• Progress in Medical Physics
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• v.6 no.2
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• pp.71-81
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• 1995

Consecutive brain 〔Tc-99m〕ECD SPECT studies before and after acetazolamide (Diamox) administration have been performed with patients for the evaluation of cerebrovascular hemodynamic reserve. However, the quantitaitve potential of SPECT Diamox imaging is limited as a result of degrading fractors such as finite detector resolution, attenuation, scatter, poor counting statistics, and methods of data analysis. Making physical measurements in phantoms filled with known amounts of radioactivity can help characterize and potentially quantify the sensitivities. However, it is often very difficult to make a realistic phantom simulating patients in clinical situations. By computer simulation, we studied the sensitivities of ECD SPECT before and after Diamox administration. The sensitivity is defined as ($\Delta$N/N)/($\Delta$S/S)$\times$100％, where $\Delta$N denotes the differences in mean counts between post-and pre-Diamox in the measured data, N denotes the mean counts before Diamox in the measure data, $\Delta$S denotes the differences in mean counts between post-and pre-Diamox in the model, and S denotes the mean counts before Diamox in the model. In clinical Diamox studies, the percentage changes of radioactivity could be determined to measure changes in radioactivity concentration by Diamox after subtracting pre-from post-Diamox data. However, the optimal amount of subtraction for 100％ sensitivity is not known since this requires a thorough sensitivity analysis by computer simulation. For consecutive brain SPECT imaging model before and after Diamox, when 30％ increased radioactivity concentrations were assingned for Diamox effect in model, the sensitivities were measured as 51.03, 73.4, 94.00, 130.74％ for 0, 100, 150, 200％ subtraction, respectively. Sensitivity analysis indicated that the partial voluming effects due to finite detector resolution and statistical noise result in a significant underestimation of radioactivity measurements and the amount of underestimation depends on the. ％ increase of radioactivity concentration and ％ subtraction of pre-from post-Diamox data. The 150％ subtraction appears to be optimal in clinical situations where we expect approximately 30％ changes in radioactivity concentration. The computer simulation may be a powerful technique to study sensitivities of ECD SPECT before and after Diamox administration.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.1
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• pp.28-35
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• 2008

Purpose: The aim of this study is to report the efficacy of infliximab, a monoclonal antibody directed against tumor necrosis factor alpha which is used for both treatment of refractory pediatric Crohn disease (CD) and induction of remission. Methods: Among pediatric patients who were diagnosed with CD at Samsung Medical Center between March 2001 and August 2007, a total of 16 patients were given infliximab to treat conventional therapyresistant refractory CD and severe active CD for induction of remission. Patients needing maintenance therapy were treated with an infliximab infusion every 8 weeks, and fistulizing CD patients occasionally received the infusion upon the condition that a fistula developed. The efficacy of treatment was assessed by comparing the Pediatric Crohn Disease Activity Index (PCDAI), Hct, ESR, CRP, and serum albumin levels using paired t-test. Results: The male/female ratio was 13:3, and the median age was 13 years (range, 21 months~15 years). The patients included 7 cases of therapy-resistant refractory CD, 7 cases of severe active CD, and 2 cases of fistulizing CD. Mean PCDAI before infliximab therapy was 34.19${\pm}$14.96, and mean follow-up PCDAI within 2 to 4 weeks after the last infusion was significantly lower, at 6.88${\pm}$10.31 (p=0.000). Hematological markers such as ESR (p=0.000), serum albumin (p=0.016), and CRP (p=0.009) also improved significantly after infusion. Remission was achieved in 2 of 4 patients refractory to conventional therapy. Among 3 steroid-dependent patients, 2 were able to discontinue steroid therapy, and dose reduction was possible in 1 patient. Remission after top-down therapy without prior use of other immunomodulators was achieved in 6 weeks in all 7 of the patients who had severe CD. Nine of ten refractory fistulizing CD patients also showed improvement after infliximab therapy. Conclusion: Infliximab was effective in pediatric refractory CD for induction of remission and maintenance therapy, as well as in severe CD for top-down induction therapy. Furthermore, infliximab has contributed to steroid cessation and dose reduction. Long-term follow-up evaluation is needed to determine safety and efficacy of infliximab in the future.

