• Radiation Oncology Journal
• /
• v.18 no.1
• /
• pp.27-31
• /
• 2000

Purpose : The aim of this study was to investigate treatment results, toxicity and efficacy of hypefractionated radiation therapy combined with paclitaxel for paraaortic node recurrence in cervix cancer. Materials and Methods: Between September 1997 to March 1999, 12 patients with paraaortic node recurrence in cervix cancer who previously received radical or postoperative radiotherapy were treated with hypefractionated radiation therapy combined with paclitaxel. Of these, 2 patients who irradiated less than 30 Gy were excluded, 10 patients were eligible for this study. Median age was 51 years. Initial FIGO stage was 1 stage IBI, 2 stage IIA, 7 stage IIB. For initial treatment, 7 patients received radical radiotherapy and 3 received postoperative radiotherapy. The paraaortic field encompassed the gross recurrent disease with superior margin at T12, and inferior margin was between L5 and S1 with gap for previously pelvic radiation field. The radiation field was initially anterior and posterior opposed field followed by both lateral field. The daily dose was 1.2 Gy, twice daily fractions, and total radiotherapy dose was between 50.4 and 60 Gy(median, 58.8 Gy). Concurrent chemotherapy was done with paclitaxel as a radiosensitizer. Dose range was from 20 mg/m$^{3}$ to 30 mg/m$^{3}$ (median, 25 mg/m$^{3}$), and cycle of chemotherapy was from 3 to 6 (median, 4.5 cycle). Follow-up period ranged from 3 to 21 months. Results : Interval between initial diagnosis and paraaortic node recurrence was range from 2 to 63 months (median, 8 months). The 1 year overall survival rate and median survival were 75$\%$ and 9.5 months, respectively. The 1 year disease free survival rate and median disease free survival were 30$\%$ and 7 months, respectively. At 1 month after treatment, 4 (40$\%$) achieved a complete response and 6 (60$\%$) experienced a partial response and all patients showed response above the partial response. There was distant metastasis in 6 patients and pelvic node recurrence In 2 patients after paraaortic node irradiation. There was 2 patients with grade 3 to 4 leukopenla and 8 patients with grade 1 to 2 nausea/ vomiting which was usually tolerable with antlemetic drug. There was no chronic complication in abdomen and pelvis during follow up period. Conclusion : hypefractionated radiation therapy combined with paclitaxel chemotherapy diosensitizer showed high response rate and few complication rate in paraaortic node recurrence in cervix cancer Therefore, present results suggest that hypefractionated radiation therapy combined with paclitaxel chemotherapy can be used as optimal treatment modality in this patients.

• Radiation Oncology Journal
• /
• v.27 no.3
• /
• pp.126-132
• /
• 2009

Purpose: We wanted to evaluate the prognostic factors for the pathologic N2 non-small cell lung cancer (NSCLC) patients who were treated by postoperative radiotherapy. Materials and Methods: We retrospectively reviewed 112 pN2 NSCLC patients who underwent surgery and postoperative radiotherapy (PORT) From January 1999 to February 2008. Seventy-five (67%) patients received segmentectomy or lobectomy and 37 (33%) patients received pneumonectomy. The resection margin was negative in 94 patients, and it was positive or close in 18 patients. Chemotherapy was administered to 103 (92%) patients. Nine (8%) patients received PORT alone. The median radiation dose was 54 Gy (range, 45 to 66), and the fraction size was 1.8~2 Gy. Results: The 2-year overall survival (OS) rate was 60.2% and the disease free survival (DFS) rate was 44.7% for all the patients. Univariate analysis showed that the patients with multiple-station N2 disease had significantly reduced OS and DFS (p=0.047, p=0.007) and the patients with an advanced T stage ($\geq$T3) had significantly reduced OS and DFS (p<0.001, p=0.025). A large tumor size ($\geq$5 cm) and positive lymphovascular invasion reduced the OS (p=0.035, 0.034). Using multivariate analysis, we found that multiple-station N2 disease and an advanced T stage ($\geq$T3) significantly reduced the OS and DFS. Seventy one patients (63.4%) had recurrence of disease. The patterns of failure were loco-regional in 23 (20.5%) patients, distant failure in 62 (55.4%) and combined loco-regional and distant failure in 14 (12.5%) patients. Conclusion: Multiple involvement of mediastinal nodal stations for the pN2 NSCLC patients with PORT was a poor prognostic factor in this study. A prospective study is necessary to evaluate the N2 subclassification and to optimize the adjuvant treatment.

