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Clinical Report of 46 Intracranial Tumors with LINAC Based Stereotactic Radiosurgery (선형가속기를 이용한 뇌종양 46예의 뇌정위다방향방사선치료 성적)

  • Yoon Sei C;Suh Tge S;Kim Sung W;Kang Ki M;Kim Yun S;Choi Byung O;Jang Hong S;Choi Kyo H;Kim Moon C;Shinn Kyung S
    • Radiation Oncology Journal
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    • v.11 no.2
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    • pp.241-247
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    • 1993
  • Between July 1988 and December 1992, we treated 45 patients who had deep seated inoperable or residual and/or recurrent intracranial tumors using LINAC based stereotactic radiosurgery at the Department of Therapeutic Radiology, Kangnam St. Mary's Hospital, Catholic University Medical College. Treated intracranial tumors included pituitary tumors (n=15), acoustic neurinomas (n=8), meningiomas (n=7), gliomas (n=6), craniopharyngiomas (n=4), pinealomas (n=3), hemangioblastomas (n=2), and solitary metastatic tumor from lung cancer (n=1). The dimension of treatment field varied from 0.23 to 42.88 $cm^3\;(mean;\;7.26\;cm^3)$. The maximum tumor doses ranging from 5 to 35.5 Gy (mean; 29.9 Gy) were given, and depended on patients' age, target volume, location of lesion and previous history of irradiation. There were 22 male and 23 female patients. The age was varied from 5 to 74 years of age (a median age; 43 years). The mean duration of follow-up was 35 months (2~55 months). To date, 18 $(39.1\%)$ of 46 intracranial tumors treated with SRS showed absent or decrease of the tumor by serial follow-up CT and/or MRI and 16 $(34.8\%)$ were stationary, e.g. growth arrest. From the view point of the clinical aspects, 34 $(73.9\%)$ of 46 tumors were considered improved status, that is, alive with no evidence of active tumor and 8 $(17.4\%)$ of them were stable, alive with disease but no deterioration as compared with before SRS. Although there showed slight increase of the tumor in size according to follow-up imagings of 4 cases (pituitary tumor 1, acoustic neurinomas 2, pinealoma 1), they still represented clinically stable status. Clinically, two $(4.4\%)$ Patients who were anaplastic astrocytoma (n=1) and metastatic brain tumor (n=1) were worsened following SRS treatment. So far, no serious complications were found after treatment. The minor degree headache which could be relieved by steroid or analgesics and transient focal hair loss were observed in a few cases. There should be meticulous long term follow-up inall cases.

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Correction Method on Mismatched Posterior Edge of Medial and Lateral Tangential Fields for Three Fields Techniques in Breast Cancer (유방암 환자의 삼문 조사 시 내외측 접면 조사야의 Posterior Edge의 어긋남의 교정)

  • Kim Hun-Jung;Loh John JK;Kim Woo-Cheol;Park Sung-Young
    • Radiation Oncology Journal
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    • v.21 no.2
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    • pp.174-181
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    • 2003
  • Purpose: The target volume for the three field technique in breast cancer include the breast tangential and supraclavicular areas. The techniques rotating the gantry and couch angles, to match these two areas, will geometrically produce mismatching of the posterior edge between the medial and lateral tangential beams. This mismatch was confirmed by film dosimetry and three-dimensional computer planning. The correction methods of this mismatching were studied in this article. Materials and Methods: After the supraclavicular field was simulated using a half beam block and the medial and lateral tangential fields, by the rotation of the couch and gantry, we compared the following two methods to correct the mismatch. The first method was the rotation of coillmator until a line drawn on the posterior edge of tangential beams before the rotation of couch aligned the line drawn on the posterior edge after the rotation. The second method was the rotation of collimator according to the formula developed by the author as follows; Co=$2sin^{-1}${$sin\{theta}\{cdot}sin(C/2)$} (Co: collimator angle, $\theta$: angle between tangential beam and table, C: couch angle) Results: The film dosimetry showed the mismatching of posterior edges of the medial and lateral tangential fields prior to the rotation of collimator, while the posterior edges matched well after the rotation of collimator according to the formula. The three-dimensional computer plan also showed that the posterior edges matched well after the rotation of collimator accordingly. The DVH of the ipsilateral lung with the proper rotation of collimator angle was better than that without the rotation of collimator angle. Conclusion: The mismatching of the posterior edges of the medial and lateral tangential fields can be recognized on the three fileld technique in breast irradiation when the gantry and couch are simultaneously rotated and can be corrected with the proper rotation of the collimator angle. The radiation dose to the ipsilateral lung could be lowered with this technique.

