• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제18권2호
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• pp.109-116
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• 2007

The objective of this review is to establish practice parameters for pharmacological treatment of children and adolescents with pervasive developmental disorders. We performed a detailed review of the literature, including a wide range of controlled clinical trials, open trials, case reports, and side-effect profiles of related drugs. Few medications have a treatment indication for pervasive developmental disorders, and few studies with well-controlled methodology are available for evaluating treatment results. Pharmacological treatments focus on associated target symptoms because symptom reduction may improve educational and social ability and enhance quality of life. Well-controlled trials have been conducted for some SSRI(selective serotonin reuptake inhibitor) antidepressants, risperidone, and methylphenidate, and showed reduction of some target symptoms. Since the medications are not specific to autism and do not treat core symptoms of the disorder, their potential side effects should be carefully considered. Family education is necessary to give proper information on target symptoms, limitation of drug treatments, and risks.

• Journal of Gastric Cancer
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• 제18권1호
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• pp.1-19
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• 2018

Gastric cancer (GC) is the second leading cause of cancer mortality and the fourth most commonly diagnosed malignant diseases. While continued efforts have been focused on GC treatment, the introduction of trastuzumab marked the beginning of a new era of target-specific treatments. Considering the diversity of mutations in GC, satisfactory results obtained from various target-specific therapies were expected, yet most of them were unsuccessful in controlled clinical trials. There are several possible reasons underlying the failures, including the absence of patient selection depending on validated predictive biomarkers, the inappropriate combination of drugs, and tumor heterogeneity. In contrast to targeted agents, immuno-oncologic agents are designed to regulate and boost immunity, are not target-specific, and may overcome tumor heterogeneity. With the successful establishment of predictive biomarkers, including Epstein-Barr virus pattern, microsatellite instability status, and programmed death-ligand 1 (PD-L1) expression, as well as ideal combination regimens, a new frontier in the immuno-oncology of GC treatment is on the horizon. Since the field of immuno-oncology has witnessed innovative, practice-changing successes in other cancer types, several trials on GC are ongoing. Among immuno-oncologic therapies, immune checkpoint inhibitors are the mainstay of clinical trials performed on GC. In this article, we review target-specific agents currently used in clinics or are undergoing clinical trials, and highlight the future clinical application of immuno-oncologic agents in inoperable GC.

• BMB Reports
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• 제41권12호
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• pp.833-839
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• 2008

Angiogenesis in tumors is driven by multiple growth factors that activate receptor tyrosine kinases. An important driving force of angiogenesis in solid tumors is signaling through vascular endothelial growth factor (VEGF) and its receptors (VEGFRs). Angiogenesis inhibitors that target this signaling pathway are now in widespread use for the treatment of cancer. However, when used alone, inhibitors of VEGF/VEGFR signaling do not destroy all blood vessels in tumors and do not slow the growth of most human cancers. VEGF/VEGFR signaling inhibitors are, therefore, used in combination with chemotherapeutic agents or radiation therapy. Additional targets for inhibiting angiogenesis would be useful for more efficacious treatment of cancer. One promising target is the signaling pathway of hepatocyte growth factor (HGF) and its receptor (HGFR, also known as c-Met), which plays important roles in angiogenesis and tumor growth. Inhibitors of this signaling pathway have been shown to inhibit angiogenesis in multiple in vitro and in vivo models. The HGF/c-Met signaling pathway is now recognized as a promising target in cancer by inhibiting angiogenesis, tumor growth, invasion, and metastasis.

• Journal of Radiation Protection and Research
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• 제36권3호
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• pp.107-118
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• 2011

Conventional (SRS) and fractionated (FSRS) stereotactic radiosurgery necessarily require stringent overall target point accuracy and precision. We determine three-dimensional intracranial target point deviations (TPDs) in a whole treatment procedure using magnetic resonance image (MRI)-based polymer-gel dosimetry, and suggest a technique for overall system tests. TPDs were measured using a custom-made head phantom and gel dosimetry. We calculated TPDs using a treatment planning system. Then, we compared TPDs using mid bi-plane and three-dimensional volume methods with spherical and elliptical targets to determine their inherent analysis errors; finally, we analyzed regional TPDs using the latter method. Average and maximum additive errors for ellipses were 0.62 and 0.69 mm, respectively. Total displacements were 0.92 ${\pm}$ 0.25 and 0.77 ${\pm}$ 0.15 mm for virtual SRS and FSRS, respectively. Average TPDtotal at peripheral regions was greater than that at central regions for both. Overall system accuracy was similar to that reported previously. Our technique could be used as an overall system accuracy test that considers the real radiation field shape.

