• 한국방사선학회논문지
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• 제16권7호
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• pp.857-862
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• 2022

본 연구의 목적은 토모다이렉트를 이용한 토모테라피 방사선치료에서 두상 각도(head tilting)에 따라 3차원 입체조형 전뇌 방사선치료 계획을 평가하고 자 하였다. 총 다섯 가지 두상 각도(-20°, -10°, 0°, +10°, +20°)를 비교 평가하였다. 두상 각도에 따라 표적에 대한 선량균질지수(homogeneity index, HI)와 처방선량지수(conformity index, CI)를 계산하였고, 정상 장기인 수정체, 안구, 귀밑샘에 대한 최대선량과 평균 선량을 구하였다. 선량균질지수와 처방선량지수는 두상 각도가 +10°와 +20°에서 수치 1에 가까웠다. 두상 각도 +10°에서 수정체와 안구의 선량은 기준 두상각도(0°)에 비해 각각 약 74%와 30% 감소하였다. 턱을 올린 상태의 +10°의 두상 각도는 표적에 대한 선량균일지수와 처방선량지수가 적합하며 렌즈와 안구의 선량을 줄일 수 있는 각도로써 권장한다.

• Molecules and Cells
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• 제38권12호
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• pp.1023-1028
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• 2015

Whole body energy balance is achieved through the coordinated regulation of energy intake and energy expenditure in various tissues including liver, muscle and adipose tissues. A positive energy imbalance by excessive energy intake or insufficient energy expenditure results in obesity and related metabolic diseases. Although there have been many obesity treatment trials aimed at the reduction of energy intake, these strategies have achieved only limited success because of their associated adverse effects. An ancient neurotransmitter, serotonin is among those traditional pharmacological targets for anti-obesity treatment because it exhibits strong anorectic effect in the brain. However, recent studies suggest the new functions of peripheral serotonin in energy homeostasis ranging from the endocrine regulation by gut-derived serotonin to the autocrine/paracrine regulation by adipocyte-derived serotonin. Here, we discuss the role of serotonin in the regulation of energy homeostasis and introduce peripheral serotonin as a possible target for anti-obesity treatment.

• Journal of Acupuncture Research
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• 제20권5호
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• pp.187-207
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• 2003

Objective: Recently, many studies have showed the evidences of the effect of the acupuncture treatment through scientific methods. One of these methods is functional MRI. We performed electro-acupuncture on Liv3 and observed the change of brain activation using fMRI. Methods: To see the effect of electro-acupuncture stimulation on Liv3. the experiment was carried out on 12 healthy volunteers. using the gradient echo sequence with the 3.0T whole-body MRI system(ISOL). After the needle insertion on right Liv3. 2 Hz of electric stimulation was given for 30 seconds. repeated five times. with 30 seconds' intervals. The Image analysis including motion correction, talairach transformation. and smoothing was done with SPM99. Results : 1. Group averaged brain activation induced by bilateral electro-acupuncture stimulation on Liv3 activates Brodman Area 6, 13, 18, 19, 22, 31, 39, 44, 2. Group averaged brain deactivation induced by bilateral Electro-acupuncture stimulation on Liv3 activates Brodman Area 4, 6, 9, 19, 36, 37, 39. 3. Group averaged brain activation induced by unilateral(right side) electro-acupuncture stimulation on Liv3 activates Brodman Area 2, 3, 6, 9, 10, 22, 40, 42, 43. 4. Group averaged brain deactivation induced by unilateral(right side) electro-acupuncture stimulation on Liv3 activates Brodman Area 6, 18, 19, 28, 30, 31, 35, 37. 5. Brain region activated by motor stimulation activates Brodman Area 4, 6, 13, 19, 42.

