• Title/Summary/Keyword: critical organ

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Evaluation of Dose Distributions Recalculated with Per-field Measurement Data under the Condition of Respiratory Motion during IMRT for Liver Cancer (간암 환자의 세기조절방사선치료 시 호흡에 의한 움직임 조건에서 측정된 조사면 별 선량결과를 기반으로 재계산한 체내 선량분포 평가)

  • Song, Ju-Young;Kim, Yong-Hyeob;Jeong, Jae-Uk;Yoon, Mee Sun;Ahn, Sung-Ja;Chung, Woong-Ki;Nam, Taek-Keun
    • Progress in Medical Physics
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    • v.25 no.2
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    • pp.79-88
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    • 2014
  • The dose distributions within the real volumes of tumor targets and critical organs during internal target volume-based intensity-modulated radiation therapy (ITV-IMRT) for liver cancer were recalculated by applying the effects of actual respiratory organ motion, and the dosimetric features were analyzed through comparison with gating IMRT (Gate-IMRT) plan results. The ITV was created using MIM software, and a moving phantom was used to simulate respiratory motion. The doses were recalculated with a 3 dose-volume histogram (3DVH) program based on the per-field data measured with a MapCHECK2 2-dimensional diode detector array. Although a sufficient prescription dose covered the PTV during ITV-IMRT delivery, the dose homogeneity in the PTV was inferior to that with the Gate-IMRT plan. We confirmed that there were higher doses to the organs-at-risk (OARs) with ITV-IMRT, as expected when using an enlarged field, but the increased dose to the spinal cord was not significant and the increased doses to the liver and kidney could be considered as minor when the reinforced constraints were applied during IMRT plan optimization. Because the Gate-IMRT method also has disadvantages such as unsuspected dosimetric variations when applying the gating system and an increased treatment time, it is better to perform a prior analysis of the patient's respiratory condition and the importance and fulfillment of the IMRT plan dose constraints in order to select an optimal IMRT method with which to correct the respiratory organ motional effect.

The expression patterns of RANKL and OPG in murine tooth eruption (치아발육시기에서의 RANKL 및 OPG의 발현 양상)

  • Hwang, Kyung-Mun;Kim, Eun-Jung;Kim, Young-Jin;Nam, Soon-Hyeun;Kim, Hyun-Jung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.33 no.2
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    • pp.290-303
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    • 2006
  • Tooth eruption is a complex and tightly regulated process that involves cells of the tooth organ and the surrounding alveolus. Osteoclast precursors must be recruited into the dental follicle prior to the onset of eruption. This function of dental follicle may be regarded as the ability of bone remodeling characterized by the interaction of osteoclasts and osteoblasts. This is because tooth eruption is a localized event in which many of the genes required for eruption are expressed in the dental follicle. RANKL is a membrane-bound protein that is a member of the TNF ligand family. which is present on bone marrow stromal cells and osteoblasts, and induces osteoclast formation and activation from precursor cell. The biologic effect of RANKL is inhibited by OPG and, in bone, the relative ratio of RANKL and OPG modulates osteoclastogenesis. To evaluate the roles of RANKL and OPG in tooth eruption and the relations with the expression pattern of Runx2, in situ hybridization was performed with mandibles of mice at postnatal stage 1, 3, 5, 7, 9 and 11. mRNA of RANKL, OPG, and Runx2 are expressed in dental follicle and surrounding tissue from P1 to 11. To determine the sites of osteoclastic activity during tooth eruption, mandibles were dissected. Peak osteoclastic activity in alveolar bone along the occlusal and basal regions was observed from P5 to 9, with osteoclasts in these regions being large and strongly TRAP-positive The specific spatio-temporal expression patterns of RANKL, OPG, and Runx2 in our study suggest that tooth eruption could be progressed through the interactions of molecular signaling among dental follicle, dental organ and alveolar bone, furthermore it means that dental follicle is quite important in tooth eruption In addition, it indicates that these genes (RANKL, OPG, and Runx2) play critical roles in tooth eruption.

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TLD Dosimetry in HDR Intracavitary Brachytherapy (고선량률 강내 근접치료시 열형광량계를 이용한 선량측정법)

  • Kim, Chang-Seon;Yang, Dae-Sik;Kim, Chul-Yong;Park, Myung-Sun
    • Progress in Medical Physics
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    • v.11 no.2
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    • pp.109-116
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    • 2000
  • One consideration of radiation delivery in cervical cancer is the complication of critical organs, e.g., bladder and rectum. The absorbed dose of bladder and rectum in HDR intracavitary brachytherapy is measured indirectly with TLD dosimetry A method for the complication reduction of bladder and rectum is suggested. For two-hundred cervical cancer patients, follow-up MRI images were reviewed and distances from cervical central axis to bladder and rectum and vaginal wall thickness were measured. The sealed TLDs were placed upon the gauze packing of the ovoids and the distances to the TLDs from the ovoid center were measured in the simulation film and actual doses of bladder and rectum were calculated. From published data, maximal tolerance doses of bladder and rectum were derived and based on the permissible doses per fraction in HDR brachytherapy the packing thicknesses were determined in both directions. The required minimal packing thicknesses for bladder and rectum were 0.43 and 0.92 cm, respectively. The results were compared with computer calculation using the Meisberger polynomial approach. It is our hope this study can be used for a guideline for users in clinic in estimating critical organ dose in bladder and rectum in HDR brachytherapy in vivo dosimetry.

