• Title/Summary/Keyword: 장기적 사용성

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A Study of Influence of Filgrastim on PET/CT In Diffuse Large B cell Lymphoma (미만성 거대 B 세포 림프종 환자에서 Filgrastim 사용이 PET/CT 영상에 미치는 영향에 대한 고찰)

  • NamKoong, Hyuk;Park, Hoon-Hee;Ban, Yung-Gak;Kang, Sin-Chang;Kim, Sang-Kyoo;Lim, Han-Sang;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.3
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    • pp.17-23
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    • 2009
  • Purpose: It has been known that PET/CT is very valuable in follow-up study of diffuse large B cell lymphoma (DLBCL). Generally, in DLBCL, radiotherapy and chemotherapy has been progressed, because the lesion hasn‘t been limited to one site. And, it has lead to the decrease of leukocyte like neutropenia, due to myelosuppression of chemotherapy. So, in that case, administration of Filgrastim (Granulocyte colony-stimulating factor; G-CSF) is universal. However, in short time after administration, PET/CT has limitation to offer accurate images, through the uptake of $^{18}F$-FDG is increased in the region that is activated bone marrow by hematopoietic growth. Therefore, the aim of this study is that PET/CT in a certain period of time after administration of Filgrastim is able to show normal degree of $^{18}F$-FDG uptake. Materials and Methods: 10 patients under follow-up study of diffuse large B cell lymphoma were examined in this study from January, 2007 to January, 2009 (Male: 4 persons; Female: 6 persons; The mean age: 53.8 years old; The mean weight: 57.3 Kg). Using PET/CT (Discovery STe; GE Healthcare, Milwaukee, WI, USA), whole body images were acquired in 1 hour after $^{18}F$-FDG injection. For image analysis, each ROI ($120\;mm^2$) was drawn on $C^6$ (the sixth C-spine), $L_4$ (the forth L-spine), liver, spleen, and lung, then SUV (Standard Uptake Value)s were measured. We compared with each uptake between in 1-day and 5~7 days after administration of Filgrastim at same patient, so confirmed significance about these by SPSS version 12. Results: In case of $C_6$, $L_4$, spleen, every SUV of 1 day later was remarkably higher than that of 5~7 days later, but liver and lung were similar. Also, the images acquired after 5~7 days distinct remarkably and show normal degree of $^{18}F$-FDG uptake, because uptake of bone was almost disappeared. Conclusions: In this study, each SUV was prominent difference as a period of time after Filgrastim’s administration. And Filgrastim makes concentrate uptake of $^{18}F$-FDG in bone, but, after 5~7 days, bone‘s uptake was greatly decreased. Therefore, we are able to infer a certain period of time that shows normal degree of uptake, by numerical value proven. Also, we consider that this study contribute to advanced study about the other agent like Pegfilgrastim, Lenograstim besides Filgrastim, afterwards.

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Evaluation of Chloride Diffusion Behavior and Analysis of Probabilistic Service Life in Long Term Aged GGBFS Concrete (장기 재령 GGBFS 콘크리트의 염화물 확산 거동 평가 및 확률론적 염해 내구수명 해석)

  • Yoon, Yong-Sik;Kim, Tae-Hoon;Kwon, Seung-Jun
    • Journal of the Korea institute for structural maintenance and inspection
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    • v.24 no.3
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    • pp.47-56
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    • 2020
  • In this study, three levels of W/B(Water to Binder) ratio (0.37, 0.42, 0.47) and substitution ratio of GGBFS (Ground Granulated Blast Furnace Slag) rate (0 %, 30 %, 50 %) were considered to perform RCPT (Rapid Chloride Diffusion Test) at the 1,095 aged day. Accelerated chloride diffusion coefficient and passed charge of each concrete mixture were assessed according to Tang's method and ASTM C 1202, and improving behaviors of durability performance with increasing aged days are analyzed based on the test results of previous aged days from the preceding study. As the age of concrete increases, the passed charge and diffusion coefficient have been significantly reduced, and especially the concrete specimens containing GGBFS showed a significantly more reduction than OPC(Ordinary Portland Cement) concrete specimen by latent hydraulic activity. In the case of OPC concrete's results of passed charge, at the 1,095 days, two of them were still in the "Moderate" class. So, if only OPC is used as the binder of concrete, the resistance performance for chloride attack is weak. In this study, the time-parameters (m) were derived based on the results of the accelerated chloride diffusion coefficient, and the deterministic and probabilistic analysis for service life were performed by assuming the design variable as a probability function. For probabilistic service life analysis, durability failure probabilities were calculated using Monte Carlo Simulation (MCS) to evaluate service life. The service life of probabilistic method were lower than that of deterministic method, since the target value of PDF (Probability of Durability Failure) was set very low at 10 %. If the target value of PDF suitable for the purpose of using structure can be set and proper variability can be considered for each design variable, it is believed that more economical durability design can be made.