• Journal of Preventive Medicine and Public Health
• /
• v.30 no.4 s.59
• /
• pp.669-685
• /
• 1997

Previous studies, reporting the inverse relationship between osteoarthritis and osteoporosis suggest the existence of possible pathophysiologic mechanisms between them. To examinine the hypothesis that 'bone mineral densities of women with osteoarthritis are significantly higher than that of women without osteoarthritis in Korea', subjects from the health and nutritional examination survey in Kuri city were sampled. Samples were selected through multi-stage sampling frame using established clusters in Kuri city. From August 18 to September 10,1997, the survey was conducted. Among the. total number of selected sample population (1,656 people), response .ate was 52.4 percent (348 men and 519 women). 420 women who took BMD measurement, radiologic exam, and anthropometric exam were selected for the analysis. The analytic results are as follows. 1. General characteristics: Mean BMD was $0.493g/cm^2$, mean age was 43.0, mean BMI was $23.9kg/m^2$. The number of women who experienced menopause was 106, hysterectomy was 19. There were 0 case of osteoarthritis of hip, 64 cases of osteoarthritis of knee, and 2 cases of osteoarthritis of hand. 2. Univariate analysis results: Mean BMD of women with the osteoarthritis of knee was significantly lower than that of women without the osteoarthritis of knee(0.4269 vs. $0.5057g/cm^2$). But, there were too few cases of osteoarthritis of hip and hand, so comparative studies of BMD in osteoarthritis of hip and hand could not be conducted. There were significant differences of BMD among pre-menopause group(0.5204), post-menopause group(0.4206), and hysterectomy group(0.4881). Additionally, there were significant differences of BMD among diabetes group(0.4297), impaired glucose tolerance group(0.4874), and normal group(0.5057). Furthermore, age, parity, BMI, bioimpedance were significantly related with BMD. 3. Multivariate analysis results: To examinine the relationship between osteoarthritis and BMD while controlling the other variables' effects which were significant in the univariate analyses, multiple linear regression analysis was done. But, it was found that osteoarthritis of knee was not a significant variable to BMD anymore. While age and menopause had significant negative relationship with BMD. Diabetes, parity, BMI, and bioimpedance did not have significant relationships with BMD. After stratification of subjects according to menopause, multiple linear regression analyses were done to each strata. Consequently, age in post-menopause group, age and osteoarthritis of knee in hysterectomy group showed significant negative relationship with BMD. The results did not support the many results of other previous studies done with white men and women. further studies of biological plausibility to Korean women are recommended. Also it is suggested that longitudinal study to verify the relationship between osteoarthritis and BMD will be valuable.

• Journal of the Korean Society of Radiology
• /
• v.11 no.1
• /
• pp.27-35
• /
• 2017