• Korean Journal of Soil Science and Fertilizer
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• v.37 no.2
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• pp.66-73
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• 2004

As one of the typical farming practices in the sloped upland in Pyeongchang and Hongcheon area, application of piling with coarse saprolite materials has been practiced by farmers for several reasons such as reduction of damage by monocropping, better development of plant roots, and better drainage. However, adverse effect on application of coarse saprolite soil materials to environmental aspects should not be ignored. Therefore, this research was conducted to evaluate the physicochemical properties of coarse saprolite materials in upland fields in Pyeongchang area. According to particle size distribution of coarse saprolite materials, averaged gravel contents for Pyeongchang and Hongcheon county were 16.7 and 25.3%, respectively. There was no significant difference in gravel contents by soil depth, and CV values for each particle size ranged from 20 to 40%, which implied that application of coarse material with similar properties. When we compared CEC values of dressed soil with or without considering gravel content, CEC values decreased as increasing gravel contents. The penetration resistances were 0.04-7.48 MPa at the 0 to 10 cm surface soil, and 0.10 to 8.80 MPa at the depth below 11 cm. The bulk density of the soil was $1.15g\;cm^{-3}$ at the surface soil and 1.29 to $1.35g\;cm^{-3}$ at the soil depth below 10 cm. The organic matter content, cation exchange capacity, and avaliable $P_2O_5$ concentrations of soil in upland where piling with saprolite materials of Pyeongchang area applied were $12.4g\;kg^{-1}$, $7.1cmol_c\;kg^{-1}$, and $526mg\;kg^{-1}$, respectively. Cation exchange capacity was lower than that of averaged Korean upland soil, while available $P_2O_5$ concentration was relatively higher than that of averaged Korean upland, which indicated high input of various fertilizers.

• Korean Journal of Soil Science and Fertilizer
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• v.25 no.4
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• pp.325-333
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• 1992

An investigation was carried out to find out the effects of long-term application (14 and 28 years) of rice straw, compost and wheat straw on changes in soil chemical and physical properities, aspests of releasing potential nitrogen and nitrogen uptake by rice and maize from fine textured paddy soils with double cropping system in warm temperate area. The result obtained were summarized as follows : 1. The long-term application of organic matters improved plow layer and soil physical properties : bulk density and solid phase were decreased, while porosity and gaseous phase were decreased. 2. Average increment of total carbon per year was 0.0371% and 0.0407% for rice straw and compost, respectively, from 1 through 14 years ; it was 0.0007% and 0.0014% for the rice straw and compost, respectively, from 15 years through 28 years. The average increment of total notrogen per year was 0.0025% and 0.038% for the rice straw and compost, respectively, from 1 through 14 years ; 0.0014% and 0.0024% for the same treatments from 15 through 28 years. 3. $NH_4-N$ and amide-N were high in the soils with wheat straw application for 28 years ; the amino sugar-N in the soils with compost application for 28 years ; amino acid -N in the soils with rice straw application for 14 and 28 years ; and unidentified-N, in the control. 4. The released amount of available nitrogen with the submerged condition was higher at $30^{\circ}C$ than at $25^{\circ}C$ during the incubation. The amount of released available nitrogen at the field was aproximately same as that of $25^{\circ}C$ incubation. However, the released amounts from the incubation and the field were always lower than those extracted with reagents. 5. The amount of nitrogen uptake by rice and maize was highly correlated with available nitrogen extracted with phosphate buffer(pH 7.0). 6. The ratio of yield increase(milled rice) was 17, 12 and 7%, respectively, by application of rice straw, compost and wheat straw for 28 years, and 11% by application of rice straw for 14 years.

