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Effects of Preoperative Radiotherapy for $T_2,\;T_3$ Distal Rectal Cancer ($T_2,\;T_3$ 하부직장암의 수술 전 방사선치료 효과)

  • Kang Ki Mun;Choi Byung Ock;Jang Hong Seok;Kang Young Nam;Chai Gyu Young;Choi Ihl Bohng
    • Radiation Oncology Journal
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    • v.20 no.3
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    • pp.215-220
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    • 2002
  • Purpose : Preoperative radiotherapy has been used to induce tumor regression and allow complete resection of rectal cancer with a sphincter preservation surgery. This study was performed to determine the effectiveness of preoperative radiotherapy for $T_2,\;T_3$ distal rectal carcinoma. Materials and Methods : From November 1995 to June 1997, fifteen patients with invasive distal rectal cancer were treated with preoperative radiotherapy followed by sphincter preservation surgery. Classification by preoperative T stage consisted of 7 $T_2$ and 8 $T_3$ tumors. Radiation therapy was delivered with 6 MV and 15 MV linear accelerator, at 1.8 Gy fractions for 5 days per week. Total radiation doses were 45 Gy to 50.4 Gy (median : 50.4 Gy). Sphincter preservation surgery was peformed $4\~6$ weeks after the completion of radiotherapy. Median follow-up was 22 months (range : $16\~37\;months$). Results : One patient $(6.7\%)$ had a complete pathologic response. Comparing the stage at the diagnostic workup with the pathologic stage, tumor downstaging of T stages occurred in 11 of 15 patients $(73.3\%)$ and $N_1$ stages occurred in 2 of 5 patients $(40\%)$. No patient developed progressive disease undergoing treatment. Two patients suffered local recurrence at 7 and 20 months, and one a distant metastasis at 30 months. No grade 3 or 4 toxicity was observed. Conclusion : Our experience suggests that preoperative radiotherapy followed by sphincter preservation surgery is well tolerated, and can significantly reduce the tumor burden for $T_2\;T_3$ distal rectal cancer.

Nanomechanical Properties of Lithiated Silicon Nanowires Probed with Atomic Force Microscopy (원자힘 현미경으로 측정된 리튬화 실리콘 나노선의 나노기계적 성질)

  • Lee, Hyun-Soo;Shin, Weon-Ho;Kwon, Sang-Ku;Choi, Jang-Wook;Park, Jeong-Young
    • Journal of the Korean Vacuum Society
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    • v.20 no.6
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    • pp.395-402
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    • 2011
  • The nanomechanical properties of fully lithiated and unlithiated silicon nanowire deposited on silicon substrate have been studied with atomic force microscopy. Silicon nanowires were synthesized using the vapor-liquid-solid process on stainless steel substrates using Au catalyst. Fully lithiated silicon nanowires were obtained by using the electrochemical method, followed by drop-casting on the silicon substrate. The roughness, derived from a line profile of the surface measured in contact mode atomic force microscopy, has a smaller value ($0.65{\pm}0.05$ nm) for lithiated silicon nanowire and a higher value ($1.72{\pm}0.16$ nm) for unlithiated silicon nanowire. Force spectroscopy was utilitzed to study the influence of lithiation on the tip-surface adhesion force. Lithiated silicon nanowire revealed a smaller value (~15 nN) than that of the Si nanowire substrate (~60 nN) by a factor of two, while the adhesion force of the silicon nanowire is similar to that of the silicon substrate. The elastic local spring constants obtained from the force-distance curve, also shows that the unlithiated silicon nanowire has a relatively smaller value (16.98 N/m) than lithiated silicon nanowire (66.30 N/m) due to the elastically soft amorphous structures. The frictional forces of lithiated and unlithiated silicon nanowire were obtained within the range of 0.5-4.0 Hz and 0.01-200 nN for velocity and load dependency, respectively. We explain the trend of adhesion and modulus in light of the materials properties of silicon and lithiated silicon. The results suggest a useful method for chemical identification of the lithiated region during the charging and discharging process.