The purpose of this study was to investigate the features of CsI:Tl and $Gd_2O_2S$ detectors with an indirect conversion method using phantom in the DR (digital radiography) system by obtaining images of thick chest phantom, medium thickness thigh phantom, and thin hand phantom and by analyzing the SNR and CNR. As a result of measuring the SNR and CNR according to the thickness change of the subject, the SNR and CNR were higher in CsI:Tl detector than in $Gd_2O_2S$ detector when the medium thickness thigh phantom and thin hand phantom were scanned. However, when the thick chest phantom was used, for the SNR at 80~125 kVp and the CNR at 80~110 kVp in the $Gd_2O_2S$ detector, the values were higher than those of CsI:Tl detector. The SNR and CNR both increased as the tube voltage increased. The SNR and CNR of CsI:Tl detector in the medium thickness thigh phantom increased at 40~50 kVp and decreased as the tube voltage increased. The SNR and CNR of $Gd_2O_2S$ detector increased at 40~60 kVp and decreased as the tube voltage increased. The SNR and CNR of CsI:Tl detctor in the thin hand phantom decreased at the low tube voltage and increased as the tube voltage increased, but they decreased again at 100~110 kVp, while the SNR and CNR of $Gd_2O_2S$ detector were found to decrease as the tube voltage increased. The MTF of CsI:Tl detector was 6.02~90.90% higher than that of $Gd_2O_2S$ detector at 0.5~3 lp/mm. The DQE of CsI:Tl detector was 66.67~233.33% higher than that of $Gd_2O_2S$ detector. In conclusion, although the values of CsI:Tl detector were higher than those of $Gd_2O_2S$ detector in the comparison of MTF and DQE, the cheaper $Gd_2O_2S$ detector had higher SNR and CNR than the expensive CsI:Tl detector at a certain tube voltage range in the thick check phantom. At chest X-ray, if the $Gd_2O_2S$ detector is used rather than the CsI:Tl detector, chest images with excellent quality can be obtained, which will be useful for examination. Moreover, price/performance should be considered when determining the detector type from the viewpoint of the user.

• Nuclear Medicine and Molecular Imaging
• /
• v.40 no.4
• /
• pp.218-227
• /
• 2006

Purpose: The HSV1-tk reporter gene system is the most widely used system because of its advantage that direct monitoring is possible without the introduction of a separate reporter gene in case of HSV1-tk suicide gene therapy. In this study, we investigate the usefulness of the reporter probe (substrate), $9-(4-[^{18}F]Fluoro-3-hydroxymethylbutyl)$guanine ($[^{18}F]FHBG$) for non-invasive reporter gene imaging using PET in HSV1-tk expressing hepatoma model. Materials and Methods: Radiolabeled FHBG was prepared in 8 steps from a commercially available triester. The labeling reaction was carried out by NCA nucleophilic substitution with $K[^{18}F]/K2.2.2.$ in acetonitrile using N2-monomethoxytrityl-9-14-(tosyl)-3-monomethoxytritylmethylbutyl]guanine as a precursor, followed by deprotection with 1 N HCl. Preliminary biological properties of the probe were evaluated with MCA cells and MCA-tk cells transduced with HSV1-tk reporter gene. In vitro uptake and release-out studies of $[^{18}F]FHBG$ were performed, and was analyzed correlation between $[^{18}F]FHBG$ uptake ratio according to increasing numeric count of MCA-tk cells and degree of gene expression. MicroPET scan image was obtained with MCA and MCA-tk tumor bearing Balb/c-nude mouse model. Results: $[^{18}F]FHBG$ was purified by reverse phase semi-HPLC system and collected at around 16-18 min. Radiothemical yield was about 20-25%) (corrected for decay), radiochemical purity was >95% and specific activity was around >55.5 $GBq/{\mu}\;mol$. Specific accumulation of $[^{18}F]FHBG$ was observed in HSV1-tk gene transduced MCA-tk cells but not in MCA cells, and consecutive 1 hour release-out results showed more than 86% of uptaked $[^{18}F]FHBG$ was retained inside of cells. The uptake of $[^{18}F]FHBG$ was showed a highly significant linear correlation ($R^2=0.995$) with increasing percentage of MCA-tk numeric cell count. In microPET scan images, remarkable difference of accumulation was observed for the two type of tumors. Conclusion: $[^{18}F]FHBG$ appears to be a useful as non-invasive PET imaging substrate in HSV1-tk expressing hepatoma model.

