• Clinical and Experimental Reproductive Medicine
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• v.51 no.3
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• pp.181-191
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• 2024

Polycystic ovary syndrome (PCOS) is a common endocrine and metabolic disorder among reproductive-age women. As a leading cause of anovulatory infertility, it complicates fertility treatments, including in vitro fertilization. The widely accepted 2003 Rotterdam diagnostic criteria for PCOS include sub-phenotypes based on variations in androgen excess, ovulatory dysfunction, and polycystic ovarian morphology. In this systematic review, we examined the impacts of inositol and vitamin D on fertility in PCOS. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines, we used relevant keywords to comprehensively search databases including PubMed, Google Scholar, and MDPI. From an initial pool of 345 articles, 10 met the inclusion criteria. The articles suggest that vitamin D and inositol, particularly myo-inositol and D-chiro-inositol, may represent therapeutic options for PCOS. Vitamin D influences ovarian follicular development, glucose regulation, and insulin sensitivity. When combined with metformin therapy, it is associated with improved menstrual regularity and ovulation. Inositol is crucial for cellular signaling, energy metabolism, glucose regulation, and fertility. This systematic review underscores the importance of investigating inositol and vitamin D within a PCOS management strategy, given the disorder's prevalence and impacts on fertility and metabolic health. Although these agents show promise, additional research could clarify their mechanisms of action and therapeutic benefits. This review emphasizes the need for exploration of effective treatments to improve the quality of life among individuals with PCOS. Inositol and vitamin D represent potential options, but more studies are required to elucidate their roles in the management of this condition.

• Yonsei Medical Journal
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• v.63 no.5
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• pp.405-412
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• 2022

Purpose We evaluated the safety, feasibility, and early treatment outcomes of intraoperative radiotherapy (IORT) using a low-energy X-ray source. Materials and Methods Patients with resectable pancreatic cancer were enrolled in this single-institution, prospective, single-arm, phase II trial. Patients underwent surgery and IORT with 10 Gy prescribed at a 5-mm depth from the tumor bed using a 50 kV X-ray source (Intrabeam, Carl Zeiss). Six cycles of adjuvant gemcitabine-based chemotherapy were administered 8-12 weeks after surgery. Results A total of 41 patients were included. Thirty-one patients (75.6%) underwent wide R0 resection, while 5 (12.2%) underwent R1 resection and 5 (12.2%) underwent narrow R0 resection (retroperitoneal margin <1 mm). Grade 3 postoperative complications were reported in only one patient (4.9%) who needed additional surgery due to ulcer perforation. At a median follow-up of 9 months, four patients showed local-only recurrence, nine had distant metastases, and two showed both local and distant recurrence. The 1-year local control rate was 76.4%. Conclusion Our preliminary report suggests that IORT is well-tolerated and feasible in patients with resectable pancreatic cancer. Further follow-up is needed to confirm the clinical benefits of IORT in terms of local control and overall survival. Trial Registration: Clinical trial registration No. (NCT03273374).

• The Journal of Korean Society for Radiation Therapy
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• v.19 no.1
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• pp.19-26
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• 2007

Purpose: To compare of the accuracy among various measurement procedures of HDR Brachytherapy, and to evaluate the clinical suitability and usefulness of alternative PMMA (polymethylmethacrylateplastics: $C_5H_8O_2$) plate phantom without any additional cost due to the purchase of measuring apparatus. Materials and Methods: We made a comparative study on three types of measuring systems: well type chamber, source calibration jig, and PMMA plate phantom. Farmer type chamber was used for source calibration jig method and PMMA plate phantom method. Measurement was done 5 times each in comparison with the measurement values from manufacturer. Measurement results from experiment were compared with that from the manufacturer which is offered with the source whenever a source is substituted by a new one and evaluate the accuracy of source activity. Results: As a consequence of Ir-192 source measurement using well type chamber, source calibration jig and PMMA plate phantom, RMS (Root Mean Square) values for the relative error are 0.6%, 1.57%, 2.1%, respectively, compared with the data from manufacturer. And the mean errors with standard deviation are given $-0.2{\pm}0.5%$, $0.97{\pm}1.23%$, $-0.89{\pm}1.87%$ respectively. Conclusion: From the results shown by the three types of measurement system (well type chamber, source calibration jig, and PMMA plate phantom), the measurement with well type chamber produced the best accuracy. It turns out that we can also use the alternative system of PMMA plate phantom clinically without purchasing any additional particular apparatus since the system does not exceed the recommendation of AAPM (American Association of Physicists in Medicine), which requires the error range of within ${\pm}5%$.

