• Journal of Korean Neurosurgical Society
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• v.59 no.6
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• pp.570-576
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• 2016

Objective : Elevated cell counts and protein levels in cerebrospinal fluid (CSF) result from disease activity in patients with leptomeningeal carcinomatosis (LMC). Previous studies evaluated the use of CSF profiles to monitor a treatment response or predict prognosis. CSF profiles vary, however, according to the sampling site and the patient's systemic condition. We compared lumbar and ventricular CSF profiles collected before intraventricular chemotherapy for LMC and evaluated the association of these profiles with patients' systemic factors and LMC disease activity. Methods : CSF profiles were retrospectively collected from 228 patients who underwent Ommaya reservoir insertion for intraventricular chemotherapy after a diagnosis of LMC. Lumbar samples taken via lumbar puncture were used for the diagnosis, and ventricular samples were obtained later at the time of Ommaya reservoir insertion. LMC disease activity was defined as the presence of LMC-related symptoms such as increased intracranial pressure, hydrocephalus, cranial neuropathy, and cauda equina syndrome. Results : Cell counts (median : 8 vs. 1 cells/mL) and protein levels (median : 68 vs. 17 mg/dL) significantly higher in lumbar CSF than in ventricular CSF (p<0.001). Among the evaluated systemic factors, concomitant brain metastasis and previous radiation were significantly correlated with higher protein levels in the lumbar CSF (p=0.01 and <0.001, respectively). Among the LMC disease activity, patients presenting with hydrocephalus or cauda equina syndrome showed higher lumbar CSF protein level compared with that in patients without those symptoms (p=0.049 and p<0.001, respectively). The lumbar CSF cell count was significantly lower in patients with cranial neuropathy (p=0.046). The ventricular CSF cell counts and protein levels showed no correlation with LMC symptoms. Carcinoembryonic antigen (CEA), which was measured from ventricular CSF after the diagnosis in 109 patients, showed a significant association with the presence of hydrocephalus (p=0.01). Conclusion : The protein level in lumbar CSF indicated the localized disease activity of hydrocephalus and cauda equina syndrome. In the ventricular CSF, only the CEA level reflected the presence of hydrocephalus. We suggest using more specific biomarkers for the evaluation of ventricular CSF to monitor disease activity and treatment response.

• Progress in Medical Physics
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• v.23 no.3
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• pp.127-137
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• 2012

A conversing beam is firstly designed for radiosurgery by a neurosugern Lars Leksell in 1949 with orthogonal x-rays tube moving through horizontal moving arc to focusing the beam at target center. After 2 decades he composits 201 source of the Co-60 for gamma knife which beams focused at locus. Sveral linac-based stereotactic radiosurgery using the circular collimated beam which size range for 0.4~4.0 cm in a diameter by non-coplanar multiarc have been developed over the decades. The irregular lesions can be treated by superimposing with several spherical shots of radiation over the tumour volume. Linac based techniques include the use of between 4 and 11 non-co-planar arcs and a dynamic rotation technique and use photon beam energies in the range of 6~10 MV. Reviews of the characteristics of several treatment techniques can be found in the literature (Podgorsak 1989, Schell 1991). More in recent, static conformal beams defined by custom shaped collimators or a mini- or micro-multileaf collimator (mMLC) have been used in SRS. Finally, in the last few years, intensity-modulated mMLC SRS has also been introduced. Today, many commercial and in-house SRS programs have also introduced non-invasive immobilization systems include the cyberknife and tomotherapy and proton beam. This document will be compared the characteristics of dose distribution of radiosurgery as introduced gamma knife, BrainLab include photon knife in-house SRS program and cyberknife in currently wide used for a cranial SRS.

• Journal of the Korean Society of Radiology
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• v.12 no.3
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• pp.343-349
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• 2018

Dose rate regulated tracking is known to be an efficient method which adaptively delivers tracking treatments when patient breathing is irregular. The Motion Management Interface (MMI, Varian Medical System, CA), which provides beam on/off switching during treatment is available for clinic. Study is to test if delivering the adaptive tumor tracking is feasible for irregular breathing using beam switching with MMI. 55 free breathing RPM traces acquired from lung cancer patients are used. The first day RPM traces of the patients are utilized to design preprogrammed tracking MLC patterns, of which periods are intentionally reduced by 20% in order to catch up the variation of patient breathing irregularity in the treatment day. Eligibility criteria for this technique are the variation of amplitude and period less than 20%. An algorithm which determines beam on/off every 100 ms by considering the preprogrammed (MLC) positions and current breathing positions is developed. Tracking error and delivery efficacy are calculated by simulating the beam-switching adaptive tracking from the RPM traces. Breathing patterns of 38 patients (70%) met the eligibility criteria. Tracking errors of all of the cases who meet the criteria are less than 2 mm (average 1.4 mm) and the average delivery efficacy was 71%. Those of rest of the cases are 1.9 mm and 48%. Adaptive tracking with beam switching is feasible if patient selection is based on the eligibility criteria.