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Treatment planning of Lung Cancer with Density corrected Computed Tomography (밀도를 입력한 CT planning을 이용한 Lung Cancer의 치료계획)

  • 김성규;김명세;신세원;홍정숙
    • Progress in Medical Physics
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    • v.4 no.2
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    • pp.19-25
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    • 1993
  • Treatment planning of lung cancer with density corrected Computed tomography. Eighty-seven patients with lung cnacer who had radiation therapy in Yeungnam University Medical Center between, April 1 1990 and Aug. 30 1993 were retrospectively evaluated total tumor dose, dose distribution, field correction, and loading change, compared with contour or CT image planning and density corrected CT planning. In dose distribution, higher dose was calculated in compare with density corrected CT planning less than 5% difference were found in 45 patient(52%), 5-10% in 25 patients (29%), 10-15% in 15 patients (17%) and over 15% in 2 patients (2%). Correction of treatment field was performed in 18 patients (21%) and changing of dose loading was given in 15 patients (17%). In conclusion, we emphasize that density corrected CT planning is the very important factor which contribute to increase therapeutic gain by exact selection of target volume, target dose, normal tissue dose and dose of critical organ.

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Effect of D-glucose feeding on mortality induced by sepsis

  • Kim, Sung-Su;Sim, Yun-Beom;Park, Soo-Hyun;Lee, Jae-Ryeong;Sharma, Naveen;Suh, Hong-Won
    • The Korean Journal of Physiology and Pharmacology
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    • v.20 no.1
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    • pp.83-89
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    • 2016
  • Sepsis is the life-threatening response to infection which can lead to tissue damage, organ failure, and death. In the current study, the effect of orally administered D-glucose on the mortality and the blood glucose level induced by D-Galactosamine (GaLN)/lipopolysaccharide (LPS)-induced sepsis was examined in ICR mice. After various amounts of D-glucose (from 1 to 8 g/kg) were orally fed, sepsis was induced by injecting intraperitoneally (i.p.) the mixture of GaLN /LPS. Oral pre-treatment with D-glucose dose-dependently increased the blood glucose level and caused a reduction of sepsis-induced mortality. The oral post-treatment with D-glucose (8 g/kg) up to 3 h caused an elevation of the blood glucose level and protected the mortality observed in sepsis model. However, D-glucose post-treated at 6, 9, or 12 h after sepsis induction did not affect the mortality and the blood glucose level induced by sepsis. Furthermore, the intrathecal (i.t.) pretreatment once with pertussis toxin (PTX; $0.1{\mu}g/5ml$) for 6 days caused a reduction of D-glucose-induced protection of mortality and hyperglycemia. Furthermore, once the hypoglycemic state is continued up to 6 h after sepsis initiated, sepsis-induced mortality could not be reversed by D-glucose fed orally. Based on these findings, it is assumed that the hypoglycemic duration between 3 and 6 h after the sepsis induction may be a critical time of period for the survival. D-glucose-induced protective effect against sepsis-induced mortality appears to be mediated via activating PTX-sensitive G-proteins in the spinal cord. Finally, the production of hyperglycemic state may be critical for the survival against the sepsis-induced mortality.

