• 제목/요약/키워드: Organs at risk

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3차원입체조형방사선치료 계획 시 간종괴의 위치에 따른 최적 조사 방향의 결정 (Optimal Radiation Port Arrangements for Hepatic Tumor using 3-dimensional Conformal Radiotherapy Planning)

  • 이익재;성진실;심수정;정경근;조광환
    • Journal of Radiation Protection and Research
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    • 제31권4호
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    • pp.187-195
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    • 2006
  • 본 연구는 간암 환자의 방사선치료 시에 정상 조직과 간암의 위치에 따른 적절한 조사방향을 찾고자 하였다. 간암의 위치는 Couinaud에 의한 분류법을 이용하여 4군으로 나누었고, 각 군의 용적을 가상의 표적 용적으로 정해서 여러 개의 방사선 치료계획을 세워 정상조직합병증발생률(normal tissue complication probability, NTCP)을 비교하였다. 그룹 I에서는 조사 수를 늘릴수록 정상간의 NTCP가 감소되었으나 6개 이상부터는 일정하였다. 그룹 II에서는 PA(posterior to anterior) 조사가 추가 되었을 때 정상간의 NTCP가 증가하였다. 그룹 III는 표적용적 주변에 정상조직이 많아 조사 방향의 설정에 어려움이 있었고 여러 방향에서의 조사 보다는 RAO(right anterior oblique)와 PA를 이용한 2개의 조사만이 시행되었을 때 정상 간의 NTCP가 가장 낮았다. 그룹 IV에서도 RAO와 PA의 2개 조사로 이루어진 치료계획에서 정상 간의 NTCP 가 가장 낮았다. 본 연구를 통해 간암의 방사선 치료계획 시 간암의 위치와 정상조직의 위치에 따라 NTCP 가 다양하게 나타남을 알 수 있었고, 간암의 방사선치료 계획 시 최적 조사 방향의 설정을 통해 임상적으로 방사선치료를 적용하는 데 유용한 지침이 될 수 있을 것으로 생각된다.

ADR을 통한 저작권분쟁 해결에 관한 검토 (The Role of ADR in the Resolution of the Copyright Disputes)

  • 김선정
    • 한국중재학회지:중재연구
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    • 제21권2호
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    • pp.85-112
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    • 2011
  • These days utilization of copyright in daily life and economic activities is becoming more important than ever, and IT technology is developing day by day. Along with those fact, copyright infringement and dispute is naturally increasing. This thesis dealt with the 3 different issues of ADR on copyright. The First part, introduce ADR system that was performed by Korea Copyright Committee according to Copyright law. This paper evaluate the committee's efforts to provide resolution of copyright disputes via conciliation was effective. So it needs to be look over several countries' ADR, beside conventional judicial remedy. And Korea's copyright conciliation system which is successfully operating also introduced. Second, In many countries, including South Korea are take advantage of conciliation as the way to settle down the dispute over copyright. Furthermore, looked over if we can use arbitration as tool to settle dispute or not. Currently in Korea, patent dispute is handled by Industrial Property Dispute Conciliation Committee(The Invention Promotion Act Ch.5) and Layout-design Review and Mediation Committee(The Act on the Layout-designs of Semiconductor Integrated Circuits Art.29-34), but using performance of those two committee is still too low. In comparison, the copyright committee, a affiliation organization of the ministry of culture, sports and tourism has much more result in conciliation compare with patent dispute. Copyright disputes has arbitrability of it's subject-matter and many regulating organs are interested in it. (especially, binding of arbitral award and final resolution). Take advantage of both conciliation and arbitration could be good way to resolve copyright disputes. Third, the writer look at the proposal on the creation of Northeast Regional Center for Intellectual Property ADR. Because of the nature of copyright and rapid development of internet technology, international use of work become more frequent and accordingly infringement cases are increasing. The role of commercial arbitration regimes and institutions which has progressed significantly worldwide level, but which has only just begun in the intellectual property ADR area, leads also to a clash of often very different legal cultures and protection in a market economy. International cooperation in regional area with conflict interests becomes an important alternative. But it will depend on the building of regional institutions and mechanisms. The feasibility of this proposal and preconditions were examined. Establishment of new international organization requires a lot of time, cost and efforts. And risk of failure is much too high. Therefore factual, statistical review should be preceded. In addition, technical measures, such as on-line arbitration is necessary to review also. Furthermore in order to establish new organization, the relative law, legal environment, public sentiment and international compliance must be carefully considered with factual review about the needs and economic benefits of each country Yet on complex regulatory matters such as IP and ADR, a great deal of the potential benefits from international standards arises not from the international legal framework nor even the formal content of national legislation, but from the informed and effective use made of the possibilities within the system, including by policymakers and regulators.