Outcome of LINAC Radiosurgery for a Cavernous Angioma (해면상혈관종에 대한 선형가속기를 이용한 고선량 정위 방사선수술의 임상경험)

  • Hong Semie;Chie Eui Kyu;Park Suk Won;Kim Il Han;Ha Sung Hwan;Park Charn Il
    • Radiation Oncology Journal
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    • v.21 no.2
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    • pp.107-111
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    • 2003
  • Purpose: To establish the role of stereoactic radiosurgery using a linear accelerator for the treatment of patients with cavernous angloma. Materials and Methods: Between February 1995 and May 1997, 11 patients with cavernous angioma were treated with stereotactic radiosurgery using a linear accelerator. Diagnoses were based on the magnetic resonance imaging in 8 patients, and the histological in 3. The vascular lesions were located on the brainstem (5 cases), cerebellum (2 cases) thalamus (1 case) and cerebrum (3 cases). The clinical presentation at onset included previous intracerebral hemorrhages (9 cases) and seizures (2 cases). All patients were treated with a a linac-based radiosurgery. The median dose of radiation delivered was 16 Gy ranging from 14 to 24 Gy, which was typically proscribed to the 80$\%$ isodose surface (range 50 $\~$ 80$\%$), corresponding to the periphery of the lesion with a single isocenter. Ten patients were followed-up. Results: The median follow-up was 49 months ranging from 8 to 73 months, during which time two patients developed an intracerebral hemorrhage, 1 at 8 months, with the other at 64 months post radiosurgery. One patient developed neurological deficit after radiosurgery, and two developed an edema on the T2 weighted images of the MRI surrounding the radiosurgical target. Conclusion: The use of stereotactic radiosurgery in the treatment of a cavernous angioma may be effective in the prevention of rebleedlng, and can be safely delivered. However, a longer follow-up period will be required.

A Patterns of Care Study of the Various Radiation Therapies for Prostate Cancer among Korean Radiation Oncologists in 2006 (Patterns of Care Study를 위한 2006년 한국 방사선종양학과 전문의들의 전립선암 방사선치료원칙 조사연구)

  • Kim, Jin-Hee;Kim, Jae-Sung;Ha, Sung-Whan;Shin, Seong-Soo;Park, Won;Cho, Jae-Ho;Suh, Chang-Ok;Oh, Young-Taek;Shin, Sei-Won;Kim, Jae-Chul;Jang, Ji-Young;Nam, Taek-Keun;Choi, Young-Min;Kim, Il-Han
    • Radiation Oncology Journal
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    • v.26 no.2
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    • pp.96-103
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    • 2008
  • Purpose: To conduct a nationwide academic hospital patterns of the practice status and principles of radiotherapy for prostate cancer. The survey will help develop the framework of a database of Korean in Patterns of Case Study. Materials and Methods: A questionnaire about radiation treatment status and principles was sent to radiation oncologists in charge of prostate cancer treatment at thirteen academic hospitals in Korea. The data was analyzed to find treatment principles among the radiation oncologists when treating prostate cancer. Results: The number of patients with prostate cancer and treated with radiation ranged from 60 to 150 per academic hospital in Seoul City and 10 to 15 outside of Seoul City in 2006. The primary diagnostic methods of prostate cancer included the ultrasound guided biopsy on 6 to 12 prostate sites(mean=9), followed by magnetic resonance imaging and a whole body bone scan. Internal and external immobilizations were used in 61.5% and 76.9%, respectively, with diverse radiation targets. Whole pelvis radiation therapy(dose ranging from 45.0 to 50.4 Gy) was performed in 76.9%, followed by the irradiation of seminal vesicles($54.0{\sim}73.8$ Gy) in 92.3%. The definitive radiotherapy doses were increased as a function of risk group, but the range of radiation doses was wide(60.0 to 78.5 Gy). Intensity modulated radiation therapy using doses greater than 70 Gy, were performed in 53.8% of academic hospitals. In addition, the simultaneous intra-factional boost(SIB) technique was used in three hospitals; however, the target volume and radiation dose were diverse. Radiation therapy to biochemical recurrence after a radical prostatectomy was performed in 84.6%; however, the radiation dose was variable and the radiation field ranged from whole pelvis to prostate bed. Conclusion: The results of this study suggest that a nationwide Korean Patterns of Care Study is necessary for the recommendation of radiation therapy guidelines of prostate cancer.

