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Result of Radiation Therapy of Cerebellar Medulloblastoma - with Emphasis on the Neuraxis Dose - (전중추신경계 조사선량을 중심으로 한 수아세포종의 방사선치료성적)

  • Kim Joo Young;Kim Il Han;Ha Sung Whan;Park Charn Il
    • Radiation Oncology Journal
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    • v.11 no.1
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    • pp.69-77
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    • 1993
  • Treatment of cerebellar medulloblastoma has been much improved with modern surgical technique for gross total tumor removal and adequate radiation therapy for the whole craniospinal axis. Questions have been arosen about the optimal radiation dose for the preventive treatment of whole cranium and whole spinal axis. Recently, many authors have reported their treatment results as comparable to older data, using lower than conventional dose of 3,600 cGy-4,000 cGy. For 50 patients treated between 1981 and 1990 at the Department of Radiation Therapy of SNUH, retrospective analysis was done for the treatment result, especially the neuraxis control, by radiation dose for the presymptomatic area of the disease. Analysis only by total spinal dose did not give any significant difference. But further analysis by following patient group; 3,600 cGy/150 cGy (n=6), 3,000 cGy/150 cGy (n=10), 2,400 cGy/150 cGy (n=17) and 2,400 cGy/100-120 cGy (n=11) showed significant improvement of neuraxis control by decreasing order (p =0.003). There was no significant difference in overall survival between the groups. For the 19 patients who had been confirmed initially as having no neuraxis disease, TDF 30 was the cur-off value that could prevent neuraxis failure (p =0.004). We couldn't define any TDF value that give reasonable control for the patient group with positive CSF study at initial diagnosis.

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The Effect of Pentoxifylline on Radiation-Induced Cardiac Injury in ICR Mice (방사선조사후 발생한 심장손상에서 Pentoxifylline 이 미치는 효과)

  • Suh Hyun Suk;Yang Kwang Mo;Kang Seung Hee;Kang Yun Kyung
    • Radiation Oncology Journal
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    • v.14 no.4
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    • pp.281-290
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    • 1996
  • Purpose : Chest irradiation leads to a significant cardiac injury in a number of patients. To prevent, or to reduce the risk of radiation-induced cardiac injury, pentoxifylline(PTX), a haemorrheologic agent that improves the blood flow through small blood capillaries has been employed. Materials and Methods : One hundred and eighty ICR mice were divided into three study groups: control, radiation alone, and radiation-pentoxifylline. Each group was subdivided into 12 subgroups: 1 3, 6 and 10 days and 2, 3, 4, 6, 8, 12, 16 and 20 weeks by observation Period after irradiation. The total 15Gy of radiation was delivered in a single fraction through anterior mediastinal port. Pentoxifylline was injected subcutaneously daily 50mg/kg to the back of the mice from the first day of irradiation throughout the observation period. The mice of each group after a certain observation period were sacrificed and sectioned for histopathologic examination of the heart. Result : The findings of acute radiation-induced carditis i.e., heterophilic infiltration and vacuolization and ballooning of endothelial cells were observed upto 6 weeks and reduced sharply afterwards. The late radiation effects including pericarditis with mononuclear cell infiltration, pericardial fibrosis, endothelial cell changes, myocardial degeneration and fibrosis present from 4 weeks onwards after irradiation but with various degree of severity. The overall process of pathologic changes of radiation-pentoxifylline group was similar to those of radiation alone group but the duration of acute stage was relatively short and the severity of late cardiac toxicity was much lesser compared with those of radiation alone group. Conclusion : Pentoxifylline can effectively reduce the late radiation-induced cardiac injury and reslve the acute effects relatively rapidly.