• The Korean Journal of Nuclear Medicine
• /
• v.38 no.1
• /
• pp.85-98
• /
• 2004

Purpose: Cellular uptake of $^{99}mTc$-sestamibi (MIBI) and $^{99}mTc$-tetrofosmin (TF) is low in cancer cells expressing multidrug resistance(MDR) by p-glycoprotein(Pgp) or multidrug related protein(MRP). Verapamil is known to increase cellular uptake of MIBI in MDR cancer cells, but is recently reported to have different effects on tracer uptake in certain cancer cells. This study was prepared to evaluate effects of verapamil on cellular uptake of MIBI and TF in several cancer cells. Materials and Methods: Celluar uptakes of Tc-99m MIBI and TF were measured in erythroleukermia K562 cell, breast cancer MCF7 cell, and human ovarian cancer SK-OV-3 cells, and data were compared with those of doxorubicin-resistant K562(Ad) cells. RT-PCR and Western blot analysis were used for the detection of mdr1 mRNA and Pgp expression, and to observe changes in isotypes of PKC enzyme. Effects of verapamil on MIBI and TF uptake were evaluated at different concentrations upto $200{\mu}M\;at\;1{\times}10^6\;cells/ml\;at\;37^{\circ}C$. Radioactivity in supernatant and pellet was measured with gamma counter to calculate cellular uptake ratio. Toxicity of verapamil was measured with MTT assay. Results: Cellular uptakes of MIBI and TF were increased by time in four cancer cells studied. Co-incubation with verapamil resulted in an increase in uptake of MIBI and TF in K562(Adr) cell at a concentration of $100{\mu}M$ and the maximal increase at $50{\mu}M$ was 10-times to baseline. In contrast, uptakes of MIBI and TF in K562, MCF7, SK-OV3 cells were decreased with verapamil treatment at a concentration over $1{\mu}M$. With a concentration of $200{\mu}M$ verapamil, MIBI and TF uptakes un K562 cells were decreased to 1.5 % and 2.7% of those without verapamil, respectively. Cellular uptakes of MIBI and TF in MCF7 and SK-OV-3 cells were not changed with $10{\mu}M$, but were also decreased with verapamil higher than $10{\mu}M$, resulting 40% and 5% of baseline at $50{\mu}M$. MTT assay of four cells revealed that K562, MCF7, SK-OV3 were not damaged with verapamil at $200{\mu}M$. Conclusion: Although verapamil increases uptake of MIBI and TF in MDR cancer cells, cellular uptakes were further decreased with verapamil in certain cancer cells, which is not related to cytotoxicity of drug. These results suggest that cellular uptakes of both tracers might differ among different cells, and interpretation of changes in tracer uptake with verapamil in vitro should be different when different cell lines are used.

• Pediatric Infection and Vaccine
• /
• v.11 no.2
• /
• pp.158-169
• /
• 2004

Purpose : Although influenza is one of the most important cause of acute respiratory tract infections in children, virus isolation is not popular and there are only a few clinical studies on influenza and diagnostic methods. We evaluated the epidemiological and clinical features of influenza in children and rapid antigen detection test(QuickVue influenza test) on fist half of the year 2004 in Busan. Methods : From January 2004 to June 2004, throat swab and nasal secretion were obtained and cultured for the isolation of influenza virus and tested by rapid antigen detection test(QuickVue influenza test) in children with suspected influenza infections. The medical records of patients with influenza virus infection were reviewed retrospectively. Results : Influenza viruses were isolated in 79(17.2%) out of 621 patients examined. Influenza virus was isolated mainly from March to April 2004. The ratio of male and female with influenza virus infection was 1.2 : 1 with median age of 4 years 6month. The most common clinical diagnosis of influenza virus infection was bronchitis. There was no difference between influenza A and B infection in clinical diagnosis and symptoms. All patients recovered without severe complication. The sensitivity obtained for rapid antigen detection test (QuickVue influenza test) was 93.6% and the specificity was 80.2%, the positive predictive value 40.8%, the negative predictive value 98.8%. Conclusion : With rapid antigen detection test, it is possible early detection of influenza in children. reduction in use of antimicrobial agent and early use of antiviral agent.

