• The Journal of Korean Society for Radiation Therapy
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• v.30 no.1_2
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• pp.191-199
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• 2018

Purpose : In this study, we evaluated the usefulness of colloid gel(slime) as a compensator for irregular patient surfaces in radiation therapy. Materials and Methods : For this study, colloid gel suitable for treatment was made and four experiments were conducted to evaluate the applicability of radiation therapy. Trilogy(Varian) and CT(SOMATOM, Siemens) were used as treatment equipment and CT equipment. First, the homogeneity according to the composition of colloid gel was measured using EBT3 Film(RIT). Second, the Hounsfield Unit(HU) value of colloid gel was measured and confirmed by CRIS phantom, Eclipse RTP(Eclipse 13.1, Varian) and CT. Third, to measure the deformation and degeneration of colloid gel during the treatment period, it was measured 3 times daily for 2 weeks using an ion chamber(PTW-30013, PTW). The fourth experiment was compared the treatment plan and measured dose distributions using bolus, rice, colloid gel and additional, dose profiles in an environment similar to actual treatment using our own acrylic phantom. Result : First experiment, density of the colloid gel cases 1, 2 and 3 was $1.02g/cm^3$, $0.99g/cm^3$ and $0.96g/cm^3$. When the homogeneity was measured at 6 MV and 9 MeV, case 1 was more homogeneous than the other cases, as 1.55 and 1.98. In the second experiment, the HU values of case 1, 2, 3 were 15 and when the treatment plan was compared with the measured doses, the difference was within 1 % at all 9, 12 MeV and a difference of -1.53 % and -1.56 % within the whole 2 % at 6 MV. In the third experiment, the dose change of colloid gel was measured to be about 1 % for 2 weeks. In the fourth experiment, the dose difference between the treatment plan and EBT3 film was similar for both colloid gel and bolus, rice at 6 MV. But colloid gel showed less dose difference than bolus and rice at 9 MeV. Also, dose profile of colloid gel showed a more uniform dose distribution than the bolus and rice. Conclusion : In this study, the density of colloid gel prepared for radiation therapy was $1.02g/cm^3$ similar to the density of water, and alteration or deformation was not observed during the radiotherapy process. Although we pay attention to the density when manufacturing colloid gel, it is sufficient in that it can deliver the dose uniformly through the compensation of the patient's body surface more than the bolus and rice, and can be manufactured at low cost. Further studies and studies for clinical applications are expected to be applicable to radiation therapy.

• Korean Journal of Psychosomatic Medicine
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• v.27 no.1
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• pp.50-59
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• 2019

Objectives : Many of the patients with type 2 diabetes are associated with sleep problems, and the rate of insomnia is known to be higher in the general population. The aims of this study were to know the frequency and clnical characteristics of insomnia, and related variables to insomnia in patients diagnosed with type 2 diabetes. Methods : For 99 patients from 18 to 80 years of age (65 males and 34 females) with type 2 diabetes, interviews were performed. Total sleep time and sleep latency was evaluated. Insomnia was evaluated using the Korean Version of the Insomnia Severity Index (ISI-K). Severity of depressive symptoms were evaluted using the Korean version of the Hamilton Depression Scale (K-HDRM). According to the cutoff score of 15.5 on the ISI-K, subjects were divided into the group of type 2 diabetics with insomnia (N=34) and those without insomnia (N=65) at first, and then statistically analyzed. Results : TInsomnia could be found in 34.34% of type 2 diabetics. Type 2 diabetics with insomnia had significantly more single or divorced (respectively 11.8%, p<0.05), higher total scores of the K-HDRS ($11.76{\pm}5.52$, p<0.001), shorter total sleep time ($5.35{\pm}2.00hours$, p<0.001), and longer sleep latency ($50.29{\pm}33.80minutes$, p<0.001). The all item scores of the ISI-K in type 2 diabetics with insomnia were significantly higher than those in type 2 diabetics without insomnia, that is, total ($18.38{\pm}2.69$), A1 (Initial insomnia) ($2.97{\pm}0.76$), A2 (Middle insomnia) ($3.06{\pm}0.69$), A3 (Terminal insomnia) ($2.76{\pm}0.61$), B (Satisfaction) ($3.18{\pm}0.72$), C (Interference) ($2.09{\pm}0.97$), D (Noticeability) ($2.12{\pm}1.09$) and E (Distress) ($2.21{\pm}0.81$) (respectively p<0.001). Variables associated with insomnia in type 2 diabetics were as following. Age had significant negative correlation with A3 items of the ISI-K (${\beta}=-0.241$, p<0.05). Total scores of the K-HDRS had significant positive correlation, while total sleep time had significant negative correlation with all items of the ISI-K (respectively p<0.05). Sleep latency had significant positive correlation with total,, A1, B and E item scores of the ISI-K (respectively p<0.05). Conclusions : Insomnia was found in about 1/3 of type 2 diabetics. According to the presence of insomnia, clinical characteristics including sleep quality as well as quantity seemed to be different. Because depression seemed to be correlated with insomnia, clinicians should pay attention to early detection and intervention of depression among type 2 diabetics.