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Development an Artificial Neural Network to Predict Infectious Bronchitis Virus Infection in Laying Hen Flocks (산란계의 전염성 기관지염을 예측하기 위한 인공신경망 모형의 개발)

  • Pak Son-Il;Kwon Hyuk-Moo
    • Journal of Veterinary Clinics
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    • v.23 no.2
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    • pp.105-110
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    • 2006
  • A three-layer, feed-forward artificial neural network (ANN) with sixteen input neurons, three hidden neurons, and one output neuron was developed to identify the presence of infectious bronchitis (IB) infection as early as possible in laying hen flocks. Retrospective data from flocks that enrolled IB surveillance program between May 2003 and November 2005 were used to build the ANN. Data set of 86 flocks was divided randomly into two sets: 77 cases for training set and 9 cases for testing set. Input factors were 16 epidemiological findings including characteristics of the layer house, management practice, flock size, and the output was either presence or absence of IB. ANN was trained using training set with a back-propagation algorithm and test set was used to determine the network's capability to predict outcomes that it has never seen. Diagnostic performance of the trained network was evaluated by constructing receiver operating characteristic (ROC) curve with the area under the curve (AUC), which were also used to determine the best positivity criterion for the model. Several different ANNs with different structures were created. The best-fitted trained network, IBV_D1, was able to predict IB in 73 cases out of 77 (diagnostic accuracy 94.8%) in the training set. Sensitivity and specificity of the trained neural network was 95.5% (42/44, 95% CI, 84.5-99.4) and 93.9% (31/33, 95% CI, 79.8-99.3), respectively. For testing set, AVC of the ROC curve for the IBV_D1 network was 0.948 (SE=0.086, 95% CI 0.592-0.961) in recognizing IB infection status accurately. At a criterion of 0.7149, the diagnostic accuracy was the highest with a 88.9% with the highest sensitivity of 100%. With this value of sensitivity and specificity together with assumed 44% of IB prevalence, IBV_D1 network showed a PPV of 80% and an NPV of 100%. Based on these findings, the authors conclude that neural network can be successfully applied to the development of a screening model for identifying IB infection in laying hen flocks.

Trans-10, cis-12 Conjugated Linoleic Acid Modulates Nuclear Factor-${\kappa}B$ p65 Activity on the Production of Tumor Necrosis Factor-${\alpha}$ in Porcine Peripheral Blood Mononuclear Cells (돼지 말초혈액 단핵구세포에서 trans-10, cis-12 conjugated linoleic acid의 TNF-${\alpha}$ 생산에 대한 nuclear factor-${\kappa}B$ p65 활성 조절 효과)

  • Kim, Young-Beum;Lee, Ill-Woo;Kang, Ji-Houn;Yang, Mban-Pyo
    • Journal of Veterinary Clinics
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    • v.28 no.2
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    • pp.190-195
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    • 2011
  • Nuclear factor ${\kappa}B$ (NF-${\kappa}B$) is a nuclear transcription factor that modulates the expression of inflammatory cytokines such as tumor necrosis factor (TNF)-${\alpha}$. trans-10, cis-12 (t10c12)-conjugated linoleic acid (CLA) participates in the inhibition of TNF-${\alpha}$ production upon lipopolysaccharide (LPS)-stimulation. However, in our previous study, t10c12-CLA enhanced the production of TNF-${\alpha}$ by LPS-unstimulated porcine peripheral blood mononuclear cells (PBMCs) and RAW 264.7 macrophages in vitro. To resolve this apparent contradiction, we hypothesized that the effect of t10c12-CLA on TNF-${\alpha}$ production depends on NF-${\kappa}B$ activation induced by LPS stimulation. To test this hypothesis, we assessed the in vitro effect of t10c12-CLA on TNF-${\alpha}$ production and NF-${\kappa}B$ p65 activity in LPS-stimulated and LPS-unstimulated porcine PBMCs. t10c12-CLA treatment resulted in increased TNF-${\alpha}$ production by LPS-unstimulated PBMCs but decreased TNF-${\alpha}$ production by LPS-stimulated PBMCs. t10c12-CLA increased the degradation of inhibitory ${\kappa}B$ ($I{\kappa}B$)-${\alpha}$ protein and activated NF-${\kappa}B$ p65 in LPS-unstimulated PBMCs, but had the opposite effect in LPS-stimulated PBMCs. Notably, t10c12-CLA enhanced NF-${\kappa}B$ p65 binding activity in LPS-unstimulated PBMCs exposed to caffeic acid phenethyl ester (CAPE), a NF-${\kappa}B$ inhibitor. Conversely, it inhibited NF-${\kappa}B$ p65 binding activity in LPS-stimulated PBMCs exposed to CAPE. These results suggest that t10c12-CLA may have different actions under different physiological conditions, and that its effect may be associated with a change in NF-${\kappa}B$ p65 activity.

