• Journal of the Korean Society of Radiology
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• v.11 no.7
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• pp.663-669
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• 2017

In diagnostic medical imaging, it is essential to reduce the scattered radiation for the high medical image quality and low patient dose. Therefore, in this study, the influence of the scattered radiation on medical images was analyzed as the tube voltage increases. For this purpose, ANSI chest phantom was used to measure the scattering ratio, and the scattering effect on the image quality was investigated by RMS evaluation, RSD and NPS analysis. It was found that the scattering ratio with increasing x-ray tube voltage gradually increased to 48.8% at 73 kV tube voltage and to 80.1% at 93 kV tube voltage. As a result of RMS analysis for evaluating the image quality, RMS value according to increase of tube voltage was increased, resulting in low image quality. Also, the NPS value at 2.5 lp/mm spatial frequency was increased by 20% when the tube voltage was increased by 93 kV compared to the tube voltage of 73 kV. From this study, it can be seen that the scattering radiation have a significant effect on the image quality according to the increase of x-ray tube voltage. The results of this study can be used as basic data for the improvement of medical imaging quality.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.3 no.1
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• pp.63-67
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• 2000

Purpose: Biliary atresia, one of the major causes of neonatal cholestais, is an idiopathic, serious disorder, affecting the newborn that results in complete obstruction of biliary tract. Successful reestablishment of bile flow is dependent on early surgical intervention, early diagnosis is imperative. The authors evaluate the utility of Tc-99m-labeled diisoprpyliminodiacetic acid (DISIDA) hepatobiliary scintigraphy in the diagnosis of biliary atresia. Methods: From January, 1995 to August, 1999, total 60 patients with neonatal cholestasis underwent Tc-99m DISIDA hepatobiliary scintigraphy at Asan Medical Center. Results: The undelying causes of neonatal cholestasis were biliary atresia in 14, neonatal hepatitis in 33, intrahepatic bile duct paucity in 9, and total parenteral nutrition induced cholestasis in 4. All patient with biliary atresia were interpreted correctely in DISIDA hepatobiliary scintigraphy, showing 100% sensitivity. Of the 46 patients with neonatal hepatitis and other causes, 37 patients had intestinal radioactivity showing 80% specificity. Conclusion: Visualization of DISIDA in the intestinal tract indicates patency of the biliary ducts and excludes the diagnosis of biliary atresia. But the absence of intestinal excretion on the DISIDA hepatobiliary scintigraphy dose not necessarily indicate biliary atresia.

• Radiation Oncology Journal
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• v.2 no.1
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• pp.107-113
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• 1984

One hundred sixty one patients with the carcinoma of uterine cervix received curative radiotherapy at the Department of Therapeutic Radiology, Seoul National University Hospital between December, 1979 and December, 1982. According to FIGO classification; stage $I_a 1(0.6\%)\;1_b\;8(5.0\%),\;II_a\;31(19.3\%),\;II_b\;66(41.0\%),\;III_a\;3(1.8\;%),\;III_b\;46(28.6\%)\;and\;IV_a\;6(3.7\;%)$. The proportion of early stage cancer is too small because most of them treated by surgery. External beam whole pelvic irradiation was done first with 10MV x-ray or Co-60 gamma ray upto 4,000 or 5,000 rad for early and advanced cases, followed by one or two courses of intracavitary radiation using Fletcher-Suit Applicator loading c Cs-137. Supplementary external radiation to pelvic side wall to bring dose to 6,000 or 6,500 rads, if there is parametrial involvement or positive pelvic lymph node. Of the 161 Patients, 49 Patients were lost to follow-up but only 22 patients were lost in disease free state. And so, 86.3 percent of the patients were followed to time of recurrence or to date. The results are as follows ; 1. Locoregional control rates according to stage is: stage I $100\%,\;II_a\;90.3\;%,\;II_b\;75.8\%,\;III_a\;66.7\%,\;III_b\;58.7\%\;and\;IV_a\;16.7\%$, respectively. 2. Persistent or recurrent disease were localized in pelvic cavity in 32 of 50 patients and 6 had distant metastasis only. 3. Rectal bleeding was the most common complication and appeared mostly between 6 and 24 months after radiotherapy. Most of them had transient minor bleeding and only 2 patients needed transfusion and 1 patient needed colostomy due to rectovaginal fistula. 4. The 3 year disease free survival rate is: stage I $100\%,\;II_a\;78.0\%,\;II_b\;60.6\%,\;III_a\;66.7\;III_b\;46.3\%\;and\;IN_a\;16.7\%$, respectively.

