• Radiation Oncology Journal
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• 제37권3호
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• pp.149-155
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• 2019

In metastatic non-small cell lung cancer (NSCLC), the role of radiotherapy (RT) has been limited to palliation to alleviate the symptoms. However, with the development of advanced RT techniques, recent advances in immuno-oncology therapy targeting programmed death 1 (PD-1) and programmed death ligand 1 (PD-L1) and targeted agents for epidermal growth factor receptor (EGFR) mutation or anaplastic lymphoma kinase (ALK) translocation allowed new roles of RT in these patients. Within this metastatic population, there is a subset of patients with a limited number of sites of metastatic disease, termed as oligometastasis that can achieve long-term survival from aggressive local management. There is no consensus on the definition of oligometastasis; however, most clinical trials define oligometastasis as having 3 to 5 metastatic lesions. Recent phase II randomized clinical trials have shown that ablative RT, including stereotactic ablative body radiotherapy (SABR) and hypofractionated RT, to primary and metastatic sites improved progression-free survival (PFS) and overall survival (OS) in patients with oligometastatic NSCLC. The PEMBRO-RT study, a randomized phase II study comparing SABR prior to pembrolizumab therapy and pembrolizumab therapy alone, revealed that the addition of SABR improved the overall response, PFS, and OS in patients with advanced NSCLC. The efficacy of RT in oligometastatic lung cancer has only been studied in phase II studies; therefore, large-scale phase III studies are needed to confirm the benefit of local ablative RT in patients with oligometastatic NSCLC. Local intensified RT to primary and metastatic lesions is expected to become an important treatment paradigm in the near future in patients with metastatic lung cancer.

• Nuclear Engineering and Technology
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• 제54권2호
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• pp.770-780
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• 2022

In 1993 the University of Extremadura initiated the design, construction and management of the Radiological Alert Network of Extremadura (RAREx). The goal was to acquire reliable near-real-time information on the environmental radiological status in the surroundings of the Almaraz Nuclear Power Plant by measuring, mainly, the ambient dose equivalent. However, the phased development of this network has been carried out from two points of view. Firstly, there has been an increase in the number of stations comprising the network. Secondly, there has been an increase in the number of monitored parameters. As a consequence of the growth of RAREx network, large data volumes are daily generated. To face this big data paradigm, software applications have been developed and implemented in order to maintain the indispensable real-time and efficient performance of the alert network. In this paper, the description of the current status of RAREx network after 30 years of design and performance is showed. Also, the performance of the graphing software for daily assessment of the registered parameters and the automatic on real time warning notification system, which aid with the decision making process and analysis of values of possible radiological and non-radiological alterations, is briefly described in this paper.

• 한국안전학회지
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• 제35권1호
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• pp.116-129
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• 2020

Resilience is defined as the intrinsic ability of a system to adjust its functioning prior to, during, or following changes and disturbances, so that it can sustain required operations or functions with the related systems under both expected and unexpected conditions. Resilience engineering is a relatively new paradigm for safety management that focuses on how to cope with complexity under pressure or disturbance to achieve successful functioning. This study aims to develop a quantitative resilience model for severe accident response organizations of nuclear power plants using the Analytic Hierarchy Process (AHP) method. First, we investigated severe accident response organizations based on a radiation emergency plan in the Korean case and developed a qualitative resilience model for the organizations with resilience-influencing factors, which have been identified in the author's previous studies. Then, a quantitative model for entire severe accident response organizations was developed by using the Analytic Hierarchy Process (AHP) method with a tool for System Dynamics. For applying the AHP method, several experts who are working on implementing, regulating or researching the severe accident response participated in collecting their expertise on the relative importance between all the possible relations in the model. Finally, a sensitivity analysis was carried out to discuss which factors have the most influenceable on resilience.