• Journal of the Korean Society of Radiology
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• v.12 no.4
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• pp.475-480
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• 2018

In lower abdominal MRI scan, patients have been tested by physically contacting with the body array coil. In this study, we have designed the acrylic assistant equipment (ACR) which allows the contactless scan of the patient to the coil and evaluated the feasibility by comparing the acquired images with ACR to those obtained without ACR. We tested 10 cases (F: 5, m: 5) by using the Ingenia $3.0T^{TM}$ MR system and dStreamTM torso coil (Philips Healthcare, Netherlands). We implemented T1 AX TSE and eTHRIVE (GRE) techniques. The scanned images were quantitatively and qualitatively assessed. In qualitatively, the TSE shows 4.44 and 4.56 mean values with and without the ACR and 4.34 and 4.28 at the GRE, respectively. In quantitatively, the TSE shows 12.15 CNR, 17.95 SNR and 12.71 CNR, 18.96 SNR with and without the ACR. And GRE shows 17.72 CNR, 22.59 SNR and 18.26 CNR, 24.47 SNR with and without the ACR, respectively. We have designed and implemented the acrylic assistant equipment to lower abdominal patients. Our data indicate that it is possible to obtain similar image qualities to current lower abdominal MRI scan without the physical contact to the patient.

• Applied Biological Chemistry
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• v.51 no.2
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• pp.148-152
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• 2008

This study was to elucidate the effect of low dose gamma (${\gamma}$)-ray irradiation on the germination, seedling growth and antioxidant activity in sunflower seeds. The seed germination was stimulated in the range of 2.7${\sim}$8.0% by low dose ${\gamma}$-ray irradiation compared with that of the control; however, the germination of seeds stored for 4 months after irradiated was decreased at all low dose ${\gamma}$-ray irradiation groups. Especially, the germination rate of 32 Gy-irradiated seed group was much lower than that of the other groups and 8 Gy was the optimal radiation dose for germination at room temperature. Though there was variation with storage time and temperature, seedling growth stored at 10$^{\circ}C$ for 4 months after irradiated was promoted at the 1 Gy ${\gamma}$-ray irradiation group compared to seed stored at 25$^{\circ}C$. For the antioxidant activity of ${\gamma}$-ray irradiated seeds extract, 4 Gy and 32 Gy groups were significantly increased by 68.83% and 95.44%, respectively, compared to control at the concentration of 100 ${\mu}g$/ml.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.12
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• pp.270-284
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• 2016

The purpose of this study was to understand the essential structure and meaning of self-management intervention for breast cancer survivors by using non-pharmacological approaches. The study participants were 10 breast cancer survivors who were completing cancer treatment that involved surgery, chemotherapy, and radiation therapy. Data collected between August 2014 and February 2015 at E Hospital in S city were analyzed by using Colaizzi's phenomenological method. Outcomes were classified into seven essential themes: 1) application of comfort measures to alleviate ongoing symptoms, 2) movement to change physical conditions, 3) special herbal intake to prevent recurrence, 4) a specially designed diet plan for health self-management, 5) constant awareness of complementary and alternative medicine, 6) unmet needs treated by one's own doctor's prescription, and 7) future life toward a nature-friendly environment. The study results contribute to a deeper understanding of self-management interventions in the daily lives of Korean breast cancer survivors. In addition, results provide an essential resource, based on actual self-management styles, that will help survivors to obtain guidance and participate in appropriate programs.

• Proceedings of the SCSK Conference
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• 2003.09a
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• pp.780-803
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• 2003

