• Tuberculosis and Respiratory Diseases
• /
• v.66 no.3
• /
• pp.205-210
• /
• 2009

Background: CXCL10 and CXCL11, which are family of CXCR3 ligands, are expressed by lymphocytes and even by bronchial epithelial cells if the cellular immunity is activated. This study evaluated the potential utility of CXCL10 and CXCL11 in the serum for active pulmonary tuberculosis in comparison with lung cancer, which activates the cellular immunity, and benign lung diseases. Methods: Patients who newly visited Pusan National University Hospital from January 2007 to December 2007 and were suspected of having lung cancer or tuberculosis were enrolled prospectively. The patients were classified pathologically and clinically into three groups, 47 with lung cancer, 18 with active pulmonary tuberculosis and 38 control patients with benign pulmonary disease. ELISA was used to determine the levels of CXCL10 and CXCL11 were determined in the serum. Results: The level of CXCL10 and CXCL11 were significantly higher in the active pulmonary tuberculosis group than in the lung cancer and benign lung disease groups (p<0.001, Kruskal-Wallis). The level of CXCL11 was significantly higher in the lung cancer group than in the benign pulmonary disease group, but there was no significant difference in level of CXCL10 between the three groups (p<0.001, p=0.655, respectively, Mann-Whitney U). The level of CXCL10 in patients with stage III+IV lung cancer was significantly higher than those with stage I+II, but there was no significant difference in the level of CXCL11 between the groups (p<0.001, p=0.07, respectively, Mann-Whitney U). There was no significant difference in the level of CXCL10 and CXCL11 between those with the presence and absence of lung cancer metastasis. There was a significant correlation between the level of CXCL10 and CXCL11 (r=0.223, p<0.001). Conclusion: CXCL10 and CXCL11 may be a potential useful markers for active pulmonary tuberculosis if used alongside other diagnostic methods.

• Progress in Medical Physics
• /
• v.16 no.2
• /
• pp.89-96
• /
• 2005

In this study, we investigated the effect of time gating threshold on the delivered dose at a organ with internal motion by respiration. Generally, the internal organs have minimum motion at exhalation during normal breathing. Therefore to compare the dose distribution time gating threshold, in this paper, was determined as the moving region of target during 1 sec at the initial position of exhalation. The irradiated fields were then delivered under three conditions; 1) non-moving target 2) existence of the moving target in the region of threshold (1sec), 3) existence of the moving target region out of threshold (1.4 sec, 2 sec). And each of conditions was described by the moving phantom system. It was compared with the dose distributions of three conditions using film dosimetry. Although the treatment time increased when the dose distributions was obtained by the internal motion to consider the TGT, it could be obtained more exact dose distribution than in the treatment field that didn't consider the internal motion. And it could be reduced the unnecessary dose at the penumbra region. When we set up 1.4 sec of threshold, to reduce the treatment time, it could not be obtained less effective dose distribution than 1 sec of threshold. Namely, although the treatment time reduce, the much dose was distributed out of the treatment region. Actually when it is treated the moving organ, it would rather measure internal motion and external motion of the moving organ than mathematical method. If it could be analyzed the correlation of the internal and external motion, the treatment scores would be improved.

• The KIPS Transactions:PartD
• /
• v.10D no.7
• /
• pp.1149-1154
• /
• 2003

Due to various requirements for the user access control to large databases in the hospitals and the banks, database security has been emphasized. There are many security models for database systems using wide variety of policy-based access control methods. However, they are not functionally enough to meet the requirements for the complicated and various types of access control. In this paper, we propose a database security system that can individually control user access to data groups of various sites and is suitable for the situation where the user's access privilege to arbitrary data is changed frequently. Data group(s) in different sixes d is defined by the table name(s), attribute(s) and/or record key(s), and the access privilege is defined by security levels, roles and polices. The proposed system operates in two phases. The first phase is composed of a modified MAC (Mandatory Access Control) model and RBAC (Role-Based Access Control) model. A user can access any data that has lower or equal security levels, and that is accessible by the roles to which the user is assigned. All types of access mode are controlled in this phase. In the second phase, a modified DAC(Discretionary Access Control) model is applied to re-control the 'read' mode by filtering out the non-accessible data from the result obtained at the first phase. For this purpose, we also defined the user group s that can be characterized by security levels, roles or any partition of users. The policies represented in the form of Block(s, d, r) were also defined and used to control access to any data or data group(s) that is not permitted in 'read ' mode. With this proposed security system, more complicated 'read' access to various data sizes for individual users can be flexibly controlled, while other access mode can be controlled as usual. An implementation example for a database system that manages specimen and clinical information is presented.

