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The role of salvage radiotherapy in recurrent thymoma

  • Yang, Andrew Jihoon;Choi, Seo Hee;Byun, Hwa Kyung;Kim, Hyun Ju;Lee, Chang Geol;Cho, Jaeho
    • Radiation Oncology Journal
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    • v.37 no.3
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    • pp.193-200
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    • 2019
  • Purpose: To explore the role of salvage radiotherapy (RT) for recurrent thymoma as an alternative to surgery. Materials and Methods: Between 2007 and 2015, 47 patients who received salvage RT for recurrent thymoma at Yonsei Cancer Center were included in this study. Recurrent sites included initial tumor bed (n = 4), pleura (n = 19), lung parenchyma (n = 10), distant (n = 9), and multiple regions (n = 5). Three-dimensional conformal and intensity-modulated RT were used in 29 and 18 patients, respectively. Median prescribed dose to gross tumor was 52 Gy (range, 30 to 70 Gy), with equivalent doses in 2-Gy fractions (EQD2). We investigated overall survival (OS), progression-free survival (PFS), and patterns of failure. Local failure after salvage RT was defined as recurrence at the target volume receiving >50% of the prescription dose. Results: Median follow-up time was 83 months (range, 8 to 299 months). Five-year OS and PFS were 70% and 22%, respectively. The overall response rate was 97.9%; complete response, 34%; partial response, 44.7%; and stable disease, 19.1%. In multivariate analysis, histologic type and salvage RT dose (≥52 Gy, EQD2) were significantly associated with OS. The high dose group (≥52 Gy, EQD2) had significantly better outcomes than the low dose group (5-year OS: 80% vs. 59%, p = 0.046; 5-year PFS: 30% vs. 14%, p=0.002). Treatment failure occurred in 34 patients; out-of-field failure was dominant (intra-thoracic recurrence 35.3%; extrathoracic recurrence 11.8%), while local failure rate was 5.8%. Conclusion: Salvage RT for recurrent thymoma using high doses and advanced precision techniques produced favorable outcomes, providing evidence that recurrent thymoma is radiosensitive.

Investigations into the Influencing Fabric Properties Factors of the 3D Shape Evaluation of Korean Hanbok Chima

  • Park, Soon-Jee
    • International Journal of Human Ecology
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    • v.7 no.1
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    • pp.37-52
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    • 2006
  • This study was designed to analyze the three-dimensional shapes of Hanbok Chima made with various fabrics and to clarify the relationship between fabric properties as well as the objective and subjective evaluations of the 3D shape. For 3D shape data, a dress form (9A2 (N; nude)) was scanned with eight Chima garments made with the same number of fabrics. The scanner used was a non-contact three-dimensional human body measuring system belonging to Bunka Women's University in Japan. Data concerning the objective evaluation of the 3D shape was obtained from the measurements of the vertical and horizontal sections: those for subjective evaluation were through the sensory test after exposure to photographs from a front and side view. Four fabric factors were extracted from fabric physical properties: softness, extension, thickness of threads, and weight of fabric. Such factors as expansion (volume), sag of rear train, shape of nodes were influential in explaining the 3D shape of Hanbok Chima. From the analysis of the 3D shape, it can be deduced that with the constituent fabric stiffer, lighter, and less stretchable, the more expanded the 3D shape appeared to be. Multiple regression results showed that vertical shape factors have a greater effect on the evaluation of the 3D shape. It also implies that dependent variables of this study such as the subjective evaluation and 3D shape can be derived from regression equations on independent variables as fabric property factors or 3D shape factors. These results can enable the manufacturers to predict the 3D shape of the garment as well as the human subjective assessment to improve the efficacy of production. The investigation method proposed in this study can also be applicable to other garment items.

The Effects of Whole Body Vibration in the Aspect of Reducing Abdominal Adipose Tissue in High-Fat Diet Mice Model (고지방 식이 섭취 소동물 모델을 활용한 전신진동 자극의 복부 지방 감소 효능 평가)

  • Hwang, Donghyun;Kim, Seohyun;Lee, Hana;lee, Sangyeob;Seo, Donghyun;Cho, Seungkwan;Chen, Seulgi;Han, Taeyoung;Kim, Han Sung
    • Journal of Biomedical Engineering Research
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    • v.38 no.1
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    • pp.49-55
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    • 2017
  • The prevalence of obesity has noticeably increased worldwide over several decades with various complication. Even though anti-obesity drug treatments have been spotlighted by resulting in effective mean weight losses, its adverse effects cannot be overlooked. Thus, this study aimed to evaluate the effects of multi-frequency whole body vibration, one of the mechanical stimulus, as a countermeasure against obesity. Thirty-two-6-week-old C57BL/6J male mice were equally assigned to four groups: the Control group (CON, n = 8), the Sham group (Sham, n = 8), the sham with single frequency whole body vibration (S+V, n = 8), and the sham with multi frequency whole body vibration (S+MV, n = 8). After 4 weeks, morphologic changes in the adipose tissue were evaluated from three-dimensional images using in vivo micro-computed tomography. At 4 weeks, the volume of the abdominal adipose tissue, which had the highest value in Sham group, noticeably reduced in S+MV group compared to it in S+V group. These results implied that the accumulation of abdominal adipose tissue can be effectively reduced through applying multi-frequency whole body vibration.

