• Journal of Gastric Cancer
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• v.5 no.4 s.20
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• pp.246-251
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• 2005

Purpose: Benign anastomotic stricture after an esophagojejunostomy using EEA stapler following a radical total gastrectomy is one of the most serious complications. The purpose of this study is to evaluate the incidence risk factors, and treatment associated with benign stricture. Materials and Methods: From March 1998 to February 2001, 436 patients underwent an esophagojejunostomy with Roux-en-Y anastomosis using an EEA stapler followed by an endoscopy. Thirty three of the 436 patients(5.5%) developed an anastomotic stricture; included 24 of the 33 patients had a benign stricture. Nine patients with a malignant stricture were excluded. Results: The median age of the 436 patients was 57 years $(23{\sim}85\;years)$. Two hundred ninety two patients were male, and 144 patients were female. The median time to diagnosing the stricture was 1.5 months $(0.5{\sim}6months)$. There was no statistical significance in any of the risk factors, including the diameter of the stapling device, the status of adjuvant treatment, the status of reflux esophagitis, and a clinical history of diabetes and hypertension. The strictured patients were treated with balloon dilatation, one to three times, with symptom relief. Conclusion: There were no statistically significant risk factors. However, further study of the vascularity of anastomoses and benign strictures needs to be considered. In the anastomotic strictured patients endoscopic balloon dilatation appeared to be the first line of treatment.

• Tuberculosis and Respiratory Diseases
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• v.52 no.4
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• pp.330-337
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• 2002

Background : A pulmonary tuberculoma is one of the most common causes of a solitary pulmonary lesion. Treating a tuberculoma is still controversial and there are few reports on antituberculosis chemotherapy. In this study, the clinical findings and changes in the size of tuberculomas on a radiograph after completing antituberculosis chemotherapy was investigated. Methods : The medical records, an chest radiographs of 18 pulmonary tuberculoma patients who were admitted to the Gachon medical school, Ghil medical center between April 1998 and August 2001, were reviewed. The symptomatic changes were recorded and the size of the tuberculomas following treatment were compared. To compare the size, the long distance of each tuberculoma on the chest radiographs were measured and the additional radiological findings of calcification, satellite nodules and cavities were investigated. Results : Fifteen patients were men and 3 were women. The median age was 46 (24-74). Among these 18 patients, 14 patients had clinical symptoms. The other 4 patients were diagnosed incidentally as during a routine chest radiograph. The mean size of the tuberculomas on the initial plain chest film was $4.3{\pm}2.3cm$(range : 1.7-10 cm) and after 6 months treatment, it had decreased to $1.68{\pm}2.00cm$(range : 1.5-6.5 cm) (P<0.05). At least 6 months of antituberculosis chemotherapy resulted in the findings of a tuberculoma with a disappearance in 9, a decreased size in 4, and no change in 5 on the chest radiograph. Calcifications were found in 3 patients on the initial chest film and the chest CT and all calcified tuberculomas had disappeared after treatment. Conclusion : Although a pulmonary tuberculoma can remain as an inactive lesion for a long time, if it is confirmed by pathological or bacteriological methods, antituberculosis chemotherapy will be beneficial despite the presence of calcification.

• Tuberculosis and Respiratory Diseases
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• v.66 no.6
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• pp.437-443
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• 2009

Background: The aim of this study was to consider the significance of pleural fluid adenosine deaminase (ADA) activity combined with lymphocyte/neutrophil (L/N) ratio in the diagnosis of tuberculous pleurisy (TBpl) in a region of intermediate prevalence of tuberculosis (TB). Methods: We collected data from 388 patients with exudative pleural effusions. The final diagnoses were compared to the results from our diagnostic method using pleural fluid ADA and L/N ratio. Results: 108 patients had a final diagnosis of TBpl; 102 cases had high levels of ADA ($\geq$40 IU/L). When we considered ADA $\geq$40 IU/L as a diagnostic criterion, the sensitivity was 94.4%, specificity 87.5%, and posttest posttest probability 74.5%. However, when we considered ADA $\geq$40 IU/L combined with the L/N ratio $\geq$0.75 as a diagnostic criterion, the specificity and post-test probability were rose to 97.5% and 93%, respectively. The other causes of high ADA and L/N ratios were lymphoma and metastatic carcinoma, but mass-like lesions were found on the chest radiographs or CT scans. Conclusion: To evaluate the causes of exudative pleural effusions in a region of intermediate prevalence of tuberculosis, we recommend measuring the pleural fluid ADA and L/N ratio first. If the result is high and malignancies are not suspected, it may be diagnostic of TBpl.