A Study on Rationalization of National Forest Management in Korea (국유림경영(國有林經營)의 합리화(合理化)에 관(關)한 연구(硏究))

  • Choi, Kyu-Ryun
    • Journal of Korean Society of Forest Science
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    • v.20 no.1
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    • pp.1-44
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    • 1973
  • Needless to say, the management of national forest in all countries is very important in view of the national mission and management purposes. Korean national forest is also in particular significant in promoting national economy for the continuous increasing of the demand for wood, conservation of the land and social welfare. But there's no denying the fact that the leading aim of the Korean forest policy has been based upon the conservation of forest resources and recovery of land conservation function instead of improvement of the forest productive capacity. Therefore, the management of national forest should be aimed as an industry in the chain of the Korean national economy. And the increment of the forest productive capacity based on rationalized forest management is also urgently needed. Not only the increment of the timber production but also the establishment of the good forest in quality and quantity are to bring naturally many functions of conservation and other public benefits. In 1908 Korean national forest was historically established for the first time as a result of the notification for ownership, and was divided into two kinds in 1911-1924, such as indisposable national forest for land conservation, forest management, scientific research and public welfare, and the other national forest to be disposed. Indisposable forest is mostly under the jurisdiction of national forest stations (Chungbu, Tongbu, Nambu), and the tother national forests are under custody of respective cities and provinces, and under custody of the other government authorities. As of the end of 1971, national forest land is 19.5% (1,297,708 ha) of the total forest land area, but growing stock is 50.1% ($35,406,079m^3$) of the total forest growing stock, and timber production of national forest is 23.6% ($205,959m^3$) of the year production of total timber in Korea. Accordingly, it is the important fact that national forest occupies the major part of Korean forestry. The author positively affirms that success or failure of the management of national forest controls rise or fall of forestry in Korea. All functions of forest are very important, but among others the function of timber production is most important especially in Korea, that unavoidably imports a large quantity of foreign wood every year (in 1971 import of foreign wood-$3,756,000m^3$, 160,995,000 dollars). So, Korea urgently needs the improvement of forest productive capacity in national forest. But it is difficult that wood production meets the rapid increase of demand for wood to the development of economy, because production term of forestry is long, so national forest management should be rationalized by the effective investment and development of forestry techniques in the long view. Although Korean national forest business has many difficulties in the budget, techniques and the lack of labour due to outflow of rural village labour by development of national economy, and the increase of labour wages and administrative expenses etc. the development of national forest depends on adoption of the suitable forest techniques and management adapted for social and economical development. In this view point the writer has investigated and analyzed the status of the management of national forest in Korea to examine the irrational problems and suggest an improvement plan. The national forestry statistics cited in this study is based on the basic statistics and the statistics of the forest business as of the end of 1971 published by Office of Forestry, Republic of Korea, and the other depended on the data presented by the national forest stations. The writer wants to propose as follows (seemed to be helpful in improvement of Korean national forest management). 1) In the organization of national forest management, more national forest stations should be established to manage intensively, and the staff of working plan officials should be strengthened because of the importance of working plan. 2) By increasing the staff of protection officials, forest area assigned for each protection official should be decreased to 1,000-2,000 ha. 3) The frequent personnel changes of supervisor of national forest station(the responsible person on-the-spot) obstructs to accomplish the consistent management plan. 4) In the working plan drafting for national forest, basic investigations should be carefully practiced with sufficient expenditure and staff not to draft unreal working plan. 5) The area of working-unit should be decreased to less than 2,000 ha on the average for intensive management and the principle of a working-unit in a forest station should be realized as soon as possible. 6) Reforestation on open land should be completed in a short time with a debt of the special fund(a long term loan), and the land on which growing hardwood stands should be changed with conifers to increase productivity per unit area, and at the same time techical utilization method of hardwood should be developed. 7) Expenses of reforestation should be saved by mechanization and use of chemicals for reforestation and tree nursery operation providing against the lack of labour in future. 8) In forest protection, forest fire damage is enormous in comparison with foreign countries, accordingly prevention system and equipment should be improved, and also the minimum necessary budget should be counted up for establishment and manintenance of fire-lines. 9) Manufacture production should be enlarged to systematize protection, processing and circulation of forest business, and, by doing this, mich benefit is naturally given for rural people. 10) Establishment and arrangement of forest road networks and erosion control work are indispensable for the future development of national forest itself and local development. Therefore, these works should be promoted by the responsibility of general accounting instead of special accounting. 11) Mechanization of forest works should be realized for exploiting hinterlands to meet the demand for timber increased and for solving lack of labour, consequently it should promote import of forest machines, home production, training for operaters and careful adminitration. 12) Situation of labour in future will grow worse. Therefore, the countermeasure to maintain forest labourers and pay attention to public welfare facilities and works should be considered. 13) Although the condition of income and expenditure grows worse because of economical change, the regular expenditure should be fixed. So part of the surplus fund, as of the end of 1971, should be established for the fund, and used for enlarging reforestation and forest road networks(preceding investment in national forest).

