• Radiation Oncology Journal
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• v.21 no.2
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• pp.112-117
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• 2003

Purpose: The effects of hypefractionation radiation therapy, such as the failure pattern and survival, on the treatment results in advanced stage head and neck cancer were studied. Materials and Methods: Between September 1990 and October 1998, 24 patients with advanced stage (III, IV) head and neck cancers, were treated using hyperfractionation radiation therapy in the Department of Radiation Oncology at the Keimyung University Dongsan Medical Center. The male to female ratio was 7 : 1, and the age range from 38 to 71 years with the median of 56 years. With regard to the TNM stage, 11 patients were stage III and 13 were stage IV. The sites of primary cancer were the nasopharynx in six, the hypopharynx in 6, the larynx in five, the oropharynx in three, the maxillary sinus in three, and the oral cavity in one patient. The radiotherapy was delivered by 6 MV X-ray, with a fraction size of 1.2 Gy at two fractions a day, with at least 6 hours inter-fractional interval. The mean total radiation doses was 72 Gy, (ranging from 64.4 to 75.8 Gy). Follow-up periods ranged between 3 and 136 months, with the median of 52 months. Results: The overall survival rates at 3 and 5 years in all patients were 66.7$\%$, and 52.4$\%$. The disease-free survival rates at 3 and S years (3YDFS, 5YDFS) in all patients were 66.7$\%$ and 47.6$\%$. The 3YDFS and 5YDFS in stage III patients were 81.8$\%$ and 63.6$\%$, and those in stage IV patients were 53.8$\%$ and 32.3$\%$. Ten patients were alive with no local nor distant failures at the time of analyses. Six patients (25$\%$) died due to distant metastasis and 12.5$\%$ died due to local failure. Distant metastasis was the major cause of failure, but 2 patients died due to unknown failures and 3 of other diseases. The distant metastasis sites were the lung (3 patients), the bone (1 patient), and the liver (2 patients). One patient died of second esophageal cancer. There were no severe late complications, with the exception of 1 osteo-radionecrosis of the mandible 58 months after treatment. Conclusion: Although this study was peformed on small patients group, we considered hypefractionated radiation therapy for the treatment of advanced stage head and neck cancer might improve the disease free survival and decrease the local failure with no increase in late complications despite of the slight Increase in acute complications.

• Radiation Oncology Journal
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• v.23 no.4
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• pp.243-252
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• 2005

Purpose: Indoor air quality (IAQ) in the radiation treatment center which is generally located underground is important to the health of hospital workers and patients treated over a long period of time. this study was conducted to measure and analyze the factors related to IAQ and subjective symptoms of sick building syndrome, and to establish the causes influencing IAQ and find a solution to the problems. Methods and Materials : Self administrated questionnaire was conducted to check the workers' symptoms and understanding of the work environment. Based on a preliminary investigation, the factors related to IAQ such as temperature, humidity, fine particulate. carbon dioxide, carbon monoxide, formaldehyde, total volatile organic compounds (TVOC), and radon gas were selected and measured for a certain period of time in specific sites where hospital workers stay long in a day. And we also evaluated the surrounding environment and the efficiency of the ventilating system simultaneously, and measured the same factors at the first floor (outdoor) to compare with outdoor all quality, All collected data were assessed by the recommended standard for IAQ of the domestic and international environmental organizations. Results: Hospital workers were discontented with foul odors, humidity and particulate. They complained symptoms related to musculo-skeletal system, neurologic system, and mucosal-irritatation. Most of the factors were not greater than the recommended standard, but the level of TVOC was third or fourth times as much as the measuring level of some offices in the United States. The frequency and the amount of the ventilating system were adequate, however, the problem arising in the position of outdoor-air inlets and indoor-air outlets involved a risk of the indraft of contaminated air. A careful attention was a requirement in handling and keeping chemical substances including a developing solution which has a risk of TVOC emissions, and repositioning the ventilating system was needed to solve the contaminated-air circulation immediately Conclusion We verified that some IAQ-related factors and inadequate ventilating system could cause subjective symptoms in hospital workers. The evaluation of IAQ was surely needed to improve the underground working environments for hospital workers and patients. On the basis of these data, from now on, we should actively engage in designs of the department of radiation oncology or improvement in environments of the existing facilities.

