• Tuberculosis and Respiratory Diseases
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• v.57 no.1
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• pp.19-24
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• 2004

Background : It is difficult to differentiate between tuberculous pneumonia and Community Acquired Pneumonia, so the diagnosis and treatment of tuberculous pneumonia can be delayed frequently. In this study, we attempted to retrospectively evaluate the clinical and radiologic characteristics of tuberculous pneumonia. Methods : We conducted a retrospective analysis of clinical characteristics of 58 patients diagnosed with tuberculous pneumonia from Nov. 1997 to May 2001 at Korea university kuro hospital. Result : The male to female ratio was 1:1 and the mean age at diagnosis was $54.5{\pm}18.6$ years. Fifty five patients were confirmed microbiologically and three patients pathologically. There were 20 patients(34.5%) who had diabetes mellitus(8cases), chronic obstructive pulmonary disease(3cases), malignancy(3cases), bronchiectasis(2cases), chronic renal failure(1cases) or long term history of corticosteroid treatment(3cases). Many patients had multilobar infiltration in chest X-ray, dominantly in the lower lobe. thirty two patients(55.2%) had infiltration in more than 2 lobes and 5 patients in more than 4 lobes. The significant correlation between the diabetes mellitus and the infiltrated Rt lower lobe(RLL) was found on the borders of confidence limit.(P=0.07<0.1). There was significant correlation between woman and infiltrated lobe(RML, RLL, LLL) excluding the both upper lobe(P=0.029). Conclusion : We must consider tuberculous pneumonia when lobar pneumonia with consolidation resistant to antibiotics, especially in the patients who have diabetes mellitus, chronic obstructive pulmonary disease, malignancy, bronchiectsis, chronic renal failure or long term history of corticosteroid treatment.

• Radiation Oncology Journal
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• v.23 no.3
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• pp.143-156
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• 2005

Background: The best dose-fractionation regimen of the definitive radiotherapy for cervix cancer remains to be clearly determined. It seems to be partially attributed to the complexity of the affecting factors and the lack of detailed information on external and intra-cavitary fractionation. To find optimal practice guidelines, our experiences of the combination of external beam radiotherapy (EBRT) and high-dose-rate intracavitary brachytherapy (HDR-ICBT) were reviewed with detailed information of the various treatment parameters obtained from a large cohort of women treated homogeneously at a single institute. Materials and Methods: The subjects were 743 cervical cancer patients (Stage IB 198, IIA 77, IIB 364, IIIA 7, IIIB 89 and IVA 8) treated by radiotherapy alone, between 1990 and 1996. A total external beam radiotherapy (EBRT) dose of $23.4\~59.4$ Gy (Median 45.0) was delivered to the whole pelvis. High-dose-rate intracavitary brachytherapy (HDR-IBT) was also peformed using various fractionation schemes. A Midline block (MLB) was initiated after the delivery of $14.4\~43.2$ Gy (Median 36.0) of EBRT in 495 patients, while In the other 248 patients EBRT could not be used due to slow tumor regression or the huge initial bulk of tumor. The point A, actual bladder & rectal doses were individually assessed in all patients. The biologically effective dose (BED) to the tumor ($\alpha/\beta$=10) and late-responding tissues ($\alpha/\beta$=3) for both EBRT and HDR-ICBT were calculated. The total BED values to point A, the actual bladder and rectal reference points were the summation of the EBRT and HDR-ICBT. In addition to all the details on dose-fractionation, the other factors (i.e. the overall treatment time, physicians preference) that can affect the schedule of the definitive radiotherapy were also thoroughly analyzed. The association between MD-BED $Gy_3$ and the risk of complication was assessed using serial multiple logistic regression models. The associations between R-BED $Gy_3$ and rectal complications and between V-BED $Gy_3$ and bladder complications were assessed using multiple logistic regression models after adjustment for age, stage, tumor size and treatment duration. Serial Coxs proportional hazard regression models were used to estimate the relative risks of recurrence due to MD-BED $Gy_{10}$, and the treatment duration. Results: The overall complication rate for RTOG Grades $1\~4$ toxicities was $33.1\%$. The 5-year actuarial pelvic control rate for ail 743 patients was $83\%$. The midline cumulative BED dose, which is the sum of external midline BED and HDR-ICBT point A BED, ranged from 62.0 to 121.9 $Gy_{10}$ (median 93.0) for tumors and from 93.6 to 187.3 $Gy_3$ (median 137.6) for late responding tissues. The median cumulative values of actual rectal (R-BED $Gy_3$) and bladder Point BED (V-BED $Gy_3$) were 118.7 $Gy_3$ (range $48.8\~265.2$) and 126.1 $Gy_3$ (range: $54.9\~267.5$), respectively. MD-BED $Gy_3$ showed a good correlation with rectal (p=0.003), but not with bladder complications (p=0.095). R-BED $Gy_3$ had a very strong association (p=<0.0001), and was more predictive of rectal complications than A-BED $Gy_3$. B-BED $Gy_3$ also showed significance in the prediction of bladder complications in a trend test (p=0.0298). No statistically significant dose-response relationship for pelvic control was observed. The Sandwich and Continuous techniques, which differ according to when the ICR was inserted during the EBRT and due to the physicians preference, showed no differences in the local control and complication rates; there were also no differences in the 3 vs. 5 Gy fraction size of HDR-ICBT. Conclusion: The main reasons optimal dose-fractionation guidelines are not easily established is due to the absence of a dose-response relationship for tumor control as a result of the high-dose gradient of HDR-ICBT, individual differences In tumor responses to radiation therapy and the complexity of affecting factors. Therefore, in our opinion, there is a necessity for individualized tailored therapy, along with general guidelines, in the definitive radiation treatment for cervix cancer. This study also demonstrated the strong predictive value of actual rectal and bladder reference dosing therefore, vaginal gauze packing might be very Important. To maintain the BED dose to less than the threshold resulting in complication, early midline shielding, the HDR-ICBT total dose and fractional dose reduction should be considered.