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Comparison and evaluation of volumetric modulated arc therapy and intensity modulated radiation therapy plans for postoperative radiation therapy of prostate cancer patient using a rectal balloon (직장풍선을 삽입한 전립선암 환자의 수술 후 방사선 치료 시 용적변조와 세기변조방사선치료계획 비교 평가)

  • Jung, hae youn;Seok, jin yong;Hong, joo wan;Chang, nam jun;Choi, byeong don;Park, jin hong
    • The Journal of Korean Society for Radiation Therapy
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    • v.27 no.1
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    • pp.45-52
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    • 2015
  • Purpose : The dose distribution of organ at risk (OAR) and normal tissue is affected by treatment technique in postoperative radiation therapy for prostate cancer. The aim of this study was to compare dose distribution characteristic and to evaluate treatment efficiency by devising VMAT plans according to applying differed number of arc and IMRT plan for postoperative patient of prostate cancer radiation therapy using a rectal balloon. Materials and Methods : Ten patients who received postoperative prostate radiation therapy in our hospital were compared. CT images of patients who inserted rectal balloon were acquired with 3 mm thickness and 10 MV energy of HD120MLC equipped Truebeam STx (Varian, Palo Alto, USA) was applied by using Eclipse (Version 11.0, Varian, Palo Alto, USA). 1 Arc, 2 Arc VMAT plans and 7-field IMRT plan were devised for each patient and same values were applied for dose volume constraint and plan normalization. To evaluate these plans, PTV coverage, conformity index (CI) and homogeneity index (HI) were compared and $R_{50%}$ was calculated to assess low dose spillage as per treatment plan. $D_{25%}$ of rectum and bladder Dmean were compared on OAR. And to evaluate the treatment efficiency, total monitor units(MU) and delivery time were considered. Each assessed result was analyzed by average value of 10 patients. Additionally, portal dosimetry was carried out for accuracy verification of beam delivery. Results : There was no significant difference on PTV coverage and HI among 3 plans. Especially CI and $R_{50%}$ on 7F-IMRT were the highest as 1.230, 3.991 respectively(p=0.00). Rectum $D_{25%}$ was similar between 1A-VMAT and 2A-VMAT. But approximately 7% higher value was observed on 7F-IMRT compare to the others(p=0.02) and bladder Dmean were similar among the all plan(P>0.05). Total MU were 494.7, 479.7, 757.9 respectively(P=0.00) for 1A-VMAT, 2A-VMAT, 7F-IMRT and at the most on 7F-IMRT. The delivery time were 65.2sec, 133.1sec, 145.5sec respectively(p=0.00). The obvious shortest time was observed on 1A-VMAT. All plans indicated over 99.5%(p=0.00) of gamma pass rate (2 mm, 2%) in portal dosimetry quality assurance. Conclusion : As a result of study, postoperative prostate cancer radiation therapy for patient using a rectal balloon, there was no significant difference of PTV coverage but 1A-VMAT and 2A-VMAT were more efficient for dose reduction of normal tissue and OARs. Between VMAT plans. $R_{50%}$ and MU were little lower in 2A-VMAT but 1A-VMAT has the shortest delivery time. So it is regarded to be an effective plan and it can reduce intra-fractional motion of patient also.