An Analysis of Factors That Affect Image Quality Deterioration in The Potable X-ray Examination on using Digital Wireless Detector (디지털 무선 검출기를 이용한 이동형 X선검사에서 영상품질 저하의 요인분석)

  • Yu, Young-Eun;Lim, Cheong-Hwan;Ko, Joo-Young
    • Journal of radiological science and technology
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    • v.37 no.2
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    • pp.93-100
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    • 2014
  • Recently the development of portable digital wireless imaging system, which acquires digital radiation images by using wireless LAN telecommunications function in an easy and fast way, provides lots of convenience for people. Considering the characteristics of portable imaging tests on emergency and critical patients, this study aims to suggest guidelines for Digital wireless detector by evaluating the effect of de-centering of focus-grid and displacement of subject in detector on the quality of image. The equipments used for this study were Elmo-T6 Digital Mobile X-ray system (SIMAZU Corp.), el' Tor ($14{\times}17$ "Wireless detector), Grid (10:1) and Chest & head phantom. After acquiring post-processing image according to dose increase and de-centering image of grid-focus and head phantom displacement image, this study compared, analyzed and evaluated these images by using a digital image analysis program by Image J. In the change of images based on dose increase, images were rough in the dose of 0.5 mAs, while there was no difference among images in the proper dose of 1~2 mAs and, especially from 2.5 mAs, average value of pixels radically decreased, affecting contrast. Over 3 mAs, contrast dropped due to saturation phenomenon of lungs. As the result of analysis using Image J program, with the increase of displacement between focus-grid and head phantom, the frequency of low pixel value also increase, causing the outline of surface image to disappear, which in turn affects contrast. For better quality imaging, a radiographer must be aware before the time of test that the image quality can be changed based on the critical patient's posture, movement, respiration, displacement of X-ray tube and distance of imaging.

An Exploratory Study on the Project Performance by PMO Capability (PMO 역량에 따른 프로젝트 성과에 관한 연구)