• Journal of Acupuncture Research
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• 제20권3호
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• pp.86-103
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• 2003

Objective : Recently, many studies have showed the evidences of the effect of the acupunture treatment through scientific methods. One of these methods is functional MRI. We performed electro-acupunture on Sp6 and observed the changes of brain activation using fMRI. Methods : To see the effect of electro-acupunture stimulation on Sp6, the experiment was carried out on 12 healthy volunteers, using the gradient echo sequence with the 3.0T whole-body MRI system(ISOL). After the needle insertion on right Sp6, 2Hz of electric stimulation was given for 30 seconds, repeated five times, with 30 seconds' intervals. The Image analysis including motion correction, talairach transformation, and smoothing was done with SPM99. Results : 1. Group averaged brain activation induced by bilateral eletro-acupunture stimulation on Sp6 activates Brodman Area 3, 7, 13. 2. Group averaged brain deactivation induced by bilateral eletro-acupunture stimulation on Sp6 activates Brodman Area 6, 38, 47. 3. Group averaged brain activation induced by unilateral(right side) eletro-acupunture stimulation on Sp6 activates Brodman Area 5, 6, 13, 17, 18, 19, 31, 38, 40 ptoms, back pain(32.5%) was the 4. Group averaged brain deactivation induced by unilateral(right side) eletro-acupunture stimulation on Sp6 activates Brodman Area 3, 4, 18, 21, 36, 38, 39. 5. Brain region activated by motor stimulation activates Brodman Area 3, 4, 6, 18, 19.

• Journal of Korean Neurosurgical Society
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• 제57권5호
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• pp.315-322
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• 2015

Intracranial germ cell tumors (ICGCT) occur in 2-11% of children with brain tumors between 0-19 years of age. For treatment of germinoma, relatively low radiation doses with or without chemotherapy show excellent 10 year survival rate of 80-100%. Past studies showed that neoadjuvant chemotherapy combined with focal radiotherapy resulted in unacceptably high rates of periventricular tumor recurrence. The use of generous radiation volume which covers the whole ventricular space with later boost treatment to primary site is considered as standard treatment of intracranial germinomas. For non-germinomatous germ cell tumors (NGGCT), 10-year overall survival rate is still much inferior than that of intracranial germinoma despite intensive chemotherapy and high-dose radiotherapy. Craniospinal radiotherapy combined with cisplatin-based chemotherapy provides the best treatment outcome for NGGCT; 60-70% of overall survival rate. There is a debate on the surgical role whether surgery can contribute to improved treatment outcome of NGGCT when added to combined chemoradiotherapy. Because higher dose of radiotherapy is required for treatment of NGGCT than for germinoma, it is tested whether whole ventricular irradiation can replace craniospinal irradiation in intermediate risk group of NGGCT to minimize radiation-related late toxicity in the recent studies. To minimize the treatment-related neural deficit and late sequelae while maintaining long-term survival rate of ICGCT patients, optimized administration of chemotherapy and radiotherapy should be selected. Use of technically upgraded radiotherapy modalities such as intensity-modulated radiotherapy or proton beam therapy is expected to bring an improved neurocognitive outcome with longitudinal assessment of the patients.

• Radiation Oncology Journal
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• 제16권2호
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• pp.125-138
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• 1998

목적 : 흰쥐의 전뇌에 방사선조사 후 cis-diamminedichloroplatinum(II)(cisplatin)을 복강내 주입하여 cisplatin이 방사선에 의한 후기 뇌손상(3개월, 6개월)에 미치는 효과를 알기 위하여 이 연구를 시행하였다. 방법 및 재료 : 흰쥐를 방사전조사군, cisplatin군, 방사선조사와 cisplatin 병용군으로 분류하였다. 방사선조사군은 선형가속기를 사용하여 20 Gy, 22.5 Gy의 x-ray를 각각 횐쥐의 전뇌에 단일조사하였다. Cisplatin군은 2, 4, 8mg/kg을 각각 복강내에 1회 주입하였다. 병용군은 방사선조사(20 Gy, 22.5 Gy) 후 즉시 cisplatin(2mg/kg)를 복강내에 1회 주입하였다. 각 군에 따라 치료 후 3개월과 6개월에 동물을 희생시키고 뇌의 조직병리학적 검사를 시행하였다. 결과 : Cisplatin군은 맥락총에 상피성 공포형성과 혈관주위의 부종 및 혈관의 확장이 3개월에 보였으며, 채상과 대뇌반구에 다원성 괴사가 3개월과 6개월에 나타났다. 방사선조사군과 병용군에서 뇌의 후기 방사선손상의 특징인 국소적 응고성 괴사와 혈관의 변화가 현저하게 나타났으며 현저한 혈관주위와 연수막에 성상세포의 증식은anti-GFAP 항체검사로 확인되었다. 방사선조사에 의한 혈관변화와 성상세포의 증식이 cisplatin에 의해서 증가되지는 않았다. 결론 : Cisplatin과 방사선조사에 의한 후기 뇌손상의 변화로 국소적 괴사가 양군에서 동시에 나타남으로서 뇌손상의 정도를 추정하는데 괴사가 지표인자로 이용될 수 있다고 본다. Cisplatin이 방사선에 의한 혈관의 변화와 성상세포의 증식에는 영향을 미치지 않았으므로, 뇌에서 cisplatin과 방사선의 상호작용을 파악하기 위해서는 향후 더 많은 실험이 필요하다.