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The Efficacy of the Change in Belly Board Aperture Location by the Addition of Bladder Compression Device for Radiotherapy of Rectal Cancer (직장암 환자의 골반 방사선치료에서 벨리보드 하위 경계 위치 변화의 영향)

  • Yoon, Hong-In;Chung, Yoon-Sun;Kim, Joo-Ho;Park, Hyo-Kuk;Lee, Sang-Kyu;Kim, Young-Suk;Choi, Yun-Seon;Kim, Mi-Sun;Lee, Ha-Yoon;Chang, Jee-Suk;Cha, Hye-Jung;Seong, Jin-Sil;Keum, Ki-Chang;Koom, Woong-Sub
    • Radiation Oncology Journal
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    • v.28 no.4
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    • pp.231-237
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    • 2010
  • Purpose: We investigated the effect of location changes in the inferior border of the belly board (BB) aperture by adding a bladder compression device (BCD). Materials and Methods: We respectively reviewed data from 10 rectal cancer patients with a median age 64 years (range, 45~75) and who underwent computed tomography (CT) simulation with the use of BB to receive pelvic radiotherapy between May and September 2010. A CT simulation was again performed with the addition of BCD since small bowel (SB) within the irradiated volume limited boost irradiation of 5.4 Gy using the cone down technique after 45 Gy. The addition of BCD made the inferior border of BB move from symphysis pubis to the lumbosacral junction (LSJ). Results: Following the addition of BCD, the irradiated volumes of SB and the abdominopelvic cavity (APC) significantly decreased ($174.3{\pm}89.5mL$ vs. $373.3{\pm}145.0mL$, p=0.001, $1282.6{\pm}218.7mL$ vs. $1,571.9{\pm}158mL$, p<0.001, respectively). Bladder volume within the treated volume increased with BCD ($222.9{\pm}117.9mL$ vs. $153.7{\pm}95.5mL$, p<0.001). The ratio of irradiated bladder volume to APC volume with BCD ($33.5{\pm}14.7%$) increased considerably compared to patients without a BCD ($27.5{\pm}13.1%$) (p<0.001), and the ratio of irradiated SB to APC volume decreased significantly with BCD ($13.9{\pm}7.6%$ vs. $24.2{\pm}10.2%$, p<0.001). The ratios of the irradiated SB volume and irradiated bladder volume to APC volume negatively correlated (p=0.001). Conclusion: This study demonstrated that the addition of BCD, which made the inferior border of BB move up to the LSJ, increased the ratio of the bladder to APC volume and as a result, decreased the irradiated volume of SB.