  • Bae, Jae-Kwon;Kim, Jin-Hwa;Kim, Sang-Yeoul
    • Asia pacific journal of information systems
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    • v.18 no.1
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    • pp.53-77
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    • 2008
  • In recent years, although numbers of corporations are bringing in PMO, they seem to be indifferent to PMO performance measurement. This demonstrates that there are also other reasons beside performance measurement of information systems (IS) project being ambiguous by introducing PMO; the lack of acknowledging the concrete function of PMO, and the scarcity of empirical study about the effect of PMO on the project members and project performance. In this sense, this study is aimed at proposing a new research model in which project success factors (i.e., standardization, management advocacy, and staff expertise) affect PMO capability (i.e., knowledge management, resources management, and problem solving competency) positively, leading to project performance (i.e., task outcomes, psychological outcomes, and organizational outcomes) eventually. To empirically test the research model, data are surveyed from PMO department and IS department. To prove the validity of the proposed research model, PLS analysis is applied with valid 132 questionnaires. By employing PLS technique, the measurement reliability and validity of research variables are tested and the path analysis is conducted to do the hypothesis testing. The path analysis results can be organized into 7 ways in large scale. First, standardization of project success factors has a positive association with knowledge management, resources management, and problem solving competency of PMO capabilities. The findings of this result indicate that the multiple or single project management should satisfy standardization in order to operate an effective PMO. Second, management advocacy of project success factors has a positive association with knowledge management, resources management, and problem solving competency. Management advocacy refers to the willingness of management to provide the required resources and authority for project success. There is agreement among researchers regarding the importance of management advocacy for favorable PMO capability. Third, staff expertise of project success factors has a positive association with knowledge management, resources management, and problem solving competency. The findings of this result indicate that the formation of an exceptional consultant or members with a proficient knowledge for staff expertise of project member is the key factor to elevate the PMO capability. Past research suggests that experience and knowledge and the resultant familiarity with the problem faced can be an important determinant of PMO capability. A capable project with appropriate staff expertise means that it enjoys a diversity of abilities and experiences. Fourth, knowledge management competency of PMO capabilities has a positive impact on psychological outcomes but has no direct effect on task outcomes and organizational outcomes. In domestic case of S. Korea, PMO was finally introduced to many other corporations in 2005 though it started bringing in 2000. Therefore, it had neither a significant impact on the task outcomes nor organizational outcomes by lacking the contents and the infrastructure of the knowledge management because the knowledge consolidation and management period of PMO is comparatively shorter by terms than other foreign nations. Fifth, resources management competency of PMO capabilities has a positive association with task outcomes, psychological outcomes, and organizational outcomes. In addition, problem solving competency of PMO capabilities has a positive association with task outcomes, psychological outcomes, and organizational outcomes. Therefore, the findings of this results stress that PMO capabilities has a positive impact on project performance. Sixth, according to the path analysis of the hypothesis, which suggested in this research, problem solving competency is the PMO capability which is the key success factor for task, psychological, and organizational outcomes as an integrated performance model. Further, the analysis reveals that problem solving competency is an important factor for integrated performance model. The finding is in line with past IS research, which affirms that the work of IS projects is essentially a problem solving endeavor. Seventh, in the path analysis of the hypothesis in this research, the path of the management advocacy $\rightarrow$ problem solving competency $\rightarrow$ organizational outcomes appears to be the most important and strongest path. In brief, the finding of this study suggests that project success factors influence PMO capability positively, and project performance as well. From the results, it can be concluded that PMO helped great improve the project success rate and project performance. This study advances research on PMO capability in three important aspects. First, the findings of our study have implications for IS theory and future research. Our study contributes to IS theory by synthesizing concepts from PMO research and project management research with those in IS research. We proposed and tested PMO capability of IS projects and the findings of our investigation provided some preliminary answers to some of the questions raised. Secondly, this thesis does not only help depicting the concept of IT governance but also approaches empirically. It makes a gradual approach to the main content, step by step, in contrary of simple standard, scholastic way of thinking. Finally, we argued that this task-oriented(technical) view is not sufficient to adequately conceptualize IS project performance. Hence, we applied that the research on organization teams, which provides a flip viewpoint to that of project management research in that it gives more weight for psychological outcomes of organizational work groups, can be very helpful in reconceptualizing the IS project performance construct. The limitations of this study are also discussed to provide research directions for future research.

Modified Blalock-Taussig Shunt in Neonates (신생아에서 변형 Blalock-Taussig 단락술)

  • 조광조;성시찬
    • Journal of Chest Surgery
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    • v.30 no.4
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    • pp.378-382
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    • 1997
  • To evaulate the effectiveness and risk factors for shunt failure of the Blalock-Taussig shunt in neonates, we analyzed the 21 neonates who were undergone Blalok-Taussig shunt operation at Dong-A University Hospital from December 1991 to Feburary 1996. We evaluated operative mortality, patency of the shunt. and distortion of pulmonary artery. We also determined the risk factors for the shunt failure. Age at operation was from 1 day to 30 days(mean 11.7 days). We ghts were 2.4 to 4.5kg(mean 3.1 kg). The underlying lesions included severe tetralogy of Fallot with pulmonary stenosls or atresia(N=11) and single ventricle varieties with. pulmonary stenosis or atresia(N=10). Prostaglandin El was given in 13 neonates prior to operation. The mean preoperative(prior to prostaglandin El therapy) and postoperative arterial oxygen tension were 30.1 mmHg and 46.3 mmHg respectively(P(0.01). The shunt was performed through a left thoracotomy in 11 patients and through a right thoracotomy In 10. A 5 mm graft was used in 15 patients and a 4 mm graft in 6 patients. The incidence of early shunt occlusion was 9.5%(2 patients). The hospital mortality was 9.5%(2 patients with early shunt occlusion). Univariate analysis revealed that body weight of 2.6 kg or less(p=0.021), pulmonary artery size of 3mm or less(p=0.008), and 4 mm graft (p=0.021) were risk factors predictive of early shunt failure. The patency rate of the shunt in hospital survivors was 100% at mean ollow-up of ll.3 months(There was not death or reoperation related to shunt failure). 10 patients were catheterized during postoperative follow-up. There was no significant distorsion of pulmonary artery. So we concluded that the modified Blalock-Taussig shunt in neonates was excellent in the hospital survivors.