• The Journal of Korean Society for Radiation Therapy
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• v.17 no.2
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• pp.141-145
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• 2005

Purpose : It is known that the neutron is generally generated from the photon, its energy is larger than 10 MV. The neutron is leaked in the container inspection system installed at the customs though its energy is below 9 MV. It is needed that the spacial effect of the neutrons released from radiation treatment machine, linac, installed in the medical canter. Materials and Methods : The medical linear accelerator(Clinac 1800, varian, USA) was used in the experiment. Measuring neutron was used bubble detector(Bubble detector, BDPND type, BTI, Canada) which was created bubble by neutron. The bubble detector is located on the medical linear accelerator outskirt in three different distance, 30, 50, 120 cm and upper, lower four point from the iso-center. In addition, for effect on protect material we have measured eight points which are 50 cm distance from iso-center. The SAD(source-axis-distance), distance from photon source to iso-center, is adjusted to 100 cm and the field size is adjusted to $15{\times}15cm^2$. Irradiate 20 MU and calculate the dose rate in mrem/MU by measuring the number of bubble. Results : The neutron is more detected at 5 position in 30, 50 cm, 7 position in 120 cm and with wedge, and 2 position without mount. Conclusion : Though detection position is laid in the same distance in neutron measurement, the different value is shown in measuring results. Also, neutron dose is affected by the additional structure, the different value is obtained in each measurement positions. So, it is needed to measure and evaluate the neutron dose in the whole space considering the effect of the distance, angular distribution and additional structure.

• Radiation Oncology Journal
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• v.6 no.1
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• pp.63-73
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• 1988

One hundred fifty-four patients with the carcinoma of the uterine cervix were studied retrospectively to assess the result and impact of treatment at Department of Radiation Oncology, Korea University, Hae-Wha Hospital from Feb 1981 through Dec. 1986. Prior to radiotherapy, the patients were evaluated and staged by recommendation of FIGO including physical examination, pelvic examination, cystoscopy, rectosigmoidoscopy, chest X-ray, IVP. Ba enema. Also, an additional pelvic CT scan was obtained for some of the patients. The patients were treated by radiotherapy alone or adjuvant postoperative irradiation; in case of radiation therapy only, whole pelvic irradiation was given with Co-60 teletherapy unit via AP and PA parallel opposing fields or 4-oblique fields, 180 cGy per day, 5 days per week and intracavitary insertion was performed. In satges Ia, Ib, and IIa with small primary lesion, external irradiation was initially given to pelvis up to $2,000\~3,000\;cGy/2frac{1}{2}\;-3frac{1}{2}$ weeks and then intracavitary insertion was performed using Fletcher-Mini-Declos Applicator with cesium-137 cources and followed by external irradiation of $1,000\~2,000\;cGy/1frac{1}{2}\;-2frac{1}{2}$weeks via AP and PA parallel opposing fields with midline shield to spare of bladder and rectum. However, if the primary lesion is large, external irradiation was given without midline shield. More than stages IIb, the patients were treated by external beam irradiation up to 5,400cGy/30f for 6 weeks via 4-oblique portals and at the dose of 5,040cGy/28f the field was cut 5cm from the top margin for spare of small bowel, and followed by intracavitary irradiation, If there was residual tumor an additional dose of $900\~l,200cGy/5\~7f$ was given to parametrium and/or residual tumor area. Total dose of radiation to A and B-point were as follows; A-point; In early stages, Ia, Ib, IIa; $8,000\~9,000$ B-point $5,000\~6,000 cGy$ A-point; In advanced stages IIb, IIIa, IIIb; $9,000\~10,000$ B-point $60,000\~7,000cGy$ The results were obtained and as fellows; 1 The patients distribution according to FIGO staging system were stage Ia 6, Ib 27, IIa 28, IIb 54, IIIa 12, IIIb 18, and stage IVa 9. 2. Value of CT scan were demonstration of cervix tumor mass, parametrial and pelvic side wall tumor spread, pelvic and inguinal lymph nodes metastases, and hydronephrosis. Three dimensional quantitative demonstration of tumor volume is also important in planning radiation therapy. Another advantage of CT scan was detection of recurrent tumor after radiation or surgery. 3. Local control rate of tumor according to the size was $91.3\%$ for less than 5cm in size and $44.6\%$ in tumor over 5cm (p<0.0068). 4. Thirty out of 50 recurrent sites has locoregional failures and 17 cases has distant metastases. And the para-aortic lymph nodes were the most common site for distant metastases. 5. The most common complication was temporal rectal bleeding which was controlled most by conservative management. However, 4 patients required for endoscopic cauterization. 6. The 5-year survival rates showed; stage la and Ib $95\%,\;stage\;IIa\;81\%\;stage\;lIb\;67\%,\;stage\;IIIa\;37.7\%,\;stage\;IIIb\;23\%$ and 3-year survival rate of stage IVa showed $11.6%$, retrospectively.