체질별(體質別) 식품표(食品表)에 근거한 태음인(太陰人), 소음인(少陰人), 소양인(少陽人) 당뇨식단(1800kcal)의 초보(初步)적 제시

  • Kim, Ji-Yeong;Go, Byeong-Hui
    • Journal of Sasang Constitution and Immune Medicine
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    • v.8 no.1
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    • pp.395-411
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    • 1996
  • 1. 연구배경 사상체질의학(四象體質醫學)을 창시하여 개인(個人)의 차별성(差別性)을 강조한 동무(東武) 이제마(李濟馬)는 양생(養生)의 방법(方法)에서도 체질별(體質別) 요법(療法)을 말하고 있는데 체질별(體質別)로 과소지장(過小之臟)의 기능(機能)이 정상적(正常的)으로 이루어지는 상황을 완실무병(完實無病)의 조건으로 제시(提示)하였고 이를 위한 수단(手段)으로 성정(性情)과 함께 약물(藥物), 식품(食品) 등을 이용하였다. 특히 식이요법(食餌療法)에 있어서도 체질(體質)에 따른 구별(區別)의 필요성(必要性)을 말하고 있는데 식품(食品)이라 하더라도 그 음식(飮食)을 섭취하여 과대(過大)한 장기(臟器)의 기능(機能)은 유제(柳制)하고 과소(過小)한 기능(機能)은 보완(補完)받음으로써 불균형(不均衡)을 조정(調整)한 것이다. 당뇨병의 식단 작성은 평생동안 열량(熱量)과 영양소(營養素) 필요치(必要置)을 맞출 것을 권장하고 당뇨병학회에서 편집한 식품교환표(食品交換表)를 사용(使用)하는 것이 일반적(一般的)인데 식품교환표(食品交換表)는 많은 식품(食品)들중에 같은 영양소를 가진 식품(食品)들을 한 그룹으로 묶어 환자(患者)의 기호(嗜好)에 따라 교환(交煥)해 가면서 먹을 수 있도록 고안(考案)한 것이니 이에 지시한 수량(數量)만 섭취해도 저(低)cal식(食)으로 관양(管養)의 균형(均衡)이 잘 이루어진다. 본 연구는 체질별로 이로운 식품표에 근거하여 식이요법(食餌療法)이 특히 강조되고 하루 섭취열량이 제한되는 성인병중의 하나인 당뇨병(糖尿病)의 식단(1800kcal)을 식단작성법에 따라 구성(構成)하여 몇가지 예를 제시해 보았다. 구체적으로 태음인(太陰人), 소음인(少陰人), 소양인(少陽人)의 당뇨 환자 1800kcal에 대한 식단을 구성하여 제시했는데 즉, 태음인(太陰人)의 식단은 태음인(太陰人)에 유리(有利)한 식품(食品)들로 구성하고 해(害)로운 식품(食品)들은 제외시키는 방법(方法)을 이용하였다. 이 식단은 다분히 이론적(理論的)인 식단으로 임상(臨床)에 이용(利用)하여 본 바는 없으나 동량(同量)의 열량(熱量)을 섭취(攝取)하더라도 체질(體質)에 적합(適合)한 식품(食品)으로 구성된 식사(食事)가 각 체질의 섭생(攝生)에 더 유리(有利)하지 않올까 하는 단순(單純)한 사고(思考)에 바탕을 둔 것이다. 2. 연구방법 1) 후세가(後世家)가 주장(主張)한 체질별(體質別) 식품(食品) 분류(分類)를 종합, 정리한 체질별(體質別) 식품표(食品表)를 제시한다. 박석언의 동의사상대전, 박인상의 동의사상요결, 송일병의 알기 쉬운 사상의학, 홍순용의 사상진료보원, 홍순용, 이을호의 사상의학원론에서 체질별로 유익한 식풍을 조사하여 곡류, 과일류, 채소류, 어패류, 육류로 분류하여 살펴본다. 2) 당뇨병(糖尿病) 식이요법의 식단 작성법의 개요(槪要)를 제시한다. 3) 1)의 체질별(體質別) 식품표(食品表)로 태음인(太陰人), 소음인(少陰人), 소양인(少陽人)의 당뇨 식단 1800kcal을 작성해 제시(提示)한다. 