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Stem Cells and Cell-Cell Communication in the Understanding of the Role of Diet and Nutrients in Human Diseases

  • Trosko James E.
    • 한국식품위생안전성학회지
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    • 제22권1호
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    • pp.1-14
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    • 2007
  • The term, "food safety", has traditionally been viewed as a practical science aimed at assuring the prevention acute illnesses caused by biological microorganisms, and only to a minor extent, chronic diseases cause by chronic low level exposures to natural and synthetic chemicals or pollutants. "food safety" meant to prevent microbiological agents/toxins in/on foods, due to contamination any where from "farm to Fork", from causing acute health effects, especially to the young, immune-compromised, genetically-predisposed and elderly. However, today a broader view must also include the fact that diet, perse (nutrients, vitamins/minerals, calories), as well as low level toxins and pollutant or supplemented synthetic chemicals, can alter gene expressions of stem/progenitor/terminally-differentiated cells, leading to chronic inflammation and other mal-functions that could lead to diseases such as cancer, diabetes, atherogenesis and possibly reproductive and neurological disorders. Understanding of the mechanisms by which natural or synthetic chemical toxins/toxicants, in/on food, interact with the pathogenesis of acute and chronic diseases, should lead to a "systems" approach to "food safety". Clearly, the interactions of diet/food with the genetic background, gender, and developmental state of the individual, together with (a) interactions of other endogenous/exogenous chemicals/drugs; (b) the specific biology of the cells being affected; (c) the mechanisms by which the presence or absence of toxins/toxicants and nutrients work to cause toxicities; and (d) how those mechanisms affect the pathogenesis of acute and/or chronic diseases, must be integrated into a "system" approach. Mechanisms of how toxins/toxicants cause cellular toxicities, such as mutagenesis; cytotoxicity and altered gene expression, must take into account (a) irreversible or reversal changes caused by these toxins or toxicants; (b)concepts of thresholds or no-thresholds of action; and (c) concepts of differential effects on stem cells, progenitor cells and terminally differentiated cells in different organs. This brief Commentary tries to illustrate this complex interaction between what is on/in foods with one disease, namely cancer. Since the understanding of cancer, while still incomplete, can shed light on the multiple ways that toxins/toxicants, as well as dietary modulation of nutrients/vitamins/metals/ calories, can either enhance or reduce the risk to cancer. In particular, diets that alter the embryo-fetal micro-environment might dramatically alter disease formation later in life. In effect "food safety" can not be assessed without understanding how food could be 'toxic', or how that mechanism of toxicity interacts with the pathogenesis of any disease.