• Korean Journal of Soil Science and Fertilizer
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• v.45 no.6
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• pp.1230-1236
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• 2012

To verify that the electrokinetic remediation is effective for decreasing salinity of fields of the plastic-film house, field tests for physical property, chemical property, and crop productivity of soils have been conducted. The abridged result of those tests is as follows. In the EK treatment, the electrokinetic remediation has been treated at the constant voltage (about 0.8 V $cm^{-1}$) for fields of the farm household. At this time, an alternating current (AC) 220 V of the farm household was transformed a direct current. The HSCI (High Silicon Cast Iron) that the length of the stick for a cation is 20cm, and the Fe Plate for an anion have been spread out on the ground. As the PVC pipe that is 10 cm in diameter was laid in the bottom of soils, cations descend on the cathode were discharged together. For soil physical properties according to the EK treatment, the destruction effect of soil aggregate was large, and the infiltration rate of water was increased. However, variations of bulk density and porosity were not considerable. Meanwhile, in chemical properties of soils, principal ions of such as EC, $NO_3{^-}$-N, $K^+$, and $Na^+$ were better rapidly reduced in the EK treated control plot than in the untreated control plot. And properties such as pH, $P_2O_5$ and $Ca^{2+}$ had a small impact on the EK. For cropping season of crop cultivation according to the EK treatment, decreasing rates of chemical properties of soils were as follows; $NO_3{^-}$-N 78.3% > $K^+$ 72.3% > EC 71.6% $$\geq_-$$ $Na^+$ 71.5% > $Mg^{2+}$ 36.8%. As results of comparing the experimental plot that EK was treated before crop cultivation with it that EK was treated during crop cultivation, the decreasing effect of chemical properties was higher in the case that EK was treated during crop cultivation. After the EK treatment, treatment effects were distinct for $NO_3{^-}$-N and EC that a decrease of nutrients is clear. However, because the lasting effect of decreasing salinity were not distinct for the single EK treatment, fertilization for soil testing was desirable carrying on testing for chemical properties of soils after EK treatments more than two times. In the growth of cabbages according to the EK treatment, the rate of yield increase was 225.5% for the primary treatment, 181.0% for the secondary treatment, and 124.2% for third treatment compared with the untreated control plot. The yield was increased by a factor of 130.0% for the hot pepper at the primary treatment (Apr. 2011), 248.1% for the lettuce at the secondary treatment (Nov.2011), and 125.4% for the young radish at the third treatment (Jul. 2012). In conclusion, the effect of yield increase was accepted officially for all announced crops.

• Journal of Chest Surgery
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• v.39 no.8 s.265
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• pp.611-618
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• 2006

Background: There have been controversies whether mitral valvular surgery is necessary in the patients with moderate ischemic mitral regurgitation undergoing coronary artery bypass grafting. The purpose of this study is to evaluate the long term clinical results of patients with moderate ischemic mitral regurgitation. Material and Method: Between January 1992 and February 2005, 44 patients with moderate ischemic mitral regurgitation underwent coronary artery bypass grafting. Concomitant mitral valvular procedure was performed in 20 patients (group 1) and isolated coronary artery bypass grafting was performed in 24 patients (group 2). There were no significant difference between groups except cardiopulmonary bypass time (p<0.01). Postoperative follow up duration was $30.1{\pm}29.6$ months and last follow up echocardiographic examination was performed at $21.2{\pm}28.0$ months. Result: There was no difference in operative mortality between groups (group 1 vs group 2, 15.0% vs 8.3%, p=0.493). Grade of mitral regurgitation ${(0.81{\pm}0.91\;vs\;1.50{\pm}0.05,\;p=0.046)}$ and reduction in regurgitation grade ${(1.75{\pm}0.93\;vs\;0.70{\pm}1.26,\;p=0.009)}$ were different between two groups. But there were no significant differences in left ventricular ejection fraction ${(34.1{\pm}11.4%\;vs\;41.6{\pm}12.9%)}$, left ventricular end systolic volume ${(118.2{\pm}63.9\;ml%\;vs\;85.6{\pm}281\;ml)}$, New York Heart Association functional class ${(2.1{\pm}0.2\;vs\;2.4{\pm}1.2)}$ and 5 year survival rate ${(85{\pm}8%\;vs\;82{\pm}8%)}$. There was no risk factor for operative mortality and the only risk factor for late death was preoperative atrial fibrillation (p=0.042). There was no significant correlation between mitral valvular surgery and late death. Conclusion: Concomitant mitral valvular procedure in patients with moderate ischemic mitral regurgitation undergoing coronary artery bypass grafting had no significant positive effect on survival and ventricular function compared with isolated coronary artery bypass grafting. Prospective randomized study may be needed to evaluate the necessity of concomitant mitral procedure and to find more effective method for the improvement of ventricular function.