The evaluation for Clinical usefulness and Safety of Sirolimus-eluting stent and Paclitaxel-Eluting Stents In Patients With Acute Myocardial Infarction (급성심근경색증 환자의 일차적 관동맥 스텐트 삽입술 시 삽입된 Sirolimus-eluting stent 와 Paclitaxel-eluting stent의 임상적 안정성 및 유용성 평가)

  • Min, Gye-Sik;Han, Man-Seok
    • Journal of the Korean Society of Radiology
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    • v.6 no.1
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    • pp.5-10
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    • 2012
  • There is a still unsettled issue about the comparison of long-term clinical effects between sirolimus-(SES) and paclitaxel-eluting stents (PES) for the patients with acute myocardial infarction (AMI). Therefore, we performed a retrospective analysis to evaluate the 4-year clinical outcome of SES as compared with PES after percutaneous coronary intervention (PCI) in patients with AMI. From January 2004 to August 2006, all consecutive patients with acute ST-segment elevation myocardial infarction (STEMI) underwent primary PCI and acute NSTEMI underwent PCI by implantation either SES or PES were enrolled. The occurrence of death, cardiac death, recurrent infarction, target vessel revascularization (TVR) and stent thrombosis were analyzed. The composite of major adverse cardiac events (MACE; death, recurrent infarction and TVR) were also analyzed. During the study period, total 668 AMI patients had visited. Of them, total 522 patients (299 with SES and 223 with PES) were enrolled. During 4-year clinical follow-up, there were similar occurrences of death ($18.3{\pm}3.0%$ vs. $14.6{\pm}2.2%$, p=0.26), cardiac death ($11.2{\pm}2.6%$ vs. $6.8{\pm}1.52%$, p=0.39), re-infarction ($6.4{\pm}1.8%$ vs. $3.3{\pm}1.1%$, p=0.31), and stent thrombosis ($5.4{\pm}1.7%$ vs. $3.2{\pm}1.1%$, p=0.53) between the two groups, consecutively. The occurrences of TVR ($10.0{\pm}3.0%$ vs. $4.0{\pm}1.2%$, p=0.008) and MACE ($29.4{\pm}3.5%$ vs. $19.4{\pm}2.5%$, p=0.003) were significantly higher in patients treated with PES than SES. In AMI patients treated with either SES or PES implantation, SES had a significantly lower risk of TVR and MACE during 4-year clinical follow-up. Rates of death, cardiac death or recurrent infarction, and stent thrombosis were similar.