Alternaria mycotoxins and its incidence in fruits and vegetables

  • Patriarca, Andrea
    • 한국균학회소식:학술대회논문집
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    • 한국균학회 2018년도 춘계학술대회 및 임시총회
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    • pp.13-13
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    • 2018
  • Alternaria is a ubiquitous fungal genus, widely distributed in the environment and a range of different habitats. It includes both plant pathogenic and saprophytic species, which can affect crops in the field or cause post-harvest spoilage of plant fruits and kernels. Numerous Alternaria species cause damage to agricultural products including cereal grains, fruits and vegetables, and are responsible for severe economic losses worldwide. Most Alternaria species have the ability to produce a variety of secondary metabolites, which may play important roles in plant pathology as well as food quality and safety. Alternariol (AOH), alternariol monomethyl ether (AME), tenuazonic acid (TeA), tentoxin (TEN) and altenuene (ALT) are considered the main Alternaria compounds thought to pose a risk to human health. However, food-borne Alternaria species are able to produce many additional metabolites, whose toxicity has been tested incompletely or not tested at all. Both alternariols are mutagenic and their presence in cereal grain has been associated with high levels of human esophageal cancer in China. TeA exerts cytotoxic and phytotoxic properties, and is acutely toxic in different animal species, causing hemorrhages in several organs. The possible involvement of TA in the etiology of onyalai, a human hematological disorder occurring in Africa, has been suggested. Altertoxins (ALXs) have been found to be more potent mutagens and acutely toxic to mice than AOH and AME. Other metabolites, such as TEN, are reported to be phytotoxins, and their toxicity on animals has not been demonstrated up to now. Vegetable foods infected by Alternaria rot are obviously not suitable for consumption. Thus, whole fresh fruits are not believed to contribute significantly with Alternaria toxins to human exposure. However, processed vegetable products may introduce considerable amounts of these toxins to the human diet if decayed or moldy fruit is not removed before processing. The taxonomy of the genus is not well defined yet, which makes it difficult to establish an accurate relationship between the contaminant species and their associated mycotoxins. Great efforts have been made to organize taxa into subgeneric taxonomic levels, especially for the small-spored, food associated species, which are closely related and constitute the most relevant food pathogens from this genus. Several crops of agricultural value are susceptible to infection by different Alternaria species and can contribute to the entry of Alternaria mycotoxins in the food chain. The distribution of Alternaria species was studied in different commodities grown in Argentina. These food populations were characterized through a polyphasic approach, with special interest in their secondary metabolite profiles, to understand their full chemical potential. Alternaria species associated with tomato, bell pepper, blueberry, apples and wheat cultivated in Argentina showed a surprisingly high metabolomic and mycotoxigenic potential. The natural occurrence of Alternaria toxins in these foods was also investigated. The results here presented will provide background for discussion on regulations for Alternaria toxins in foods.

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인도의 집단 성폭행 사건들과 지역적 특성의 연관성 (Association of Regional Sexual Assaults with Regional Traits in India)

  • 강위달;이거룡
    • 한국콘텐츠학회논문지
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    • 제19권12호
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    • pp.615-622
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    • 2019
  • 근래 인도에서의 잔혹한 집단 성폭행 사건에 대한 보도를 자주 접하고 있다. 인도에서 가장 부각된 집단 성폭행 사건은 2012년 의대생인 조티 싱을 버스에서 6명이 집단 성폭행한 후 성기와 장기를 손상해 사망하게 만든 사건이다. 이 사건을 계기로 성폭행에 대해 사형까지도 포함한 강력한 처벌 법안이 발의되고 통과되었다. 그러나 그 이후로도 성폭행은 여전히 증가하고 있다. 이에 성폭행 사건 발생지역을 중심으로 지역적 특성과의 연관성을 살펴본 결과, 언론에 보도된 집단 성폭행 사례의 대부분이 인도 중북부에서 발생하는 것으로 나타났으며, 이것은 지역적으로 힌두 강세지역과 일치하는 것을 확인하였다. 그렇다면 그 원인은 여성 경시가 심각한 힌두 근본주의가 그 원인이라고 결론 내릴 수밖에 없다. 힌두 근본주의자들은 강한 복고주의적 경향을 가지고 여성에 관한 전통적 가치를 부활시키려 한다. 인도 사회에서 여성은 아직도 종속적인 피해 위험에 노출되어 있다. 집권당과 정치지도자들의 힌두 근본주의 노선 추구는 인도 여성의 사회적 지위와 인권을 개선하는 데는 많은 시간이 더 필요할 것으로 보인다.