• The Journal of Korean Society for Radiation Therapy
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• v.24 no.2
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• pp.189-196
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• 2012

Purpose: The sufficiency of skin dose and the reemergence of patient set-up position to the success of skin cancer radiation treatment is a very important element. But the conventional methods to increase the skin dose were used to vacuum cushion, bolus and water tank have several weak points. For this reason, we producted Foxtail Millet Vacuum Cushion and evaluated the efficiency of the Foxtail Millet Vacuum Cushion in skin cancer Radiation treatment. Materials and Methods: We measured absolute dose for 3 materials (Foxtail Millet Vacuum Cushion, bolus and solid water phantom) and compared each dose distribution. We irradiated 6 MV 100 MU photon radiation to every material of 1 cm, 2 cm, 3 cm thickness at three times. We measured absolute dose and compared dose distribution. Finally we inspected the CT simulation and radiation therapy planing using the Foxtail Millet Vacuum Cushion. Results: Absolute dose of Foxtail Millet Vacuum Cushion was similar to absolute dose of bolus and solid water phantom's result in each thickness. it Showed only the difference of 0.1~0.2% between each material. Also the same result in dose distribution comparison. About 97% of the dose distribution was within the margin of error in the prescribed ranges ($100{\pm}3%$), and achieved the enough skin dose (Gross Tumor Volume dose : $100{\pm}5%$) in radiation therapy planing. Conclusion: We evaluated important fact that Foxtail Millet Vacuum Cushion is no shortage of time to replace the soft tissue equivalent material and normal vacuum cushion at the low energy radiation transmittance. Foxtail Millet Vacuum Cushion can simultaneously achieve the enough skin dose in radiation therapy planing with maintaining normal vacuum cushion' function. Therefore as above We think that Foxtail Millet Vacuum Cushion is very useful in skin cancer radiation treatment.

• The Journal of Korean Society for Radiation Therapy
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• v.24 no.2
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• pp.137-147
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• 2012

Purpose: Analyze the Effectiveness of Radiation Treatment Planning by dose calculation and optimization algorithm, apply consideration of actual treatment planning, and then suggest the best way to treatment planning protocol. Materials and Methods: The treatment planning system use Eclipse 10.0. (Varian, USA). PBC (Pencil Beam Convolution) and AAA (Anisotropic Analytical Algorithm) Apply to Dose calculation, DVO (Dose Volume Optimizer 10.0.28) used for optimized algorithm of Intensity Modulated Radiation Therapy (IMRT), PRO II (Progressive Resolution Optimizer V 8.9.17) and PRO III (Progressive Resolution Optimizer V 10.0.28) used for optimized algorithm of VAMT. A phantom for experiment virtually created at treatment planning system, $30{\times}30{\times}30$ cm sized, homogeneous density (HU: 0) and heterogeneous density that inserted air assumed material (HU: -1,000). Apply to clinical treatment planning on the basis of general treatment planning feature analyzed with Phantom planning. Results: In homogeneous density phantom, PBC and AAA show 65.2% PDD (6 MV, 10 cm) both, In heterogeneous density phantom, also show similar PDD value before meet with low density material, but they show different dose curve in air territory, PDD 10 cm showed 75%, 73% each after penetrate phantom. 3D treatment plan in same MU, AAA treatment planning shows low dose at Lung included area. 2D POP treatment plan with 15 MV of cervical vertebral region include trachea and lung area, Conformity Index (ICRU 62) is 0.95 in PBC calculation and 0.93 in AAA. DVO DVH and Dose calculation DVH are showed equal value in IMRT treatment plan. But AAA calculation shows lack of dose compared with DVO result which is satisfactory condition. Optimizing VMAT treatment plans using PRO II obtained results were satisfactory, but lower density area showed lack of dose in dose calculations. PRO III, but optimizing the dose calculation results were similar with optimized the same conditions once more. Conclusion: In this study, do not judge the rightness of the dose calculation algorithm. However, analyzing the characteristics of the dose distribution represented by each algorithm, especially, a method for the optimal treatment plan can be presented when make a treatment plan. by considering optimized algorithm factors of the IMRT or VMAT that needs to optimization make a treatment plan.