Exposure of skin cells, particularly keratinocytes to various nuclear factor-kappaB ($\textrm{NF}_{-{\kappa}}\textrm{B}$) activators [e.g. tumor necrosis factor-$\alpha$, interleukin-1, lipopolysaccharides, and ultraviolet light] leads to phosphorylation and degradation of the inhibitory protein, $\textrm{I}_{{\kappa}}\textrm{B}$. Liberated $\textrm{NF}_{-{\kappa}}\textrm{B}$ is translocated into the nucleus where it can change or alter expression of target genes, resulting in the secretion of extracellular signaling molecules including melanotrophic factors affecting melanocyte. In order to demonstrate the possible role of $\textrm{NF}_{-{\kappa}}\textrm{B}$ activation on the synthesis of melanotrophic factors from the keratinocytes, the activities of $\textrm{NF}_{-{\kappa}}\textrm{B}$ induced by melanogenic inhibitors (MIs) were determined in human HaCaT keratinocytes transfected with $\textrm{pNF}_{-{\kappa}}\textrm{B}$-SEAP-NPT plasmid. Transfectant cells released the secretory alkaline phosphatase (SEAP) as a transcription reporter in response to the $\textrm{NF}_{-{\kappa}}\textrm{B}$ activity and contain the neomycin phosphotransferase (NPT) gene for the dominant selection marker for geneticin resistance. MIs such as niacinamide, kojic acid, hydroquinone, resorcinol, arbutin, and glycolic acid were preincubated with transfectant HaCaT cells for 3 h and then ultraviolet B (UVB) was irradiated. $\textrm{NF}_{-{\kappa}}\textrm{B}$ activation was measured with the SEAP reporter gene assay using a fluorescence detection method. Of the Mis tested, kojic acid ($IC_{50}$/ = 60 $\mu$M) was found to be the most potent inhibitor of UVB-upregulating $\textrm{NF}_{-{\kappa}}\textrm{B}$ activation in transfectant HaCaT cells, which is followed by niacinamide ($IC_{50}$/= 540 $\mu$M). Pretreatment of the transfectant HaCaT cells with the Mis, especially kojic acid and niacinamide, effectively lowered $\textrm{NF}_{-{\kappa}}\textrm{B}$ binding measured by electrophoretic mobility shift assay. Furthermore, these two inhibitors remarkably reduced the secretion level of IL-6, one of melanotrophic factors, triggered by UV-radiation of the HaCaT cells. These observations suggest that Mis working at the in vivo level might act partially through the modulation of the synthesis of melanotrophic factors in keratinocyte.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.10
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• pp.4147-4152
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• 2014

Standard therapy for advanced head and neck cancer consists of a combination of surgery and radiation. However, survival of this patient population has not improved during the past 20 years. Many different multimodality treatment schedules have been proposed, and chemotherapy is often used with the intent of organ preservation. The present study was intended to establish the efficacy of concomitant chemoradiation with a single agent carboplatin in advanced head and neck cancers.The objectives were to investigate the feasibility of concomitant administration of carboplatin, monitor acute toxicity during radiotherapy, and determine subacute side effects, such as wound healing following surgery after chemoradiotherapy. A prospective study was conducted wherein a total of 40 patients with stage III and IV squamous cell carcinomas of oral cavity, oropharynx, hypopharynx and larynx were enrolled. All patients were treated with external beam radiotherapy and weekly carboplatin area under curve (AUC of 5). Radiotherapy was given in single daily fractions of 1.8-2 grays (Gy) to a total dose of 66-72 Gy. Salvage surgery was performed for any residual or recurrent locoregional disease. Neck dissection was recommended for all patients with neck disease showing less than a complete response after chemoradiation. A total of 40 patients were enrolled of whom 32 were males and 8 were females. Highest incidence of cancer was seen in the 5th-6th decades of life with a median age of 47.7 years. Oropharyngeal tumours constituted a maximum of 21 patients followed by hypopharynx in 10, larynx in 7 and oral cavity in 2. 80% of the patients had a neck node on presentation of which 40% had N2-N3 nodal status. TNM staging revealed that 58% of patients were in stage III and 43% in stage IV. Evaluation of acute toxicity revealed that 50% had grade II mucositis, 25% grade III mucositis, 2.5% grade IV mucositis. 50% of patients had grade I skin reactions, 65% of patients had grade I thrombocytopenia, and 24% of patients had grade I anaemia. After completion of treatment 65% of patients had complete response at the primary and regional sites, and 35% of patients had a partial response of whom 23% underwent neck dissection and 5% of them underwent salvage surgery at the primary site. At the end of one year there were six deaths and four recurrences and 70% were free of disease. Concurrent chemoradiation with carboplatin provided good locoregional control for locally advanced head and neck cancers. This regimen, although toxic, is tolerable with appropriate supportive intervention. Primary site conservation is possible in many patients. Chemoradiotherapy appears to have an emerging role in the primary management of head and neck cancers.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.1
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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.

• Progress in Medical Physics
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• v.22 no.2
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• pp.79-84
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• 2011

In this study, Geant4 based Monte Carlo simulations were carried out for medical linear accelerator. Modified Medical Linac2 toolkit was used for calculation. The energy spectrum, most probable energy and the photon mean energy compared with the published results using the EGS4 code. The results well agreed with published results. The calculated results of photon fluence, energy fluence and mean energy according to the radius from the centre of the beam were analyzed. Monte Carlo simulation using Medical Linac2 code is considered to be useful for analysis of medical linear accelerator. Because the calculated results varies depending on Physics List model for same head structure. It it important to choose the right model for research purpose. Monte Carlo simulation using GEANT4 Medical Linac2 is a valuable for any novice to adopt this code to the study related to 6 MV photon fluence from medical linear accelerator.