• Journal of Chest Surgery
• /
• v.37 no.8
• /
• pp.691-701
• /
• 2004

Background: Tissue hypoxia is a characteristic of many human malignant neoplasms, and hypoxia inducible factor-1 (HIF-1) plays a pivotal role in essential adaptive response to hypoxia, and activates a signal pathway for the expression of the hypoxia-regulated genes, resulting in increased oxygen delivery or facilitating metabolic adaptation to hypoxia. Increased level of HIF-1 a has been reported in many human malignancies, but in esophageal squamous cell carcinoma, the influence of HIF-1 a on tumor biology, including neovascularization, is not still defined. Material and Method: The influence of HIF-1 a expression on angiogenic factors, correlation between the tumor proliferation and HIF-1 a expression, interaction of HIF-1 a expression and p53, and correlation between HIF-1 a expression and clinicopathological prognostic parameters were investigated, using immunohistochemical stains for HIF-1 a, VEGF, CD34, p53, and Ki-67 on 77 cases of resected esophageal squamous cell carcinoma. Result: HIF-1 a expression in cancer cells was found in 33 of 77 esophageal squamous cell carcinoma cases. The 33 cases (42.9%) showed positive stain for HIF-1 a. High HIF-1 a expression was significantly associated with several pathological parameters, such as histologic grade (p=0.032), pathological TMN stage (p=0.002), the depth of tumor invasion (p=0.022), regional lymph node metastasis (p=0.002), distant metastasis (p=0.049), and lymphatic invasion (p=0.004). High HIF-1 a expression had significant VEGF immunoreactivity (p=0.008) and Ki-67 labeling index (p<0.001), but was not correlated with microvascular density within tumors (p=0.088). The high HIF-1 a expression was correlated with aberrant p53 accumulation with a marginal significance (p=0.056). The overall 5-year survival rate was 34.9%. The survival rate of patients with a high HIF-1 a expression was worse than that of patients with low-expression tumors (log-rank test, p=0.0001). High HIF-1 a expression was independent unfavorable factors although statistical significance is marginal in multivariate analysis. Conclusion: It is suggested that (1) high HIF-1 a expression in esophageal squamous cell carcinoma is associated with tumor hypoxia, or with genetic alteration in early carcinogenesis and progressive stages, (2) high HIF-1 a expression may be associated with intratumoral neovascularization through HIF-VEGF pathway, and (3) high HIF-1 a expression is associated with poor prognosis in patients with esophageal squamous cell carcinoma and may playa role as biomarker for regional lymph node metastasis.

• Journal of Chest Surgery
• /
• v.39 no.11 s.268
• /
• pp.828-837
• /
• 2006

Background: Tissue hypoxia is characteristic of many human malignant neoplasm, and hypoxia inducible factor-1(HIF-1) plays a pivotal role in essential adaptive response to hypoxia, and activates a signal pathway for the expression of the hypoxia-regulated genes, resulting in increasing $O_2$ delivery or facilitating metabolic adaptation to hypoxia. Increased level of HIF-$1{\alpha}$ has been reported in many human malignancies, but in non-small cell lung carcinoma the influence of HIF-$1{\alpha}$ on tumor biology, including neovascularization, is not still defined. In present study the relationship of HIF-$1{\alpha}$ expression on angiogenetic factors, relationship between the tumor proliferation and HIF-$1{\alpha}$ expression, interaction of HIF-$1{\alpha}$ expression and p53, and relationship between HIF-$1{\alpha}$ expression and clinico-pathological prognostic parameters were investigated. Material and Method: Archival tissue blocks recruited in this study were retrieved from fifty-nine patients with primary non-small cell lung carcinoma, who underwent pneumonectomy or lobectomy from 1997 to 1999. HIF-$1{\alpha}$, VEGF(vascular endothelial growth factor), and p53 protein expression and Ki-67 labeling index in tumor tissues were evaluated, using a standard avidin-biotin-peroxidase complex(ABC) immunohistochemistry. Relationship between the HIF-$1{\alpha}$ expression and VEGF, p53 overexpression and correlation between the HIF-$1{\alpha}$ expresseion and Ki-67 index were analyzed. Clinico-pathologic prognostic parameters were also analyzed. Result: HIF-$1{\alpha}$ expression in cancer cells was found in 24 of 59 cases of non-small cell lung carcinoma(40.7%). High HIF-$1{\alpha}$ expression was significantly associated with several pathological parameters, such as pathological TMN stage(p=0.004), pT stage(p=0.020), pN stage (p=0.029), and lymphovascular invasion(p=0.019). High HIF-$1{\alpha}$ expression was also significantly associated with VEGF immunoreactivity(p<0.001), and aberrant p53 expression(p=0.040). but was marginally associated with Ki-67 labeling index(p=0.092). The overall 5-year survival rate was 42.3%. The survival curve of patients with a high HIF-$1{\alpha}$ expression was worse than that of patients with low-expression(p=0.002). High HIF-$1{\alpha}$ expression was independent unfavorable factors with a marginal significance in multivariate analysis performed by Cox regression. Conclusion: It is suggested that high HIF-$1{\alpha}$ expression may be associated with intratumoral neovascularization possibly through HIF-VEGF pathway, and high HIF-$1{\alpha}$ expression could be associated with lymph node metastasis and post operative poor prognosis in patients with non-small cell lung carcinoma.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.4 no.1
• /
• pp.28-33
• /
• 2001