Impact of the Planning CT Scan Time on the Reflection of the Lung Tumor Motion (전산화단층촬영 주사시간(Scan Time)이 폐종양운동의 재현성에 미치는 영향 분석)

  • Kim Su Ssan;Ha Sung Whan;Choi Eun Kyung;Yi Byong Yong
    • Radiation Oncology Journal
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    • v.22 no.1
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    • pp.55-63
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    • 2004
  • Purpose : To evaluate the reflection of tumor motion according to the planning CT scan time. Material and Methods : A model of N-shape, which moved aiong the longitudinal axis during the ventilation caused by a mechanical ventilator, was produced. The model was scanned by planning CT, while setting the relative CT scan time (T: CT scan time/ventilatory period) to 0.33, 0.50, 0.67, 0.75, 1.00, 1.337, and 1.537. In addition, three patients with non-small cell lung cancer who received stereotactic radiosurgery In the Department of Radiation Oncology, Asan Medical Center from 03/19/2002 to 05/21/2002 were scanned. Slow (10 Premier, Picker, scan time 2.0 seconds per slice) and fast CT scans (Lightspeed, GE Medical Systems, with a scan time of 0.8 second per slice) were peformed for each patient. The magnitude of reflected movement of the N-shaped model was evaluated by measuring the transverse length, which reflected the movement of the declined bar of the model at each slice. For patients' scans, all CT data sets were registered using a stereotactic body frame scale with the gross tumor volumes delineated in one CT image set. The volume and three-dimensional diameter of the gross tumor volume were measured and analyzed between the slow and fast CT scans. Results : The reflection degree of longitudinal movement of the model increased in proportion to the relative CT scan times below 1.00 7, but remained constant above 1.00 T Assuming the mean value of scanned transverse lengths with CT scan time 1.00 T to be $100\%$, CT scans with scan times of 0.33, 0.50, 0.57, and 0.75 T missed the tumor motion by 30, 27, 20, and $7.0\%$ respectively, Slow (scan time 2.0 sec) and Fast (scan time 0.8 sec) CT scans of three patients with longitudinal movement of 3, 5, and 10 mm measured by fluoroscopy revealed the increases in the diameter along the longitudinal axis Increased by 6.3, 17, and $23\%$ in the slow CT scans. Conculsion : As the relative CT scan time increased, the reflection of the respiratory tumor movement on planning CT also Increased, but remained constant with relative CT scan times above 1.00 T When setting the planning CT scan time above one respiration period (>1.00 T), only the set-up margin is needed to delineate the planning target volume. Therefore, therapeutic ratio can be increased by reducing the radiation dose delivered to normal lung tissue.

Effect of Dietary Calcium on Spinal Bone Fusion in an Ovariectomized Rat Model

  • Cho, Jae-Hoon;Cho, Dae-Chul;Yu, Song-Hee;Jeon, Young-Hoon;Sung, Joo-Kyung;Kim, Kyoung-Tae
    • Journal of Korean Neurosurgical Society
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    • v.52 no.4
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    • pp.281-287
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    • 2012
  • Objective : To evaluate the effect of calcium supplementation on spinal bone fusion in ovariectomized (OVX) rats. Methods : Sixteen female Sprague Dawley rats underwent bilateral ovariectomy at 12 weeks of age to induce osteoporosis and were randomly assigned to two groups : control group (n=8) and calcium-supplemented group (OVX-Ca, n=8). Autologous spinal bone fusion surgery was performed on both groups 8 weeks later. After fusion surgery, the OVX-Ca group was supplemented with calcium in drinking water for 8 weeks. Blood was obtained 4 and 8 weeks after fusion surgery. Eight weeks after fusion surgery, the rats were euthanized and the L4-5 spine removed. Bone fusion status and fusion volume were evaluated by manual palpation and three-dimensional computed tomography. Results : The mean fusion volume in the L4-5 spine was significantly greater in the OVX-Ca group ($71.80{\pm}8.06mm^3$) than in controls ($35.34{\pm}8.24mm^3$) (p<0.01). The level of osteocalcin, a bone formation marker, was higher in OVX-Ca rats than in controls 4 weeks ($610.08{\pm}10.41$ vs. $551.61{\pm}12.34$ ng/mL) and 8 weeks ($552.05{\pm}19.67$ vs. $502.98{\pm}22.76$ ng/mL) after fusion surgery (p<0.05). The level of C-terminal telopeptide fragment of type I collagen, a bone resorption marker, was significantly lower in OVX-Ca rats than in controls 4 weeks ($77.07{\pm}12.57$ vs. $101.75{\pm}7.20$ ng/mL) and 8 weeks ($69.58{\pm}2.45$ vs. $77.15{\pm}4.10$ ng/mL) after fusion surgery (p<0.05). A mechanical strength test showed that the L4-5 vertebrae in the OVX-Ca group withstood a 50% higher maximal load compared with the controls (p<0.01). Conclusion : Dietary calcium given to OVX rats after lumbar fusion surgery improved fusion volume and mechanical strength in an ovariectomized rat model.