• Journal of Practical Agriculture & Fisheries Research
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• v.24 no.3
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• pp.15-24
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• 2022

In 2000, a total of 23,794ha of forest was lost due to the East Coast forest fire, and about 70% of the damaged area was concentrated in Samcheok. In 2001, artificial restoration and natural restoration were implemented in the damaged area. This study was conducted to understand the current vegetation structure 21 years after the restoration of forest fire damage in the Samcheok, Gumbong Mountain area. As a result of classifying the vegetation community, it was divided into three communities: Quercus variabilis-Pinus densiflora community, Pinus densiflora-Quercus mongolica community, and Pinus thunbergii community. Quercus variabilis, Pinus densiflora, and Pinus thunbergii planted in the artificial restoration site were found to continue to grow as dominant species in the local vegetation after restoration. As for the species diversity index of the community, the Quercus variabilis-Pinus densiflora community dominated by deciduous broad-leaf trees showed the highest, and the coniferous forest Pinus thunbergii community showed the lowest. Vegetation in areas affected by forest fires is greatly affected by reforestation tree species, and 21 years later, it has shown a tendency to recover to the forest type before forest fire. In order to establish DataBase for effective restoration and to prepare monitoring data, it is necessary to construct data through continuous vegetation survey on the areas affected by forest fires.

• Journal of Life Science
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• v.34 no.2
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• pp.113-121
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• 2024

Endoplasmic reticulum (ER) stress responses are markedly induced during toxic responses caused by various chemical substances, including difenoconazole, but no research has been conducted on 1,2,3-trichloropropane (TCP), a chemical that is generally used in agriculture and industry, which induces hepatotoxicity. Therefore, in this study, the changes in indicators for hepatotoxicity, apoptosis, and ER stress were analyzed in TCP-treated Sprague Dawley (SD) rats to study the regulatory mechanism of ER stress during the hepatotoxicity. The TCP-treated group decreased in body weight and dietary intake compared to the vehicle-treated group, and necrosis and vacuolation increased significantly in liver histology. In addition, the expression of apoptosis-related factors, including Bax/Bcl-2 and cleaved caspase (Cas)-3/Cas-3 increased significantly in the TCP-treated group compared to the vehicle-treated group. In the analysis of ER stress response indicators, the expression of C/EBP homologous protein (CHOP), phospho-eukaryotic translation initiation factor 2 alpha subunit (eIF2α), and phospho-inositol-requiring enzyme 1α (IRE1α) increased only in the TCP100-treated group and decreased in the TCP200-treated group. However, the transcriptions of growth arrest and DNA damage-34 (GADD34) increased in the TCP200-treated group, while Spliced X-box binding protein-1 (XBP1s) and unspliced XBP1(XBP1u) decreased in the same group. These results suggest that the ER stress response is successfully triggered during the hepatotoxicity induced by TCP treatment through the alternative regulation of the unfolded-protein response (UPR) pathway.