Destabilization of TNF-α mRNA by Rapamycin

  • Park, Jong-Woo;Jeon, Ye-Ji;Lee, Jae-Cheol;Ahn, So-Ra;Ha, Shin-Won;Bang, So-Young;Park, Eun-Kyung;Yi, Sang-Ah;Lee, Min-Gyu;Han, Jeung-Whan
    • Biomolecules & Therapeutics
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    • v.20 no.1
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    • pp.43-49
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    • 2012
  • Stimulation of mast cells through the high affinity IgE receptor (Fc${\varepsilon}$RI) induces degranulation, lipid mediator release, and cytokine secretion leading to allergic reactions. Although various signaling pathways have been characterized to be involved in the Fc${\varepsilon}$RI-mediated responses, little is known about the precious mechanism for the expression of tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) in mast cells. Here, we report that rapamycin, a specific inhibitor of mammalian target of rapamycin (mTOR), reduces the expression of TNF-${\alpha}$ in rat basophilic leukemia (RBL-2H3) cells. IgE or specific antigen stimulation of RBL-2H3 cells increases the expression of TNF-${\alpha}$ and activates various signaling molecules including S6K1, Akt and p38 MAPK. Rapamycin specifically inhibits antigeninduced TNF-${\alpha}$ mRNA level, while other kinase inhibitors have no effect on TNF-${\alpha}$ mRNA level. These data indicate that mTOR signaling pathway is the main regulation mechanism for antigen-induced TNF-${\alpha}$ expression. TNF-${\alpha}$ mRNA stability analysis using reporter construct containing TNF-${\alpha}$ adenylate/uridylate-rich elements (AREs) shows that rapamycin destabilizes TNF-${\alpha}$ mRNA via regulating the AU-rich element of TNF-${\alpha}$ mRNA. The antigen-induced activation of S6K1 is inhibited by specific kinase inhibitors including mTOR, PI3K, PKC and $Ca^{2+}$chelator inhibitor, while TNF-${\alpha}$ mRNA level is reduced only by rapamycin treatment. These data suggest that the effects of rapamycin on the expression of TNF-${\alpha}$ mRNA are not mediated by S6K1 but regulated by mTOR. Taken together, our results reveal that mTOR signaling pathway is a novel regulation mechanism for antigen-induced TNF-${\alpha}$ expression in RBL-2H3 cells.

Study of Downward Speed Limit of Main Roads on Traffic Accident and Effect Analysis - In Busan Metropolitan City - (간선도로 최고속도제한 하향이 교통사고에 미치는 영향 및 효과분석 - 부산광역시를 중심으로 -)

  • Lim, Chang-Sik;Choi, Yang-Won
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.38 no.1
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    • pp.81-90
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    • 2018
  • The purpose of this study is to evaluate the effect of downward speed limit of urban arterial roads at 29 sites in Busan Metropolitan Police Agency to reduce road traffic accidents from '10 to '15. As a result of analyzing the traffic accidents occurred for 1~3 years after the decrease in the speed limit, the number of traffic accidents decreased by 3.09% and the number of injured persons decreased by 8.76%, but the number of deaths decreased by 36.73% The results of this study are as follows. The average speed reduction rate of 6.31km/h was decreased by investigating the change of the vehicle speed before and after the downward speed limit, and the change of average speed was statistically significant in most of the sections. The rate of compliance with the speed limit increased by 10.26% p, which is considered to have greatly improved overall traffic safety. A survey conducted by residents near the target area with a lower speed limit showed that 57.9% of the respondents felt the driving speed of the vehicle was lowered. However, this project was focused on vehicles with limited speed road signs and traffic safety signs, Only 25.8% of respondents said walking safety was improved. In the future, it is necessary to consider the safety of pedestrians by improving roads around roads such as road curvature and separation. In addition, there is a clear positive result in terms of decreasing the fatal accidents in the downward speed limit zone of Busan Metropolitan Subway. However, more detailed analysis is needed for the 29 accidents. Therefore, it is expected that traffic practitioners will be able to utilize it as a basis to increase the accident reduction effect by setting an appropriate speed limit based on the easy and objective grounds.

Impact Evaluation of Water Footprint on Stages of Drainage Works (배수공 각 작업 단계별 물발자국 영향평가)

  • Chen, Di;Kim, Joon-Soo;Batagalle, Vinuri;Kim, Byung-Soo
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.40 no.2
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    • pp.225-231
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    • 2020
  • Fresh water that can be used by a person of the total amount of water on the planet is increased because it is less than 0.01 % except underground water, ice and snow, etc. water management response need. In order to protect and efficiently utilize water resources, major countries are conducting water footprint studies that can quantitatively estimate the amount of water put into the operating phase of the resource harvesting phase, mainly agriculture. Korea has also recently developed a number of policies in order to cope with water shortages, and in the construction industry, as well as the need for basic research to support it has been emphasized. This study was constructed DB up to the raw material harvesting step, the transport step, the production stage in order to estimate the water consumption of resources to be put into the work process to target the drainage of the road. Water usage estimation method was utilized the method presented in the Water Footprint Manual and the environmental score card certification guide, unit water usage each drainage main method was calculated after estimating the water footprint considering the water character factor, indirect water and the direct water, the water consumption factor of material input to each process. Brown asphalt, rebar, remicon of the drainage material as a result of the water footprint calculation accounted for 97 % of the total. Drainage method is a culvert, a side channel, a culvert wing wall, reinforced concrete open channel accounted for 92.2 % of the total. Drainage total step-by-step calculated water consumption and water footprint was found in order of raw material harvesting step, transport stage, production stage. Water footprint each drainage method or total drainage material calculated in this study can be used as a base data in the agricultural and construction sectors. In order to increase the reliability of the analysis, it is believed that further overseas databases will be needed for continuous review and research.