Numerical Simulation of Flow Characteristics behind a Circular Patch of Vegetation using a Two-Dimensional Numerical Model (2차원 수치모형을 이용한 원형군락 하류의 흐름특성 수치모의)

  • Kim, Hyung Suk;Park, Moonhyeong
    • Journal of Korea Water Resources Association
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    • v.48 no.11
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    • pp.891-903
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    • 2015
  • This paper presents numerical simulations of flow around a circular patch of vegetation using a depth-averaged two-dimensional numerical model which is capable of simulating flow structure in vegetated open channel. In order to account for vegetation effect, drag force terms are included in governing equations. Numerical simulations are conducted with various solid volume fractions (SVF). Flow passes through a circular patch and low velocity region, which is called wake region, is formed downstream of the patch. When SVF is larger than 0.08, a recirculation is observed. The location of the recirculation is moved further downstream as SVF decreases. Von-$K{\acute{a}}rm{\acute{a}}n$ vortex street is developed beyond the wake region due to interaction between two shear layers induced by a circular patch of vegetation. The vortex is developed as SVF is larger than 0.08, and the location of the vortex is consistent with the maximum of turbulence kinetic energy. The location of the peak of turbulence kinetic energy is moved further downstream as SVF decreases.

Wear of primary teeth caused by opposed all-ceramic or stainless steel crowns

  • Choi, Jae-Won;Bae, Ik-Hyun;Noh, Tae-Hwan;Ju, Sung-Won;Lee, Tae-Kyoung;Ahn, Jin-Soo;Jeong, Tae-Sung;Huh, Jung-Bo
    • The Journal of Advanced Prosthodontics
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    • v.8 no.1
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    • pp.43-52
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    • 2016
  • PURPOSE. This study was conducted to evaluate the effects of full-coverage all-ceramic zirconia, lithium disilicate glass-ceramic, leucite glass-ceramic, or stainless steel crowns on antagonistic primary tooth wear. MATERIALS AND METHODS. There were four study groups: the stainless steel (Steel) group, the leucite glass-ceramic (Leucite) group, the lithium disilicate glass-ceramic (Lithium) group, and the monolithic zirconia (Zirconia) group. Ten flat crown specimens were prepared per group; opposing teeth were prepared using primary canines. A wear test was conducted over 100,000 chewing cycles using a dual-axis chewing simulator and a 50 N masticating force, and wear losses of antagonistic teeth and restorative materials were calculated using a three-dimensional profiling system and an electronic scale, respectively. Statistical significance was determined using One-way ANOVA and Tukey's test (P<.05). RESULTS. The Leucite group ($2.670{\pm}1.471mm^3$) showed the greatest amount of antagonist tooth wear, followed by in decreasing order by the Lithium ($2.042{\pm}0.696mm^3$), Zirconia ($1.426{\pm}0.477mm^3$), and Steel groups ($0.397{\pm}0.192mm^3$). Mean volume losses in the Leucite and Lithium groups were significantly greater than in the Steel group (P<.05). No significant difference was observed between mean volume losses in the Zirconia and Steel groups (P>.05). CONCLUSION. Leucite glass-ceramic and lithium disilicate glass-ceramic cause more primary tooth wear than stainless steel or zirconia.

