• Proceedings of the Korean Society of Medical Physics Conference
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• 2002.09a
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• pp.241-243
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• 2002

New types of protocols have been recently in development, all based on an absorbed dose-to-water with the aim of improving the accuracy of measurements of absorbed dose to water. IAEA TRS-277, the air-kerma standard-based present protocol, and IAEA TRS-398 and AAPM TG-51, the absorbed dose-to-water standard-based new one, were studied and compared theoretically and experimentally for photon beams of 6, 10, and 15 MV. NE 2571 and 3 Farmer types of ionization chambers in widely commercial use were used to determine an absorbed dose to water at the reference depth in water. Two different kinds of calibration factors were given respectively for every chamber calibrated in $\^$60/CO gamma ray beams from a Korean Secondary Standard Dosimetry Laboratory (KFDA). This work shows that there is around 1 % of difference of absorbed doses measured between two different types of calibration systems owing to different physical parameters and reference conditions used. We hope this work to help form the basis on development of new type of protocol in Korea.

• Journal of Sasang Constitutional Medicine
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• v.23 no.1
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• pp.132-138
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• 2011

1. Objectives: This case study reports a Taeumin patient with Gastro-esophageal reflux disease who had suffered from chest pain, heartburn, acid regurgitation and dyspepsia who improved after Yeoldahanso-tang(Reduohanshao-tang) medication. 2. Methods: This patient had started treatment with Yeoldahanso-tang(Reduohanshao-tang), three times per day for three months and assessed the changes of the main symptoms such as chest pain, heartburn and acid regurgitation from baseline to post-treatment using a questionnaire with visual analogue scale(VAS). Electrogastrography(EGG) was also performed for assessment of gastric function from baseline to post-treatment. 3. Results: After the treatment, symptoms of GERD such as chest pain, heartburn, and acid regurgitation are almost disappeared. The patient don't need to take the proton pump inhibitor therapy. There was significant increase of % bradygastria parameters in fed EEG after treatment with Yeoldahansotang(Reduohanshao-tang). And significant increase of the power ratio after treatment was shown (20.5), compared with initial EGG(0.0). 4. Conclusions: This results show Yeoldahanso-tang(Reduohanshao-tang) can be used to treat GERD with Dry-heat symptom of Taeumin. This results suggest that Sasang Constitutional treatment for GERD patients who has a chronic condition with highly recurrence rate, might be a candidate for a therapeutic agent. Also effects of Yeoldahanso-tang(Reduohanshaotang) on GERD need further studies such as clinical trials.

• Journal of the Korean Magnetics Society
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• v.24 no.6
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• pp.191-196
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• 2014

The purpose of this study is to evaluate the reproducibility and usefulness of an image through the fusion of the computed tomography image and the magnetic resonance image by using a self-produced phantom when planning the treatment, and also to compare and analyze the target dose on the acquired image. The size of small hole and the reproducibility of capacity existed in the phantom on the image of the phantom obtained by the computed tomography and the magnetic resonance image of the phantom scanning with different intensity of magnetic field are compared, and the change of dose in the random target is compared and analyzed.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.5
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• pp.470-476
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• 2006

Low-dose rate brachytherapy(LDR) has been effective modality for treatment of oral cancer. But the disadvantage of LDR is radioexposure of medical staff. To overcome this problem, high dose rate(HDR) brachytherapy has been developed. Our study evaluates the outcomes of patients with tongue cancer as treated by HDR brachytherapy. Between 2002 and 2005, eight patients with carcinoma of the tongue were treated with HDR brachytherapy. Five patients had AJCC stage I or II disease and the remaining three patients had AJCC stage III or IV. The male-to-female ratio was 2:6 and the mean age was 60.1 years (range: 21-80 years).The median follow-up time was 23.8 months (range: 7-55 months). There was no local failure until now. Three patients showed some complications. Two patients showed soft tissue necrosis. There was no bone sequela in all cases. Our experience in treating tongue cancer with HDR brachytherapy is encouraging, because it gave a satisfactory local control. Prospective studies are necessary to delineate the optimum indication for this treatment modality and long-term outcome.

• Radiation Oncology Journal
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• v.34 no.2
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• pp.106-112
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• 2016