• The Journal of the Korean bone and joint tumor society
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• v.18 no.1
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• pp.7-13
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• 2012

Purpose: The purpose of this study is to compare general survival rate and survival rate according to expectable prognostic factors by analyzing the result of treating a patient of squamous cell carcinoma. Materials and Methods: From Mar. 1999 to Feb. 2011, 151 patients were pathologically confirmed as squamous cell carcinoma of limbs and body in our hospital, and among those patients, 51 patients underwent the surgical treatment. This study included 41 patients who underwent the surgical treatment and were followed-up for more than 12 months. The mean age of population was 64.4 years. 31 males and 10 females were included. Wide excision with following skin grafts or flaps for reconstruction (29 cases) was mostly performed, but amputation (12 cases) was also performed for cases with extremities where resection margin was difficult to obtain and cases with neural or vascular invasion. 8 patients underwent chemotherapy or radiotherapy after resection, and 33 underwent the operation only. Stages were classified by AJCC Classification, survival rate was calculated by Kaplan-Meier method and survival rate of groups was compared by Log-rank test. For the expectable prognostic factors related to survival rate, location of primary lesion, cause of disease, pathologic grade, staging, surgical method, additional anticancer therapy were examined and each survival rate was compared. Results: The average follow-up period was 65.2 (12-132) months. Thirty patients survived out of 41 patients till last follow up. The overall survival rate in 5 years was 77%. Three cases (7.3%) had local recurrence, and 7 cases (17.0%) had metastasis. The average period of recurrence from operation was 27 (18-43) months. Possible prognostic factors such as location of primary lesion, cause of disease, pathologic grade, staging, additional anticancer therapy showed no significant difference in survival rates. However, patients with amputation showed significantly lower survival rate than those with wide excision. Conclusion: In analysis the results of treating 41 cases of squamous cell carcinoma, the overall 5-year survival rate was 77%. And, among the several prognostic factors, only the surgical method was significant statistically.

• The Journal of Korean Society for Radiation Therapy
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• v.28 no.2
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• pp.171-178
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• 2016