• Asian Pacific Journal of Cancer Prevention
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• 제15권11호
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• pp.4717-4721
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• 2014

Background: Dosimetric comparison of two dimensional (2D) radiography and three-dimensional computed tomography (3D-CT) based dose distributions with high-dose-rate (HDR) intracavitry radiotherapy (ICRT) for carcinoma cervix, in terms of target coverage and doses to bladder and rectum. Materials and Methods: Sixty four sessions of HDR ICRT were performed in 22 patients. External beam radiotherapy to pelvis at a dose of 50 Gray in 27 fractions followed by HDR ICRT, 21 Grays to point A in 3 sessions, one week apart was planned. All patients underwent 2D-orthogonal and 3D-CT simulation for each session. Treatment plans were generated using 2D-orthogonal images and dose prescription was made at point A. 3D plans were generated using 3D-CT images after delineating target volume and organs at risk. Comparative evaluation of 2D and 3D treatment planning was made for each session in terms of target coverage (dose received by 90%, 95% and 100% of the target volume: D90, D95 and D100 respectively) and doses to bladder and rectum: ICRU-38 bladder and rectum point dose in 2D planning and dose to 0.1cc, 1cc, 2cc, 5cc, and 10cc of bladder and rectum in 3D planning. Results: Mean doses received by 100% and 90% of the target volume were $4.24{\pm}0.63$ and $4.9{\pm}0.56$ Gy respectively. Doses received by 0.1cc, 1cc and 2cc volume of bladder were $2.88{\pm}0.72$, $2.5{\pm}0.65$ and $2.2{\pm}0.57$ times more than the ICRU bladder reference point. Similarly, doses received by 0.1cc, 1cc and 2cc of rectum were $1.80{\pm}0.5$, $1.48{\pm}0.41$ and $1.35{\pm}0.37$ times higher than ICRU rectal reference point. Conclusions: Dosimetric comparative evaluation of 2D and 3D CT based treatment planning for the same brachytherapy session demonstrates underestimation of OAR doses and overestimation of target coverage in 2D treatment planning.

• 대한방사선치료학회지
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• 제30권1_2호
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• pp.153-160
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• 2018

목 적 : 부분절제술 시행 후 좌측 유방암 환자의 방사선 치료 시 적용된 각 방사선 치료 기법 별 선량을 후향적으로 분석하여 정상장기와 종양용적의 선량적 결과를 전형적인 분할치료 선량(EQD2)을 고려한 선량 결과를 도출함으로써 임상적 참고 지표로 활용하고자 한다. 대상 및 방법 : 본원에서 시행한 좌측 유방암 환자 중 부분절제술을 시행한 40명을 대상으로 3가지의 치료기법으로 구분하여 적용하였다. 각 치료법의 총 종양용적과 임상적 표적용적에서 HI(homogeneity index), $D_{95%}$, 그리고 CI(conformity index)값, 그리고 $V_{hot}$ 수치를 도출한 후 치료계획을 평가하였다. 사이버나이프를 이용한 경우 종양용적은 타 기법에서의 고선량 용적과 동일하여 임상적 표적용적는 고려하지 않았다. 정상장기에 대한 평가는 평균선량을 비교하였다. 결 과 : 세가지 치료법의 HI는 3D-CRT, VMAT, RIMRT 모두 큰 차이를 보이지 않았다. 체적조절 호형 방사선치료(VMAT)을 이용한 치료의 경우 임상적 표적용적의 $D_{95%}$의 경우 $95.84{\pm}0.75%$로 3차원 입체조형 방사선 치료(3D-CRT) 치료법에 비해 높은 값을 나타냈다. 총 종양용적의 $D_{95%}$값은 다른 치료법들에 비해 미세하게 높은 결과를 보여줬다. 사이버나이프를 이용한 치료법은 정상장기들에 조사되는 선량이 타 치료법에 비해 현저하게 낮았다. 결 론 : 3D-CRT의 경우 DIBH를 동반하여 치료할 경우 전반적으로 심장을 보호하는데 유용한 치료 기법이며 VMAT의 경우 탁월한 TARGET COVERAGE를 나타내지만 저 선량 영역이 타 기법에 비해 넓은 것을 알 수 있다. 그러나 앞선 두 가지 치료법에서 치료계획 평가를 위한 대부분의 선량적 지표에서 비슷한 값을 보여 치료 계획 결과 및 평가에서는 큰 차이가 없는 것으로 환자의 해부학적 구조나 호흡 조절 가능 유무에 따라 치료기법 선택이 가능할 것으로 사료된다. 사이버나이프를 이용한 치료의 경우 종양용적에 정확한 고 선량을 주며 정상장기 보호에 매우 유용한 치료법이지만 국소부위 치료만 가능한 점, 치료시간이 상대적으로 긴 점, 치료 전 침습적 시술인 금침 삽입술을 해야 하는 제약이 있다.