• Radiation Oncology Journal
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• v.25 no.2
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• pp.101-108
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• 2007

[ $\underline{Purpose}$ ]: To compare radiation therapy alone to combined modality therapy about survival rate and tolerance of elderly patients ($70=or{\geq}$) with non-small-cell lung cancer (NSCLC). $\underline{Materials\;and\;Methods}$: Between 1998 and 2002, 57 patients given radiation therapy due to NSCLC (Stage III) were analysed retrospectively. Radiation therapy alone (RT), concurrent chemoradiation (CRT), and sequential chemoradiation (SCRT) was done to 33, 16 and 8 patients, respectively. Patients' median age was 74 (range $70{\sim}85$). Male and female are 51 patients and 6 patients, respectively. 23 patients were stage IIIa and 34 were stage IIIb. Patients' characteristic distribution of RT and CRT was not significantly different except mass size that RT has a bigger than CRT. The fraction size of radiation therapy was 1.8 Gy in CRT and $1.8{\sim}3\;Gy$ in other groups. Total radiation dose was $51{\sim}63\;Gy$ according to the fraction size. If the prescribed total radiation dose was successfully irradiated, we stated that it was completion of radiation therapy. $\underline{Results}$: 52 patients were dead. Median period of radiation therapy was as follow: RT, 35 days, CRT, 60.5 days and SCRT, 35 days. Overall median survival time (MST) was 10.1 months. The 1 yr- and 2 yr-overall survival rate was 39.8% and 17.6%, respectively. MST of RT, CRT and SCRT was 8.9, 8.2 and 11.7 months, respectively. The 1 yr survival rate of RT, CRT and SCRT was 38.4%, 37.5% and 50% (not significant). Patients given incomplete radiation therapy were 12 (RT, 5 CRT, 6 SCRT, 1). N stage (p=0.081) and the difference of treatment methods (p=0.079) were the factors affecting incompletion of radiation therapy, but it was not significant. In case of combined-agents chemotherapy, 4 of 8 ceased radiation therapy. T stage ($T{\geq}3$), mass size (${\geq}5\;cm$), Karnofsky performance scale (${\leq}70$) and completion of radiation therapy were the prognostic factors in uni- and multi-variate analysis. $\underline{Conclusion}$: In elderly patients with NSCLC, radiation therapy alone was a treatment method with similar survival period compared with other methods. Generally, patients given radiation therapy alone was tolerable to a treatment. Before planning concurrent chemoirradiation in elderly patients with NSCLC, physicians pay attention to a selection of patients and chemotherapy agents considering general condition and toxicity.

• Nuclear Medicine and Molecular Imaging
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• v.41 no.4
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• pp.317-325
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• 2007

Purpose: Biological parameters can be quantified using dynamic PET data with compartment modeling and Nonlinear Least Square (NLS) estimation. However, the generation of parametric images using the NLS is not appropriate because of the initial value problem and excessive computation time. In irreversible model, Patlak graphical analysis (PGA) has been commonly used as an alternative to the NLS method. In PGA, however, the start time ($t^*$, time where linear phase starts) has to be determined. In this study, we suggest a new Multiple Linear Analysis for irreversible radiotracer (MLAIR) to estimate fluoride bone influx rate (Ki). Methods: $[^{18}F]Fluoride$ dynamic PET scans was acquired for 60 min in three normal mini-pigs. The plasma input curve was derived using blood sampling from the femoral artery. Tissue time-activity curves were measured by drawing region of interests (ROls) on the femur head, vertebra, and muscle. Parametric images of Ki were generated using MLAIR and PGA methods. Result: In ROI analysis, estimated Ki values using MLAIR and PGA method was slightly higher than those of NLS, but the results of MLAIR and PGA were equivalent. Patlak slopes (Ki) were changed with different $t^*$ in low uptake region. Compared with PGA, the quality of parametric image was considerably improved using new method. Conclusion: The results showed that the MLAIR was efficient and robust method for the generation of Ki parametric image from $[^{18}F]Fluoride$ PET. It will be also a good alternative to PGA for the radiotracers with irreversible three compartment model.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.5
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• pp.411-420
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• 2009