• Radiation Oncology Journal
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• v.19 no.4
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• pp.312-318
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• 2001

Purpose : To assess the locoregional recurrence rate, survival rate and prognostic factors after modified radical mastectomy and postoperative adjuvant radiation therapy with or with chemotherapy in high-risk breast cancer patients. Methods : Between $1984\~1995$, 48 patients underwent postoperative irradiation to the regional lymphatics and chest wall due to large tumor size $(\geq5\;cm)$ or small tumor size (<5 cm) with axillary lymph node involvement after modified radical mastectomy. The median age of the patients was 47 years (range, $31\~79\;years$). The clinical tumor size was <2 cm in 1 patient, $2\~5\;cm$ in 15 patients, and >5 cm in 32 patients. Thirty two patients had positive axillary lymph nodes. Forty two patients were irradiated to the chest wall and regional lymph node and 6 patients were irradiated in the chest wall only. Radiation dose to the chest wall and regional lymph node was 5040 cGy/28 fraction. The median follow-up time was 61 months. Results : Locoregional recurrence rate was $8\%$ and distant metastatic rate was $14\%$. The actuarial overall survival rate and disease-free survival rate was $53\%\;and\;62\%$ at 5 years, respectively. The median survival time was 57 months. Five-year overall survival rate by the stage is $70\%$ in IIB and $58\%$ in IIA. The significant prognostic factor for survival on multivariate analysis was the stage. Conclusion : Postoperative adjuvant radiation therapy in high-risk breast cancer can reduce the locoregional recurrence rate and increase the survival time by combined chemotherapy. The significant prognostic factor for survival rate was the stage.

• Journal of Veterinary Clinics
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• v.30 no.5
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• pp.363-365
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• 2013

A 15-year-old, spayed female Maltese dog weighing 2.80 kg was referred with seizure of unknown origin. At presentation, serum biochemistry showed marked hypoglycemia (46 mg/dL; reference interval [RI], 65-118 mg/dL). There were, however, no abnormalities on electrolytes, complete blood counts, urinalysis, survey radiographs, and abdominal ultrasonography. In the adrenocorticotropic hormone (ACTH) stimulation test, pre-ACTH and post-ACTH cortisol concentrations were within normal reference ranges. Serum insulin level was normal and fructosamine level was slightly lower than reference ranges. The clinical signs, including seizure and collapse caused by hypoglycemia, were gradually resolved with oral administration of prednisolone (PDS) twice daily. Forty five weeks later, serum biochemistry revealed hypoglycemia with markedly increased insulin level. On abdominal ultrasonography, increased heterogenous echogenecity with hypoechoic lesion was found within pancreatic parenchyma. Based on these findings, the dog was presumptively diagnosed to insulinoma. Hypoglycemic seizure was resolved with higher dose of PDS (1 mg/kg, q12h). At 688 days after first presentation, the patient was still alive without recurrence of hypoglycemic seizure. This case describes long-term management with PDS monotherapy in a Maltese dog with insulinoma.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.10 no.1
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• pp.96-107
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• 2003

Objective: The purpose of this study was to identify the effects of tracheal suction and the effects of different methods of bronchodilator inhalation (Ultrasonic nebulizer: MDI puff, MDI puff with spacer) in VSD surgery patients. Material & Method: From June 2001 to March 2002, sixty consecutive patients were randomly assigned to a control group (n= 15), ultrasonic nebulizer group (n=15), metered dose inhalation (MDI) puff group (n=15) and MDI with spacer group (n=15). Vital signs (HR, BP, CVP), ABGA and pulmonary functions were measured before suction (baseline for suction), after suction, 15 minutes after suction (base of bronchodilator inhalation), 30 minutes after bronchodilator inhalation, and 2 hours after bronchodilator inhalation. Stastistical analysis was performed using SPSS software. Repeated measure ANOVA was used to examine the effects of tracheal suction. One way ANOVA with Bonferroni's correction and multiple range test (the least significant difference test) were used to examine the effects of albuterol inhalation. Result: 1. Heart .ate increased significantly immediately after suction (p<.01) and recovered 15 minutes after suction. 2. $PaO_2$ and PH decreased significantly immediately after suction (p<.05) and $PaO_2$ recovered 15 minutes after suction. $PaCO_2$ increased immediately after suction and significantly 15 minutes after suction (p<.01). But changes in vital signs and ABGA were within the normal range. 3. Tidal volume decreased significantly 15 minutes after suction (p<.05). 4. Changes of HR and tidal volume were greater in the nebuizer group compared to the other groups (p<.05) 30 minutes after bronchodilator inhalation and recovered 2 hours after bronchodilator inhalation. 5. Changes of airway deadspace was greater in the nebulizer group compared to the control group and MDI puff group 30 minutes after albuterol inhalation (p<.05) and at 2 hours (p<.01). Conclusion: Tracheal suction did not have significant effect on vital signs and pulmonary functions after OHS. Although the methods of bronchodilator inhalation did not showed any significant difference on pulmonary function, the nebulizer method increased $PaO_2$ (20%) and tidal volume transiently. If the patient needs bronchodilator inhalation with bronchospasm after OHS, the nebulizer method is the best choice. More study on the effects of bronchodilator inhalation in bronchospasm group is needed.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.4
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• pp.607-612
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• 2009

The malignant tumor in childhood is one of the main causes of children s death due to disease. The traditional treatment for the malignancy is known for the radiation therapy and the chemical therapy or both. However, the treatments tend to induce intraoral complications. Different from adults, almost all children on cancer therapy are expected to have dental complications, because their permanent teeth are on the developmental stage. The degree of dental complication depends on the patient's age, type of chemical and other factors-radiation dose and frequency. In this report, 3 children who had experienced the anti-cancer therapy on their age between 1 and 4 years were selected and dental complications were examined. The children have chance for the various oral complications including the developmental problems such as agenesis, microdontia and hypoplasia of the teeth. Therefore, it's important to understand the side-effects of anticancer therapy during the permanent teeth had been developmental stage in young patients. Also, oral health care specialists, including pediatric and hospital dentist can support the oncology team by providing basic oral care, implementing oral care protocols, delivering emergency dental treatment undergoing anticancer treatment.

