment of the median nerve.

• Progress in Medical Physics
• /
• v.13 no.1
• /
• pp.32-36
• /
• 2002

For Intensity Modulated Radiation Therapy(IMRT), the spatial resolution of intensity map(IM) is limited by the width of multi-leaf collimator, which would make an effect on the conformity of the target, as well as organs at risk. Several Methods are suggested to increase the spatial resolution, which can be categorized by the hardware-dependent technique and the software-based technique. However the best solution might be to make the width of MLC finer. it has several obstacles in the respects of technical difficulty and cost. This preliminary study is designed to investigate the clinical effectiveness of the virtual-micro IMRT(VMIMRT) technique, one of the software-based technique. A particular intensity map was created, which has 42$\times$54 pixel dimension ,0.5cm pixel size and 15 intensity levels. Using this intensity map, segment fields of IMRT were generated with 1$\times$lcm, 0.5$\times$1cm, 0.5$\times$0.5cm(VMIM) beamlet size, respectively As results, we found that there was no evidence of improvement for VMIMRT, compared with the 0.5$\times$lcm beamlet size which can be delivered by 1cm width MLC. The reason seems to be due to the constraint of VMIMRT. Further study is required to prove the benefit of the VIMRT in clinical case like head and neck cancer, where is expected that higher resolution than 1cm is necessary.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
• /
• v.25 no.2
• /
• pp.61-67
• /
• 2012

Objective : The endpoint of this trial is to verify therapeutical availability of conventional western eyedrops combined with acupuncture treatment by means of BUT(tear film break-up time), Schirmer's test, which have been considered to be typical methods for diagnosing dry eye syndrome. Methods : The subjects of this trial included the outpatients who had been diagnosed with dry eye syndrome in Pusan national university hospital and underwent acupuncture treatment from March 2011 to April 2011. They received acupuncture treatment once a week, three times while constantly using Restasis or artificial tears. We collated and analyzed the outcome data of Schirmer's test and BUT conducted at the beginning of this trial and three times more after each acupuncture treatments. Acupoints, such as, Chanjuk(BL2), Eoryo, Sajukgong(TE23), Taeyang, Sabaek(ST2), limited around both eyes were selected based on their clinical effects referring to medical books. Results : 1. From BUT test results, Restasis and acupuncture combined group showed statistically significant difference, however, artificial tears and acupuncture combined group showed difference only between before and after the treatment, which is not statistically significant. 2. From Schirmer's test results, Restasis and acupuncture combined group showed statistically significant difference, however, artificial tears and acupuncture combined group showed difference only between before and after the treatment, which is not statistically significant. 3. The average duration of treatment was statistically 16.3 days for Restasis and acupuncture combined group. Conclusions : Combination of acupuncture and Restasis for dry eye syndrome can shorten the duration of treatment. Therefore, clinical benefit is expected to be worth.

• The Korean Society of Law and Medicine
• /
• v.23 no.2
• /
• pp.119-139
• /
• 2022

Brain stimulation technology that administers electrical and magnetic stimulation to a brain has shown a significant level of possibility for treating a wide range of various neurological and psychiatric disorders. Depending on its nature, the technology is defined either as invasive or non-invasive, and deep brain stimulation (DBS) is one of the most well-known invasive brain stimulation technologies. Currently categorized as grade 4 medical device in accordance with Guideline On Medical Devices And Their Grades, a Notification of Ministry of Food and Drug Safety (MFDS), the DBS has been used as a stable treatment for several diseases. At the same time, the DBS technology has recently achieved substantial advancement, encouraging active discussions for its use from various perspectives. On the contrary, debates over legal regulation related to the use of DBS has relatively been smaller in numbers. In this context, this article aims to 1) introduce the DBS technology and its safety in setting out the tone; 2) touch upon major legal issues that would potentially rise from its use for four different purposes of treatment, clinical study, areas of non-standard treatment where no other methods are available, and enhancement; and finally 3) highlight disputes concerning common emerging issues observed in the aforementioned four purposes from the viewpoint of legal responsibility and liability of using the DBS, which are benefit-risk assessment, physicians' duty of information, patients' capacity to consent, control for device, and insurance coverage.

