• Radiation Oncology Journal
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• 제6권2호
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• pp.177-182
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• 1988

1979년부터 1985년까지 서울대학교병원 치료방사선과에서 치료를 받은 송과선종 환자 23명에 대한 후향적 분석을 시행하였다. 종양에 대한 조직학적 진단은 1명에서만 이루어졌고, 나머지 22명의 환자에 있어서의 진단은 임상적 소견 및 방사선학적 경사결과에 의거하였다. 방사선조사는 1명에 있어서는 종양부위에 국한하였고, 14명에 있어서는 전 뇌부위, 8명에 있어서는 전뇌-척수부위에 대하여 시행하였다. 전 환자의 5년 생존율은 $71.5\%$이었고, 전 뇌부위 치료 환자의 5년 생존율은$69.3\%$, 전뇌-척수부 위 치료 환자의 5년 생존율은 $73.3\%$이었다. 원발 부위 및 원격부위에서의 재발이 각각 한명씩 확인되었으며 척수부위에서의 치료실패는 확인된 경우가 없었다. 이상의 분석결과 및 기왕의 여러 보고를 바탕으로 하여 송과선종의 방사선치료에 있어서 모든 환자에서 전척수 조사를 시행하는 것은 타당치 않으며 전척수 조사는 뇌척수액내에서 종양세포가 발견된 경우나 또는 종양의 제거나 생검을 위하여 외과적 시술이 시행되었던 경우 등에 국한되어야 할 것으로 결론지었다

• Journal of Chest Surgery
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• 제13권2호
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• pp.85-91
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• 1980

Extracorporeal circulation by hemodilution technique has been currently used with its clinical safety and good peripheral tissue perfusion in open heart surgery. There is no doubt that $O_{2}$ carrying capacity of the blood is disturbed by decreased hemoglobin level resulting from hemodilution of the circulating blood. From the view point of the blood gas exchange, these experimental studies were undertaken to determined the sate limit of hemodilution in the condition of cardiopulmonary bypass with a constant perfusion flow rate. Twelve adult mongrel dogs weighing 10 to 13 Kg. were anesthetized with pentobarbital and then respiration was controlled with Harvard volume respirator using room air. The cardiopulmonary by pass was performed by use of Sarns heart lung machine (console 5000, 5 head and 2 roller pumps) and Travenol pediatric bubble oxygenator. The perfusion rate during bypass was maintained at a constant rate of 80 ml/min/Kg of body weight. The ratio of oxygen gas flow to blood flow was kept in 3 to 1 constantly. International hemodilution was attained by serial blood withdrawals and immediate infusion of equal volumes of diluants composed of Ringer's lactate, 5% dextrose in water and 25% mannitol solution, proportionally 60%, 30%, and 10%. Arterial and venous blood samples were obtained between 15 and 20 minutes following each hemodilution. Hematocrits and hemoglobin values, $PO_{2}$, $PCO_{2}$ and pH were measured. Oxygen and carbon dioxide contents oxygen consumption and carbon dioxide elimination were calculated groups according to different hematocrit values and the correlations were evaluated. Result were as follows. 1. the arterial $O_{2}$ tension and $O_{2}$ saturation were maintained at the physiological level irrespective of the hematocrit value. 2. The venous $O_{2}$ tension and $O_{2}$ saturation showed a tendency to decline with the decrease in hematocrit value and positive correlation between them (r = +0.49, r = +0.76), The mean values of venous $O_{2}$ tension and $O_{2}$ saturation, however, were not decreased when the hematocrit levels were lower than 20%. 3. The arterial $O_{2}$ content declined lineally in proportion to the fall of hematocrit level with a positive correlation between them (r = +0.95). 4. The venous $O_{2}$ contents were decreased gradually as the hematocrit value decreased with positive correlation between them ( r =+0.89). The trend of diminution of venous $O_{2}$ content, however, was became low according to progressive decrease of hematocrit level. 5. Systemic oxygen consumption was in higher range than $O_{2}$ requirement of basal metabolism when the hematocrit value was above 20%, but abruptly decreased when the hematocrit value became to below 20%. 6. The arterial $CO_{2}$ tension and $CO_{2}$ content showed trend of increasing with progressive decrease of hematocrit value but exhibited a rather broad range and there was no relationship between those value and the hematocrit value. 7. The venous $CO_{2}$ tension and $CO_{2}$ content have also no correlation with change of Ht. value but related directly to those value of arterial blood with positive correlation between them (r = +0.78, r = +0.95_. 8. A-V difference of $CO_{2}$ content and $CO_{2}$ elimination wasnot significantly influenced by Ht. value. From the results, we obtained that feasible limit in inteneional hemodilution is above the hematocrit value of 20% under the given experimental condition.