• Progress in Medical Physics
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• v.22 no.3
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• pp.140-147
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• 2011

The purpose of this study was to estimate internal motion using molecular sieve for quantitative improvement of lung tumor and to localize lung tumor in the small animal PET image by evaluated data. Internal motion has been demonstrated in small animal lung region by molecular sieve contained radioactive substance. Molecular sieve for internal lung motion target was contained approximately 37 kBq Cu-64. The small animal PET images were obtained from Siemens Inveon scanner using external trigger system (BioVet). SD-Rat PET images were obtained at 60 min post injection of FDG 37 MBq/0.2 mL via tail vein for 20 min. Each line of response in the list-mode data was converted to sinogram gated frames (2~16 bin) by trigger signal obtained from BioVet. The sinogram data was reconstructed using OSEM 2D with 4 iterations. PET images were evaluated with count, SNR, FWHM from ROI drawn in the target region for quantitative tumor analysis. The size of molecular sieve motion target was $1.59{\times}2.50mm$. The reference motion target FWHM of vertical and horizontal was 2.91 mm and 1.43 mm, respectively. The vertical FWHM of static, 4 bin and 8 bin was 3.90 mm, 3.74 mm, and 3.16 mm, respectively. The horizontal FWHM of static, 4 bin and 8 bin was 2.21 mm, 2.06 mm, and 1.60 mm, respectively. Count of static, 4 bin, 8 bin, 12 bin and 16 bin was 4.10, 4.83, 5.59, 5.38, and 5.31, respectively. The SNR of static, 4 bin, 8 bin, 12 bin and 16 bin was 4.18, 4.05, 4.22, 3.89, and 3.58, respectively. The FWHM were improved in accordance with gate number increase. The count and SNR were not proportionately improve with gate number, but shown the highest value in specific bin number. We measured the optimal gate number what minimize the SNR loss and gain improved count when imaging lung tumor in small animal. The internal motion estimation provide localized tumor image and will be a useful method for organ motion prediction modeling without external motion monitoring system.