체질별(體質別)로 유익(有益)한 식품(食品)은 1)의 식품표에 근거(根據)하고 체질별(體質別)로 해(害)로운 식품(食品)은 노정우(盧正祐), 한동석(韓東錫)의 주장에 근거(根據)한다. 3. 결과 체질별(體質別) 식품표(食品表)는 후세가의 연구를 종합하여 제시(提示)하였고, 식품(食品)을 분류(分類)한 후(後) 약명(藥名)과 성미(性味), 귀경(歸經)을 찾아 도표화 하였다. 체질별 식품들은 대부분 소음인(少陰人)의 경우 신감(辛甘) 온열(溫熱)하며 비위(脾胃)로 귀경(歸經)하고 태음인(太陰人)의 경우 감신(甘辛) 온열(溫熱)하며 폐간(肺肝)으로 귀경(歸經)하고 소양인(少陽人)의 산고(酸苦) 양한(凉寒)하고 신(腎)으로 귀경(歸經)함이 우세(優勢)함을 알 수 있다. 즉, 체질적으로 양성(陽性)인 소양인(少陽人)은 식품의 성질이 음성(陰性)인 것이 유리(有利)하고 체질적으로 음성(陰性)인 태음인(太陰人), 소음인(少陰人)은 식품의 성질이 양성(陽性)인 것이 유리(有利)하다. 다양한 식품(食品)을 섭취하고자 하는 환자의 욕구(慾求)에 맞추면서도 식품교환의 범위를 체질별로 유익한 식품들로 제한하여 동일(同一)한 열량(熱量)의 식단이라도 체질에 맞는 식품으로 차별성(差別性)을 두었는데 식단의 작성은 전문 영양사의 의견을 거쳤다. 제시된 식단은 다소 이론적(理論的)으로 작성(作成)된 단계이고 임상적(臨床的) 검증을 거친 바 없으나 활용하기에 따라 실용성을 얻을 수 있으리라 본다. <식단예> 태음인의 식단: 곡류 : 콩, 율무, 밀가루, 밀, 수수, 들깨, 고구마, 땅콩, 기장, 옥수수, 두부, 설탕등 태음인에 유리한 식품으로 교환한다 어때류 : 우렁이, 대구, 조기, 민어, 청어, 오정어, 낙지, 미역, 김, 다시마등으로 교환한다 육류 : 소고기, 우유등으로 교환한다 과일류 : 밤, 배, 호도, 은행, 잣, 살구, 매실, 자두등으로 교환한다 채소류 : 무우, 도라지, 연근, 토란, 마, 고사리, 더덕, 목이버섯, 송이버섯, 석이버섯등으로 교환한다 해로운 음식 : 닭, 돼지, 모밀, 배추, 사과, 염소고기, 조개, 계란, 곳감, 커피등은 피한다 * 아침 ; 콩나물죽, 대구포묶음, 우령이무침, 갓김치, 우유, 자두 점심 ; 기장밥, 콩나물두부찌게, 장어양념구이, 도라지나물, 열무김치, 배 저녁 ; 수수밥, 두부명란, 더덕양념구이, 깍두기 * 아침 ; 비빔국수, 토란국, 알타리김치, 두유, 살구주스 점심 ; 율무밥, 낙지전골, 김무생채, 느타리나물무침, 동치미, 귤 저녁 ; 콩밥, 감자북어국, 두부묶음, 열무김치 소음인의 식단: 곡류 : 찹쌀, 좁쌀, 차조, 감자등 소음인에 유익한 식품으로 교환한다 어패류 : 명태, 미꾸라지, 뱀장어, 뱀, 메기등 육류 : 닭, 개, 꿩, 염소, 양, 참새고기등 과일류 : 사과, 귤, 복숭아, 대추등 채소류 : 미나리, 파, 마늘, 후추, 시금치, 양배추, 생강, 고추, 당근, 양파, 감자, 쑥갓등 해로운 음식 : 메밀, 호도, 계란, 고구마, 녹두, 돼지고기, 밤, 배, 배추, 보리, 쇠고기, 수박, 오이, 참외, 팥등은 피한다. * 아침 ; 찰밥, 닭찜, 감자전, 쑥갓나물, 부추김치, 사과 점심 ; 감자밥, 메기매운탕, 명태조림, 미나리, 고들빼기김치, 사과주스 저녁 ; 좁쌀밥, 양배추감자국, 병어양념구이, 연근양념조림, 귤, 인삼차.