Purpose: H. pylori infection is thought to contribute to iron-deficiency anemia, especially during puberty. The ferritin protein Pfr of H. pylori is homologous to eukaryotic and prokaryotic ferritins. The purpose of this study was to analyze the H. pylori pfr status in gastric biopsy specimens according to clinical data, including antral gastritis with or without iron-deficiency anemia. Methods: A total of 26 H. pylori-positive patients aged from ten to 18 years were categorized into subgroups based on the presence or absence of iron-deficiency anemia. All of them had antral gastritis. Sixteen patients were proved to have iron-deficiency anemia by hematological study, two of which had a duodenal ulcer. The other ten patients showed normal hematological findings. DNA isolation was performed from each of the gastric biopsy specimens. PCR amplification of the pfr gene coding was done using two sets of primers. The pfr region, 501 bp, was generated by linking the sequences of the two PCR products. The nucleotide and protein sequences were compared between the pfr regions from Korean H. pylori strains and the NCTC 11638, 26695, and J99 strain, which were obtained from the Genbank. Sequence comparisons were also performed for the pfr regions between the iron-deficiency anemia (+) and (-) groups. Results: Analysis of the complete coding region of pfr gene revealed three sites of mutation. The Ser39Ala mutation was found in 100% (26/26), Gly111Asn in 26.9% (7/26), and Gly82Ser in 11.5% (3/26). There were no significant differences in the mutations of the pfr regions between the iron deficiency anemia (+) and (-) groups. Conclusion: The mutation in the pfr gene did not relate with the clinical phenotype, iron deficiency anemia. Further studies are needed on the aspects of host side or other complex factors to elucidate anemia. Further studies are needed on the aspects of host side or other complex factors to elucidate the mechanisms by which the H. pylori infection might lead to iron deficiency anemia.

• Radiation Oncology Journal
• /
• v.22 no.1
• /
• pp.64-68
• /
• 2004

Purpose : To study the feasibility of verifying real-time 2-D dose distribution measurement system with the scintillation screen for the quality assurance. Materials and Methods : The water phantom consisted of a scintillation screen (LANEX fast screen, Kodak, USA) that was axially located in the middle of an acrylic cylinder with a diameter of 25 cm. The charge-coupled device (CCD) camera was attached to the phantom In order to capture the visible light from the scintillation screen. To observe the dose distribution In real time, the intensity of the light from the scintillator was converted to a dosage. The isodose contours of the calculations from RTP and those of the measurements using the scintillation screen were compared for the arc therapy and the Intensity modulated radiation therapy (IMRT). Results : The kernel, expressed as a multiplication of two error functions, was obtained in order to correct the sensitivity of the CCD of the camera and the scintillation screen. When comparing the calculated isodose and measured isodose, a discrepancy of less than 8 mm in the high dose region was observed. Conclusion : Using the 2-D dosimetry system, the relationship between the light and the dosage could be found, and real-time verification of the dose distribution was feasible.