자가간호증진을 위한 건강계약이 고혈압자의 건강행위 이행에 미치는 영향 (A Study of the Effects of Health Contracting on Compliance with Health Behaviors in Clients with Hypertension)

  • 이향련
    • 대한간호학회지
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    • 제17권3호
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    • pp.204-217
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    • 1987
  • It is generally accepted that the delivery of health care is undergoing many changes specially those related to acute, contagious disease care and to the increase of chronic illnesses which can not be cured but are controlable. The health care practitioner can not be soley responsible for the control of their clients' care. Because the clients will play a vital role in controlling their illnesses, long term participation by both the health care provider and the client is necessary. Since most individuals with hypertension do not experience signs or symptoms, the disease is difficult to detect and even when diagnosed, clients do not comply well with their hypertension regimens. The noncompliant client is at increased risk for compliants involving the heart, brain, kidney and other organs. In an effort to explore methods of increasing patient participation in and adherence to treatment programs for hypertension, the researcher used health contracting to promote self care. The research questions are; 1) Will the health contracting increase compliance in health behavior and reduce the blood pressure\ulcorner 2) If clients comply with their regimens will this reduce their blood pressure\ulcorner The research design utilized in this study was a quasi-experimental design. A purposive sample, was abtained from two churches in the 1. area, consisting of 64 clients with hypertension. The data was collected from the middle of January to the 1st of September 1985. Randomization was only of the two church groups into experimental and control groups. Compliance with health behavior related to the hypertensive regimen, blood pressure and body weight were measured, compared and analyzed. In the experimental group measurements were made 6 times; one month before the education program after education program when health contracting was done and 4 more times once a month for 4 months. In the control group measurements were made 3 times; one month before the education program after the education program, and once 4 months later. There was no health contracting. The data were analyzed by t-test, Pearson correlation and ANOVA according to purpose of the study. The result of this study may be summarized as follows: The result related to the hypothesis on the effect of health contracting are as follows: H$_1$; “The hypothesis that the experimental group, with a health contractual agreement will demonstrate increased compliance levels for health behavior than the control group” was supported(t=-5.29, df=62, p=.000). H$_2$; “The hypothesis that the experimental group, with a health contractual agreement, will demonstrate a greater reduction in blood pressure than the control group” was supported (for systolic blood pressure t=2.72, df=62, p=.009, for diastolic blood pressure t=1.95, df=62, p=.050). H$_3$; The hypothesis that the greater the compliance of the client with health behavior the lower the client's blood pressure will be was partially supported (for systolic pressure r=-.2981, p=.008, for diastolic pressure r=-.1720, p=.087). From the examination of the results of this study it can be concluded that the interaction between the nurse and the client, contracting to define goals and reinforcing compliant behavior, leads to improved compliance with health care behaviors and thus to an increase in the effectiveness of nursing care. Further consideration need to be given to the inclusion of the concept of health contracting in primary nursing and to further research in this area.

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가상 미세 세기조절방사선치료(Virtual micro-IMRT;VMIMRT) 기법의 임상 적용을 위한 예비적 연구 (A Preliminary Study of Virtual-micro Intensity Modulated Radiation Therapy)