• 대한예방한의학회지
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• 제20권1호
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• pp.145-159
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• 2016

Objectives : The aim was to investigate the characteristics of low dose effect and non monotonic dose responses(NMDRs) and to predict the influence it might have on the health and medicine, traditional Korean medicine. Methods : By investigating recently published major literatures related to low dose effect and NMDRs, the definition, mechanism, major related fields, and the influence on public health and medicine has been categorized and summarized. Results : Although there are still heated debates about the definition of low dose, it implies the biological responses in environmental exposure level and the NDMDRs means the nonlinear relationship between the dose-response in the slope sign change. Also, it implies the new form of the curve showing a U, reverse U shape, and the slop sign constantly changing showing various forms. This mechanism is because the two acceptor shows opposing effects to toxic materials and the affinity is different along with the numerical value that increase and decrease being different. These characteristics generally appear in endocrine disrupters such as bisphenol A, agricultural pesticides, metal, and radiation. The research field in the public health and medical treatment is obesity, problems in metabolism, growth hormone treatment, climacteric treatment, breast cancer, intake of Korean traditional medicine for pregnancy, menopause and phytoestrogen. Conclusions : As a result of discussing implications, NMDRs is a particular effect in low dose and heated debates surround this response, research is being conducted surrounding the field of obesity, problems in metabolism, growth hormone treatment, climacteric treatment, breast cancer, intake of Korean traditional medicine for pregnancy, menopause, and phytoestrogen. More research and interest in needed as it can have a massive influence in the public health and medicine.

• Journal of Chest Surgery
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• 제36권10호
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• pp.748-753
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• 2003

배경: 폐결절은 경우에 따른 특히 경피침생검이 기술적으로 어렵거나 검사 후 병리세포검사로 확진이 되지 않는 경우에 대부분에서 흉강경을 이용한 조직검사를 요한다. 그러나 결절의 크기나 작거나 폐실질 깊숙이 위치한 경우에는 술 전 또는 술 중에 결절의 위치를 파악하기 위한 여러 가지 방법 등이 이용된다. 따라서 저자들은 폐결절을 경피침생검 시 방사선 비투과성 백금조각(이하 결절표시기)을 생검 전 또는 생검 후에 결절 내 또는 결절주위에 위치하여 병리조직검사에서 확진이 어려운 경우에 흉강경수술 시 재차 술 전 폐결절표시 과정을 피하는 방법을 고안하여 전향적으로 평가하였다. 대상 및 방법: 흉부 CT검사하여 경피침생검과정에 생검침을 결절내부 또는 결절인접부위에 위치한 경우에 결절 표시기를 생검침내부에 위치한 후 스타일렛을 이용하여 결절표시를 서서히 밀어 넣어 결절 내 혹은 인접부위에 위치한 것을 CT검사에서 확인한 다음 결절의 생검검사를 한다. 결과: 1999년 5월부터 2000년 5월 사이에 26명의 환자에서 28 결절을 대상으로 1예를 제외하고 모두에서 결절표시기를 결절 내 혹은 주위에 위치하였다. 이중 7건은 생검을 하지 않고 흉강경수술을 위하여 결절표시기를 위치하였고, 21건의 흉강경수술 중 18예(85%)에서 결절의 위치파악을 파악하거나 결절절제시 충분한 여유를 확보하기 위하여 수술 중 이동용 방사선 투시기를 이용하였다. 결론: 흉강경수술이 예상되는 폐결절에 대한 저자들의 방침이 흉부 CT검사하 폐결절 위치 표시과정을 생략함으로써 의료비, 시간을 절감할 수 있는 효과적인 방법으로 생각한다.