• Progress in Medical Physics
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• v.26 no.4
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• pp.250-257
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• 2015

Multi-leaf collimator (MLC) systems are frequently used to deliver photon-based radiation, and allow conformal shaping of treatment beams. Many proton beam centers currently make use of aperture and snout systems, which involve use of a snout to shape and focus the proton beam, a brass aperture to modify field shape, and an acrylic compensator to modulate depth. However, it needs a lot of time and cost of preparing treatment, therefore, we developed the manual MLC for solving this problem. This study was carried out with the intent of designing an MLC system as an alternative to an aperture block system. Radio-activation and dose due to primary proton beam leakage and the presence of secondary neutrons were taken into account during these iterations. Analytical calculations were used to study the effects of leaf material on activation. We have fabricated tray model for adoption with a wobbling snout ($30{\times}40cm^2$) system which used uniform scanning beam. We designed the manual MLC and tray and can reduce the cost and time for treatment. After leakage test of new tray, we upgrade the tray with brass and made the safety tool. First, we have tested the radio-activation with usually brass and new brass for new manual MLC. It shows similar behavior and decay trend. In addition, we have measured the leakage test of a gantry with new tray and MLC tray, while we exposed the high energy with full modulation process on film dosimetry. The radiation leakage is less than 1%. From these results, we have developed the design of the tray and upgrade for safety. Through the radio-activation behavior, we figure out the proton beam leakage level of safety, where there detects the secondary particle, including neutron. After developing new design of the tray, it will be able to reduce the time and cost of proton treatment. Finally, we have applied in clinic test with original brass aperture and manual MLC and calculated the gamma index, 99.74% between them.

• The Korean Journal of Nuclear Medicine Technology
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• v.21 no.2
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• pp.74-79
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• 2017

Purpose Proton therapy can deliver an optimal dose to tumor while reducing unnecessary dose to normal tissue as compared the conventional photon therapy. As proton beams are irradiated into tissue, various positron emitters are produced via nuclear fragmentation reactions. These positron emitters could be used for the dose verification by using PET. However, the short half-life of the radioisotopes makes it hard to obtain the enough amounts of events. The aim of this study is to investigate the effect of off-line PET imaging scan time on the PET image quality. Materials and Methods The various diameters of spheres (D=37, 28, 22 mm) filled with distilled water were inserted in a 2001 IEC body phantom. Then proton beams (100 MU) were irradiated into the center of the each sphere using the wobbling technique with the gantry angle of $0^{\circ}$. The modulation widths of the spread out bragg peak were 16.4, 14.7 and 9.3 cm for the spheres of 37, 28 and 22 mm in diameters respectively. After 5 min of the proton irradiation, the PET images of the IEC body phantom were obtained for 50 min. The PET images with different time courses (0-10 min, 11-20 min, 21-30 min, 31-40 min and 41-50 min) were obtained by dividing the frame with a duration of 10 min. In order to evaluate the off-line PET image quality with the different time courses, the contrast-to-noise ratio (CNR) of the PET image calculated for each sphere. Results The CNRs of the sphere (D=37 mm) were 0.43, 0.42, 0.40, 0.31 and 0.21 for the time courses of 0-10 min, 11-20 min, 21-30 min, 31-40 min and 41-50 min respectively. The CNRs of the sphere (D=28 mm) were 0.36, 0.32, 0.27, 0.19 and 0.09 for the time courses of 0-10 min, 11-20 min, 21-30 min, 31-40 min and 41-50 min respectively. The CNR of 37 mm sphere was decreased rapidly after 30 min of the proton irradiation. In case of the spheres of 28 mm and 22 mm, the CNR was decreased drastically after 20 min of the irradiation. Conclusion The off-line PET imaging time is an important factor for the monitoring of the proton therapy. In case of the lesion diameter of 22 mm, the off-line PET image should be obtained within 25 min after the proton irradiation. When it comes to small size of tumor, the long PET imaging time will be beneficial for the proton therapy treatment monitoring.