• Tuberculosis and Respiratory Diseases
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• v.42 no.3
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• pp.351-360
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• 1995

Background: Pressure support(PS) is becomimg a widely accepted method of mechanical ventilation either for total unloading or for partial unloading of respiratory muscle. The aim of the study was to find out if PS exert different effects on respiratory mechanics in synchronized intermittent mandatory ventilation(SIMV) and continuous positive airway pressure (CPAP) modes. Methods: 5, 10 and 15 cm $H_2O$ of PS were sequentially applied in 14 patients($69{\pm}12$ yrs, M:F=9:5) and respiratory rate (RR), tidal volume($V_T$), work of breathing(WOB), pressure time product(PTP), $P_{0.1}$, and $T_1/T_{TOT}$ were measured using the CP-100 pulmonary monitor(Bicore, USA) in SIMV and CPAP modes respectively. Results: 1) Common effects of PS on respiratory mechanics in both CPAP and SIMV modes As the level of PS was increased(0, 5, 10, 15 cm $H_2O$), $V_T$ was increased in CPAP mode($0.28{\pm}0.09$, $0.29{\pm}0.09$, $0.31{\pm}0.11$, $0.34{\pm}0.12\;L$, respectively, p=0.001), and also in SIMV mode($0.31{\pm}0.15$, $0.32{\pm}0.09$, $0.34{\pm}0.16$, $0.36{\pm}0.15\;L$, respectively, p=0.0215). WOB was decreased in CPAP mode($1.40{\pm}1.02$, $1.01{\pm}0.80$, $0.80{\pm}0.85$, $0.68{\pm}0.76$ joule/L, respectively, p=0.0001), and in SIMV mode($0.97{\pm}0.77$, $0.76{\pm}0.64$, $0.57{\pm}0.55$, $0.49{\pm}0.49$ joule/L, respectively, p=0.0001). PTP was also decreased in CPAP mode($300{\pm}216$, $217{\pm}165$, $179{\pm}187$, $122{\pm}114cm$ $H_2O{\cdot}sec/min$, respectively, p=0.0001), and in SIMV mode($218{\pm}181$, $178{\pm}157$, $130{\pm}147$, $108{\pm}129cm$ $H_2O{\cdot}sec/min$, respectively, p=0.0017). 2) Different effects of PS on respiratory mechanics in CP AP and SIMV modes By application of PS (0, 5, 10, 15 cm $H_2O$), RR was not changed in CPAP mode($27.9{\pm}6.7$, $30.0{\pm}6.6$, $26.1{\pm}9.1$, $27.5{\pm}5.7/min$, respectively, p=0.505), but it was decreased in SIMV mode ($27.4{\pm}5.1$, $27.8{\pm}6.5$, $27.6{\pm}6.2$, $25.1{\pm}5.4/min$, respectively, p=0.0001). $P_{0.1}$ was reduced in CPAP mode($6.2{\pm}3.5$, $4.8{\pm}2.8$, $4.8{\pm}3.8$, $3.9{\pm}2.5\;cm$ $H_2O$, respectively, p=0.0061), but not in SIMV mode($4.3{\pm}2.1$, $4.0{\pm}1.8$, $3.5{\pm}1.6$, $3.5{\pm}1.9\;cm$ $H_2O$, respectively, p=0.054). $T_1/T_{TOT}$ was decreased in CPAP mode($0.40{\pm}0.05$, $0.39{\pm}0.04$, $0.37{\pm}0.04$, $0.35{\pm}0.04$, respectively, p=0.0004), but not in SIMV mode($0.40{\pm}0.08$, $0.35{\pm}0.07$, $0.38{\pm}0.10$, $0.37{\pm}0.10$, respectively, p=0.287). 3) Comparison of respiratory mechanics between CPAP+PS and SIMV alone at same tidal volume. The tidal volume in CPAP+PS 10 cm $H_2O$ was comparable to that of SIMV alone. Under this condition, the RR($26.1{\pm}9.1$, $27.4{\pm}5.1/min$, respectively, p=0.516), WOB($0.80{\pm}0.85$, 0.97+0.77 joule/L, respectively, p=0.485), $P_{0.1}$($3.9{\pm}2.5$, $4.3{\pm}2.1\;cm$ $H_2O$, respectively, p=0.481) were not different between the two methods, but PTP($179{\pm}187$, $218{\pm}181 cmH_2O{\cdot}sec/min$, respectively, p=0.042) and $T_1/T_{TOT}$($0.37{\pm}0.04$, $0.40{\pm}0.08$, respectively, p=0.026) were significantly lower in CPAP+PS than in SIMV alone. Conclusion: PS up to 15 cm $H_2O$ increased tidal volume, decreased work of breathing and pressure time product in both SIMV and CPAP modes. PS decreased respiration rate in SIMV mode but not in CPAP mode, while it reduced central respiratory drive($P_{0.1}$) and shortened duty cycle ($T_1/T_{TOT}$) in CPAP mode but not in SIMV mode. By 10 em $H_2O$ of PS in CPAP mode, same tidal volume was obtained as in SIMV mode, and both methods were comparable in respect to RR, WOB, $P_{0.1}$, but CPAP+PS was superior in respect to the efficiency of the respiratory muscle work (PTP) and duty cycle($T_1/T_{TOT}$).