  • 김상노;조병철;서택석;배훈식;최보영;이형구
    • 한국의학물리학회지:의학물리
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    • 제13권1호
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    • pp.32-36
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    • 2002
  • 세기조절방사선치료(Intensity Modulated Radiation TheraIntensity modulated radiation therapy ; Virtual micro-IMRT ; Intensity map ; MLCpy)에서 세기분포도(intensity map; IM)의 공간적 분해능은 방사선 민감장기(Critical Organ)를 보호하면서 종양에 최대 선량을 주는데 매우 중요하며, 일반적으로 다엽콜리메이터(MLC)의 폭에 좌우된다. 세기분포도의 공간적 분해능을 향상시키기 위한 방법으로는 두. 가지 방법이 있는데, 하드웨어를 추가하는 방법과 방사선 조사 기술을 변경하는 것이다. 물론 다엽콜리메이터의 폭을 작게 만드는 것이 최상의 방법이나, 하드웨어 기술적으로 어렵고 또한 추가비용이 많이 들게 된다. 따라서 여기에서는 추가적 비용이 들지 않으면서 기존의 장비를 그대로 활용할 수 있는 기술적 방법 중의 하나인 가상 미세 세기조절방사선치료(Virtual micro-IMRT) 기법을 구현하여 임상적으로 적용을 하기 위한 예비적 연구를 수행하였다. 가상의 42$\times$54 픽셀크기, 0.5cm의 15 level IM을 이용하여 1$\times$1cm, 0.5$\times$lcm, 0.5$\times$0.5cm(VMIM) beamlet 크기에 대해 비교하였다. 분석결과, 기대와는 달리, 1cm 폭의 MLC로 전달가능한 0.5$\times$lcm beamlet에 비해 크게 개선되지 않았다. 이는 VMIM의 제약조건에 기인되는 것으로 판단된다. 향후, 두경부암에서와 같이 1cm이하의 beamlet 분해능이 요구되는 경우에 적용시켜 추가적인 연구가 필요하다 하겠다.

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Comparison of Dosimetrical and Radiobiological Parameters on Three VMAT Techniques for Left-Sided Breast Cancer

  • Kang, Seong-Hee;Chung, Jin-Beom;Kim, Kyung-Hyeon;Kang, Sang-Won;Eom, Keun-Yong;Song, Changhoon;Kim, In-Ah;Kim, Jae-Sung
    • 한국의학물리학회지:의학물리
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    • 제30권1호
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    • pp.7-13
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    • 2019
  • Purpose: To compare the dosimetrical and radiobiological parameters among various volumetric modulated arc therapy (VMAT) techniques using restricted and continuous arc beams for left-sided breast cancer. Materials and Methods: Ten patients with left-sided breast cancer without regional nodes were retrospectively selected and prescribed the dose of 42.6 Gy in 16 fractions on the planning target volume (PTV). For each patient, three plans were generated using the $Eclipse^{TM}$ system (Varian Medical System, Palo Alto, CA) with one partial arc 1pVMAT, two partial arcs 2pVMAT, and two tangential arcs 2tVMAT. All plans were calculated through anisotropic analytic algorithm and photon optimizer with 6 MV photon beam of $VitalBEAM^{TM}$. The same dose objectives for each plan were used to achieve a fair comparison during optimization. Results: For PTV, dosimetrical parameters such as Homogeneity index, conformity index, and conformal number were superior in 2pVMAT than those in both techniques. $V_{95%}$, which indicates PTV coverage, was 91.86%, 96.60%, and 96.65% for 1pVMAT, 2pVMAT, and 2tVMAT, respectively. In most organs at risk (OARs), 2pVMAT significantly reduced the delivered doses compared with the other techniques, excluding the doses to contralateral lung. For the analysis of radiobiological parameters, a significant difference in normal tissue complication probability was observed in ipsilateral lung while no difference was observed in the other OARs. Conclusions: Our study showed that 2pVMAT had better plan quality and normal tissue sparing than 1pVMAT and 2tVMAT but not for all parameters. Therefore, 2pVMAT could be considered the priority choice for the treatment planning for left breast cancer.