• Pediatric Infection and Vaccine
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• v.15 no.1
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• pp.36-44
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• 2008

Purpose : Orbital cellulitis is rare, but it could be from the serious complication of sinusitis in children. It is often difficult to distinguish periorbital cellulitis from orbital cellulitis. The purpose of this study is to describe the clinical features of orbital and periorbital cellulitis in a pediatric population and to assess the predisposing factors and their complications. Methods : Forty-one patients aged 18 years and younger who were admitted between January 2000 and December 2006 to Hanil General Hospital and Kyunghee University Hospital with orbital or periorbital cellulitis. The retrospective analyses included clinical characteristics of orbital and periorbital cellulitis, dermographics, past history, predisposing factors, clinical presentations, treatments, and complications. Results : Among 41 patients, 34 patients had periorbital cellulitis, 7 patients had orbital cellulitis. While paranasal sinus disease was the most common predisposing cause in orbital cases, skin lesion, insect bite, dacrocystitis and conjunctivitis were the common causes in periorbital cases. In comparison with periorbital cases, orbital cases had higher level of white blood cell count, erythrocyte sedimentation rate, and C-reactive protein. Blood cultures were taken in 23 patients, but only one had Staphylococcus aureus from blood. Only one case had surgical incision and drainage and recovered without complications. Conclusion : From the results of our data, when patient shows erythematous swelling of periorbital area with opthalmoplegia, chemosis and proptosis, orbital CT scan is required to make diagnosis of orbital cellulitis. Most cases of orbital cellulitis can be treated successfully without surgical intervention. If there is no clinical improvement, repeated CT scan and/or surgical intervention should be considered.

• The Journal of Society for e-Business Studies
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• v.8 no.2
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• pp.99-111
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• 2003

By virtue of diverse advantages derived from digital media, eBook is getting started to use. And many market research agencies have predicted that its market will be greatly expanded soon. But against those expectations, copyright-related problems and the difficulties of its accessing inherited from various eBook content formats become an obstacle to its diffusion. The first problems can be solved by DRM technology. And to solve the second problems, each nation has published its own content standard format. But the domestic standards are useful only the domestic level, they still leave the problems in the national level. The variety of content formats has created a demand for mechanisms that allow the exchange of eBook contents. Therefore we study the mapping relations between eBook contents for conversion. To define the mapping relations, first we extract the mapping both between eBook contents and between normal XML documents. From those mappings, we define seven mapping relations and classify them by cardinality. And we analyze the classified relations, which can be generated by automatic, or not. Using these results, we also classify the eBook content conversion as automatic, semi-automatic, and manual. Besides, we provide the conversion templates for mapping relations for automatic generation of conversion scripts. To show the feasibility of conversion templates, we apply them to the eBook content conversion. Experiment shows that our conversion templates generate the conversion scripts properly. We expected that defined mapping relations and conversion templates can be used not only in eBook content conversion , but also in normal XML document conversion.

• Radiation Oncology Journal
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• v.15 no.2
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• pp.159-165
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• 1997

Purpose : Secondary electrons generated by interaction between Primary X-rar beam and block tray in megavoltage irradiation, result in excess soft radiation dose to the surface layer To reduce the surface dose from the electron contamination, electron filters were attached under the tray when a customized block was used. Materials and Methods : Cu, Al or Cu/Al combined Plate with different thickness was used as a filter and the surface dose reduction was measured for each case. The measurement to find optimal filter was performed with $10m\times10cm$ field size and 78.5cm source to surface distance. The measurement points are positioned with 2mm intervals from surface to maximum build-up point. To acquire the effect of field size dependence on optimal electron filter, the measurement was performed from $4cm\times4cm\;to\;25cm\times25cm$ field sizes. Results : The surface dose was slowly increased by increasing irradiation field but rapidly increased beyond $15cm\times15cm$ field size. Al plate was found to be inadequate filter because of the failure to have surface dose kept lowering than the dose of deep area. Cu 0.5mm plate and Cu/Al=0.28mm/1.5mm combined plate were found to be optimal filters. By using these 2 filters, the absorbed dose to the surface layer was effectively reduced by $5.5\%,\;11.3\%,\;and\;22.3\%$ for the field size $4cm\times4cm,\;10m\times10cm,\;and\;25cm\times25cm$, respectively. Conclusion : The surface dose attributable to electron contamination had a dependence on field size. The electron contamination was increased when tray was used. Specially the electron contamination in the surface layer was greater when the larger field was used. 0.5mm Cu Plate and Cu/Al=0.28mm/15mm combined plates were selected as optimal electron filters. When the optimal electron filter was attached under the tray, excessive surface dose was decreased effectively The effect of these electron filters was better when a larger field was used.