• Pediatric Infection and Vaccine
• /
• v.13 no.2
• /
• pp.163-173
• /
• 2006

Purpose : To reduce the number of injections necessary to vaccinate young infants, various combined vaccines have been developed. The $Comvax^{TM}$ manufactured by Merck & Co. is a combination of Hepatitis B and PRP-OMP conjugate Haemophilus influenzae Type b vaccine. The purpose of this study is to evaluate the immunogenicity and safety of $Comvax^{TM}$ in Korean infants. Methods : The infants who were vaccinated at 0 months of age with Hepatitis B vaccine, were recruited for this study after parental informed consent was obtained. The subjects were vaccinated with $Comvax^{TM}$ at 2 and 4 months of age. At each visit, infants were also immunized with DTaP, inactivated poliovirus vaccine, and pneumococcal vaccine when indicated. The serum anti-PRP and anti-HBs were measured at 2 months after the 1st dose(4 months age), and the 2nd dose(6 months age) by the ELISA and chemiluminescent microparticle immunoassay method, respectively. The local and systemic adverse reactions of vaccination were monitored for 3 consecutive days after each immunization. Results : Among sixty-five healthy infants(35 male infants) enrolled in this study; fifty eight(32 male infants) completed the scheduled immunizations. The geometric mean titers (GMTs) of anti-PRP at 2 months after the 1st dose and the 2nd dose were 1.96 ${\mu}g/mL$ (95% CI; 1.38~2.78) and 10.02 ${\mu}g/mL$ (95% CI; 7.04~14.26), respectively. Anti-PRP ${\geq}1.0$ ${\mu}g/mL$, was obtained in 63.2%(95% CI; 53.75~72.65) after 1 dose, and 96.6%(95% CI; 93.05~100) after 2 doses. The GMTs of anti-HBs were 38.32 mIU/mL(95% CI; 22.42~65.51), and 101.17 mIU/mL(95% CI; 65.94~155.25) at 2 month after the 1st dose and 2nd dose of $Comvax^{TM}$, respectively. Anti-HBs ${\geq}10$ mIU/mL was observed in 73.7%(95% CI; 65.07~82.33) after 1 dose and 94.8%(95% CI; 90.45~99.15) after 2 doses. Most of the adverse reactions after vaccination were mild. Irritability, the most common systemic reaction, was observed in 24.8%, followed by drowsiness(19.2%), poor feeding(19.2%) and fever(7.2%). Among the local reactions tenderness was observed in 25.6%, redness(${\geq}5$ mm) in 19.2% and swelling(${\geq}5$ mm) in 4.8%. Conclusion : The $Comvax^{TM}$ vaccine was highly immunogenic for PRP and safe in Korean infants. Although the hepatitis B vaccine component was administered at 0, 2, 4 months, this study showed good immunogenicity against HBsAg.

• Journal of Preventive Medicine and Public Health
• /
• v.27 no.2 s.46
• /
• pp.258-273
• /
• 1994