Accuracy and reproducibility of 3D digital tooth preparations made by gypsum materials of various colors

  • Tan, Fa-Bing;Wang, Chao;Dai, Hong-Wei;Fan, Yu-Bo;Song, Jin-Lin
    • The Journal of Advanced Prosthodontics
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    • v.10 no.1
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    • pp.8-17
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    • 2018
  • PURPOSE. The study aimed to identify the accuracy and reproducibility of preparations made by gypsum materials of various colors using quantitative and semi-quantitative three-dimensional (3D) approach. MATERIALS AND METHODS. A titanium maxillary first molar preparation was created as reference dataset (REF). Silicone impressions were duplicated from REF and randomized into 6 groups (n=8). Gypsum preparations were formed and grouped according to the color of gypsum materials, and light-scanned to obtain prepared datasets (PRE). Then, in terms of accuracy, PRE were superimposed on REF using the best-fit-algorithm and PRE underwent intragroup pairwise best-fit alignment for assessing reproducibility. Root mean square deviation (RMSD) and degrees of similarity (DS) were computed and analyzed with SPSS 20.0 statistical software (${\alpha}=.05$). RESULTS. In terms of accuracy, PREs in 3D directions were increased in the 6 color groups (from 19.38 to $20.88{\mu}m$), of which the marginal and internal variations ranged $51.36-58.26{\mu}m$ and $18.33-20.04{\mu}m$, respectively. On the other hand, RMSD value and DS-scores did not show significant differences among groups. Regarding reproducibility, both RMSD and DS-scores showed statistically significant differences among groups, while RMSD values of the 6 color groups were less than $5{\mu}m$, of which blue color group was the smallest ($3.27{\pm}0.24{\mu}m$) and white color group was the largest ($4.24{\pm}0.36{\mu}m$). These results were consistent with the DS data. CONCLUSION. The 3D volume of the PREs was predisposed towards an increase during digitalization, which was unaffected by gypsum color. Furthermore, the reproducibility of digitalizing scanning differed negligibly among different gypsum colors, especially in comparison to clinically observed discrepancies.

Development and validation of a computational multibody model of the elbow joint

  • Rahman, Munsur;Cil, Akin;Johnson, Michael;Lu, Yunkai;Guess, Trent M.
    • Advances in biomechanics and applications
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    • v.1 no.3
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    • pp.169-185
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    • 2014
  • Computational multibody models of the elbow can provide a versatile tool to study joint mechanics, cartilage loading, ligament function and the effects of joint trauma and orthopaedic repair. An efficiently developed computational model can assist surgeons and other investigators in the design and evaluation of treatments for elbow injuries, and contribute to improvements in patient care. The purpose of this study was to develop an anatomically correct elbow joint model and validate the model against experimental data. The elbow model was constrained by multiple bundles of non-linear ligaments, three-dimensional deformable contacts between articulating geometries, and applied external loads. The developed anatomical computational models of the joint can then be incorporated into neuro-musculoskeletal models within a multibody framework. In the approach presented here, volume images of two cadaver elbows were generated by computed tomography (CT) and one elbow by magnetic resonance imaging (MRI) to construct the three-dimensional bone geometries for the model. The ligaments and triceps tendon were represented with non-linear spring-damper elements as a function of stiffness, ligament length and ligament zero-load length. Articular cartilage was represented as uniform thickness solids that allowed prediction of compliant contact forces. As a final step, the subject specific model was validated by comparing predicted kinematics and triceps tendon forces to experimentally obtained data of the identically loaded cadaver elbow. The maximum root mean square (RMS) error between the predicted and measured kinematics during the complete testing cycle was 4.9 mm medial-lateral translational of the radius relative to the humerus (for Specimen 2 in this study) and 5.30 internal-external rotation of the radius relative to the humerus (for Specimen 3 in this study). The maximum RMS error for triceps tendon force was 7.6 N (for Specimen 3).

Numerical Simulation of Body Motion Using a Composite Grid System (중첩 격자계를 이용한 물체운동의 수치 시뮬레이션)

  • 박종천;전호환;송기종
    • Journal of the Society of Naval Architects of Korea
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    • v.40 no.5
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    • pp.36-42
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    • 2003
  • A CFD simulation technique has been developed to handle the unsteady body motion with large amplitude by use of overlapping multi-block grid system. The three-dimensional, viscous and incompressible flow around body is investigated by solving the Navier-Stokes equations, and the motion of body is represented by moving effect of the grid system. Composite grid system is employed in order to deal with both the body motion with large amplitude and the condition of numerical wave maker in convenience at the same time. The governing equations, Navier-Stokes (N-S) and continuity equations, are discretized by a finite volume method, in the framework of an O-H type boundary-fitted grid system (inner grid system including test model) and a rectangular grid system (outer grid system including simulation equipments for generation of wave environments). If this study, several flow configurations, such as an oscillating cylinder with large KC number, are studied in order to predict and evaluate the hydrodynamic forces. Furthermore, the motion simulation of a Series 60 model advancing in a uniform flow under the condition of enforced roll motion of angle 20$^{\circ}$ is performed in the developed numerical wave tank.