• Radiation Oncology Journal
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• v.17 no.2
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• pp.158-165
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• 1999

Purpose : To investigate the percentage of colonies wi1h16or more cells distribution of human skin fibroblast according to in vitro aging, and to evaluate the relationship between percentage of colonies with 10 or more cells and in vivo donor age in human skin fibroblast culture. Material and Method : C1, C2, C3a, and C3b human skin fibroblast samples from three breast cancer patients were used as subjects. The C1, C2, and C3a donor were 44, 54, and 55 years old, respectively. C3a and C3b cells were isolated from the same person. Single cell suspension of skin fibroblasts was prepared with primary explant technique. One hundred cells are plated into 100m1 tissue culture flask and cultured for two weeks. The colony size was defined as colonies with 16 or more cells. The cultured cell was stained with crystal violet, and number of cells in each colony was determined with stereo microscope at $\times$10 magnification. Passage number of C1, C2, C3a and C3b skin fibroblast were 12th, 17th, and 14th, respectively. Results : Percentage of colonies with 16 or more cells of skin fibroblast samples decreased with increasing in vitro passage number. In contrast, cumulative population doublings of skin fibroblast sample increased with increasing in vitro passage number. Percentage of colonies with 16 or more cells also decreased with increasing population doublings in human skin fibroblast culture. There was strong correlation with percentage of colonies with 16 or more cells and population doublings En C3a skin fibroblast sampie. At the same point of population doublings, the percentage of colonies with 16 or more cells of the young C1 donor was higher level than the old C3a donor. Conclusion : The population doublings increased with increasing in vitro passage number but percentage of colonies with 16 or more cells decreased. The results of this study imply that percentage of colonies with 16 or more cell is useful as a indicator of in vitro human skin fibroblast aging and may estimate the in vivo donor age.

• Journal of Chest Surgery
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• v.37 no.8
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• pp.672-683
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• 2004

Background: The treatment results of the advanced lung carcinoma is not satisfactory with the present therapeutic modalities: surgical resection, anti-cancer chemotherapy, and radiotherapy or combination therapy. To predict the prognosis of the non-small-cell lung carcinoma, TNM classification has been was as the basic categorization; however, it has been not satisfactory. It is necessary to consider the causes and the prognosis of the lung carcinoma from another points of view rather the conventional methods. We intended to find out the relationship between the major apoptotic factor, p53 gene and the prognosis of the patient with lung carcinoma. Material and Method: Three hundreds and fifty-nine patients with lung carcinoma who underwent surgery were analysed. We observed p53 protein accumulated in the cellular nuclei. The p53 protein was detected by immuno-histo-chemical method. We collected information of the patient retrospectively. Result: p53 protein densities were observed in 40% in average as a whole. The protein density was 44 percent in man, 25 percent in woman, 49 percent in the squamous cell carcinoma, and 38 percent in the adenocarcinoma. There were significant correlations between the p53 protein density and the mortality in the squamous cell carcinoma (p=0.025), follow-up duration in TNM stage I group (p=0.010), and follow-up duration in the lobectomy patient group (p=0.043), and tumor cell differentiation (p=0.009). p53 protein densities were significantly different between the lobectomy and the pneumonectomy group (p=0.044). Conclusion: The authors found that p53 protein had some correlations with the prognosis of the lung cancer partially in some factors. We suggest the p53 protein density could be used as a marker of prognosis in the non-small-cell lung carcinoma.