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Controlled Release of 2,4-D(2,4-Dichlorophenoxy Acetic Acid ) from the Complex of Rice Husk Lignin and 2,4-D-IV. Variation of Herbicidal Activity by Soil Environmental Factors (조곡(組穀) Lignin과 2,4-D (2,4-Dichlorophenoxy Acetic Acid) 결합체(結合體)의 방출제어(放出制御) 연구(硏究)- IV. 토양환경요인(土壤環境要因)에 따른 제초활성(除草活性)의 변이(變異))

  • Guh, J.O.;Lee, D.J.;Lim, K.P.;Kwon, S.L.
    • Korean Journal of Weed Science
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    • v.10 no.2
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    • pp.114-121
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    • 1990
  • Inactivation in soil absorption, translocation of 2, 4-D by plants vary depending upon soil environments and herbicide formulations. Experiment was conducted in a glasshouse using rectangular pots($1350cm^2$) to evaluate the growth responses of barnyardgrass (Echinochloa crus-galli) and Indian jointvetch (Aesehyrcomene indica) to two formulations of 2, 4-D. The formulations used were 40% 2, 4-D amin salt (2, 4-D/AS) and 19.7% complex of rice husk lignin and 2, 4-D (2, 4-D/LG) which were applied at 200g ai/ha. Soil environments included fertilizer levels, soil pH, organic matter contents, and soil textures, Each treatment was replicated three times. The herbicidal activity of 2.4-D increased and lasted with increased levels of fertilizer. The activity also increased and lasted with low soil pH and decreased content of organic matter. Generally 2, 4-D/LG showed higher and longer herbicidal activity than 2. 4-D/AS for both test plants under all conditions applied. However, the herbicidal activity was influenced by the formulations more than by soil textures. It was thought that 2, 4-D/AS was released in a short time and inactivated readily while 2, 4-D/LG was slowly released and gave an opportunity of absorption by plants for a long period.

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Relationship Between Adenosine-Induced ST Segment Depression During $^{99m}Tc$-MIBI Scintigraphy and The Severity of Coronary Artery Disease (Adenosine 부하 $^{99m}Tc$-MIBI 심근 관류스캔도중 나타나는 ST절 하강과 관상동맥 질환의 중증도와의 관계)