• 한국콘텐츠학회논문지
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• 제14권8호
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• pp.225-232
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• 2014

전유방절제술을 시행하고 방사선치료시 조사야에 흉벽과 IMNs이 포함되어 심장과 동측 폐에 고선량의 방사선이 흡수되어 만성이환율에 영향을 미칠 수 있다. 따라서 본 연구에서는 전유방절제술을 시행한 유방암 환자의 방사선 치료시 IMRT와 VMAT 기법을 이용하여 선량분포양상을 비교하고자 한다. 유방암 진단을 받고 전유방절제술과 방사선 치료를 시행 받은 환자 중 PTV내에 IMNs가 포함되는 10명의 환자를 선택하여 환자의 흉벽조직, SCL, IMNs을 포함하여 각각 IMRT와 VMAT를 이용하여 치료계획을 실시한 후 PTV의 일치성과 심장 및 폐에 입사되는 선량을 서로 비교하고자 하였다. 그 결과 IMRT와 VMAT에서 모두 PTV의 일치성은 동일 양상(p<0.05)을 보였으며, 좌측유방암 환자인 경우 심장의 고선량 영역은 VMAT이 더 적은 체적으로 관찰(p<0.05)되었다. 폐선량의 경우 IMRT 보다 VMAT시 선량이 더 적게 관찰(p<0.05)되었다. IMNs을 포함하여 치료하는 경우 VMAT가 IMRT보다 방사선 치료 효율이 높을 것으로 사료된다.

• 대한방사선치료학회지
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• 제25권1호
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• pp.69-75
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• 2013

목 적: 경기관지 근접치료에 이용되는 2차원 치료계획의 경우 환부를 확인하는 과정에서 종양의 위치 파악에 어려움이 있어 정확한 치료계획 분석이 어려울 수 있다. 이에 본 연구에서는 전산화단층모의치료기를 이용한 3차원 치료계획으로 환자의 치료계획을 비교 분석하고자 한다. 대상 및 방법: 2012년 6월 본원을 내원한 환자를 대상으로 전산화모의치료장비(Lightspeed RT, GE, USA)와 Oncentra Brachy planning system (Nucletron, Netherland)를 사용하여 3차원 치료계획을 시행하여 2차원 치료계획과 비교 분석하였다. 결 과: 분할 조사로 시행되는 경기관지 근접치료에서 매회 카테터의 위치 파악이 치료계획 상에서 확인 되었고, GTV 용적은 $3.5cm^3$, $3.3cm^3$로 확인 할 수 있었다. 또한 종양의 선량분포 파악이 용이하여 GTV에 대하여 첫 번째 치료 시 처방선량의 92%, 두 번째 치료 시 88%로 파악되어 선량전달 오차를 파악할 수 있었다. 결 론: 2차원 치료계획을 통한 근접치료의 문제점을 보완하기 위하여 치료용적과 선량분포의 정확한 파악과 분석이 가능한 3차원 치료계획으로 검증이 필요하고, 선량전달 오차를 정량적으로 파악하여 치료계획에 반영하는 과정이 필요하다고 생각된다.