• The Korean Journal of Nuclear Medicine Technology
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• v.20 no.2
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• pp.54-61
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• 2016

Purpose Precocious Puberty is defined as the development of secondary sexual characteristics in girls younger than 8 years, and boys 9 years. Cause premature closure of the epiphysis is a disease that eventually decreases the final adult height. In this study, we retrospectively analyzed to evaluate the diagnostic difference the GnRH (Gonado-tropin-releasing Hormone) stimulation test results with medical records of precocious puberty in girls. Materials and Methods From February 2015 to December 2015 it was enrolled in the girls 118 people who visited the Seoul National University Bundang Hospital, Pediatrics, Endocrinology Internal Medicine. True precocious puberty group (n=57), early puberty group (n=39), were divided into Premature thelarche (n=22) group. A Tanner stage, chronological age, bone age, height, body weight for each group was determined by examining the mean${\pm}$standard deviation. GnRH test result was compared LH (Basal, 30 min, 45 min, 60 min), FSH (Basal, 30 min, 60 min) for each group, Each group LH, FSH Peak value distribution, the mean${\pm}$standard deviation was calculated for the peak LH/LH basal ratio, peak LH/Peak FSH ratio. The significance probability (P-value) between the value of each third group was determined. Results The average height of the true precocious puberty group $131{\pm}14.85$, the mean weight was $28.80{\pm}4.93$, the average chronological age $7.1{\pm}0.81$, the mean bone age was $9.9{\pm}0.9$, The average height of early puberty group was $134{\pm}5.10$, the average weight $28.50{\pm}4.43$, the average chronological age $8.05{\pm}0.03$, the mean bone age was $10.0{\pm}0.62$, The average height of Premature thelarche $129{\pm}6,01$, the average weight was $28.65{\pm}5.98$, the average chronological age $7.02{\pm}0.58$, the mean bone age was $8.04{\pm}1.29$. There was no significant difference when compared to the height and weight. There was a significant difference between the groups in the chronologic age and bone age difference (P <0.0002) True precocious puberty group showed peak LH levels at 30'(82.5%), 45'(12.3%), 60'(5.3%), in Peak FSH 30'(8.8%), 60'(91.2%). Early Puberty group showed high values in Peak LH at 30'(79.5%), 45'(17.9%), 60'(2.6%), in peak FSH levels at 30'(7.7%), 60'(92.32%). In Premature thelarche Group it showed the Peak LH levels at 30'(30%), 45'(59%), 60'(9.09%), Peak FSH levels at 30'(0%) 60'(100%). When compared with the The Peak LH/basal LH ratio, True precocious puberty group was $19.09{\pm}17.15$, early puberty group was $15.23{\pm}10.88$, Premature thelarche group showed significant differences between the three groups as $4.93{\pm}4.36$.(P <0.0001) LH Peak/FSH Peak ratio, true precocious puberty group was $1.222{\pm}0.77$, early puberty group was $1.34{\pm}1.23$, Premature thelarche group showed significant differences between the three groups as $0.3{\pm}0.09$(P <0.0001) Conclusion In order to diagnose the true precocious puberty have a diagnostic value when the LH peak after GnRH stimulation is increased by more than two to three times compared to baseline or a predetermined level or more than 5~10 IU/L increases. GnRH Test is a test for a long time and the patient discomfort due to repeated blood sampling, but the hypothalamus-pituitary gland- gonad axis activity evaluate and is the most basic accurate test in the differential diagnosis of precocious puberty disorders.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1982.05a
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• pp.17.2-19
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• 1982