Purpose: To identify possible predictors of pathologic complete response (pCR) of rectal cancer after preoperative concurrent chemoradiotherapy (CCRT). Materials and Methods: We conducted a retrospective review of 53 patients with rectal cancer who underwent preoperative CCRT followed by radical surgery at a single center between January 2007 and December 2012. The median radiotherapy dose to the pelvis was 54.0 Gy (range, 45.0 to 63.0 Gy). Five-fluorouracil-based chemotherapy was administered via continuous infusion with leucovorin. Results: The pCR rate was 20.8%. The downstaging rate was 66%. In univariate analyses, poor and undifferentiated tumors (p = 0.020) and an interval of ${\geq}7$ weeks from finishing CCRT to surgery (p = 0.040) were significantly associated with pCR, while female gender (p = 0.070), initial carcinoembryonic antigen concentration of <5.0 ng/dL (p = 0.100), and clinical stage T2 (p = 0.100) were marginally significant factors. In multivariate analysis, an interval of ${\geq}7$ weeks from finishing CCRT to surgery (odds ratio, 0.139; 95% confidence interval, 0.022 to 0.877; p = 0.036) was significantly associated with pCR, while stage T2 (odds ratio, 5.363; 95% confidence interval, 0.963 to 29.877; p = 0.055) was a marginally significant risk factor. Conclusion: We suggest that the interval from finishing CCRT to surgery is a predictor of pCR after preoperative CCRT in patients with rectal cancer. Stage T2 cancer may also be an important predictive factor. We hope to perform a robust study by collecting data during treatment to obtain more advanced results.

• Journal of Digestive Cancer Research
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• v.4 no.1
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• pp.1-9
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• 2016

The abundance of multi-drug resistance ATPase binding cassette and deranged self-renewal pathways shown in cancer stem cells (CSCs) played a crucial role in tumorigenesis, tumor resistance, tumor recurrence, and tumor metastasis. Therefore, elucidation of CSCs biology can improve diagnosis, enable targeted treatment, and guide the follow up of GI cancer patients. In order to achieve chemoquiescence, seizing cancer through complete ablation of CSCs, CSCs are rational targets for the design of interventions that will enhance responsiveness to traditional therapeutic strategies and contribute in the prevention of local recurrence as well as metastasis. However, current cancer treatment strategies fail to either detect or differentiate the CSCs from their non-tumorigenic progenies mostly due to the absence of specific biomarkers and potent agents to kill CSCs. Recent advances in knowledge of CSCs enable to produce several candidates to ablate CSCs in gastrointestinal (GI) cancers, especially cancers originated from inflammation-driven mutagenesis such as Barrett's esophagus (BE), Helicobacter pylori-associated gastric cancer, and colitis-associated cancer (CAC). Our research teams elucidated through revisiting old drugs that proton pump inhibitor (PPI) and potassium competitive acid blocker (p-CAB) beyond authentic acid suppression, chloroquine for autophage inhibition, sonic hedgehog (SHH) inhibitors, and Wnt/β-catenin/NOTCH inhibitor can ablate CSCs specifically and efficiently. Furthermore, nanoformulations of these molecules could provide an additional advantage for more selective targeting of the pathways existing in CSCs just like current molecular targeted therapeutics and sustained action, while normal stem cells intact. In this review article, the novel approach specifically to ablate CSCs existing in GI cancers will be introduced with the introduction of explored mode of action.

• Radiation Oncology Journal
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• v.33 no.3
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• pp.188-197
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• 2015

Purpose: To investigate the patterns of care for patients with nasopharyngeal carcinoma (NPC) in South Korea. Materials and Methods: A multi-institutional retrospective study was performed (Korean Radiation Oncology Group [KROG] 11-06) on a total of 1,445 patients from 15 institutions. Results: Of the 1,445 patients, more than half were stages III (39.9%) and IV (35.8%). In addition to patterns of care, we also investigated trends over time with the periods 1988-1993, 1994-2002, and 2003-2011. The frequencies of magnetic resonance imaging and positron emission tomography-computed tomography were markedly increased in the third period compared to previous 2 periods. Concurrent chemoradiation (CCRT) was performed on 894 patients (61.9%), neoadjuvant chemotherapy on 468 patients (32.4%), and adjuvant chemotherapy on 366 patients (25.3%). Of stage II-IV patients, CCRT performed on 78.8% in 2003-2011 compared to 15.0% in 1988-1993. For patients treated with CCRT, cisplatin was the most commonly used agent in 81.3% of patients. Over the periods of time, commonly used radiotherapy (RT) techniques were changed from 2-dimensional RT (1988-1993, 92.5%) to 3-dimensional RT (2003-2011, 35.5%) or intensity-modulated RT (IMRT; 2003-2011, 56.5%). Median RT doses given to primary tumors, high-risk lymphatics, and low-risk lymphatics were 70.0 Gy, 58.1 Gy, and 48.0 Gy, respectively. Adoption of IMRT increased the dose per fraction and escalated total radiation dose. Conclusion: Assessment of the patterns of care for NPC patients in South Korea demonstrated that management for NPC including diagnostic imaging, treatment regimen, RT techniques and dose schedule, advanced in accordance with the international guidelines.