Growth Temperature Effects of In0.4Al0.6As Buffer Layer on the Luminescence Properties of InGaAs/InAlAs Quantum Well Structures (InGaAs/InAlAs 양자우물구조의 발광특성에 대한 In0.4Al0.6As 버퍼층 성장온도의 영향)

  • Kim, Hee-Yeon;Ryu, Mee-Yi;Lim, J.Y.;Shin, S.H.;Kim, S.Y.;Song, J.D.
    • Journal of the Korean Vacuum Society
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    • v.20 no.6
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    • pp.449-455
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    • 2011
  • The luminescence properties of $In_{0.5}Ga_{0.5}As/In_{0.5}Al_{0.5}As$ multiple quantum wells (MQWs) grown on $In_{0.4}Al_{0.6}As$ buffer layer have been investigated by using photoluminescence (PL) and time-resolved PL measurements. A 1-${\mu}m$-thick $In_{0.4}Al_{0.6}As$ buffer layers were deposited at various temperatures from $320^{\circ}C$ to $580^{\circ}C$ on a 500-nm-thick GaAs layer, and then 1-${\mu}m$-thick $In_{0.5}Al_{0.5}As$ layers were deposited at $480^{\circ}C$, followed by the deposition of the InGaAs/InAlAs MQWs. In order to study the effects of $In_{0.4}Al_{0.6}As$ layer on the optical properties of the MQWs, four different temperature sequences are used for the growth of $In_{0.4}Al_{0.6}As$ buffer layer. The MQWs consist of three $In_{0.5}Al_{0.5}As$ wells with different well thicknesses (2.5-nm, 4.0-nm, and 6.0-nm-thick) and 10-nm-thick $In_{0.5}Al_{0.5}As$ barriers. The PL peaks from 4-nm QW and 6-nm QW were observed. However, for the MQWs on the $In_{0.4}Al_{0.6}As$ layer grown by using the largest growth temperature variation (320-$580^{\circ}C$), the PL spectrum only showed a PL peak from 6-nm QW. The carrier decay times in the 4-nm QW and 6-nm QW were measured from the emission wavelength dependence of PL decay. These results indicated that the growth temperatures of $In_{0.4}Al_{0.6}As$ layer affect the optical properties of the MQWs.

Parameter Estimation of Water Balance Analysis Method and Recharge Calculation Using Groundwater Levels (지하수위를 이용한 물수지분석법의 매개변수추정과 함양량산정)

  • An, Jung-Gi;Choi, Mu-Woong
    • Journal of Korea Water Resources Association
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    • v.39 no.4 s.165
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    • pp.299-311
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    • 2006
  • In this paper it is outlined the methodology of estimating the parameters of water balance analysis method for calculating recharge, using ground water level rises in monitoring well when values of specific yield of aquifer are not available. This methodology is applied for two monitoring wells of the case study area in northern area of the Jeiu Island. A water balance of soil layer of plant rooting zone is computed on a daily basis in the following manner. Diect runoff is estimated by using SCS method. Potential evapotranspiration calculated with Penman-Monteith equation is multiplied by crop coefficients($K_c$) and water stress coefficient to compute actual evapotranspiration(AET). Daily runoff and AET is subtracted from the rainfall plus the soil water storage of the previous day. Soil water remaining above soil water retention capacity(SWRC) is assumed to be recharge. Parameters such as the SCS curve number, SWRC and Kc are estimated from a linear relationship between water level rise and recharge for rainfall events. The upper threshold value of specific yield($n_m$) at the monitoring well location is derived from the relationship between rainfall and the resulting water level rise. The specific yield($n_c$) and the coefficient of determination ($R^2$) are calculated from a linear relationship between observed water level rise and calculated recharge for the different simulations. A set of parameter values with maximum value of $R^2$ is selected among parameter values with calculated specific yield($n_c$) less than the upper threshold value of specific yield($n_m$). Results applied for two monitoring wells show that the 81% of variance of the observed water level rises are explained by calculated recharge with the estimated parameters. It is shown that the data of groundwater level is useful in estimating the parameter of water balance analysis method for calculating recharge.