• Asian Pacific Journal of Cancer Prevention
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• 제14권1호
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• pp.489-494
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• 2013

Background: Lung cancer is one of the commonest and most lethal cancers throughout the world. The epidemiological and pathological profile varies among different ethnicities and geographical regions. At present adenocarcinoma is the commonest histological subtype of non-small cell lung cancer (NSCLC) in most of the Western and Asian countries. However, in India squamous cell carcinoma has been reported as the commonest histological type in most of the series. The aim of the study was to analyze the current clinico-pathological profile and survival of lung cancer at our centre. Materials and Methods: We analyzed 434 pathologically confirmed lung cancer cases registered at our centre over a period of three years. They were evaluated for their clinical and pathological profiles, treatment received and outcome. The available histology slides were reviewed by an independent reviewer. Results: Median age was 55 years with a male:female ratio of 4.6:1. Some 68% of patients were smokers. There were 85.3% NSCLC and 14.7% SCLC cases. Among NSCLCs, adenocarcinoma was the commonest histological subtype after the pathology review. Among NSCLC, 56.8% cases were of stage IV while among SCLC 71.8% cases had extensive stage disease. Some 29% of patients did not receive any anticancer treatment. The median overall and progression free survivals of the patients who received treatment were 12.8 and 7.8 months for NSCLC and 9.1 and 6.8 months for SCLC. Conclusions: This analysis suggests that adenocarcinoma may now be the commonest histological subtype also in India, provided a careful pathological review is done. Most of the patients present at advanced stage and outcome remains poor.

• Asian Pacific Journal of Cancer Prevention
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• 제17권7호
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• pp.3465-3468
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• 2016

Background: Fluorodeoxyglucose ($^{18}FDG$) PET/CT imaging has become an important component of the management paradigm in oncology. However, the significant imparted radiation exposure is a matter of growing concern especially in younger populations who have better odds of survival. The aim of this study was to estimate the effective dose received by patients having whole body $^{18}F$-FDG PET/CT scanning as per recent dose reducing guidelines at a tertiary care hospital. Materials and Methods: This prospective study covered 63 patients with different cancers who were referred for PET/CT study for various indications. Patients were prepared as per departmental protocol and 18FDG was injected at 3 MBq/Kg and a low dose, non-enhanced CT protocol (LD-NECT) was used. Diagnostic CT studies of specific regions were subsequently performed if required. Effective dose imparted by 18FDG (internal exposure) was calculated by using multiplying injected dose in MBq with coefficient $1.9{\times}10^{-2}mSv/MBq$ according to ICRP publication 106. Effective dose imparted by CT was calculated by multiplying DLP (mGy.cm) with ICRP conversion coefficient "k" 0.015 [mSv / (mG. cm)]. Results: Mean age of patients was $49{\pm}18$ years with a male to female ratio of 35:28 (56%:44%). Median dose of 18FDG given was 194 MBq (range: 139-293). Median CTDIvol was 3.25 (2.4-6.2) and median DLP was 334.95 (246.70 - 576.70). Estimated median effective dose imparted by $^{18}FDG$ was 3.69 mSv (range: 2.85-5.57). Similarly the estimated median effective dose by low dose (non-diagnostic) CT examination was 4.93 mSv (range: 2.14 -10.49). Median total effective dose by whole body 18FDG PET plus low dose non-diagnostic CT study was 8.85 mSv (range: 5.56-13.00). Conclusions: We conclude that the median effective dose from a whole body 18FDG PET/CT in our patients was significantly low. We suggest adhering to recently published dose reducing strategies, use of ToF scanner with CT dose reducing option to achieve the lower if not the lowest effective dose. This would certainly reduce the risk of second primary malignancy in younger patients with higher odds of cure from first primary cancer.