The Critical Roles of Zinc: Beyond Impact on Myocardial Signaling

  • Lee, Sung Ryul;Noh, Su Jin;Pronto, Julius Ryan;Jeong, Yu Jeong;Kim, Hyoung Kyu;Song, In Sung;Xu, Zhelong;Kwon, Hyog Young;Kang, Se Chan;Sohn, Eun-Hwa;Ko, Kyung Soo;Rhee, Byoung Doo;Kim, Nari;Han, Jin
    • The Korean Journal of Physiology and Pharmacology
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    • v.19 no.5
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    • pp.389-399
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    • 2015
  • Zinc has been considered as a vital constituent of proteins, including enzymes. Mobile reactive zinc ($Zn^{2+}$) is the key form of zinc involved in signal transductions, which are mainly driven by its binding to proteins or the release of zinc from proteins, possibly via a redox switch. There has been growing evidence of zinc's critical role in cell signaling, due to its flexible coordination geometry and rapid shifts in protein conformation to perform biological reactions. The importance and complexity of $Zn^{2+}$ activity has been presumed to parallel the degree of calcium's participation in cellular processes. Whole body and cellular $Zn^{2+}$ levels are largely regulated by metallothioneins (MTs), $Zn^{2+}$ importers (ZIPs), and $Zn^{2+}$ transporters (ZnTs). Numerous proteins involved in signaling pathways, mitochondrial metabolism, and ion channels that play a pivotal role in controlling cardiac contractility are common targets of $Zn^{2+}$. However, these regulatory actions of $Zn^{2+}$ are not limited to the function of the heart, but also extend to numerous other organ systems, such as the central nervous system, immune system, cardiovascular tissue, and secretory glands, such as the pancreas, prostate, and mammary glands. In this review, the regulation of cellular $Zn^{2+}$ levels, $Zn^{2+}$-mediated signal transduction, impacts of $Zn^{2+}$ on ion channels and mitochondrial metabolism, and finally, the implications of $Zn^{2+}$ in health and disease development were outlined to help widen the current understanding of the versatile and complex roles of $Zn^{2+}$.

Seven-day and In-hospital Mortality According to Left and Right Ventricular Dysfunction in Patients With Septic Shock

  • Sua Kim;Hyeri Seok;Beong Ki Kim;Yu Jin Kim;Seung Heon Lee;Je Hyeong Kim;Yong-Hyun Kim
    • Korean Circulation Journal
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    • v.53 no.12
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    • pp.813-825
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    • 2023
  • Background and Objectives: The prognostic implications of septic cardiomyopathy have not been clearly demonstrated. We evaluated serial changes in left ventricular (LV) and right ventricular (RV) function in patients with septic shock and their prognostic value on 7-day and in-hospital mortality. Methods: Transthoracic echocardiography was performed within 48 hours of the diagnosis of septic shock and 7 days after the initial evaluation. In addition to traditional echocardiographic parameters, LV and RV function was evaluated using global longitudinal strain (GLS), and tricuspid annular plane systolic excursion (TAPSE). Results: A total of 162 patients (men, 83, 51.5%; 70.7±13.4 years; Acute Physiology and Chronic Health Evaluation [APACHE] II, 30.6±9.2) were enrolled. Initial GLS and TAPSE were -14.9±5.2% and 16.9±5.5 mm, and improved in the follow-up evaluation (GLS, -17.6±4.9%; TAPSE, 19.2±5.4 mm). Seven-day and in-hospital mortality were 24 (14.9%) and 64 (39.8%). Seven-day mortality was significantly associated with initial GLS >-16% (odds ratio [OR], 14.066, 95% confidence interval [CI], 1.178-167.969, p=0.037) and APACHE II score (OR, 1.196, 95% CI, 1.047-1.365, p=0.008). The in-hospital mortality of 7-day survivors was associated with follow-up TAPSE <16 mm (OR, 10.109, 95% CI, 1.640-62.322, p=0.013) and Sequential Organ Failure Assessment score (OR, 1.340, 95% CI, 1.078-1.667, p=0.008). GLS was not associated with in-hospital mortality of 7-day survivors. Conclusions: Fluctuation of both ventricular function was common in septic shock. Seven-day mortality of patients with septic shock was related to GLS, whereas in-hospital mortality of 7-day survivors was related to TAPSE, not to GLS.

Packing effects on the intracavitary radiation therapy of the utaine lervix cancer ($^{192}Ir$source를 이용할 자궁경부암 강내치료시 사용하는 packing의 효과에 대한 고찰)

  • Cho, Jung-Kun;Lee, Du-Hyun;Si, Chang-Kun;Choi, Yoon-Kyung;Kim, Tae-Yoon
    • The Journal of Korean Society for Radiation Therapy
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    • v.16 no.1
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    • pp.73-77
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    • 2004
  • Purpose of the radio-therapy is maximize the radiation dose to the tumor while minimizing the dose to the critical organ. Carcinoma of the uterine cervix treatment are external irradiation or an interstitial brachtheraphy make use of isotope. Brachytherapy is a method of radiotherapy in advantage to achieve better local control with minimum radiation toxicity in comparison with external irradiation because radiation dose is distributed according to the inverse square low of gamma-ray emitted from the implanted sources. Authors make use of the patients data which 192Ir gives medical treatment intrcavity. Intracavitary radiation of the uterine cervix cancer, critical organ take $20\%$ below than exposure dose of A point in the ICRU report. None the less of the advice, Radiation proctitis and radiation cystitis are frequent and problematic early complications in patients treated with radiation for the uterine cervix cancer. In brachytherapy of uterine cervical cancer using a high dose rate remote afterloading system, it is of prime importance to deliver a accurate dose in each fractionated treatment by minimizing the difference between the pre-treatment planned and post-treatment calculated doses. Use of packing to reduce late complications intracavitary radiation of the uterine cervix cancer. Bladder and rectum changes exposure dose rate by radiotherphy make use of packing.