Purpose: The aim of this study was to investigate the usefulness of $^{18}F$-FDG PET/CT with neck ultrasonography (neck US) in patients with recurrent, papillary thyroid cancer. Material and methods: This retrospective study (December 2006 to April 2008) enrolled sixty-one patients (ninety-one lesions) who underwent high-dose $^{131}I$-ablation therapy after total thyroidectomy, and evaluated recurred papillary thyroid cancer. All lesions were confirmed by histopathology and compared histopathologic findings to PET, PET/CT, and neck US findings. Results: In sixty-one patients (57 women, 4 men; age range, 24-81 years, mean 49 years; 61 papillary carcinomas), the sensitivity, specificity, accuracy of $^{18}F$-FDG PET/CT was 87.2%, 64.0%, 78.1% on a patient basis and 92.3%, 66.7%, 80.9% on a lesion basis, respectively. The sensitivity, specificity, accuracy of $^{18}F$-FDG PET was 71.8% (p=0.03), 59.0% (p=1.00), 67.2% (p=0.03) on a patient basis and 78.8% (p<0.01), 64.1% (p=1.00), 72.5% (p=0.02) on a lesion basis, respectively. The sensitivity, specificity, accuracy of neck US was 71.1% (p=0.07), 52.2% (p=0.75), 63.9% (p=0.05) on a patient basis and 71.2% (p<0.01), 61.5% (p=1.00), 67.0% (p=0.06) on a lesion basis, respectively. Combined $^{18}F$-FDG PET/CT with neck US improved the sensitivity, specificity, accuracy to 94.7% (p=0.50), 82.6% (p=0.13), 90.2% (p=0.03) on a patient basis and 96.2% (p=0.50), 89.7% (p<0.01), 93.4% (p<0.01) on a lesion basis, respectively. Conclusion: $^{18}F$-FDG PET/CT demonstrated significantly higher sensitivity than neck US for the detection of recurred papillary thyroid cancer lesions. Furthermore, combined $^{18}F$-FDG PET/CT with neck US showed more improved sensitivity, specificity, accuracy for diagnosis of recurrent papillary thyroid cancer.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.4
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• pp.287-293
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• 2009

Purpose: This study is to evaluate rib fractures on bone scan in breast cancer patients treated with breast cancer surgery and radiation therapy and to evaluate its relation with radiation therapy and operation modality. Materials and Methods: Two hundred seventy cases that underwent serial bone scan after breast cancer surgery and radiation therapy were enrolled. Bone scan and chest a findings of rib fracture were analyzed. Results: The rib uptake was seen in 74 of 270 cases (27.4%) on bone scan and 50 cases (18.5%) were confirmed to have rib fracture by chest CT. The rate of modified radical mastectomy in patients with rib fracture was significantly higher than that in patients without rib fracture (66.0% vs. 27.0%, p = 0.000). The rate of additional radiation therapy to axillar or supraclavicular regions in patients with rib fracture was significantly higher than that in patients without rib fracture (62.0% vs. 28.6%, p =0.000). Rib fracture was seen most frequently at 1-2 years after radiation therapy (51.9%) and single rib fracture was seen most frequently (55.2%). Of total 106 rib fractures, focal rib uptake was seen in 94 ribs (88.7%) and diffuse rib uptake was seen in 12 ribs (11.3%). On one year follow-up bone scan, complete resolution of rib uptake was seen in 15 ribs (14.2%). On chest a, the rate of fracture line in ribs with intense uptake was significantly higher than that in ribs with mild or moderate uptake (p = 0.000). The rate of presence of fracture line in ribs with focal uptake was significantly higher than that in ribs with diffuse uptake (p = 0.001). Conclusion: Rib fracture in breast cancer patients after radiation therapy was related to radiation portal and operation modality. It should be interpreted carefully as a differential diagnosis of bone metastasis.