• 한국조경학회지
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• 제36권1호
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• pp.80-89
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• 2008

Generally, trees lining the streets are the most easily accessible green areas in the city and constitute the smallest basic unit in the formation of the urban linear green axis. This study attempts to interpret issues related to city trees from a comprehensive and relational viewpoint. The site of this study is Central Park Street in front of Incheon Metropolitan City Hall. This street is representative of those in Incheon City. This study is an inter-relational interpretation of issues by measuring the vitality of these trees. The following are results of this study: First, the vitality of city trees is higher in those trees growing in natural ground than those growing in plant gratings. This observation can lead to budget savings and increased natural areas in the city. Also, if planter and multi-layering planting methods are introduced where damage to trees is predicted, variation to urban landscape can be achieved while linking to reinforced rearing foundation of street-side trees. Second, there is need for a holistic approach to caring for street-side trees regarding the damage caused by drastic pruning and strong street lights. The typical functions of these trees, like supplying freshness in summer, absorbing solar radiation, and controlling the urban micro-climate are closely related to the vitality of the trees. Accordingly, the function and ecology should be understood holistically, not separately. In this aspect, the functional and ecological use of the multi-layering planting method is effective in protecting pedestrians from vehicles as well. Third, the fallen leaves of monotonous rows of trees have different ecological and functional effects. Not only is the index of greenness in the urban setting increased, but there are also aesthetic and symbolic effects. Fourth, in spite of being the street along which Incheon Metropolitan City Hall, major administrative buildings and Central Park are located, this street does not have its own special identity to discriminate it from other streets. It fulfills only functional criteria based on uniformity. If there is no paradigm shift from today's street system based on vehicles, the role of landscape architecture will be very passive in regards to street-side trees, the minimum unit of urban green. Fifth, on this particular street, many trees were planted in December, which reflects a deficiency of short and long-term strategy, like a street-tree master plan. In this aspect, we still lack a mature culture concerning these trees as a basic unit in urban greenery. Furthermore, there needs to be cultural introspection concerning present administrative practices.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제31권6호
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• pp.515-525
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• 2005

Purpose of study: Lingual nerve damage can be caused by surgery or trauma such as physical irriatation, radiation, chemotherapy, infection and viral infection. Once nerve damage occurred, patients sometimes complain taste change and loss of taste along with serious disturbance of tongue. The purpose of this study was to evaluate the effects of unilateral lingual nerve transection on taste as well as on the maintenance of taste buds. Materials & Methods: Male Sprague-Dawley rats weighing 220-250g received unilateral transection of lingual nerve, subjected to the preference test for various taste solutions (0.1M NaCl, 0.1M sucrose, 0.01M QHCl, or 0.01M HCl) with two bottle test paradigm at 2, 4, 6, or 8 weeks after the operation. Tongue was fixed with 8% paraformaldehyde. After fixation, they were observed with scanning electron microscope(JSM-$840A^{(R)}$, JEOL, JAPAN) and counted the number of the dorsal surface of the fungiform papilla for changes of fungiform papilla. And, Fungiform papilla were obtained from coronal sections of the anterior tongue(cryosection). After cryosection, immunostaining with $G{\alpha}gust$(I-20)(Santa Cruz Biotechnology, USA), $PLC{\beta}2$(Q-15)(Santa Cruz Biotechnology, USA), and $T_1R_1$(Alpha Diagnostic International, USA) were done. Immunofluorescence of labeled taste bud cells was examined by confocal microscopy(F92-$300^{(R)}$, Olympus, JAPAN). Results: The preference score for salty and sweet tended to be higher in the operated rats with statistical significance, compared to the sham rats. Fungiform papilla counting were decreased after lingual nerve transaction. In 2 weeks, maximum differences occurred. Gustducin and $T_1R_1$ expressions of taste receptor in 2 and 4 weeks were decreased. $PLC{\beta}2$ were not expressed in both experimental and control group. Conclusion: This study demonstrated that the taste recognition for sweet and salty taste changed by week 2 and 4 after unilateral lingual nerve transection. However, regeneration related taste was occurred in the presence of preserving mesoneurial tissue and the time was 6 weeks. Our results demonstrated that unilateral lingual nerve damage caused morphological and numerical change of fungiform papilla. It should be noted in our study that lingual nerve transection resulted in not only morphological and numerical change but also functional change of fungiform papillae.