Prediction of Potential Risk Posed by a Military Gunnery Range after Flood Control Reservoir Construction (홍수조절지 건설 후 사격장 주변지역의 위해성예측 사례연구)

  • Ryu, Hye-Rim;Han, Joon-Kyoung;Nam, Kyoung-Phile;Bae, Bum-Han
    • Journal of Soil and Groundwater Environment
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    • v.12 no.1
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    • pp.87-96
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    • 2007
  • Risk assessment was carried out in order to improve the remediation and management strategy on a contaminated gunnery site, where a flood control reservoir is under construction nearby. Six chemicals, including explosive chemicals and heavy metals, which were suspected to possess risk to humans by leaching events from the site were the target pollutants for the assessment. A site-specific conceptual site model was constructed based on effective, reasonable exposure pathways to avoid any overestimation of the risk. Also, conservative default values were adapted to prevent underestimation of the risk when site-specific values were not available. The risks of the six contaminants were calculated by API's Decision Support System for Exposure and Risk Assessment with several assumptions. In the crater-formed-area(Ac), the non-carcinogenic risks(i.e., HI values) of TNT(Tri-Nitro-Toluene) and Cd were slightly larger than 1, and for RDX(Royal Demolition Explosives), over 50. The total non-carcinogenic risk of the whole gunnery range calculated to a significantly high value of 62.5. Carcinogenicity of Cd was estimated to be about $10^{-3}$, while that of Pb was about $5\;{\times}\;10^{-4}$, which greatly exceeded the generally acceptable carcinogenic risk level of $10^{-4}{\sim}10^{-6}$. The risk assessment results suggest that an immediate remediation practice for both carcinogens and non-carcinogens are required before the reservoir construction. However, for more accurate risk assessment, more specific estimations on condition shifts due to the construction of the reservoir are required, and more over, the effects of the pollutants to the ecosystem is also necessary to be evaluated.

True Orthoimage Generation from LiDAR Intensity Using Deep Learning (딥러닝에 의한 라이다 반사강도로부터 엄밀정사영상 생성)

  • Shin, Young Ha;Hyung, Sung Woong;Lee, Dong-Cheon
    • Journal of the Korean Society of Surveying, Geodesy, Photogrammetry and Cartography
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    • v.38 no.4
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    • pp.363-373
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    • 2020
  • During last decades numerous studies generating orthoimage have been carried out. Traditional methods require exterior orientation parameters of aerial images and precise 3D object modeling data and DTM (Digital Terrain Model) to detect and recover occlusion areas. Furthermore, it is challenging task to automate the complicated process. In this paper, we proposed a new concept of true orthoimage generation using DL (Deep Learning). DL is rapidly used in wide range of fields. In particular, GAN (Generative Adversarial Network) is one of the DL models for various tasks in imaging processing and computer vision. The generator tries to produce results similar to the real images, while discriminator judges fake and real images until the results are satisfied. Such mutually adversarial mechanism improves quality of the results. Experiments were performed using GAN-based Pix2Pix model by utilizing IR (Infrared) orthoimages, intensity from LiDAR data provided by the German Society for Photogrammetry, Remote Sensing and Geoinformation (DGPF) through the ISPRS (International Society for Photogrammetry and Remote Sensing). Two approaches were implemented: (1) One-step training with intensity data and high resolution orthoimages, (2) Recursive training with intensity data and color-coded low resolution intensity images for progressive enhancement of the results. Two methods provided similar quality based on FID (Fréchet Inception Distance) measures. However, if quality of the input data is close to the target image, better results could be obtained by increasing epoch. This paper is an early experimental study for feasibility of DL-based true orthoimage generation and further improvement would be necessary.