• The Journal of KAIRB
• /
• v.5 no.1
• /
• pp.21-32
• /
• 2023

Purspose: The purpose of this study is to examine the meaning and definition of vulnerable subjects in clinical trials in light of domestic and international regulations and guidelines, to analyze the contents of standard operation procedures (SOPs) among advanced general hospitals in Korea that conduct clinical trials, and to examine deliberation procedures for operation plans. Methods: The study examined how vulnerable research subjects were defined and described in related regulations and the classification of vulnerable research subjects presented in the IRB/HRPP SOPs of 18 clinical trial institutions, including 11 AAHRPP-accreditated general hospitals in Korea, as well as the operation of the IRB deliberation. Results: Among all domestic and international regulations and guidelines, only the The Council for International Organization of Medical Sciences (CIOMS) guidelines explain why vulnerability is related to judgments on the severity of physical, psychological, and social harm, why individuals are vulnerable, and for what reasons. However, the classification of vulnerable subjects by institutions differed from the classification by the International Conference on Harmonization-Good Clinical Practice (ICH-GCP). A total of the 16 institutions classified children and minors as vulnerable research subjects. 14 institutions classified subjects who cannot consent freely were classified as vulnerable subjects. 15 institutions classified sujects who can be affected by the organizational hierarchy were classified as vulnerable subjects. Subjects in emergency situations were regarded as vulnerable research subjects in 8 of institutions, while people in wards, patients with incurable diseases, and the economically poor including the unemployed were categorized as vulnerable research subjects in 7, 4, and 4 of institutions, respectively. Additionally, some research subjects were not classified as vulnerable by ICH-GCP but were classified as vulnerable by domestic institutions 15 of the institutions classified pregnant women and fetuses as vulnerable, 11 classified the elderly as vulnerable, and 6 classified foreigners as vulnerable. Conclution: The regulations and institutional SOPs classify subjects differently, which may affect subject protection. There is a need to improve IRBs' classifications of vulnerable research subjects. It is also necessary to establish the standards according to the differences in deliberation processes. Further, it is recommended to maintain a consistent review of validity, assessment of risk/benefit, and a review using checklists and spokeperson. The review of IRB is to be carried out in a manner that respects human dignity by taking into account the physical, psychological, and social conditions of the subjects.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.11 no.1
• /
• pp.28-35
• /
• 2008

Purpose: The aim of this study is to report the efficacy of infliximab, a monoclonal antibody directed against tumor necrosis factor alpha which is used for both treatment of refractory pediatric Crohn disease (CD) and induction of remission. Methods: Among pediatric patients who were diagnosed with CD at Samsung Medical Center between March 2001 and August 2007, a total of 16 patients were given infliximab to treat conventional therapyresistant refractory CD and severe active CD for induction of remission. Patients needing maintenance therapy were treated with an infliximab infusion every 8 weeks, and fistulizing CD patients occasionally received the infusion upon the condition that a fistula developed. The efficacy of treatment was assessed by comparing the Pediatric Crohn Disease Activity Index (PCDAI), Hct, ESR, CRP, and serum albumin levels using paired t-test. Results: The male/female ratio was 13:3, and the median age was 13 years (range, 21 months~15 years). The patients included 7 cases of therapy-resistant refractory CD, 7 cases of severe active CD, and 2 cases of fistulizing CD. Mean PCDAI before infliximab therapy was 34.19${\pm}$14.96, and mean follow-up PCDAI within 2 to 4 weeks after the last infusion was significantly lower, at 6.88${\pm}$10.31 (p=0.000). Hematological markers such as ESR (p=0.000), serum albumin (p=0.016), and CRP (p=0.009) also improved significantly after infusion. Remission was achieved in 2 of 4 patients refractory to conventional therapy. Among 3 steroid-dependent patients, 2 were able to discontinue steroid therapy, and dose reduction was possible in 1 patient. Remission after top-down therapy without prior use of other immunomodulators was achieved in 6 weeks in all 7 of the patients who had severe CD. Nine of ten refractory fistulizing CD patients also showed improvement after infliximab therapy. Conclusion: Infliximab was effective in pediatric refractory CD for induction of remission and maintenance therapy, as well as in severe CD for top-down induction therapy. Furthermore, infliximab has contributed to steroid cessation and dose reduction. Long-term follow-up evaluation is needed to determine safety and efficacy of infliximab in the future.