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Combined Chemotherapy and Radiation Therapy in Limited Disease Small-Cell Lung Cancer (국한성 소세포 폐암에서 항암 화학 및 흉부 방사선치료의 병합요법 적응)

  • Kim Moon Kyung;Ahn Yong Chan;Park Keunchil;Lim Do Hoon;Huh Seung Jae;Kim Dae Yong;Shin Kyung Hwan;Lee Kyu Chan;Kwon O Jung
    • Radiation Oncology Journal
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    • v.17 no.1
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    • pp.9-15
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    • 1999
  • Purpose : This is a retrospective study to evaluate the response rate, acute toxicity, and survival rate of a combined chemotherapy and radiation therapy in limited disease small cell lung cancer, Materials and Methods : Firty-six patients with limited disease small-cell lung cancer who underwent combined chemotherapy and radiation therapy between October 1994 and April 1998 were evaluated. Six cycles of chemotherapy were planned either using a VIP regimen etoposide, ifosfamide, and cis-platin) or a EP regimen (etoposide and cis-platin). Thoracic radiation therapy was planned to deli- ver 44 Gy using 1 OMV X-ray, starting concurrently with chemotherapy. Response was evaluated 4 weeks after the completion of the planned chemotherapy and radiation therapy, and the prophylaetic cranial irradiation was planned only for the patients with complete responses. Acute toxicity was evaluated using the SWOG toxicity criteria, and the overall survival and disease-free survival were calculated using the Kaplan-Meier Method. Results : The median follow-up period was 16 months (range:2 to 41 months). Complete response was achieved En 30 (65$\%$) patients, of which 22 patients received prophylactic cranial irradiations. Acute toxicities over grade III were granulocytopenia in 23 (50$\%$), anemia in 17 (37$\%$), thrombo- cytopenia in nine (20$\%$), alopecia in nine (20$\%$), nausea/vomiting in five (11$\%$), and peripheral neuropathy in one (2$\%$). Chemotherapy was delayed in one patient, and the chemotherapy doses were reduced in 58 (24$\%$) out of the total 246 cycles. No radiation esophagitis over grade 111 was observed, while interruption during radiation therapy for a mean of 8.3 days occurred in 21 patients. The local recurrences were observed in 8 patients and local progressions were in 6 patients, and the distant metastases in 17 patients. Among these, four patients had both the local relapse and the distant metastasis. Brain was the most common metastatic site (10 patients), followed by the liver as the next common site (4 patients). The overall and progression-free survival rates were 79$\%$ and 55$\%$ in 1 year, and 45'/) and 32% in 2 years, respectively, and the median survival was 23 months. Conclusion : Relatively satisfactory local control and suwival rates were achieved after the combined chemotherapy and radiation therapy with mild to moderate acute morbidities in limited disease small cell lung cancer.

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Efficacy and Accuracy of Patient Specific Customize Bolus Using a 3-Dimensional Printer for Electron Beam Therapy (전자선 빔 치료 시 삼차원프린터를 이용하여 제작한 환자맞춤형 볼루스의 유용성 및 선량 정확도 평가)

  • Choi, Woo Keun;Chun, Jun Chul;Ju, Sang Gyu;Min, Byung Jun;Park, Su Yeon;Nam, Hee Rim;Hong, Chae-Seon;Kim, MinKyu;Koo, Bum Yong;Lim, Do Hoon
    • Progress in Medical Physics
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    • v.27 no.2
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    • pp.64-71
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    • 2016
  • We develop a manufacture procedure for the production of a patient specific customized bolus (PSCB) using a 3D printer (3DP). The dosimetric accuracy of the 3D-PSCB is evaluated for electron beam therapy. In order to cover the required planning target volume (PTV), we select the proper electron beam energy and the field size through initial dose calculation using a treatment planning system. The PSCB is delineated based on the initial dose distribution. The dose calculation is repeated after applying the PSCB. We iteratively fine-tune the PSCB shape until the plan quality is sufficient to meet the required clinical criteria. Then the contour data of the PSCB is transferred to an in-house conversion software through the DICOMRT protocol. This contour data is converted into the 3DP data format, STereoLithography data format and then printed using a 3DP. Two virtual patients, having concave and convex shapes, were generated with a virtual PTV and an organ at risk (OAR). Then, two corresponding electron treatment plans with and without a PSCB were generated to evaluate the dosimetric effect of the PSCB. The dosimetric characteristics and dose volume histograms for the PTV and OAR are compared in both plans. Film dosimetry is performed to verify the dosimetric accuracy of the 3D-PSCB. The calculated planar dose distribution is compared to that measured using film dosimetry taken from the beam central axis. We compare the percent depth dose curve and gamma analysis (the dose difference is 3%, and the distance to agreement is 3 mm) results. No significant difference in the PTV dose is observed in the plan with the PSCB compared to that without the PSCB. The maximum, minimum, and mean doses of the OAR in the plan with the PSCB were significantly reduced by 9.7%, 36.6%, and 28.3%, respectively, compared to those in the plan without the PSCB. By applying the PSCB, the OAR volumes receiving 90% and 80% of the prescribed dose were reduced from $14.40cm^3$ to $0.1cm^3$ and from $42.6cm^3$ to $3.7cm^3$, respectively, in comparison to that without using the PSCB. The gamma pass rates of the concave and convex plans were 95% and 98%, respectively. A new procedure of the fabrication of a PSCB is developed using a 3DP. We confirm the usefulness and dosimetric accuracy of the 3D-PSCB for the clinical use. Thus, rapidly advancing 3DP technology is able to ease and expand clinical implementation of the PSCB.