• The Korean Journal of Nuclear Medicine Technology
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• v.18 no.1
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• pp.134-139
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• 2014

Purpose: Adaptive statistical iterative reconstruction (ASIR) technique is a reconstruction method of CT image using statistical noise modeling which is known to reduce image noise and to preserve image quality despite reducing radiation dose. The aim of this study is to evaluate images using ASIR on bone SPECT/CT which is primarily performed in our hospital. Materials and Methods: We compared the images of applied ASIR (ASIR level: 20-80%) and none ASIR by changing the mA based on 120 kVp, 100 mA using Discovery NM/CT 670 (GE, U.S.A). First, we evaluated attenuation correction in SPECT image by changing the ASIR level using Anthropomorphic phantom. Second, we compared the contrast to noise ratio (CNR), image noise and spatial resolution in CT image using ACR phantom. Third, after selecting the ASIR level applicable patient using lower torso phantom, we examined 2 patients who followed up bone SPECT/CT and we performed blind test. Results: The degree of attenuation correction in SPECT image showed no significant difference between applied ASIR and none ASIR (P>0.05). When applied ASIR, the noise of CT image were reduced at least 17 up to 52% by changing the mA. The CNR of image with ASIR was maintained more than 0.8 at 40 mA (ASIR 60%) while those without ASIR showed 0.42 at standard 40 mA. In comparison of the high contrast object, we distinguished 12 line pairs/cm at 40 mA regardless of appling ASIR. Comparison of the patients image applied ASIR level 60% (40 mA) which found out by spine image of lower torso phantom showed no signigicant difference between applied ASIR and none ASIR in blind test. The CTDIvol and DLP for applied ASIR 60% showed decreased by 60%, 60% on average than using standard mA. Conclusion: The study show that the radiation dose in SPECT/CT using ASIR can be reduced despite degradation of SPECT and CT images. In addition, higher ASIR level could be possibly applied characteristics of SPECT/CT that region of interest is limited to bone.

• Journal of Bio-Environment Control
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• v.1 no.2
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• pp.154-161
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• 1992

This experiment was carried oui to determine the relativeness between growth, yield characters and bio-informations as influenced by the spray and rest time intervals of nutrient solution. Tomato(Lycopersicon esculentum Mill.) were grown in aeroponic system on a misting schedule of continuously 60 sec, 30 sec and 10 sec at 10 min intervals with full strength Yamazaki's solution recommended for tomato production. The results obtained were as follows : 1. Leaf area was highest in the plot of 30 sec spray and 10 min rest while the forest one was the plot of 60 sec spray and 10 min rest. Growth characteristics in terms of dry weight of each organ, number of flower, number of flower setted and fruit dry weight were greater in the plot of 30 sec spray and 10 min rest than the other treatments. 2. The number of flower increased with decreasing dry weight but number of flower sorted was not significantly different among treatment except for the plot of 60 sec spray and 10 min rest. 3. Leaf dry weight and fruit dry weight were highly correlated so that 30 sec spray and 10 min rest plot which is the highest fruit dry weight showed the largest leaf area. Continuously sprayed plot reduced markedly the fruit dry weight compared with leaf area. Optimum spray and rest time of nutrient solution in the range of this experiment was determined as 30 sec spray and 10 min rest. 4. Solar radiation within glasshouse during daytime reduced severely compared with outdoor one and air temperature within greenhouse was higher than the leaf temperature of tomato plant. The changes of environmental factors, solar radiation, temperature were accompanied with the sensitive change of bio-informations of tomato leaf Especially differences of spray intervals of nutrient solution affected greatly to the changes of bio-informations : leaf water potential, stomatal resistance and leaf temperature etc. 5. The changing patterns of leaf growth as influenced by the spray and rest intervals of nutrient solution were closely related to the leaf water potential, stomatal resistance and leaf temperature. Feasibility was demonstrated that measurement of bio-information of tomato leaf as influenced by the change of environmental factors could be expected to the amount of growth and fruit yield.