Purpose : In order to minimize the dose of femoral head as an appropriate treatment plan for rectal cancer radiation therapy, we compare and evaluate the usefulness of 3-field 3D conformal radiation therapy(below 3fCRT), which is a universal treatment method, and 5-field 3D conformal radiation therapy(below 5fCRT), and Volumetric Modulated Arc Therapy (VMAT). Materials and Methods : The 10 cases of rectal cancer that treated with 21EX were enrolled. Those cases were planned by Eclipse(Ver. 10.0.42, Varian, USA), PRO3(Progressive Resolution Optimizer 10.0.28) and AAA(Anisotropic Analytic Algorithm Ver. 10.0.28). 3fCRT and 5fCRT plan has $0^{\circ}$, $270^{\circ}$, $90^{\circ}$ and $0^{\circ}$, $95^{\circ}$, $45^{\circ}$, $315^{\circ}$, $265^{\circ}$ gantry angle, respectively. VMAT plan parameters consisted of 15MV coplanar $360^{\circ}$ 1 arac. Treatment prescription was employed delivering 54Gy to recum in 30 fractions. To minimize the dose difference that shows up randomly on optimizing, VMAT plans were optimized and calculated twice, and normalized to the target V100%=95%. The indexes of evaluation are D of Both femoral head and aceta fossa, total MU, H.I.(Homogeneity index) and C.I.(Conformity index) of the PTV. All VMAT plans were verified by gamma test with portal dosimetry using EPID. Results : D of Rt. femoral head was 53.08 Gy, 50.27 Gy, and 30.92 Gy, respectively, in the order of 3fCRT, 5fCRT, and VMAT treatment plan. Likewise, Lt. Femoral head showed average 53.68 Gy, 51.01 Gy and 29.23 Gy in the same order. D of Rt. aceta fossa was 54.86 Gy, 52.40 Gy, 30.37 Gy, respectively, in the order of 3fCRT, 5fCRT, and VMAT treatment plan. Likewise, Lt. Femoral head showed average 53.68 Gy, 51.01 Gy and 29.23 Gy in the same order. The maximum dose of both femoral head and aceta fossa was higher in the order of 3fCRT, 5fCRT, and VMAT treatment plan. C.I. showed the lowest VMAT treatment plan with an average of 1.64, 1.48, and 0.99 in the order of 3fCRT, 5fCRT, and VMAT treatment plan. There was no significant difference on H.I. of the PTV among three plans. Total MU showed that the VMAT treatment plan used 124.4MU and 299MU more than the 3fCRT and 5fCRT treatment plan, respectively. IMRT verification gamma test results for the VMAT plan passed over 90.0% at 2mm/2%. Conclusion : In rectal cancer treatment, the VMAT plan was shown to be advantageous in most of the evaluation indexes compared to the 3D plan, and the dose of the femoral head was greatly reduced. However, because of practical limitations there may be a case where it is difficult to select a VMAT treatment plan. 5fCRT has the advantage of reducing the dose of the femoral head as compared to the existing 3fCRT, without regard to additional problems. Therefore, not only would it extend survival time but the quality of life in general, if hospitals improved radiation therapy efficiency by selecting the treatment plan in accordance with the hospital's situation.

• The Journal of Korean Society for Radiation Therapy
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• v.31 no.1
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• pp.57-65
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• 2019

Purpose: The purpose is to clarify the effect of additional scattering ratio on the edge of the block according to the increasing block thickness with low melting point lead alloy and pure lead in electron beam therapy. Methods and materials: $10{\times}10cm^2$ Shielding blocks made of low melting point lead alloy and pure lead were fabricated to shield mold frame half of applicator. Block thickness was 3, 5, 10, 15, 20 (mm) for each material. The common irradiation conditions were set at 6 MeV energy, 300 MU / Min dose rate, gantry angle of $0^{\circ}$, and dose of 100 MU. The relative scattering ratio with increasing block thickness was measured with a parallel plate type ion chamber(Exradin P11) and phantom(RW3) by varying the position of the shielding block(cone and on the phantom), the position of the measuring point(surface ans depth of $D_{max}$), and the block material(lead alloy and pure lead). Results : When (depth of measurement / block position / block material) was (surface / applicator / pure lead), the relative value(scattering ratio) was 15.33 nC(+0.33 %), 15.28 nC(0 %), 15.08 nC(-1.31 %), 15.05 nC(-1.51 %), 15.07 nC(-1.37 %) as the block thickness increased in order of 3, 5, 10, 15, 20 (mm) respectively. When it was (surface / applicator / alloy lead), the relative value(scattering ratio) was 15.19 nC(-0.59 %), 15.25 nC(-0.20 %), 15.15 nC(-0.85 %), 14.96 nC(-2.09 %), 15.15 nC(-0.85 %) respectively. When it was (surface / phantom / pure lead), the relative value(scattering ratio) was 15.62 nC(+2.23 %), 15.59 nC(+2.03 %), 15.53 nC(+1.67 %), 15.48 nC(+1.31 %), 15.34 nC(+0.39 %) respectively. When it was (surface / phantom / alloy lead), the relative value(scattering ratio) was 15.56 nC(+1.83 %), 15.55 nC(+1.77 %), 15.51 nC(+1.51 %), 15.42 nC(+0.92 %), 15.39 nC(+0.72 %) respectively. When it was (depth of $D_{max}$ / applicator / pure lead), the relative value(scattering ratio) was 16.70 nC(-10.87 %), 16.84 nC(-10.12 %), 16.72 nC(-10.78 %), 16.88 nC(-9.93 %), 16.90 nC(-9.82 %) respectively. When it was (depth of $D_{max}$ / applicator / alloy lead), the relative value(scattering ratio) was 16.83 nC(-10.19 %), 17.12 nC(-8.64 %), 16.89 nC(-9.87 %), 16.77 nC(-10.51 %), 16.52 nC(-11.85 %) respectively. When it was (depth of $D_{max}$ / phantom / pure lead), the relative value(scattering ratio) was 17.41 nC(-7.10 %), 17.45 nC(-6.88 %), 17.34 nC(-7.47 %), 17.42 nC(-7.04 %), 17.25 nC(-7.95 %) respectively. When it was (depth of $D_{max}$ / phantom / alloy lead), the relative value(scattering ratio) was 17.45 nC(-6.88 %), 17.44 nC(-6.94 %), 17.47 nC(-6.78 %), 17.43 nC(-6.99 %), 17.35 nC(-7.42 %) respectively. Conclusions: When performing electron therapy using a shielding block, the block position should be inserted applicator rather than the patient's body surface. The block thickness should be made to the minimum appropriate shielding thickness of each corresponding using energy. Also it is useful that the treatment should be performed considering the influence of scattering dose varying with distance from the edge of block.