To compare the physical complaints of vinylhouse farmers with those of non-vinylhouse farmers, a personal interviews on 250 vinylhouse and 142 non-vinylhouse farmers were conducted in Sungjoo county in Kyungpook province selected by a random sampling from July 5 to July 10, 1993. Blood pressure of the subjects was also measured. Vinylhouse farmers had a higher average age, larger family size, shorter experience of farming, more working hours per day and working days per year and higher annual income than the non-vinylhouse farmers. The frequency of pesticide spray of the vinylhouse farmers was 3.4 times on the average in June 1993 as compared with 2.0 times of non-vinylhouse farmers, and 16.7 times for the vinylhouse farmers during the last one year while it was 8.3 times for the non-vinylhouse farmers in the same period. While 39.6% of vinylhouse farmers experienced pesticide intoxication symptoms such as headache, nausea, vomiting, dizziness, itching, and skin irritation, etc. during the month of June, 25.4% of non-vinylhouse farmers experienced such symptoms. The most frequent symptoms among eight symptoms that constitute the farmers' syndrome were lumbago, numbness of hand or foot, shoulder pain and dizziness regardless of sex and type of farming. Prevalence of the farmers' syndrome in male and female among vinylhouse farmers were 22.1%, 43.4%, respectively, and the prevalence in non-vinylhouse farmers was 23.2% for male and 50.7% for female. There was no statistically significant difference in the prevalence of farmers' syndrome between vinylhouse and non-vinylhouse farmers. However, the prevalence in female was about 2 times higher than that of male. When the effects of other factors were adjusted by multiple logistic regression for farmers' syndrome, the prevalence in female was 3.0 times higher than that of male. The prevalence of farmers' syndrome was increased as the age of farmers increased in both vinylhouse and non-vinylhouse farmers, and adjusted odds ratio of farmers' syndrome increased by 3% as the age increased by 1 year. Adjusted odds ratio for Farmers' syndrome in farmers who experienced pesticide intoxication during the month of June was 3.1 times higher than that of farmers who did not have such experience. While the prevalence of hypertension in male and female non-vinylhouse farmers were 22.4%, 13.7%, respectively, the prevalence in vinylhouse farmers were 13.5% for male and 12.0% for female. However, there was no association between farmers' syndrome and hypertension. It was found in this study that the vinylhouse farmers are at a high risk of pesticide intoxication, which is associated with tile common physical complaints. To reduce such risk it is necessary to develop farming methods which do not require the pesticide or may use less pesticide, a safer method of pesticide spraying, and the protective equipments which can be worn at a high temperature and have a better protective effect. Also education of farmers for the correct methods of ventilation after pesticide spraying in the vinylhouse and wearing the protective equipments may be considered as a supportive method. Since inappropriate posture at work and intensive labor may cause farmers' syndrome, it is recommended to develop farming tools which reduce physical burden and take a rest and exercise periodically during work. It is necessary to strengthen the hypertension management program of the Kyungpook province, because the prevalence of hypertension was as high as about 15%.

• Journal of radiological science and technology
• /
• v.30 no.3
• /
• pp.205-212
• /
• 2007

To evaluate the feasibility and efficacy of a pulsatile aortic aneurysm phantoms for in-vitro study. The phantoms consisted of a pulsating motor part(heart part) and an aortic aneurysm part, which mimicked true physiologic conditions. The heart part was created from a high-pressured water pump and a pulsatile flow solenoid valve for the simulation of aortic flow. The aortic aneurysm part was manufactured from paper clay, which was placed inside a acrylic plastic square box, where liquid silicone was poured. After the silicone was formed, the clay was removed, and a silicone tube was used to connect the heart and aneurysm part. We measured the change in pressure as related to the opening time(pulse rate, Kruskal-Wallis method) and pressure before and after the stent-graft implantation(n = 5, Wilcoxon's signed ranks test). The changes in blood pressures according to pulse rate were all statistically significant(p<0.05). The systolic/diastolic pressures at the proximal aorta, the aortic aneurysm, and the distal aorta of the model were $157.80{\pm}1.92/130.20{\pm}1.92$, $159.40{\pm}1.14/134.00{\pm}2.92$, and $147.20{\pm}1.480/129.60{\pm}2.70\;mmHg$, respectively, when the pulse rate was 0.5 beat/second. The pressures changed to $161.40{\pm}1.34/90.20{\pm}1.64$, $175.00{\pm}1.58/93.00{\pm}1.58$, and $176.80{\pm}1.48/90.80{\pm}1.92\;mmHg$, respectively, when the pulse rate was 1.0 beat/second, and $159.40{\pm}1.82/127.20{\pm}1.48$, $166.60{\pm}1.67/138.00{\pm}1.87$, and $161.00{\pm}1.22/135.40{\pm}1.67\;mmHg$, respectively, when it was 1.5 beat/second. When pulse rate was set at 1.0 beat/second, the pressures were $143.60{\pm}1.67/90.20{\pm}1.64$, $147.20{\pm}1.92/84.60{\pm}1.82$, and $137.40{\pm}1.52/88.80{\pm}1.64\;mmHg$ after stent-graft implantation. The changes of pressure before and after stent-graft implantation were statistically significant(p<0.05) except the diastolic pressures at the proximal(p =1.00) and distal aorta(p=0.157). The aortic aneurysm phantoms seems to be useful for the evaluation of the efficacy of stent-graft before animal or clinical studies because of its easy reproducibility and ability to display a wide range of pressures.