• Radiation Oncology Journal
• /
• v.14 no.3
• /
• pp.237-244
• /
• 1996

Purpose : The accurate dosimetry of independent collimator equipped for 6MV and 15MV X-ray beam was investigated to search for the optimal correction factor. Materials and Methods : The field size factors, beam quality and dose distribution were measured by using 6MV, 15MV X-ray Field size factors were measured from $3{\times}3cm^2$ to $35{\times}35cm^2$ by using 0.6cc ion chamber (NE 2571) at Dmax. Beam qualities were measured at different field sizes, off-axis distances and depths. Isodose distributions at different off-axis distance using $10\times10cm^2$ field were also investigated and compared with symmetric field. Result: 1) Relative field size factors was different along lateral distance with maximum changes in $3.1\%$ for 6MV and $5\%$ for 15MV. But the field size factors of asymmetric fields were identical to the modified central-axis values in symmetric field, which corrected by off-axis ratio at Dmax. 2) The HVL and PDD was decreased by increasing off-axis distance. PDD was also decreased by increasing depth For field size more than $5{\times}cm^2$ and depth less than 15cm, PDD of asymmetric field differs from that of symmetric one ($0.5\~2\%$ for 6MV and $0.4\~1.4\%$ for 15MV). 3) The measured isodose curves demonstrate divergence effects and reduced doses adjacent to the edge close to the flattening filter center was also observed. Conclusion . When asymmetric collimator is used, calculation of MU must be corrected with off-axis and PDD with a caution of underdose in central axis.

• Radiation Oncology Journal
• /
• v.18 no.4
• /
• pp.345-354
• /
• 2000

Purpose : Conventional radiation therapy Portal images gives low contrast images. The purpose of this study was to enhance image contrast of a linacgram by developing a low-cost image processing method. Materials and Methods : Chest linacgram was obtained by irradiating humanoid Phantom and scanned using Diagnostic-Pro scanner for image processing. Several types of scan method were used in scanning. These include optical density scan, histogram equalized scan, linear histogram based scan, linear histogram independent scan, linear optical density scan, logarithmic scan, and power square root scan. The histogram distribution of the scanned images were plotted and the ranges of the gray scale were compared among various scan types. The scanned images were then transformed to the gray window by pallette fitting method and the contrast of the reprocessed portal images were evaluated for image improvement. Portal images of patients were also taken at various anatomic sites and the images were processed by Gray Scale Expansion (GSE) method. The patient images were analyzed to examine the feasibility of using the GSE technique in clinic. Results :The histogram distribution showed that minimum and maximum gray scale ranges of 3192 and 21940 were obtained when the image was scanned using logarithmic method and square root method, respectively. Out of 256 gray scale, only 7 to 30$\%$ of the steps were used. After expanding the gray scale to full range, contrast of the portal images were improved. Experiment peformed with patient image showed that improved identification of organs were achieved by GSE in portal images of knee joint, head and neck, lung, and pelvis. Conclusion :Phantom study demonstrated that the GSE technique improved image contrast of a linacgram. This indicates that the decrease in image quality resulting from the dual exposure, could be improved by expanding the gray scale. As a result, the improved technique will make it possible to compare the digitally reconstructed radiographs (DRR) and simulation image for evaluating the patient positioning error.