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Comparison of Treatment Plans with Multileaf Collimators of different Leaf Width (Leaf width가 다른 다엽 콜리메터에 의한 치료계획 비교)

  • Kim Joo Young;Park Sung Yong;Lee Doo Hyun;Lee Seok Ho;Kim Tae Hyun;Cho Kwan Ho
    • Progress in Medical Physics
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    • v.15 no.4
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    • pp.173-178
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    • 2004
  • Purpose: To compare desimetrically intensity-modulated radiotherapy treatment plans with commercially available multileaf collimators (MLCs) of different leaf width for intracranial lesions. Materials and Methods: Twelve patients with intracranial lesions were treated with BrainLAB's micro-MLCs (mMLCs) and performed with the BrainSCAN ver. 5.2 planning software. They were replanned using the Varian 120 and 80 MLCs. These collimators have minimum leaf width of 3 mm, 5 mm and 10 mm at isocenter, respectively. PTV was $3.3~339.2\textrm{cm}^3$ and the number of beams was 3~7. These three plans were compared with respect to the uniformity and the conformity indices, doses to critical organ and normal tissue. Results: For the uniformity index of the planning target volume (PTV), there were no statistically significant differences between mMLCs and 120 MLCs (p=0.057) and between 120 MLCs and 80 MLCs (p=0.388). However, there was a difference between mMLCs and 80 MLCs (p<0.001). Maximum target dose to the PTV showed no dependency with respect to the leaf width. On the contrary, there were statistically significant differences in the conformity indices between mMLCs and 120 MLCs (p=0.003), between mMLCs and 80 MLCs (p=0.003) and between 120 MLCs and 80 MLCs (p=0.003). The volume of brainstem irradiated to $\geq$70% dose and to $\geq$50% dose was increased as the leaf width of MLCs increased. In particular, the volume of normal tissue irradiated is obviously changed for different leaf width. Volumetric increments for MLCs with leaf widths of 5 mm and 10 mm were 6.3% and 23.2% to the normal tissue irradiated to $\geq$50% dose, and 8.7% and 32.7% to the normal tissue irradiated to $\geq$70% dose, respectively, compared to the volume for MLCs with leaf width of 3 mm. Conclusions: The uniformity index and maximum target dose to the PTV showed no dependency with respect to leaf width of MLCs. However, the conformity index was improved as the leaf width decreased. For the sparing of normal brain tissue, treatment plans with MLCs of 3 mm leaf width is more effective, compared to ones with MLCs of 5 mm and 10 mm leaf widths.

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Growth and Critical Light Intensity at Cotyledon Stage of Cornus controversa Hemsl. Seedling (층층나무 자엽단계(子葉段階) 유묘(幼苗)의 생장(生長)과 한계광도(限界光度)에 관(關)한 연구(硏究))

  • Cho, Jae Hyoung;Hong, Sung Gak;Kim, Jong Jin
    • Journal of Korean Society of Forest Science
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    • v.87 no.3
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    • pp.493-500
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    • 1998
  • To investigate the effects of light intensity on the growth, and the critical minimum light intensity for growing of Cornus controversa seedlings at the stage of cotyledon, hypocotyl elongation, cotyledon expansion, the times of leaves appearance, dry weights of each organ, and specific leaf area(SLA) were measured on a growth chamber with several light intensity gradients(385, 32, 17, 8, and $5{\mu}mol\;m^{-2}s^{-1}$). There was a positive correlationship between the size of cotyledon and the biomass of cotyledon and total seedling. Hypocotyl was more elongated under relatively low light intensities, such as 32, 17, 8, and $5{\mu}mol\;m^{-2}s^{-1}$ than under $385{\mu}mol\;m^{-2}s^{-1}$ light intensity, however, dry weight of the hypocotyl was adverse. As the light intensities decreased, the leaf appearance was delayed and the number of leaves decresed. In addition, leaves did not appear under $8{\mu}mol\;m^{-2}s^{-1}$ and $5{\mu}mol\;m^{-2}s^{-1}$ light intensity. Although cotyledons were more fully expanded under 32 and $17{\mu}mol\;m^{-2}s^{-1}$ light intensities than $385{\mu}mol\;m^{-2}s^{-1}$ light intensity, the dry weights of cotyledons were greater under the high light intensity. The dry weight of cotyledon, hypocotyl, root and leaves showed a decreased pattern with decreasing light intensities, but root to shoot(hypocotyl+leaves) ratio rapidly increased. Roots did not develop below $8{\mu}mol\;m^{-2}s^{-1}$ light intensity. In conclusion, the results showed that the critical minimum light intensity for growing of Cornus controversa seedlings was above $17{\mu}mol\;m^{-2}s^{-1}$ light intensity.

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