A Comparative Study on Hydraulic Jump and Specific Energy Losses at Downstream According to the Weir Discharge Types (보 유출형태에 따른 하류부 도수 및 비에너지 손실에 관한 비교 연구)

  • Park, Hyo-Seon;Yoon, Geun-Ho;Koo, Bon-Jin;Choi, Gye-Woon
    • Journal of Wetlands Research
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    • v.15 no.1
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    • pp.149-157
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    • 2013
  • The weirs built so far are mainly overflow type weirs overflowing to the upstream. Main advantages of overflow type weirs are, effective water resources management and easy design, construction and maintenance due to many accumulated studies. However, due to the special feature of the overflow type weir where water overflows through the upstream of the weir, the silt coming from the upstream is not discharged to the downstream of the weir. This increases the river bed and reduces the reservoir capacity, and as a result, the weir loses its function. A underflow type weir with a water gate has been implemented in order to solve such sediment deposit and weir maintenance problems. However due to the design problem of recently constructed underflow type weirs, the river bed of the downstream of a weir has been scoured. And this leds to a structural problem. In this study, the flow characteristics of overflow type weirs and underflow type weir, hydraulic jump length analysis depending on change of water depth and the amount of specific energy loss generated per unit length depending on a weir type have been compared and analyzed, for the effective design and management of the weirs. The experiment results show that, when identical upstream conditions of underflow type weir and an overflow type weir were maintained, the hydraulic jump length was up to twice longer with Fr(Froude number) 3.5 of the hydraulic jump length at the underflow type weir, and the hydraulic jump length gradually decreased as the downstream water depth increased. The comparative analysis result of the amount of specific energy loss generated per unit length showed that the amount of energy loss per unit length was twice higher for an overlfow type weir than a underflow type weir. Therefore, in case of a underflow type facility, an additional energy reduction facility is determined to be necessary for safety of water construction structures.

Radiation Dose of Lens and Thyroid in Linac-based Radiosurgery in Humanoid Phantom (선형가속기형 방사선수술시 인형 팬텀에서 수정체 및 갑상선 선량)

  • Kim, Dae-Yong;Kim, Il-Han
    • Radiation Oncology Journal
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    • v.16 no.4
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    • pp.517-529
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    • 1998
  • Purpose : Although many studies have investigated the dosimetric aspects of stereotactic radiosurgery in terms of target volume, the absorbed doses at extracranial sites: especially the lens or thyroid - which are sensitive to radiation for deterministic or stochastic effect -have infrequently been reported. The aim of this study is to evaluate what effects the parameters of radiosurgery have on the absorbed doses of the lens and thyroid in patients treated by stereotactic radiosurgery, using a systematic plan in a humanoid phantom. Materials and Methods : Six isocenters were selected and radiosurgery was planned using the stereotactic radiosurgery system which the Department of Therapeutic Radiology at Seoul National University College of Medicine developed. The experimental radiosurgery plan consisted of 6 arc planes per one isocenter, 100 degrees for each arc range and an accessory collimator diameter size of 2 cm. After 250 cGy of irradiation from each arc, the doses absorbed at the lens and thyroid were measured by thermoluminescence dosimetry. Results : The lens dose was 0.23$\pm$0.08$\%$ of the maximum dose for each isocenter when the exit beam did not pass through the lens and was 0.76$\pm$0.12$\%$ of the maximum dose for each isocenter when the exit beam passed through the lens. The thyroid dose was 0.18$\pm$0.05$\%$ of the maximum dose for each isocenter when the exit beam did not pass through the thyroid and was 0.41$\pm$0.04$\%$ of the maximum dose for each isocenter when the exit beam Passed through the thyroid. The passing of the exit beam is the most significant factor of organ dose and the absorbed dose by an arc crossing organ decides 80$\%$ of the total dose. The absorbed doses of the lens and thyroid were larger as the isocenter sites and arc planes were closer to each organ. There were no differences in the doses at the surface and 5 mm depth from the surface in the eyelid and thyroid areas. Conclusion : As the isocenter and arc plane were placed closer to the lens and thyroid, the doses increased. Whether the exit beams passed through the lens or thyroid greatly influenced the lens and thyroid dose. The surface dose of the lens and thyroid consistently represent the tissue dose. Even when the exit beam passes through the lens and thyroid, the doses are less than 1$\%$ of the maximum dose and therefore, are too low to evoke late complications, but nevertheless, we should try to minimize the thyroid dose in children, whenever possible.