• Journal of Haehwa Medicine
• /
• v.4 no.2
• /
• pp.255-272
• /
• 1996

소적백출산(消積白朮散)은 ${\ll}$화제국방(和劑局方)${\gg}$에 삼령백출산(蔘笭白朮散)에 정열해독약(淸熱解毒藥)인 와송(瓦松) 금은화(金銀花) 포공영(蒲公英)을 가미(加味)한 처방(處方)으로, 본방(本方)인 삼령백출산(蔘笭白朮散)은 비위허약(脾胃虛弱), 음식부진(飮食不振), 다곤소력(多困少力) 중만비대(中滿痺臺), 심정기천(心柾氣喘), 구토(嘔吐), 설사(泄瀉), 상한해수(傷寒咳嗽)를 치료목적(治療目的)으로 쓰여 온 이래(以來) 임상에서는 대편부실(大便不實), 구설(久泄), 옹달궤후(癰疸潰後) 불사식자(不思食者)를 치료(治療)하는데 다용(多用)되어 왔다. 종양(腫瘍)(Neoplasia)은 새로운 성장(成長)(New+ Glowth) 이라는 세포학적(細胞學的)으로 비정상세포(非正常細胞)의 과다증식(過多增殖)으로 인해 실질장기(實質臟器), 유강장기(有腔腸器), 및 골격(骨格), 피부조직(皮膚組織)에 비정상조직(非正常組織)을 형성(形成)하는 질환(疾患)이다. 현대적(現代的) 종양(腫瘍)과 유사(類似)한 한의학적(韓醫學的)인 병증(病症)은 ${\ll}$소문(素問)${\gg}$에서는 "궐산(厥疝), 복량(伏梁), 식적(息積)"으로 ${\ll}$영추(靈樞)${\gg}$에서는 "장담(腸覃), 석가"로 표시(表示)된 이후(以後)로 소원방(巢元方)은 징가, 식일, 석옹(石癰), 완저(緩疽), 석저(石疽) 등으로 표현(表現)하였다. 원인(原因)에 대(對)해서는 ${\ll}$내경(內經)${\gg}$에서는 허(虛)와 한기(寒氣), 한(寒) 열(熱)로 보았고, 그 외(外)의 학자(學者)들은 내허(內虛)와 기혈불순(氣血不順), 화(火), 한(寒), 기울(氣鬱), 음양불화(陰陽不和)등으로 보았다. 치료(治療)는 ${\ll}$내경(內經) 자법론(刺法論)${\gg}$에서 "정기재내(正氣在內) 사불가우(邪不可于)" 이라 하여 생명활동(生命活動)의 원동력(原動力)인 정기(正氣)의 역할(役割)을 강조(强調)하였고, ${\ll}$육원정기대론(六元正氣大論)${\gg}$에서는 "대적대취(大積大聚) 불가범야(不可犯也) 쇠기태반이지(衰其太半而止)"라 하여 공벌약(攻伐藥)을 과용(過用)하여 정기(正氣)를 손상(損傷)시켜서는 안된다고 하는 등 부정위주(扶正爲主), 거사위주(祛邪爲主) 혹은 부정거사(扶正祛邪) 겸용(兼用)의 방법(方法)이 혼용(混用)되고 있다. 현대(現代) 서양의학(西洋醫學)의 항암제(抗癌劑)는 치료효과(治療效果)는 우수(優秀)하지만 악심(惡心), 구토(嘔吐)를 비롯하여 골수억제효과(骨髓抑制效果)와 간(肝), 심(心), 신(腎), 폐(肺)의 손상(損傷)을 초래(招來)하는 등(等)의 부작용(副作用)을 나타내며, 빈번(頻繁)한 화학요법제(化學療法劑)의 투여(投與)로 인(因)한 암세포(癌細胞)의 약제저항성(藥劑抵抗性) 출현(出現)등이 항암제(抗癌劑)의 문제점(問題點)으로 제시(提示)되고 있다. 이에 저자(著者)는 비위기능(脾胃機能)을 강화(强化)시켜 정기형성(正氣形成)에 깊이 관여(關與)하는 삼령백출산(蔘笭白朮散)에 청열해독(淸熱解毒), 소종산결지제(消腫散結之劑)인 금은화(金銀花), 포공영(浦公英), 와송(瓦松)을 가미(加味)하여 암발생(癌發生) 백서(白鼠)에 투약(投藥)한 후(後) sarcoma 180암세포(癌細胞)에 대(對)한 생명연장효과(生命延長效果)와 항암제(劑)의 일종(一種)인 cis-platin을 이용(利用)하여 양방항암제(洋方抗癌劑)의 부작용(副作用)에 대(對)한 본(本) 방(方)의 효과(效果)를 실험(實驗)하여 관찰(觀察)하였던 바 다음과 같은 결론(結論)을 얻었다. 1. 소적백출산(消積白朮散)은 sarcoma 180 암세포(癌細胞) 이식종양(移植腫瘍)에 대(對)해 생명연장효과(生命延長效果)가 인정(認定)되었다. 2. 소적백출산(消積白朮散)은 치암제(治癌劑)인 cis-platin 치사독성(致死毒性)에 대(對)해 생존연장효과(生存延長效果)가 인정(認定)되었다. 3. 소적백출산(消積白朮散)은 cis-platin 현독성(腎毒性) 생쥐 및 흰쥐에 있어서 유의성(有意性) 있는 체중감소억제효과(體重減少抑制效果) 및 serum BUN 상승억제효과(上昇抑制效果)가 인정(認定)되었다. 4. 소적백출산(消積白朮散)은 cis-platin 현독성(賢毒性) 흰쥐에 대(對)해 유의성(有意性) 있는 serum creatinine 상승억제효과(上昇抑制效果)가 나타났으며, cis-platin의 혈액학적(血液學的) 부작용(副作用)인 RBC, WBC 감소(減少)에 대(對)해 감소억제효과(減少抑制效果)가 인정(認定)되었다. 5. 소적백출산(消積白朮散)은 cis-platin 현독성(腎毒性) 흰쥐에 대(對)해 뇨량감소억제(尿量減少抑制) 효과(效果) 및 ureanitrogen과 creatinine 배수감소억제효과가 관찰(觀察)되었다. 이상(以上)의 결과(結果)로부터 소적백출산(消積白朮散)은 악성종양치료(惡性腫瘍治療) 및 항암제(劑)의 부작용(副作用)을 경감(輕減)시키는 데 응용(應用)할 수 있을 것으로 사료(思料)된다.