The sinus tympani is subject to great variability in the size, shape and posterior extent. A heavy compact bony zone, especially in the posterior portion and the narrow space between the facial nerve and posterior semicircular canal are the limitation of surgical approach. The facial recess should be opened, creating a wide connection between the mesotympanum and mastoid in the Intact canal wall tympanoplasty with mastoidectomy. The surgically created limits of the facial recess are the facial nerve medially, the chorda tympani laterally and the bone adjacent to the incus superiorly. Using adult Korean's thirty-five temporal bones, the authors measured the osteologic reslationship in the posterior tympanum, especially sinus tympani and facial recess. The result was as followed. 1. The average distance from the anterior end of the pyramidal eminence. 1) to the edge of the sinus tympani directly posterior was 2.54(1.05-5.40)mm. 2) to the maximum posterior extent was 3.22(1.25-7.45)mm. 3) to the maximum cephaled extent was 0.67 (0.40-1.75)mm. 2. The boundary of the sinus tympani was 82.9% from the lower margin oval window to the upper margin round window niche. 3. The deepest part of the sinus tympani was 62.9% in the mid portion, between the ponticulus and subiculum. 4. The oblique dimension from the fossa incudis above to the hypotympanum below was 8.13(7.90-9.55)mm. 5. The transverse dimensions midway between the oval window above and round window below was 3.00(2.85-3.45)mm. 6. The transverse dimension at the level of the fossa incudis was 1.81(1.40-2.15)mm. 7. The facial nerve dehiscence was 14.3%. 8. Anterior-posterior diameter of the footplate was 2.98(2.85-3.05) mm. 9. The average distance from the footplate. 1) to the cochleariform process was 1.42(1.35-1.55) mm. 2) to the round window niche was 1.85(1.45-2.10) mm.

• Radiation Oncology Journal
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• v.22 no.4
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• pp.237-246
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• 2004

Purpose: To investigate the effects of radiation dose-escalation on the treatment outcome, complications and the other prognostic variables for glioblastoma patients treated with 3D-conformal radiotherapy (3D-CRT). Materials and Methods: Between Jan 1997 and July 2002, a total of 75 patients with histologically proven diagnosis of glioblastoma were analyzed. The patients who had a Karnofsky Performance Score (KPS) of 60 or higher, and received at least 50 Gy of radiation to the tumor bed were eligible. All the patients were divided into two arms; Arm 1, the high-dose group was enrolled prospectively, and Arm 2, the low-dose group served as a retrospective control. Arm 1 patients received $63\~70$ Gy (Median 66 Gy, fraction size $1.8\~2$ Gy) with 3D-conformal radiotherapy, and Arm 2 received 59.4 Gy or less (Median 59.4 Gy, fraction size 1.8 Gy) with 2D-conventional radiotherapy. The Gross Tumor Volume (GTV) was defined by the surgical margin and the residual gross tumor on a contrast enhanced MRI. Surrounding edema was not included in the Clinical Target Volume (CTV) in Arm 1, so as to reduce the risk of late radiation associated complications; whereas as in Arm 2 it was included. The overall survival and progression free survival times were calculated from the date of surgery using the Kaplan-Meier method. The time to progression was measured with serial neurologic examinations and MRI or CT scans after RT completion. Acute and late toxicities were evaluated using the Radiation Therapy Oncology Group neurotoxicity scores. Results: During the relatively short follow up period of 14 months, the median overall survival and progression free survival times were $15{\pm}1.65$ and $11{\pm}0.95$ months, respectively. The was a significantly longer survival time for the Arm 1 patients compared to those in Arm 2 (p=0.028). For Arm 1 patients, the median survival and progression free survival times were $21{\pm}5.03$ and $12{\pm}1.59$ months, respectively, while for Arm 2 patients they were $14{\pm}0.94$ and $10{\pm}1.63$ months, respectively. Especially in terms of the 2-year survival rate, the high-dose group showed a much better survival time than the low-dose group; $44.7\%$ versus $19.2\%$. Upon univariate analyses, age, performance status, location of tumor, extent of surgery, tumor volume and radiation dose group were significant factors for survival. Multivariate analyses confirmed that the impact of radiation dose on survival was independent of age, performance status, extent of surgery and target volume. During the follow-up period, complications related directly with radiation, such as radionecrosis, has not been identified. Conclusion: Using 3D-conformal radiotherapy, which is able to reduce the radiation dose to normal tissues compared to 2D-conventional treatment, up to 70 Gy of radiation could be delivered to the GTV without significant toxicity. As an approach to intensify local treatment, the radiation dose escalation through 3D-CRT can be expected to increase the overall and progression free survival times for patients with glioblastomas.