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Efficacy of Small Bowel Displacement System in Post-Operative Pelvic Radiation Therapy of Rectal Cancer (소장 용적 측정을 통한 직장암의 수술 후 방사선치료 시 사용하는 소장 전위 장치(Small Bowel Displacement System : SBDS) 의 효용성 검토)

  • Ahn Yong Chan;Lim Do Hoon;Kim Moon Kyung;Wu Hong Gyun;Kim Dae Yong;Huh Seung Jae
    • Radiation Oncology Journal
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    • v.16 no.1
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    • pp.63-69
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    • 1998
  • Purpose : This study is to evaluate the efficacy of small bowel displacement system(SBDS) in post-operative pelvic radiation therapy(RT) of rectal cancer patients by measurement of small bowel volume included in the radiation fields receiving therapeutic dose. Materials and Method : Ten consecutive new rectal cancer patients referred to the department of Radiation Oncology of Samsung Medical Center in May of 1997 were included in this study. All patients were asked to drink $Castrographin^(R)$ before simulation and were laid prone for conventional simulation and CT scans with and without SBDS. The volume of opacified small bowel on CT scans, which was to be included in the radiation fields receiving therapeutic dose, was measured using Picture archiving and communication system (PACS). Results : The average small bowel volumes with and without SBDS were 176.0ml(5.2-415.6ml) and 185.1ml(54.5-434.2ml), respectively The changes of small bowel volume with SBDS compared to those without SBDS were more than $10\%$ decrease in three, less than 10% decrease in two, less than $10\%$ increase in three, and more than $10\%$ increase in two patients. Conclusion : No significant advantage of using SBDS in post-operative pelvic RT for rectal cancer patients has been shown by small bowel volume measurement using CT scan considering additional effort and time needed for simulation and treatment setup.

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A Study of a Non-commercial 3D Planning System, Plunc for Clinical Applicability (비 상업용 3차원 치료계획시스템인 Plunc의 임상적용 가능성에 대한 연구)

  • Cho, Byung-Chul;Oh, Do-Hoon;Bae, Hoon-Sik
    • Radiation Oncology Journal
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    • v.16 no.1
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    • pp.71-79
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    • 1998
  • Purpose : The objective of this study is to introduce our installation of a non-commercial 3D Planning system, Plunc and confirm it's clinical applicability in various treatment situations. Materials and Methods : We obtained source codes of Plunc, offered by University of North Carolina and installed them on a Pentium Pro 200MHz (128MB RAM, Millenium VGA) with Linux operating system. To examine accuracy of dose distributions calculated by Plunc, we input beam data of 6MV Photon of our linear accelerator(Siemens MXE 6740) including tissue-maximum ratio, scatter-maximum ratio, attenuation coefficients and shapes of wedge filters. After then, we compared values of dose distributions(Percent depth dose; PDD, dose profiles with and without wedge filters, oblique incident beam, and dose distributions under air-gap) calculated by Plunc with measured values. Results : Plunc operated in almost real time except spending about 10 seconds in full volume dose distribution and dose-volume histogram(DVH) on the PC described above. As compared with measurements for irradiations of 90-cm 550 and 10-cm depth isocenter, the PDD curves calculated by Plunc did not exceed $1\%$ of inaccuracies except buildup region. For dose profiles with and without wedge filter, the calculated ones are accurate within $2\%$ except low-dose region outside irradiations where Plunc showed $5\%$ of dose reduction. For the oblique incident beam, it showed a good agreement except low dose region below $30\%$ of isocenter dose. In the case of dose distribution under air-gap, there was $5\%$ errors of the central-axis dose. Conclusion : By comparing photon dose calculations using the Plunc with measurements, we confirmed that Plunc showed acceptable accuracies about $2-5\%$ in typical treatment situations which was comparable to commercial planning systems using correction-based a1gorithms. Plunc does not have a function for electron beam planning up to the present. However, it is possible to implement electron dose calculation modules or more accurate photon dose calculation into the Plunc system. Plunc is shown to be useful to clear many limitations of 2D planning systems in clinics where a commercial 3D planning system is not available.

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Post-operative Radiation Therapy for Esophageal Cancer; Analysis of Failure Pattern (식도암의 수술 후 방사선 치료: 실패 양상 분석)