  • Cho, Jung-Ah;Choi, Chung-Il;Kwak, Dong-Suk;Kim, Jeong-Gyun;Bae, Sun-Kun;Chung, Byung-Cheon;Lee, Jae-Tae;Lee, Kyu-Bo;Kang, Seung-Wan;Woo, Eon-Jo;Kim, Sin-Woo;Sohn, Sang-Kyun;Chae, Shung-Chull
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.2
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    • pp.177-185
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    • 1994
  • Pharmacologic coronary vasodilation in conjunction with myocardial perfusion scintigraphy has become an alternative to dynamic exercise test for the diagnosis and risk stratification of coronary artery disease, especially in patients who are unable to perform adequate exercise. Dipyridamole and adenosine have been used for pharmacologic stress testing with myocardial perfusion imaging. Adenosine is a potent coronary vasodilator with rapid onset of action, short half-life, near maximal coronary vasodilation and less serious side effects. ST segment depression has been reported in about 7-15% of patients with coronary artery disease receiving dipyridamole in conjunction with myocardial perfusion imaging. The exact cause and clinical significance are not known. In order to evaluate the relationship between adenosine-induced ST segment depression during $^{99m}Tc$-MIBI myocardial perfusion scintigraphy and the severity of coronary artery disease, we performed $^{99m}Tc$-MIBI imaging after intravenous Infusion of adenosine In 120 patients with suspected coronary artery disease. Of the 120 patients, 28 also performed coronary angiography. There were 24 patients with ST segment depression during $^{99m}Tc$-MIBI scintigraphy and 96 patients without ST segment depression. Adenosine was infused Intravenously at a dose of 0.14mg/kg per minute lot 6minutes and $^{99m}Tc$-MIBI was injected at 3 minute. We then com-pared the hemodynamic changes, side effects, scintigraphic and angiographic findings. Heart rate increased $90{\pm}19$ beats/minute in the group with ST depression compared with $80{\pm}16$ beats/minute in the group without ST depression(p<0.05). Baseline systolic blood pressure was significantly higher in the group with ST depression($152{\pm}27$ mmHg) than in the group without 57 depression($140{\pm}21$mmHg, p<0.05). Double product at baseline($10.90{\pm}2.77$ versus $9.55{\pm}2.34\;beats/minute{\times}mmHg$) and during adenosine infusion($12.72{\pm}3.89$ versus $10.83{\pm}2.98\;beats/minute{\times}mmHg$) were significantly higher in the group with ST depression(p<0.05). The incidence of anginal chest pain was also significantly higher in the group with ST depression(ST versus 29%, p<0.0001). The $^{99m}Tc$-MIBI images were abnormal in 23(96%) patients with ST segment depression and 66(69%) patients without ST segment depression(p<0.05). In patients with ST segment depression, there were more reversible perfusion defects than in patients without ST segment depression(83 versus 55%, p<0.05). The number of abnormal segments were significantly higher in the group with ST depression($3.05{\pm}2.01$ versus $1.51{\pm}1.45$, p<0.005). In patients with ST segment depression, there were more segments of reversible perfusion defects than in patients without segment depression($2.15{\pm}2.11$ versus $0.89{\pm}1.24$, p<0.05). There were no differences in the angiographic severity by vessel(p ; NS). We concluded that ST segment depression during $^{99m}Tc$-MIBI myocardial perfusion scintigraphy with Intravenous adenosine is related to the severity of coronary artery disease.

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Usefulness of Prone Position on PET-CT in Breast Cancer (유방암 PET-CT 검사에서 Prone(복와위)자세의 유용성 평가)

  • Park, Hoon-Hee;Kim, Sei-Yung;Kim, Jung-Yul;Park, Min-Soo;Lim, Han-Snag;Jung, Suk;Kang, Chun-Goo;Kim, Jae-Sam;Lee, Chang-Ho;Lee, Yung-Joo
    • The Korean Journal of Nuclear Medicine Technology
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    • v.12 no.1
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    • pp.44-48
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    • 2008
  • Purpose: In FDG-PET/CT of breast cancer, a sensitivity was 80~96% and a specificity was 75~95% commonly. It was valuable to identify a cancer in early stage been difficult in Mammography. Most of the PET/CT scans have been examined on supine position, so, the image of breast has been acquired by reconstructed whole body scan image. However, using prone position with a compensator, a shape of breast was reassembly shown to be real by gravity. Therefore, the purpose of this study was to evaluate diagnostic value of prone position in FDG PET-CT of breast cancer. Materials and Methods: 30 female patients with doubtful or positive breast cancer were examined. The PET-CT whole body scan was acquired at 60 minutes after $^{18}F$-FDG injection on Supine position. Then, regional breast spot scan was progressed on prone position using a compensator. Each image was evaluated by physicians blinded to patient's data, and statistical analysis did through SUVs measured in PET-CT images. Results: In 27 of 30 patients, prone position was shown accurate discrimination and diagnostic value, but in another 3 patients had a lesion 1cm below, PET-CT couldn't detect it, unlike MRI. Consequently, prone position distinguished a lesion better than Supine position, because of low degree of metamorphosis by gravity. The SUVs analysis of each position was significant (p value=0.004). Conclusion: In PET-CT of breast cancer, prone position could detect micrometastasis as well as primary lesion, better than supine position. Therefore, this study proposes that any technical change considered morphological feature like prone position can offer adequate and useful diagnostic information, together with complementary quantitative analysis.

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