• 한국지구물리탐사학회:학술대회논문집
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• 2002.09a
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• pp.139-162
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• 2002

Since weak zones or geological lineaments are likely to be eroded, weak zones may develop beneath rivers, and a careful evaluation of ground condition is important to construct structures passing through a river. Dc resistivity surveys, however, have seldomly applied to the investigation of water-covered area, possibly because of difficulties in data aquisition and interpretation. The data aquisition having high quality may be the most important factor, and is more difficult than that in land survey, due to the water layer overlying the underground structure to be imaged. Through the numerical modeling and the analysis of case histories, we studied the method of resistivity survey at the water-covered area, starting from the characteristics of measured data, via data acquisition method, to the interpretation method. We unfolded our discussion according to the installed locations of electrodes, ie., floating them on the water surface, and installing at the water bottom, since the methods of data acquisition and interpretation vary depending on the electrode location. Through this study, we could confirm that the dc resistivity method can provide the fairly reasonable subsurface images. It was also shown that installing electrodes at the water bottom can give the subsurface image with much higher resolution than floating them on the water surface. Since the data acquired at the water-covered area have much lower sensitivity to the underground structure than those at the land, and can be contaminated by the higher noise, such as streaming potential, it would be very important to select the acquisition method and electrode array being able to provide the higher signal-to-noise ratio data as well as the high resolving power. The method installing electrodes at the water bottom is suitable to the detailed survey because of much higher resolving power, whereas the method floating them, especially streamer dc resistivity survey, is to the reconnaissance survey owing of very high speed of field work.

• Radiation Oncology Journal
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• v.21 no.4
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• pp.299-305
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• 2003

Purpose: In order to develop the national guide-lines for the standardization of radiotherapy we are planning to establish a web-based, on-line data-base system for laryngeal cancer. As a first step this study was performed to accumulate the basic clinical information of laryngeal cancer and to determine the items needed for the data-base system. Materials and Methods: We analyzed the clinical data on patients who were treated under the diagnosis of laryngeal cancer from January 1998 through December 1999 In the South-west area of Korea. Eligiblity criteria of the patients are as follows: 18 years or older, currently diagnosed with primary epithelial carcinoma of larynx, and no history of previous treatments for another cancers and the other laryngeal diseases. The items were developed and filled out by radiation oncologlst who are members of forean Southwest Radiation Oncology Group. SPSS vl0.0 software was used for statistical analysis. Results: Data of forty-five patients were collected. Age distribution of patients ranged from 28 to 88 years(median, 61). Laryngeal cancer occurred predominantly In males (10 : 1 sex ratio). Twenty-eight patients (62$\%$) had primary cancers in the glottis and 17 (38$\%$) in the supraglottis. Most of them were diagnosed pathologically as squamous cell carcinoma (44/45, 98$\%$). Twenty-four of 28 glottic cancer patients (86$\%$) had AJCC (American Joint Committee on Cancer) stage I/II, but 50$\%$ (8/16) had In supraglottic cancer patients (p=0.02). Most patients(89$\%$) had the symptom of hoarseness. indirect laryngoscopy was done in all patients and direct laryngoscopy was peformed in 43 (98$\%$) patients. Twenty-one of 28 (75$\%$) glottic cancer cases and 6 of 17 (35$\%$) supraglottic cancer cases were treated with radiation alone, respectively. The combined treatment of surgery and radiation was used in 5 (18$\%$) glottic and 8 (47$\%$) supraglottic patients. Chemotherapy and radiation was used in 2 (7$\%$) glottic and 3 (18$\%$) supraglottic patients. There was no statistically significant difference in the use of combined modality treatments between glottic and supraglottic cancers (p=0.20). In all patients, 6 MV X-ray was used with conventional fractionation. The iraction size was 2 Gy In 80$\%$ of glottic cancer patients compared with 1.8 Gy in 59$\%$ of the patients with supraglottic cancers. The mean total dose delivered to primary lesions were 65.98 ey and 70.15 Gy in glottic and supraglottic patients treated, respectively, with radiation alone. Based on the collected data, 12 modules with 90 items were developed or the study of the patterns of care In laryngeal cancer. Conclusion: The study Items for laryngeal cancer were developed. In the near future, a web system will be established based on the Items Investigated, and then a nation-wide analysis on laryngeal cancer will be processed for the standardization and optimization of radlotherapy.