Brain F-18 FDG PET for localization of epileptogenic zones in frontal lobe epilepsy: visual assessment and statistical parametric mapping analysis (전두엽 간질에서 F-18-FDG PET의 간질병소 국소화 성능: 육안 판독과 SPM에 의한 분석)

  • Kim, Yu-Kyeong;Lee, Dong-Soo;Lee, Sang-Kun;Chung, Chun-Kee;Yeo, Jeong-Seok;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.3
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    • pp.131-141
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    • 2001
  • Purpose: We evaluated the sensitivity of the F-18 FDG PET by visual assessment and statistical parametric mapping (SPM) analysis for the localization of the epileptogenic zones in frontal lobe epilepsy. Materials and Methods: Twenty-four patients with frontal lobe epilepsy were examined. All patients exhibited improvements after surgical resection (Engel class I or II). Upon pathological examination, 18 patients revealed cortical dysplasia, 4 patients revealed tumor, and 2 patients revealed cortical scar. The hypometabolic lesions were found in F-18 FDG PET by visual assessment and SPM analysis. On SPM analysis, cutoff threshold was changed. Results: MRI showed structural lesions in 12 patients and normal results in the remaining 12. F-18 FDG PET correctly localized epileptogenic zones in 13 patients (54%) by visual assessment. Sensitivity of F-18 FDG PET in MR-negative patients (50%) was similar to that in MR-positive patients (67%). On SPM analysis, sensitivity decreased according to the decrease of p value. Using uncorrected p value of 0.05 as threshold, sensitivity of SPM analysis was 53%, which was not statistically different from that of visual assessment. Conclusion: F-18 FDG PET was sensitive in finding epileptogenic zones by revealing hypometabolic areas even in MR-negative patients with frontal lobe epilepsy as well as in MR-positive patients. SPM analysis showed comparable sensitivity to visual assessment and could be used as an aid in the diagnosis of epileptogenic zones in frontal lobe epilepsy.

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Effect of 1-methylcyclopropene Treatment on Extension of Freshness and Storage Potential of Fresh Ginseng (1-methylcyclopropene 처리의 수삼의 신선도 유지 및 저장성 연장 효과)

  • Park, Me-Hea;Shin, Yu-Su;Kim, Sun-Ju;Kim, Ji-Gang
    • Horticultural Science & Technology
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    • v.31 no.3
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    • pp.308-316
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    • 2013
  • Fresh ginseng has a limited storage life due to the quality change caused by microbial spoilage as well as physiological deterioration. The present study investigated the effects of 1-methylcyclopropene (1-MCP) treatment, an inhibitor of ethylene action, on the microbial growth and quality maintenance of fresh ginseng during storage. Harvested fresh ginsengs were treated with $1{\mu}L{\cdot}L^{-1}$ 1-MCP for 20 hours at $4^{\circ}C$ and then stored at room temperature (RT) for 18 days or low temperature ($4^{\circ}C$) for 160 days. After 18 days of storage at RT, the percentage weight loss in 1-MCP treated fresh ginseng (8.3%) is lower than that of control (10.1%). During long-term storage at $4^{\circ}C$, weight losses were increased slightly until 120 days without difference between non-treated and 1-MCP ginsengs. In contrast, after 120 days of storage at $4^{\circ}C$, higher increase in weight loss was observed in non-treated ginsengs than in 1-MCP treated ginsengs. Respiration rate and ethylene production of fresh ginseng were reduced by 1-MCP treatments at RT. The 1-MCP treatment also resulted in lower microbial population compared to those of non-treated ginsengs at RT. However, in ginsengs stored at $4^{\circ}C$ for short-term (45 days), no differences were noted in weight loss and microbial population between 1-MCP treated and non-treated ginsengs. Major ginsenosides was not changed by 1-MCP treatment during the 7 days of storage at RT. Results suggest that 1-MCP treatment can be used to maintain the freshness of ginseng at room temperature for short term storage and at low temperature for long term storage. 1-MCP treatment could be applied on fresh ginseng to avoid deleterious effect of exogenous ethylene during storage and shipping.