• Radiation Oncology Journal
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• v.25 no.4
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• pp.249-260
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• 2007

Purpose: In order to enhance the quality of IMRT as employed in Korea, we developed a remote monitoring system. The feasibility of the system was evaluated by conducting a pilot study. Materials and Methods: The remote monitoring system consisted of a head and neck phantom and a user manual. The phantom contains a target and three OARs (organs at risk) that can be detected on CT images. TLD capsules were inserted at the center of the target and at the OARs. Two film slits for GafchromicEBT film were located on the axial and saggital planes. The user manual contained an IMRT planning guide and instructions for IMRT planning and the delivery process. After the manual and phantom were sent to four institutions, IMRT was planed and delivered. Predicted doses were compared with measured doses. Dose distribution along the two straight lines that intersected at the center of the axial film was measured and compared with the profiles predicted by the plan. Results: The measurements at the target agreed with the predicted dose within a 3% deviation. Doses at the OARs that represented the thyroid glands showed larger deviations (minimum 3.3% and maximum 19.8%). The deviation at OARs that represented the spiral cord was $0.7{\sim}1.4%$. The percentage of dose distributions that showed more than a 5% of deviation on the lines was $7{\sim}27%$ and $7{\sim}14%$ along the horizontal and vertical lines, respectively. Conculsion: Remote monitoring of IMRT using the developed system was feasible. With remote monitoring, the deviation at the target is expected to be small while the deviation at the OARs can be very large. Therefore, a method that is able to investigate the cause of a large deviation needs to be developed. In addition, a more clinically relevant measure for the two-dimensional dose comparison and pass/fail criteria need to be further developed.

• Progress in Medical Physics
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• v.28 no.4
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• pp.226-231
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• 2017

The aim is to investigate the spectra responsibilities of QD (Quantum Dot) for the innovation of new dosimetry application for therapeutic Megavoltage X-ray range. The unique electrical and optical properties of QD are expected to make it a good sensing material for dosimeter. This study shows the spectra responsibility of toluene based ZnCd QD and PPO (2.5-diphenyloxazol) mixed liquid scintillator. The QDs of 4 sizes corresponding to an emission wavelength (ZnCdSe/ZnS:$440{\pm}5nm$, ZnCdSeS:470, 500, $570{\pm}5nm$) were utilized. A liquid scintillator for control sample was made of toluene, PPO. The Composition of QD loaded scintillators are about 99 wt% Toluene as solvent, 1 wt% of PPO as primary scintillator and 0.05, 0.1, 0.2 and 0.4 wt% of QDs as solute. For the spectra responsibility of QD scintillation, they were irradiated for 30 second with 6 MV beam from a LINAC ($Infinity^{TM}$, Elekta). With the guidance of 1.0 mm core diameter optical fiber, scintillation spectrums were measured by a compact CCD spectrometer which could measure 200~1,000 nm wavelength range (CCS200, Thorlabs). We measured the spectra responsibilities of QD loaded organic liquid scintillators in two scintillation mechanisms. First was the direct transfer and second was using wave shifter. The emission peaks from the direct transfer were measured to be much smaller luminescent intensity than based on the wavelength shift from the PPO to QDs. The emission peak was shifted from PPO emission wavelength 380 nm to each emission wavelength of loaded QD. In both mechanisms, 500 nm QD loaded samples were observed to radiate in the highest luminescence intensity. We observed the spectra responsibility of QD doped toluene based liquid scintillator in order to innovate QD dosimetry applicator. The liquid scintillator loading 0.2 wt% of 500 nm emission wavelength QD has most superior responsibility at 6 MV photon beam. In this study we observed the spectra responsibilities for therapeutic X-ray range. It would be the first step of innovating new radiation dosimetric methods for radiation treatment.

• Journal of radiological science and technology
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• v.29 no.2
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• pp.83-92
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• 2006

Based on the data of cervical cancer patients who were treated by the radiotherapy with concurrent chemotherapy at the radiation oncology department of National Cancer Center from January 2002 to February 2003, we have studied the method recommended by ICRU 38 to maximize the prescription dose to the planing target volume (PTV) with minimizing the dose to surrounding normal organs. Clinical stage of the patients are 1 patient for stage IB, 3 patients for IIA, 19 patients for IIB, 3 patients for IIIA, 3 patients for IIIB and 1 patient for IV. All patients took the MRI before treatment and the maximum size of the gross tumor volume were under 4cm for 17 patients and from 4 cm to 6 cm for 12 patients and above 6 cm for 1 patient. The results show that while the irradiated volume can be reduced with optimized dose distribution using PTV treatment planning (p<0.0001) when the remained tumor size is small, the surrounding normal organs will receive unnecessarily large dose when the irradiated tumor volume is relatively large. This is because there is some limitation in controling the intensity of radiation in Fletcher Williamson Applicator. To overcome the limit of applicator and to achieve the optimal dose distribution, we have virtually applied 4 needles with Fletcher Williamson Applicator for 10 patients who have relatively large tumor and studied the change in dose distribution before and after application. The results show that this new virtual treatment plan reduces the volume covered by 100 % isodose (p=0.0608, p=0.0607) and reduces the dose of normal organs (p=0.0162, p=0.008). This evidence suggest that this method is superior than the currently used method such as PTV treatment and ICRU treatment.