• Journal of Sasang Constitutional Medicine
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• v.8 no.1
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• pp.101-186
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• 1996

The clinical application of constitutional Diagnosis is the most important part of Sasang constitutional medicine. It has been studied in various way. However, the study of morphologic characteristics on the face is applied for the first time. For quantitative analysis of the correlation between the sasang constitution and the shape of the face, the head-facial part of 170 cases were measured by Martin's measurement and analysis of a) the measurement value of height and the component ratio from the Gnathion to each part of face by constitution. b) the measurement value of depth and the component ratio from T-projected to each part of the face by constitution. c) the measurement value of breadth and component ratio between each parts of the facial breadth by constitution. d) the ratio of square on every part of face by constitution. e) the characteristics on each part of the face by constitution. f) the contour line of the forehead. g) the result of discriminant analysis about the constitution. Authors obtained the results from the study as follows; 1. The characteristics of Taeum-IN (1) The measurement value of Height, Breadth, T-Projected had a tendency to maximum value in general. (2) The value of lower opthal height and the square of lower opthal part was maximum. (3) The value of Pronasal T-projected length and Subnasal T-projected length was minimum, so Taeum-In has characteristics of depression in middle face, nasal part. (4) In the ratio of Breadth, T-Projected, T-Projected was minimum. (5) It was maximum that the square of nose, Alare, Middle face, Lower face and it was minimum that the square of eye. The square of nose, Alare, Middle facc, Lower face was maximum and the square of eye was minimum. (6) The curvature of the eyebrow was minimum. (7) The projection of jaw (Pogonion T-projection length) was maximum. (8) The breadth of eye was minimum. (9) There was a tendency that the projection of the forehead to the right in general. 2. The characteristics of Soeum-In (1) In all cases of projected length the measurement value was minimum. (2) The value of lower opthal height and the square of lower opthal part was minimum. (3) By the Pupulare T-projected length, the value of Pronasal T-projected length and Subnasal T-projected length was minimum, so the Soeum In's face shape is flat. (4) The square of eye, mouth, forehead was maximum and the square of nose, Alare, Middle face, Lower face was minimum. (5) The curvature of the eyebrow was maximum. (6) The projection of mouth was minimum. (7) The jaw was flat. (8) The breadth of eye was maximum. (9) There was a tendency that the projection of the forehead to the left in general. 3. The characteristics of Soyang-In. (1) In most cases of 고경 length the measurement value was minimum. (2) By the Pupulare T-projected length, each ratio of projected length was maximum, so the Soyang-In's face shape has many protrusions (3) In the ratio of Breadth, T-Projected, T-Projected was maximum. (4) The square of mouth was minimum. (5) The inclination of the forehead was minimum. (6) The projection of mouth was maximum. (7) The breadth of eye was minimum. (8) There was a tendency that the projection of the forehead to the left in general. (9) The middle face was protruded. 4. Discriminant about the constitution. According to the result of discriminant, the accuracy probability of discriminant was 85.58% in total and Taeum-In was 90.5%, Soeum-In was 70.8%, Soyang-In was 89.5%. The accuracy probability of discriminant about 3 constitutional group increased by 49.03% than the accident probility 36.55% 5. Suggestion (1) The study which gather and analysis the data should be continued. (2) The study which subdivide the characteristics of each part of the face by the constitution should be continued. (3) The analysis method about Moire should be supplement. (4) The study about the morphologic characteristics of the whole body should be continued. (5) Computer program of constitution diagnosis should be developed. (6) To increase utility of this method, the measurement should be automation.