  • Kim Mi Sook;Kim Jae Young;Yoo Seoung Yul;Zo Chul Goo;Yoo Hyung Jun;Zo Jae Ill;Baek Hee Jong;Park Jong Ho;Choi Soo Yong
    • Radiation Oncology Journal
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    • v.16 no.4
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    • pp.447-454
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    • 1998
  • Purpose : This study evaluated the survival, local control, prognostic factor, and failure pattern of patients with esophageal cancer treated with operation and adjuvant radiation therapy to use as fundermental data of postoperative radiation therapy. Materials and Methods : A retrospective analysis was undertaken of 82 patients who had locally advanced esophageal cancer treated with operation and adjuvant radiation therapy from January 1988 to December 1995. According to AJCC staging, stage IIA were in 26 patients, stage IIB in 4 patients, and stage III in 52 patients. Squamous cell carcinoma were in 77 patients, adenosquamous carcinoma in 3 patients, and adenocarcinoma in 2 patients. The patients received radiation therapy ranging from 41.0 Gy to 64.8 Gy. Five patients received neoadjuvant chemotherapy. Results : Two-year survival and local control rates for all patients were 36.8$\%$ and 30.4$\%$ respectively. And they were 9.3$\%$ and 26.3$\%$ respectively at 5 years. According to stages, 2-year survival rates were 50.2$\%$ in IIA, 0$\%$ in IIB and 23.3$\%$ in III (p=0.004). Two-year local control rates were 49.2 $\%$ in IIA, 66.6$\%$ in IIB and 24.7$\%$ in III (p=0.01). Sixty patients developed recurrence, which were 3 tumor margin, 23 lymph node recurrence, 4 tumor margin and lymph node, 1 tumor margin and distant metastasis, 9 lymph node and distant metastasis, 17 distant metastasis and 3 unknown metastatic site. Prognostic factors affecting survival were smoking (p=0.02), T-staging (p=0.0092), N-staging (p=0.0045). Prognostic factors affecting local control were T-staging (p=0.019), N-staging (p=0.047). Conclusion : In spite of post-operative radiation therapy, predominant failure pattern was local failure. Especially regional lymph node failure was major cause of local failure. So strategy of aggresive adjuvant radiation therapy to regional lymph node area in post operative treatment should be proposed.

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Feasibility of Reflecting Improvement of Tumor Hypoxia by Mild Hyperthermia in Experimental Mouse Tumors with $^18F-Fluoromisonidazole$ (저온온열치료에 의한 종양 내 저산소상태 개선효과를 $^18F$-Fluoromisonidazole의 섭취 변화를 이용한 평가)

  • Lee Sang-wook;Ryu Jin Sook;Oh Seung Joon;Im Ki Chun;Chen Gi Jeong;Lee So Ryung;Song Do Young;Im Soo Jeong;Moon Eun Sook;Kim Jong Hoon;Ahn Seung Do;Shin Seong Soo;Lee Kyeong Ryong
    • Radiation Oncology Journal
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    • v.22 no.4
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    • pp.288-297
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    • 2004
  • Puporse: The aims of this study were to evaluate the change of $[^18F]fluoromisonidazole$($[^18F]FMISO$) uptake in C3H mouse squamous cell carcinoma-VII (SCC-VII) treated with mild hyperthermia ($42^{circ}C$) and nicotinamide and to assess the biodistribution of the markers in normal tissues under similar conditions. Methods and Materials: $[^18F]FMISO$ was producedby our hospital. Female C3H mice with a C3H SCC-VII tumor grown on their extremities were used. Tumors were size matched. Non-anaesthetized, tumor-bearing mice underwent control or mild hyperthermia at $42^{circ}C$ for 60 min with nicotinamide (50 mg/kg i.p. injected) and were examined by gamma counter, autoradiography and animal PET scan 3 hours after tracer i.v. injected with breathing room air, The biodistribution of these agents were obtained at 3 h after $[^18F]FMISO$ injection. Blood, tumor, muscle, heart, lung, liver, kidney, brain, bone, spleen, and intestine were removed, counted for radioactivity and weighed. The tumor and liver were frozen and cut with a cryomicrotome into 10- um sections. The spatial distribution of radioactivity from the tissue sections was determined with digital autoradiography. Results: The mild hyperthermia with nicotinamide treatment had only slight effects on the biodistribution of either marker in normal tissues. We observed that the whole tumor radioactivity uptake ratios were higher in the control mice than in the mild hyperthermia with nicotinamide treated mice for $[^18F]FMISO$ ($1.56{\pm}1.03$ vs. $0.67{\pm}0.30$; p=0.063). In addition, autoradiography and animal PET scan demonstrated that the area and intensity of $[^18F]FMISO$ uptake was significantly decreased. Conclusion: Mild hyperthermla and nicotinamide significantly improved tumor hypoxia using $[^18F]FMISO$ and this uptake reflected tumor hypoxic status.