• Journal of Radiation Protection and Research
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• v.33 no.1
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• pp.13-20
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• 2008

The flow rate measurements in a multi-phase flow pipeline were evaluated quantitatively by means of a clamp-on sealed radioisotope based on a cross correlation signal processing technique. The flow rates were calculated by a determination of the transit time between two sealed gamma sources by using a cross correlation function following FFT filtering, then corrected with vapor fraction in the pipeline which was measured by the ${\gamma}$-ray attenuation method. The pipeline model was manufactured by acrylic resin(ID. 8 cm, L=3.5 m, t=10 mm), and the multi-phase flow patterns were realized by an injection of compressed $N_2$ gas. Two sealed gamma sources of $^{137}Cs$ (E=0.662 MeV, ${\Gamma}$ $factor=0.326\;R{\cdot}h^{-1}{\cdot}m^2{\cdot}Ci^{-1}$) of 20 mCi and 17 mCi, and radiation detectors of $2"{\times}2"$ NaI(Tl) scintillation counter (Eberline, SP-3) were used for this study. Under the given conditions(the distance between two sources: 4D(D; inner diameter), N/S ratio: $0.12{\sim}0.15$, sampling time ${\Delta}t$: 4msec), the measured flow rates showed the maximum. relative error of 1.7 % when compared to the real ones through the vapor content corrections($6.1\;%{\sim}9.2\;%$). From a subsequent experiment, it was proven that the closer the distance between the two sealed sources is, the more precise the measured flow rates are. Provided additional studies related to the selection of radioisotopes their activity, and an optimization of the experimental geometry are carried out, it is anticipated that a radioisotope application for flow rate measurements can be used as an important tool for monitoring multi-phase facilities belonging to petrochemical and refinery industries and contributes economically in the light of maintenance and control of them.

• Journal of Dental Rehabilitation and Applied Science
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• v.25 no.2
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• pp.139-155
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• 2009

Objective : To assess the biological stability of immediate transmucosal placement of tapered implants into tooth extraction sockets. Material and methods : Following tooth extraction, tapered implants were immediately placed into the sockets. Teeth with evidence of acute periapical pathology were excluded. After implant placement, sutured allowing a non-submerged, transmucosal healing. Standardized radiographs were obtained every visiting from baseline to 32 weeks after implant placment. Changes in depth of the distance from the implant shoulder (IS) and from the alveolar crest (AC) to the bottom of the defect (BD) were assessed. Results : Thirteen patients (10 males and 3 females) were enrolled and followed. They contributed with 15 tapered implants. extraction iste displayed sufficient residual bone volume to allow primary stability of all implants. The mean surgery time was $41{\pm}10.0$ mins. All implants healed uneventfully yielding a survival rate of 100%. Mean ISQ values were relatively stable. Interproximal crestal bone decreased $1.69{\pm}1.2mm$ (mesial), $1.65{\pm}1.2mm$ (distal) from baseline to 32-week follow-up. No statistically significant changes with respect to FMPS, FMBS, PPD and width of KG were observed. Conclusions: Immediate transmucosal implant placement represented a predictable treatment option for the replacement of teeth lost due to reasons including fractures, endodontic failures and caries.