• The Korean Journal of Nuclear Medicine Technology
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• v.23 no.2
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• pp.51-58
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• 2019

Purpose In in-vitro laboratories of nuclear medicine department, when the reagent lot or reagent lot changes Comparability test or parallel test is performed to determine whether the results between lots are reliable. The most commonly used standard domestic laboratories is to obtain %difference from the difference in results between two lots of reagents, and then many laboratories are set the standard to less than 20% at low concentrations and less than 10% at medium and high concentrations. If the range is deviated from the standard, the test is considered failed and it is repeated until the result falls within the standard range. In this study, several tests are selected that are performed in nuclear medicine in-vitro laboratories to analyze parallel test results and to establish criteria for customized percent difference for each test. Materials and Methods From January to November 2018, the result of parallel test for reagent lot change is analyzed for 7 items including thyroid-stimulating hormone (TSH), free thyroxine (FT4), carcinoembryonic antigen (CEA), CA-125, prostate-specific antigen (PSA), HBs-Ab and Insulin. The RIA-MAT 280 system which adopted the principle of IRMA is used for TSH, FT4, CEA, CA-125 and PSA. TECAN automated dispensing equipment and GAMMA-10 is used to measure insulin test. For the test of HBs-Ab, HAMILTON automated dispensing equipment and Cobra Gamma ray measuring instrument are used. Separate reagent, customized calibrator and quality control materials are used in this experiment. Results 1. TSH [%diffrence Max / Mean / Median] (P-value by t-test > 0.05) C-1(low concentration) [14.8 / 4.4 / 3.7 / 0.0 ] C-2(middle concentration) [10.1 / 4.2 / 3.7 / 0.0] 2. FT4 [%diffrence Max / Mean / Median] (P-value by t-test > 0.05) C-1(low concentration) [10.0 / 4.2 / 3.9 / 0.0] C-2(high concentration) [9.6 / 3.3 / 3.1 / 0.0 ] 3. CA-125 [%diffrence Max / Mean / Median] (P-value by t-test > 0.05) C-1(middle concentration) [9.6 / 4.3 / 4.3 / 0.3] C-2(high concentration) [6.5 / 3.5 / 4.3 / 0.4] 4. CEA [%diffrence Max / Mean / median] (P-value by t-test > 0.05) C-1(low concentration) [9.8 / 4.2 / 3.0 / 0.0] C-2(middle concentration) [8.7 / 3.7 / 2.3 / 0.3] 5. PSA [%diffrence Max / Mean / Median] (P-value by t-test > 0.05) C-1(low concentration) [15.4 / 7.6 / 8.2 / 0.0] C-2(middle concentration) [8.8 / 4.5 / 4.8 / 0.9] 6. HBs-Ab [%diffrence Max / Mean / Median] (P-value by t-test > 0.05) C-1(middle concentration) [9.6 / 3.7 / 2.7 / 0.2] C-2(high concentration) [8.9 / 4.1 / 3.6 / 0.3] 7. Insulin [%diffrence Max / Mean / Median] (P-value by t-test > 0.05) C-1(middle concentration) [8.7 / 3.1 / 2.4 / 0.9] C-2(high concentration) [8.3 / 3.2 / 1.5 / 0.1] In some low concentration measurements, the percent difference is found above 10 to nearly 15 percent in result of target value calculated at a lower concentration. In addition, when the value is measured after Standard level 6, which is the highest value of reagents in the dispensing sequence, the result would have been affected by a hook effect. Overall, there was no significant difference in lot change of quality control material (p-value>0.05). Conclusion Variations between reagent lots are not large in immunoradiometric assays. It is likely that this is due to the selection of items that have relatively high detection rate in the immunoradiometric method and several remeasurements. In most test results, the difference was less than 10 percent, which was within the standard range. TSH control level 1 and PSA control level 1, which have low concentration target value, exceeded 10 percent more than twice, but it did not result in a value that was near 20 percent. As a result, it is required to perform a longer period of observation for more homogenized average results and to obtain laboratory-specific acceptance criteria for each item. Also, it is advised to study observations considering various variables.