• The Journal of Korean Society for Radiation Therapy
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• v.24 no.2
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• pp.85-93
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• 2012

Purpose: It is essential to minimize the respiratory-induced motion of involved organs in the Tomotherapy for tumor located in the chest and abdominal region. However, the application of breathing control system to Tomotherapy is limited. This study was aimed to investigate the possible application of the ABCHES system and its efficacy as a means of breathing control in the tomotherapy treatment. Materials and Methods: Five subjects who were treated with a Hi-Art Tomotherapy system for lung, liver, gallbladder and pancreatic tumors. All patients undertook trained on two breathing methodes using an ABCHES, free breathing methode and shallow breathing methode. When the patients could carry out the breathing control, 4D-CT scan was a total of 10 4D tomographic images were acquired. A radiologist resident manually drew the tumor region, including surrounding nomal organs, on each of CT images at the inhalation phase, the exhalation phase and the 40% phase (mid-inhalation) and average CT image. Those CT images were then exported to the Tomotherapy planning station. Data exported from the Tomotherapy planning station was analyzed to quantify characteristics of dose-volume histograms and motion of tumors. Organ motions under free breathing and shallow breathing were examined six directions, respectively. Radiation exposure to the surrounding organs were also measured and compared. Results: Organ motion is in the six directions with more than a 5 mm displacement. A total of 12 Organ motions occurred during free breathing while organ motions decreased to 2 times during shallow breathing under the use of Abches. Based on the quantitative analysis of the dose-volume histograms shallow breathing showed lower resulting values, compared to free breathing, in every measure. That is, treatment volume, the dose of radiation to the tumor and two surrounding normal organs (mean doses), the volume of healthy tissue exposed to radiation were lower at the shallow breathing state. Conclusion: This study proposes that the use of ABCHES is effective for the Tomotherapy treatment as it makes shortness of breathing easy for patients. Respiratory-induced tumor motion is minimized, and radiation exposure to surrounding normal tissues is also reduced as a result.

• The Journal of Korean Society for Radiation Therapy
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• v.20 no.1
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• pp.37-43
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• 2008

Purpose: To evaluate dosimetry results of three different techniques for whole breast irradiation after conservative surgery of large pendulous breast patient. Materials and Methods: Planning computed tomography (CT) scans for three techniques were performed on a GE Hi-speed advantage CT scanner in the supine (SP), supine with breast supporting Device (SD) and prone position on a custom prone mattress (PP). Computed tomography images were acquired at 5 mm thickness. The clinical target volumes (CTV), ipsilateral lung and heart were delineated to evaluate the dose statistic, and all techniques were planned with the tangential photon beams (Pinnacle$^3$, Philips Medical System, USA). The prescribed dose was 50 Gy delivered in 25 fractions. To evaluate the dose coverage for CTV, we analysed percent volume of CTV receiving minimum of 95%, 100%, 105%, and 110% of prescription dose ($V_{95}$, $V_{100}$, $V_{105}$, and $V_{110}$) and minimal dose covering 95% ($D_{95}$) of CTV. The dosimetric comparison for heart and ipsilateral lung was analysed using the minimal dose covering 5% of each organs ($D_5$) and the volume that received >18 Gy for the heart and >20 Gy for the ipsilateral lung. Results: Target volume coverage ($V_{95}$ and $V_{100}$) was not significantly different for all technique. The V105 was lower for PP (1.2% vs. 4.4% for SP, 11.1% for SD). Minimal dose covering 95% ($D_{95}$) of target was 47.5 Gy, 47.7 Gy and 48 Gy for SP, SD and PP. The volume of ipsilateral lung received >20 Gy was 21.7%, 11.6% and 4.9% for SP, SD and PP. The volume of heart received >18 Gy was 17.0%, 16.1% and 9.8% for SP, SD and PP. Conclusion: Prone positioning of patient for large pendulous breast irradiation enables improving dose uniformity with minimal heart and lung doses.