• The Korean Journal of Physiology
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• 제2권1호
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• pp.31-38
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• 1968

Total body fat measurement by means of skinfold thickness was performed in 94 secondary school boys. Hydrostatic weighing was made on the same subject and corrected for residual volume in lung. Skinfold thicknesses at four sites, namely, back, waist, arm and abdomen, were compared with total body fat calculated from the equation given by Keys and Brozek and regression equation were computated. In 48 middle school boys aged between 13 and 16 years and 46 high school boys aged between 16 and 19 years, skinfold thicknesses increased at all 4 sites as age increased. The body density, however, showed different pattern. In middle school ages, body density showed little variation. Density in 13-14 years was 1.0608, in 14-15 years 1.0578 and in 15-16 years 1.0546. In high school ages density in-creased abruptly to 1.0703 (16 yr.), 1.0730 (17 yr.) and 1.0740 (18 yr.). Subsequently 15 years was a boundary for density change and total body fat change. In middle school boys as a group of 48 the observed values were: density: 1.0562, total body fat: 15.9%, mean skinfold thickness at four sites: 6.02 mm. The coefficient of correlation between mean skinfold thickness and density were r=-0.759 and r=0.781 with %fat. The regression equations were : Body $density=-0.00527{\times}Mean$ skinfold thickness (mm)+1.0879, %Fat=$1.933{\times}Mean$ skinfold thickness (mm)+4.26 In high school boys the values were: density: 1.0723, body fat: 10.4%, and mean skinfold thickness: 7.89 mm. Coefficients of correlation between mean skinfold thickness and density were r=-0.868 and r=0.855 with % fat. Thus, Body density=$-0.00365{\times}Mean$ skinfold thickness (mm)+1.1008, and %Fat=$1.326{\times}Mean$ skinfold thickness (mm)-0.064, were obtained. Although skinfold thicknesses at 4 sites showed a continuous increase in absolute value as age increased, relative growth of skinfold at specific site differed. On arm the growth of skinfold showed a decrease and on waist it showed an increase as compared to the mean thickness.

• Journal of Korean Neurosurgical Society
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• 제61권5호
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• pp.592-599
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• 2018

Objective : Metastatic brain tumors (MBTs) often present with intracerebral hemorrhage. Although Gamma Knife surgery (GKS) is a valid treatment option for hemorrhagic MBTs, its efficacy is unclear. To achieve oncologic control and reduce radiation toxicity, we used a radiosurgical targeting technique that confines the tumor core within the hematoma when performing GKS in patients with such tumors. We reviewed our experience in this endeavor, focusing on local tumor control and treatment-associated morbidities. Methods : From 2007 to 2014, 13 patients with hemorrhagic MBTs were treated via GKS using our targeting technique. The median marginal dose prescribed was 23 Gy (range, 20-25). GKS was performed approximately 2 weeks after tumor bleeding to allow the patient's condition to stabilize. Results : The primary sites of the MBTs included the liver (n=7), lung (n=2), kidney (n=1), and stomach (n=1); in two cases, the primary tumor was a melanoma. The mean tumor volume was $4.00cm^3$ (range, 0.74-11.0). The mean overall survival duration after GKS was 12.5 months (range, 3-29), and three patients are still alive at the time of the review. The local tumor control rate was 92% (tumor disappearance 23%, tumor regression 46%, and stable disease 23%). There was one (8%) instance of local recurrence, which occurred 11 months after GKS in the solid portion of the tumor. No GKS-related complications were observed. Conclusion : Our experience shows that GKS performed in conjunction with our targeting technique safely and effectively treats hemorrhagic MBTs. The success of this technique may reflect the presence of scattered metastatic tumor cells in the hematoma that do not proliferate owing to the inadequate microenvironment of the hematoma. We suggest that GKS can be a useful treatment option for patients with hemorrhagic MBTs that are not amenable to surgery.