• Journal of Radiation Protection and Research
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• v.36 no.1
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• pp.28-34
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• 2011

The measurement-based verification for intensity modulated radiation therapy (IMRT) is a time-and labor-consuming procedure. Instead, this study aims to develop a MU fluence reconstruction method for IMRT QA. Total actual fluences from treatment planning system (TPS, Eclipse 8.6, Varian) were selected as a reference. Delivered leaf positions according to MU were extracted by the dynalog file generated after IMRT delivery. An in-house software was develop to reconstruct MU fluence from the acquired delivered leaf position data using MATLAB. We investigated five patient's plans delivered by both step-and-shoot IMRT and sliding window technologies. The total actual fluence was compared with the MU fluence reconstructed by using commercial software (Verisoft 3.1, PTW) and gamma analysis method (criteria: 3%/3 mm and 2%/1 mm). Gamma pass rates were $97.8{\pm}1.33$% and the reconstructed fluence was shown good agreement with RTP-based actual fluence. The fluence from step and shoot IMRT was shown slightly higher agreement with the actual fluence than that from sliding window IMRT. If moving from IMRT QA measurements toward independent computer calculations, the developed method can be used for IMRT QA. A point dose calculation method from reconstructed fluences is under development for the routine IMRT QA purpose.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.1
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• pp.413-418
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• 2016

Objective: To assess the safety and effectiveness of a mouth-rinse with G-CSF (JiSaiXin, produced by NCPC Biotechnology Co., Ltd) in treating patients with chemotherapy-induced oral mucositis (CIM). Method: A consecutive cohort of patients with advanced cancers and CIM were treated with mouth-rinse G-CSF. All chemotherapy for patients with advanced cancers was adopted from regimens suggested by NCCN guidelines. The mouth-rinse with G-CSF at a dose of 150-300ug plus 100ml-500ml normal saline was started from the time of oral mucositis was confirmed and continuously used for at least 7 days as one course. After at least two courses of treatment, safety and efficacy were evaluated. Results: There were 7 female and 7 male patients with advanced cancer and CIM recruited into this study, including 5 with colorectal, 2 with lung, 1 patient with gastric, 1 with cervical and 1 with pancreatic cancer, as well as 2 patients with diffuse large B cell lymphomas, 1 with nasopharyngeal and 1 with gastric cancer. The median age was 57 (41-79) years. Grade 1 to 2 myelosuppression was observed in 3/14 patients, and Grade 4 myelosuppression in 1/14. Adverse effects on the gastrointestinal tract were documented in 5/14 patients, and were Grade 1 to Grade 3. No treatment related death was documented. Regarding CIM, the median response time to mouth rinse of G-CSF was 2 (1-5) days, and all patients with CIM demonstrated a positive response. Conclusions: Mouth-rinse with G-CSF proved to be safe and effective in treating patients with advanced cancers and CIM. However, further randomized controlled studies should be conducted to clarify the effectiveness of this treatment with other lesions.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.20
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• pp.8911-8916
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• 2014

Background: The aim of the present study was to determine the predictive/prognostic value of the secreted protein, acidic and rich in cysteine (SPARC) in cases of unresectable, locally advanced, non-small cell lung cancer. Materials and Methods: The study included 84 patients with Stage IIIA-B non-small cell lung cancer, undergoing simultaneous chemoradiotherapy including radiotherapy at a dose of 66 Gy and weekly docataxel ($20mg/m^2$) and cisplatin ($20mg/m^2$). SPARC expression was studied in biopsy material by immunohistochemical methods and correlations with treatment responses or survival were evaluated. Results: Median overall survival was $16{\pm}2.73$ (11.55-20.46) months for low expression vs $7{\pm}1.79$ months (7.92-16.08) months for high expression (p=0.039), while median local control was $13{\pm}2.31$ (8.48-17.5) months for low expression vs $6{\pm}0.85$ (4.34-7.66) months for high expression (p=0.045) and median progression-free survival was $10{\pm}2.31$ (5.48-14.5) months for low expression vs $6{\pm}1.10$ (3.85-8.15) months for high expression (p=0.022). In both univariate and multivariate analyses, high SPARC expression was associated with significantly shorter overall survival (p=0.003, p=0.007, respectively), local control (p=0.008, p=0.036) and progression-free survival (p=0.004, p=0.029) when compared to low SPARC expression. No significant difference was detected between high and low SPARC expression groups regarding age, sex, T stage, N stage, histopathology and stage-related patient characteristics. Conclusions: High SPARC expression was identified as a poor prognostic factor in cases with locally advanced NSCLC treated with concurrent chemoradiotherapy.