Assessment of Dose Distributions According to Low Magnetic Field Effect for Prostate SABR

  • Son, Jaeman;An, Hyun Joon;Choi, Chang Heon;Chie, Eui Kyu;Kim, Jin Ho;Park, Jong Min;Kim, Jung-in
    • Journal of Radiation Protection and Research
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    • 제44권1호
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    • pp.26-31
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    • 2019
  • Background: Stereotactic ablative radiotherapy (SABR) plans in prostate cancer are compared and analyzed to investigate the low magnetic effect (0.35 T) on the dose distribution, with various dosimetric parameters according to low magnetic field. Materials and Methods: Twenty patients who received a 36.25 Gy in five fractions using the MR-IGRT system (ViewRay) were studied. For planning target volume (PTV), the point mean dose ($D_{mean}$), maximum dose ($D_{max}$), minimum dose ($D_{min}$) and volumes receiving 100% ($V_{100%}$), 95% ($V_{95%}$), and 90% ($V_{90%}$) of the total dose. For organs-at-risk (OARs), the differences compared using $D_{max}$, $V_{50%}$, $V_{80%}$, $V_{90%}$, and $V_{100%}$ of the rectum; $D_{max}$, $V_{50%}$, $V_{30Gy}$, $V_{100%}$ of the bladder; and $V_{30Gy}$ of both left and right femoral heads. For both the outer and inner shells near the skin, $D_{mean}$, $D_{min}$, and $D_{max}$ were compared. Results and Discussion: In PTV analysis, the maximum difference in volumes ($V_{100%}$, $V_{95%}$, and $V_{90%}$) according to low magnetic field was $0.54{\pm}0.63%$ in $V_{100%}$. For OAR, there was no significant difference of dose distribution on account of the low magnetic field. In results of the shells, although there were no noticeable differences in dose distribution, the average difference of dose distribution for the outer shell was $1.28{\pm}1.08Gy$ for $D_{max}$. Conclusion: In the PTV and OARs for prostate cancer, there are no statistically-significant differences between the plan calculated with and without a magnetic field. However, we confirm that the dose distribution significantly increases near the body shell when a magnetic field is applied.

Matrix-assisted Laser Desorption/Ionization Time-of-flight Mass Spectrometry의 활용 (Application of Matrix-assisted Laser Desorption/Ionization Time-of-flight Mass Spectrometry)

  • 권필승
    • 대한임상검사과학회지
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    • 제55권4호
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    • pp.244-252
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    • 2023
  • 검사 결과의 적시성과 정확성은 임상의가 특히 생명을 위협하는 감염이나 시력과 같은 중요한 장기 및 기능이 위험에 처한 경우, 효과적이고 표적화된 항균 요법을 결정하고 즉시 시행하는데 중요한 요소이다. 가능한 한 최단 시간 내에 정확하고 신뢰할 수 있는 결과를 얻기 위해 matrix assisted laser desorption/ionization time-of-flight (MALDI-TOF) 질량분석기기반 분석을 개선하고 최적화하기 위한 추가 연구 노력이 이루어져야 할 것이다. MALDI-TOF 질량분석기기반 세균 식별은 주로 임상 시료에서 병원체를 분리 및 정제하는 기술, 스펙트럼 라이브러리 확장 및 소프트웨어의 업그레이드에 중점을 둔다. 기술이 발전함에 따라 많은 MALDI-TOF 기반 미생물 동정 데이터베이스 및 시스템이 허가되어 임상에 사용되고 있다. 그럼에도 불구하고, 포괄적인 임상미생물의 특성화를 위해서는 MALDI-TOF 질량분석기 기반 항균제 내성 분석을 개발하는 것이 여전히 필요하다. 특정 적용 범주, 일반적인 분석물질, 주요 수행방법, 한계 및 해결점을 포함하여 임상 연구에서 MALDI-TOF의 적용이 중요하다. 임상 미생물 검사실에서 업무 활용을 위해 임상병리사들의 교육 및 훈련을 통한 전문성 확보가 필수적이며, 데이터베이스 구축과 경험을 극대화하여야 할 것이다. 향후 더 강력한 데이터베이스의 활용으로 다양한 분야에서 MALDI-TOF 질량분석기가 적용될 것으로 보인다.