• 한국진공학회:학술대회논문집
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• 한국진공학회 2016년도 제50회 동계 정기학술대회 초록집
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• pp.245-245
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• 2016

본 연구에서는 선형 대향 타겟 스퍼터 (Linear Facing Target Sputtering: LFTS) 시스템을 이용하여 ITO와 Ti doped $In_2O_3$ (TIO) 타겟을 Co-sputtering한 InSnTiO 투명 전극의 전기적, 광학적 특성을 연구하였다. InSnTiO 투명전극의 전기/광학적 및 구조적 특성은 Hall measurement, UV/Vis spectrometry, X-ray Diffraciton 분석법을 통해 최적화 하였고, DC power, substrate to target distance (TSD), target to target distance (TTD), ambient treatment 변수 조절을 통해 최적화된 LFTS InSnTiO 투명전극을 제작하였다. LFTS 공정을 이용한 InSnTiO 투명전극의 성막 공정 중 DC파워와 공정압력 변화에 따른 구조적, 표면적 특성 변화는 Field-Emission Scanning Electron Microscopy (FE-SEM) 과 X-ray Diffractometer (XRD) 분석을 통해 관찰하였다. 이렇게 증착된 InSnTiO 투명전극은 급속열처리 시스템으로 (Rapid Thermal Annealing system) 후열처리를 진행하여 투과도의 향상과 면저항의 감소를 확인하였다. 본 연구에서는 다양한 분석을 통해 Co-sputtering한 InSnTiO 박막의 특성과 다양한 장점을 소개한다.

• 한국의학물리학회:학술대회논문집
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• 한국의학물리학회 2002년도 Proceedings
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• pp.53-60
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• 2002

Motion of lung tumors from respiration has been reported in the literature to be as large as of 1-2 cm. This motion requires an additional margin between the Clinical Target Volume (CTV) and the Planning Target Volume (PTV). While such a margin is necessary, it may not be sufficient to ensure proper delivery of Intensity Modulated Radiotherapy (IMRT) to the CTV during the simultaneous movement of the DMLC. Gated treatment has been proposed to improve normal tissues sparing as well as to ensure accurate dose coverage of the tumor volume. The following questions have not been addressed in the literature: a) what is the dose error to a target volume without gated IMRT treatment\ulcorner b) what is an acceptable gating window for such treatment. In this study, we address these questions by proposing a novel technique for calculating the 3D dose error that would result if a lung IMRT plan were delivered without gating. The method is also generalized for gated treatment with an arbitrary triggering window. IMRT plans for three patients with lung tumor were studied. The treatment plans were generated with HELIOS for delivery with 6 MV on a CL2100 Varian linear accelerator with a 26 pair MLC. A CTV to PTV margin of 1 cm was used. An IMRT planning system searches for an optimized fluence map ${\Phi}$ (x,y) for each port, which is then converted into a dynamic MLC file (DMLC). The DMLC file contains information about MLC subfield shapes and the fractional Monitor Units (MUs) to be delivered for each subfield. With a lung tumor, a CTV that executes a quasi periodic motion z(t) does not receive ${\Phi}$ (x,y), but rather an Effective Incident Fluence EIF(x,y). We numerically evaluate the EIF(x,y) from a given DMLC file by a coordinate transformation to the Target's Eye View (TEV). In the TEV coordinate system, the CTV itself is stationary, and the MLC is seen to execute a motion -z(t) that is superimposed on the DMLC motion. The resulting EIF(x,y)is inputted back into the dose calculation engine to estimate the 3D dose to a moving CTV. In this study, we model respiratory motion as a sinusoidal function with an amplitude of 10 mm in the superior-inferior direction, a period of 5 seconds, and an initial phase of zero.

• Journal of Ginseng Research
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• 제38권2호
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• pp.83-88
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• 2014

The adenosine monophosphate (AMP)-activated protein kinase (AMPK) is a key sensor of cellular energy. Once activated, it switches on catabolic pathways generating adenosine triphosphate (ATP), while switching off biosynthetic pathways consuming ATP. Pharmacological activation of AMPK by metformin holds a therapeutic potential to reverse metabolic abnormalities such as type 2 diabetes and nonalcoholic fatty liver disease. In addition, altered metabolism of tumor cells is widely recognized and AMPK is a potential target for cancer prevention and/or treatment. Panax ginseng is known to be useful for treatment and/or prevention of cancer and metabolic diseases including diabetes, hyperlipidemia, and obesity. In this review, we discuss the ginseng extracts and ginsenosides that activate AMPK, we clarify the various mechanisms by which they achieve this, and we discuss the evidence that shows that ginseng or ginsenosides might be useful in the treatment and/or prevention of metabolic diseases and cancer.

• Asian Pacific Journal of Cancer Prevention
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• 제14권2호
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• pp.609-617
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• 2013

Renal cell carcinomas make up 3% of all cancers and one in four patients is metastatic at time of diagnosis. This cancer is one of the most resistant to cytotoxic chemotherapy. Studies have shown that the efficiency of interferon-alpha and/or interleukin-2 based immune therapies is limited in patients with metastatic renal cell carcinoma but latest advances in molecular biology and genetic science have resulted in better understanding of its biology. Tumor angiogenesis, tumor proliferation and metastasis develop by the activation of signal message pathways playing a role in the development of renal cell carcinomas. Better definition of these pathways has caused an increase in preclinic and clinical studies into target directed treatment of renal cell carcinoma. Many recent studies have shown that numerous anti-angiogenic agents have marked clinical activity. In this article, the focus is on general characteristics of molecular pathways playing a major role in renal cell carcinoma, reviewing clinical information onagents used in the target directed treatment of metastatic lesions.