• 한방안이비인후피부과학회지
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• 제19권2호
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• pp.1-18
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• 2006

Objective : Although management of asthma has become increasingly effective, its cure remains elusive, necessitating a new modality to prevent or eliminate causes triggering clinical progress. Based in the clinical experiences, a novel decoration Cheongsangbiyeum (CSB), has been developed to treat asthma, which consists of Polyporus, Semen Myristicae, Pericarpium citri Reticulatae, Rhizoma Cimicifugae, Cortex Albizziae, Fructus Rubi, Rhizoma Zedoariae, and Rhizoma Rhei. In the current study, its anti-asthmatic efficacy was evaluated using a mouse model of asthma. Methods : Experimental allergic asthma was induced by repeated intraperitioneal sensitization and intranasal challenge of ovalbumin (OVA). Water extract of CSB (1 mg/mouse/day) was administrated orally whereas control mice on given with identical volume of phosphate-buffered saline (PBS) for 5 days during the course of antigen challenge. When airway hyperreactivity(AHR) measured by ${\bata}-methacoline-induced$ airflow obstruction was compared, AHR of CSB-treated mice was significantly lower than those of control mice, indicating that CM extract can attenuate an asthmatic symptom. Airway recruitment of leukocytes and eosinophils was also markedly reduced by CSB treatment suggesting that oral treatment of CSB can alleviate the airway inflammation. For a better understanding of possible mechanisms underlying anti-asthmatic effet of CSB, cytokine (IL-4, IL-5, IL-13 and $IFN{\gamma}$ levels in bronchoalveola lavage fluid (BALF) and lung tissues were determined. Results : The results showed that cytokine levels were significantly lowered by CSB treatment. Additionally, number of draining lymph node cells was significantly lower than those of control mice. These data indicate that CSB suppress in vivo allergen-specific response. However, notably, levels of type 2 cytokines such as IL-5 and IL-13 were more profoundly influenced. Moreover, in vitro OVA-specific proliferative response and type 2 cytokine (IL-4, IL-5 and IL-13) production lymph node cells was markedly decreased in CSB-treated mice, whereas their $IFN{\gamma}$ production was not significantly altered Thrse data clearly showed a preferential inhibition of type 2 T cell (Th2) response by CSB treatment. This finding was also supported by serum antibody data showing that levels of OVA-specific type 2 antibodies, IgE and IgG1, in CSB-treated mice were significantly lower than in control mice, while type 1 antibody, IgG2a level m rather higher than controls, although the difference was in significant. Conclusions : In conclusion, oral administration of CSB attenuates asthmatic manifestations including AHR ad airway recruitment of eosinophils in a mouse model which possibly results from selective inhibition of Th2 cell response to allergen. Our data suggest a potential clinical application of CSB for control of allergic asthma.

• Journal of Korean Neurosurgical Society
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• 제50권4호
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• pp.299-303
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• 2011

Objective : Brainstem metastases are rarely operable and generally unresponsive to conventional radiation therapy or chemotherapy. Recently, Gamma Knife Radiosurgery (GKRS) was used as feasible treatment option for brainstem metastasis. The present study evaluated our experience of brainstem metastasis which was treated with GKRS. Methods : Between November 1992 and June 2010, 32 patients (23 men and 9 women, mean age 56.1 years, range 39-73) were treated with GKRS for brainstem metastases. There were metastatic lesions in pons in 23, the midbrain in 6, and the medulla oblongata in 3 patients, respectively. The primary tumor site was lung in 21, breast in 3, kidney in 2 and other locations in 6 patients. The mean tumor volume was $1,517mm^3$ (range, 9-6,000), and the mean marginal dose was 15.9 Gy (range, 6-23). Magnetic Resonance Imaging (MRI) was obtained every 2-3 months following GKRS. Follow-up MRI was possible in 24 patients at a mean follow-up duration of 12.0 months (range, 1-45). Kaplan-Meier survival analysis was used to evaluate the prognostic factors. Results : Follow-up MRI showed tumor disappearance in 6, tumor shrinkage in 14, no change in tumor size in 1, and tumor growth in 3 patients, which translated into a local tumor control rate of 87.5% (21 of 24 tumors). The mean progression free survival was 12.2 months (range, 2-45) after GKRS. Nine patients were alive at the completion of the study, and the overall mean survival time after GKRS was 7.7 months (range, 1-22). One patient with metastatic melanoma experienced intratumoral hemorrhage during the follow-up period. Survival was found to be associated with score of more than 70 on Karnofsky performance status and low recursive partitioning analysis class (class 1 or 2), in terms of favorable prognostic factors. Conclusion : GKRS was found to be safe and effective for management of brainstem metastasis. The integral clinical status of patient seems to be important in determining the overall survival time.