• Radiation Oncology Journal
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• 제12권1호
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• pp.33-42
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• 1994

1982년부터 1991년까지 경희대학병원 치료방사선과에서 원발성 중추신경계 림프종으로 확진되어 방사선치료를 받은 16명의 환자를 대상으로 치료결과를 후향적으로 분석하였다. 가장 흔한 세포아형은 large, noncleaved cell과 B cell의 immunoblastic 림프종이었으며 측두엽과 심핵부위에 호발하였다. 치료는 환자를 생검 또는 절제술후 전뇌에 40 Gy(range=30-50 Gy)를 방사선 조사하였으며 원발병소에 15-20 Gy를 추가조사하였다. 16명의 환자중 14명은 방사선치료후 2개월에서 49개월 사이에 사망하였으며, 2명은 재발없이 각각 8개월과 22개월째 생존하고 있다. 1년 및 2년생존율은 각각 55.6$ \% $와 34.7$ \% $이었고, 중간 생존기간은 12개월이었다. 16명의 환자중 재발된 11명을 분석하였다. 방사선치료후 원발부위에 재발은 드물었으나 전뇌조사에서 불구하고 다른 부위에서 재발하였다. 재발율은 뇌에서 68.7$ \% $ (l1/16)이고 척추에서 25.0$ \% $(4/16)이었다. 나이, 성별 발생부위, 병소수, 방사선치료선량등은 각각 생존율과 무관하였다. 이와 같은 결과로 중추신경계 림프종은 방사선 치료의 초기반응은 양호하나 통상적인 방사선치료만으로는 조절이 어려운 질환이다. 따라서 분할치료방법에 의한 방사선량 증가와 항암제의 병용으로 중추신경계 림프종에 대한 치료효과를 향상시키리라 기대한다.

• Journal of Korean Neurosurgical Society
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• 제38권3호
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• pp.184-189
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• 2005

Objective : Hemangioblastomas are highly vascular and benign neoplasm of the central nervous system[CNS]. They can often be found as multiple lesions, as is commonly observed in von Hippel-Lindau[VHL] disease. The aim of this study is to determine the proper management for multiple hemangioblastomas. Methods : Since 1990, 78cases of hemangioblastoma have been encountered. Among these, 9cases were multiple hemangioblastomas that were treated with surgical resection with or without radiosurgery. The medical, radiological, surgical and histological records were reviewed retrospectively and analyzed statistically. Results : Nine patients presented with multiple hemangioblastomas and were diagnosed as VHL disease. The mean follow-up duration was 75.7months [$6.6{\sim}159.2months$] after the first surgical treatment. Three patients were treated with surgical resection alone and six patients were treated by both surgical resection and radiosurgery. Twenty-one surgical procedures [13 surgical resections and 8 radiosurgery] were performed. One patient required ventriculoperitoneal shunt and a posterior fossa decompressive craniectomy because of post-radiation brain swelling. Another patient refused additional treatment for the newly developed lesions after the successful treatment of initial lesions. The other patient who presented with numerous lesions in the whole brain and spine underwent cranio-spinal irradiation. Remaining patients showed good results. Conclusion : The surgical outcomes for the patients with a single lesion of the CNS hemangioblastoma are favorable. However. the treatment of multiple hemangioblastoma is more difficult, and should be treated by surgical resection and radiosurgery with careful consideration.