• Journal of Life Science
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• v.28 no.7
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• pp.819-826
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• 2018

Orostachys japonicus (OJ) is a medicinal herb with immunoregulatory, anti-aging, anti-oxidative, and many other therapeutic properties. The purpose of this study was to elucidate the anti-cancer property of cultivated OJ. SW480 cell viability was significantly reduced by cumulative exposure to OJ extract. We also observed inhibitory effects of OJ after 72 hr through the growth and migration of SW480 cells using scratch assay. SW480 cells in OJ-free medium began to move into the scratch site at 24 hr; however, cells in medium containing OJ did not migrate into the scratch site until 48 hr. Male C57BL/6 mice (4 weeks old) were orally administered OJ extract for 31 days before injection of SW480 cells. At 7, 14, and 28 days after subcutaneous injection of SW480 cells, tumor weight and volume were analyzed. The body weight of the OJ-treated group was continuously increased during administration of the OJ extract relative to the control group. Injection of SW480 cells caused a reduction in body weight in all groups; however, the OJ-treated group exhibited a significant increase in body weight after 14 days. Tumor weight and volume were lower in the OJ-treated group than in the control group after 28 days. Although these results suggest that OJ suppresses the proliferation and migration of human colon cancer cells, additional studies are required to provide preclinical evidence before launching clinical trials evaluating OJ as an anti-cancer biohealth product.

• The Journal of the Korean bone and joint tumor society
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• v.18 no.2
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• pp.78-82
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• 2012

Purpose: Interferon-${\alpha}2b$ using immunotherapy of malignant melanoma is known to increase the microscopic enemies that remain after surgical resection of the tumor to prevent recurrence, disease-free survival and overall survival. Authors in patients with malignant melanoma after surgical resection and high-dose interferon-${\alpha}$ immunotherapy treated group of disease-free survival and overall survival compared with the results of the treatment of immune therapy to a preliminary report. Materials and Methods: From February 2010 to October 2012 at our institution between being diagnosed with malignant melanoma after surgical immunotherapy treated patients were analyzed. Patients was evaluated using the stage AJCC stage IIA 3 cases, IIB 1 cases, IV 1 were as follows. Follow-up period of at least 7 months, and a maximum of 32 months. As maintenance therapy after the first induction therapy group underwent immunotherapy interferon-${\alpha}$ of body-surface area per 200,000 IU five times in a week for 4 weeks sedentary and body surface area a total of 48 weeks per week to 100,000 IU three times subcutaneously. These patients for local recurrence and metastases, and distant metastasis were investigated disease-free survival was investigated. Results: Interferon-evaluation through follow-up chest computed tomography (CT) and positron emission computed tomography (PET CT) in patients who underwent the ${\alpha}$ immunotherapy results above both local recurrence and metastases without evidence of distant metastases. Conclusion: The high-dose ${\alpha}2b$ immunotherapy performed in patients to prevent the local recurrence of the tumor and metastasis to the current or future ultimate survival and disease-free survival improvement achieved is additional study and follow-up will be needed.