• Asian Pacific Journal of Cancer Prevention
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• 제16권7호
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• pp.2889-2894
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• 2015

Background: To investigate the impact of the breast size, shape, maximum heart depth (MDH), and chest wall hypotenuse (the distance connecting middle point of the sternum and the length of lung draw on the selected transverse CT slice) on the volumetric dose to heart with whole breast irradiation (WBI) of left-sided breast cancer patients. Materials and Methods: Fifty-three patients with left-sided breast cancer undergoing adjuvant intensity-modulated radiotherapy (IMRT) were enrolled in the study. The primary breast size and shape, MHD and DCWH (chest wall hypotenuse) were contoured on radiotherapy (RT) planning CT slices. The dose data of hearts were obtained from the dose-volume histograms (DVHs). Data were analyzed by one-way analysis of variance (ANOVA), Student's t-test and linear regression analysis. Results: Breast size was independent of heart dose, whereas breast shape, MHD and DCWH were correlated with heart dose. The shapes of breasts were divided into four types, as the flap type, hemisphere type, cone type and pendulous type with heart mean dose being $491.8{\pm}234.6cGy$, $752.7{\pm}219.0cGy$, $620.2{\pm}275.7cGy$, and $666.1{\pm}238.0cGy$, respectively. The flap type of breasts shows a strong statistically reduction in heart dose, compared to others (p=0.008 for V30 of heart). DCWH and MHD were found to be the most important parameters correlating with heart dose in WBI. Conclusions: More attention should be paid to the heart dose of non-flap type patients. The MHD was found to be the most important parameter to correlate with heart dose in tangential WBI, closely followed by the DCWH, which could help radiation oncologists and physicsts evaluate heart dose and design RT plan in advance.

• Tuberculosis and Respiratory Diseases
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• 제42권2호
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• pp.218-225
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• 1995

연구배경: 기도저항은 body plethysmograph를 이용하여 flow/alveolar pressure의 관계를 측정함으로써 얻어질 수 있는데, 기도저항이 정상인 경우 oscillooscope 상에서 얻어지는 resistance curve가 거의 linear 하나 증가된 경우에는 그 모양이 기울어지거나 loop을 형성하는 경우가 많아 이러한 curve를 분석하여 환자의 임상평가에 도움이 되는 결과를 얻고자 하였다. 방법: 기도저항이 증가되어 있는 환자를 대상으로 body plethysmograph에서 quiet breathing시에 얻어진 resistance curve의 형태를 분석하여 폐기능을 비교하였다. 결과: 1) Resistance curve는 type 1: linear, type 2: ovoid, type 3: sigmoid, type 4: scoop, type 5: paisley의 5가지 형태로 구분할 수 있었으며, 1예를 제외한 type 3과 type 4 및 5는 loop을 형성하였다. 2) Curve의 형태가 특정 질환에 특징적이지는 않았으나 급성질환은 주로 type 1, 및 2, 만성기류폐쇄는 주로 type 3, 4 및 5에 속하였으며, 기관지 천식이나 오래된 폐결핵은 그 정도에 따라 type 1 에서 5까지의 형태를 모두 보였다. 3) Type 1에서 type 5로 갈 수록, loop을 형성 할 수록 기도폐쇄가 심하고 기도저항이 증가되며 잔기량이 커지는 경향을 보였다. 결론: 기도저항을 측정할 경우 기도저항의 측정치 뿐 아니라 resistance curve를 분석하여 기도폐쇄와 air trapping의 정도를 판단하는데 도움을 얻을수 있으며, resistance curve의 모양이 특정 질환에 특징적이지는 않았지만 호기시 loop이 형성되는 경우 심한 기도폐쇄를 시사하였다.