• 대한한의학회지
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• 제24권3호
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• pp.51-64
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• 2003

Objective : This study investigated the alteration of neural activity and effect of Yanggyuksanhwa-tang (Lianggesanhuo-tang) on cerebral ischemia of rats. Methods : Considering age-related impact on cerebral ischemia, aged rats (18 months old) were used for this study. Ischemic damage was induced by the transient occlusion of bilateral common carotid arteries (BCAO) with hypotension. Yanggyuksanhwa-tang (Lianggesanhuo-tang) was administered twice a day orally. Then alterations of neural activities in the brain of aged BCAO rats were measured by the [$^{14}C$]2-deoxyglucose autoradiography method. Results : The BCAO in aged rats led to significant decrease of neural activity in the whole brain. Treatment with Yanggyuksanhwa-tang (Lianggesanhuo-tang) significantly attenuated the decrease of neural activity in the whole brain following BCAO ischemia. Treatment significantly attenuated the decrease of neural activity in the CA1, CA2, CA3, dentate gyrus of the hippocampus, activated barrel, barrel cortex, somatosensory cortex, cingulate cortex, caudate putamen, and medial septal nucleus following BCAO in aged rats. Treatment with Yanggyuksanhwa-tang (Lianggesanhuo-tang) also significantly attenuated the decrease of neural activity in the anteroventral thalamic nucleus, ventral anterior thalamic nucleus, arcuate nucleus, posterior hypothalamic area, medial mammillary nucleus, lateral periaqueductal gray, dorsal raphe nucleus, interpeduncular nucleus, median raphe nucleus, and medial pontine nucleus. Conclusion : It can be suggested that Yanggyuksanhwa-tang (Lianggesanhuo-tang) has a neuroprotecuve effect on cerebral ischemia through the control of glucose metabolic rate and cerebral blood flow.

• Radiation Oncology Journal
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• 제12권2호
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• pp.165-173
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• 1994

목적 : 폐암환자에 있어서 뇌전이는 심각한 문제이며 또한 장기간 생존을 기대할 수가 없다. 종양억제효과를 증가시키는 동시에 만발 장애를 감소시켜 전체 치료기간을 가능한 단축시키기 위하여 비소세포성 폐암화자의 뇌전이에 대한 다분할 조사법인 급속분할조사법을 시행하였다. 재료 및 방법 : 1991년부터 1993년까지 비소세포성 폐암으로 확진되어 뇌전이가 발생한 24명의 환자에게 6시간 간격으로 2Gy씩 하루 2회로 총 48Gy를 전뇌에 조사하였다. 단일 병소는 전뇌에 40Gy 조사후 치료범위를 축소하여 8Gy를 추가하였다. 총 26예증 신경증상이 점차 진행되는 양상을 보인 2명은 방사선치료를 중단하였다. 결과 : 방사선치료 도중에 3명은 급성 방사선효과로 오심과 구토를 호소하였으나, 방사선량 증가로 인한 심각한 부작용은 없었다. 통상적인 치료방법인 2주에 30Gy를 조사한 경우(4.5개월)보다 48Gy의 급속분할조사에 의한 방사선치료법이 중간생존기간을 향상시켰으나(7개월)통계학적 의의는 없었다(p>0.05). 뇌에 국한된 전이 환자와 활동수행 상태가 양호한 군이 다발성 전이나 활동수행상태가 불량한 군보다 중간생존기간과 반년생존율에 있어서 유의한 증가를 나타내었다(p<0.01). 결론 : 뇌전이 단독소견과 양호한 활동수행능력 상태등 양호한 예후인자를 가진 환자는 생존기간 향상이 기대된다. 본 연구결과로 환자의 quaility of life를 고려하여 하후 1회 치료법과 2또는 3회치료법을 비교하는 다자간의 전향적인 연구가 필요하리라 생각된다.