• Tuberculosis and Respiratory Diseases
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• v.42 no.6
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• pp.846-854
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• 1995

Background: Cytokeratin 19 is a subunit of cytokeratin intermediate filament expressed in simple epithelia such as respiratory epithelial cells and their malignant counterparts. An immunoradiometric assay is available to detect a fragment of the cytokeratin, referred to as Cyfra 21-1 in the serum. This study was conducted to evaluate the clinical utility of this new marker in the diagnosis of lung cancer compared with established markers of squamous cell carcinoma antigen (SCC Ag) and carcino-embryonic antigen(CEA). In addition, we compared the diagnostic sensitivity and specificity of Cyfra 21-1 with those of SCC Ag in squamous cell carcinoma of the lung. We also measured the level of Cyfra 21-1 in the different stages of squamous cell carcinoma of the lung. Method: We measured Cyfra 21-1(ELSA-CYFRA 21-1), SCC Ag(ABBOTT SCC RIABEAD) and CEA(ELSA2-CEA) in 79 patients with primary lung cancer and in 78 persons as a comparison group including 32 patients with pulmonary tuberculosis, 23 patients with benign lung disease and 23 cases with healthy individual. Cyfra 21-1 is measured by a solid-phase immunoradiometric assay(CIS Bio International, France) based on the two-site sandwich method. SCC Ag is measured by a radioimmunoassay(Abbott Laboratories, USA). CEA is measured by a immunoradiometric assay(CIS Bio International, France). All data were expressed as the mean$\pm$standard deviation. Results: 1) The mean value of Cyfra 21-1 was $18.38{\pm}3.65\;ng/mL$ in the lung cancer and $1.l6{\pm}0.53\;ng/mL$ in the comparison group(p<0.0001). SCC Ag was $3.53{\pm}6.06\;ng/mL$ in the lung cancer and $1.19{\pm}0.5\;ng/mL$ in the comparison group(p<0.01). CEA was $35.03{\pm}13.9\;ng/mL$ in the lung cancer and $2.89{\pm}1.01\;ng/mL$ in the comparison group(p<0.0001). 2) Cyfra 21-1 level in squamous cell carcinoma($31.52{\pm}40.13\;ng/mL$) was higher than that in adenocarcinoma($2.41{\pm}1.34\;ng/mL$)(p<0.0001) and small cell carcinoma($2.15{\pm}2.05\;ng/mL$)(p=0.007). SCC Ag level in squamous cell carcinoma($5.1{\pm}7.68\;ng/mL$) was higher than that in adenocarcinoma($1.36{\pm}0.69\;ng/mL$)(p=0.009) and small cell carcinoma($1.1{\pm}0.24\;ng/mL$) (p=0.024). 3) The level of Cyfra 21-1 was not correlated with the progression of stage in squamous cell carcinoma of the lung. 4) Using the cut-off value of 3.3ng/mL, the diagnostic sensitivity of Cyfra 21-1 was 83% in squamous cell carcinoma, 22% in adenocarcinoma and 17% in small cell carcinoma. The sensitivity of SCC Ag and CEA were 39% and 20%, respectively in squamous cell carcinoma, 11% and 39% in adenocarcinoma, and 0% and 33% in small cell carcinoma. 5) Comparison of the receiver operating characteristics curves(ROC curve) for Cyfra 21-1, SCC Ag and CEA revealed that Cyfra 21-1 showed highest diagnostic sensitivity among them in the diagnosis of lung cancer. Conclusion: Cyfra 21-1 is thought to be a better tumor marker for the diagnosis of lung cancer than SCC Ag and CEA, especially in squamous cell carcinoma of the lung.