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Development of Conformal Radiotherapy with Respiratory Gate Device (호흡주기에 따른 방사선입체조형치료법의 개발)

  • Chu Sung Sil;Cho Kwang Hwan;Lee Chang Geol;Suh Chang Ok
    • Radiation Oncology Journal
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    • v.20 no.1
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    • pp.41-52
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    • 2002
  • Purpose : 3D conformal radiotherapy, the optimum dose delivered to the tumor and provided the risk of normal tissue unless marginal miss, was restricted by organ motion. For tumors in the thorax and abdomen, the planning target volume (PTV) is decided including the margin for movement of tumor volumes during treatment due to patients breathing. We designed the respiratory gating radiotherapy device (RGRD) for using during CT simulation, dose planning and beam delivery at identical breathing period conditions. Using RGRD, reducing the treatment margin for organ (thorax or abdomen) motion due to breathing and improve dose distribution for 3D conformal radiotherapy. Materials and Methods : The internal organ motion data for lung cancer patients were obtained by examining the diaphragm in the supine position to find the position dependency. We made a respiratory gating radiotherapy device (RGRD) that is composed of a strip band, drug sensor, micro switch, and a connected on-off switch in a LINAC control box. During same breathing period by RGRD, spiral CT scan, virtual simulation, and 3D dose planing for lung cancer patients were peformed, without an extended PTV margin for free breathing, and then the dose was delivered at the same positions. We calculated effective volumes and normal tissue complication probabilities (NTCP) using dose volume histograms for normal lung, and analyzed changes in doses associated with selected NTCP levels and tumor control probabilities (TCP) at these new dose levels. The effects of 3D conformal radiotherapy by RGRD were evaluated with DVH (Dose Volume Histogram), TCP, NTCP and dose statistics. Results : The average movement of a diaphragm was 1.5 cm in the supine position when patients breathed freely. Depending on the location of the tumor, the magnitude of the PTV margin needs to be extended from 1 cm to 3 cm, which can greatly increase normal tissue irradiation, and hence, results in increase of the normal tissue complications probabiliy. Simple and precise RGRD is very easy to setup on patients and is sensitive to length variation (+2 mm), it also delivers on-off information to patients and the LINAC machine. We evaluated the treatment plans of patients who had received conformal partial organ lung irradiation for the treatment of thorax malignancies. Using RGRD, the PTV margin by free breathing can be reduced about 2 cm for moving organs by breathing. TCP values are almost the same values $(4\~5\%\;increased)$ for lung cancer regardless of increasing the PTV margin to 2.0 cm but NTCP values are rapidly increased $(50\~70\%\;increased)$ for upon extending PTV margins by 2.0 cm. Conclusion : Internal organ motion due to breathing can be reduced effectively using our simple RGRD. This method can be used in clinical treatments to reduce organ motion induced margin, thereby reducing normal tissue irradiation. Using treatment planning software, the dose to normal tissues was analyzed by comparing dose statistics with and without RGRD. Potential benefits of radiotherapy derived from reduction or elimination of planning target volume (PTV) margins associated with patient breathing through the evaluation of the lung cancer patients treated with 3D conformal radiotherapy.

Prediction of Parthenogenetic Developmental Potential by Polar Body Extrusion and First Cleavage on In Vitro Maturation and Development of Porcine Follicular Oocytes (돼지 난모 세포의 Ethanol 처리에 의한 단위 발생에 있어서 극체 방출란과 분할란 선별에 따른 배발달율 비교)

  • Kim, H.J.;Cho, S.R.;Choe, J.Y.;Choi, S.H.;Han, M.H.;Son, D.S.;Lee, S.S.;Sang, B.D.;Ryu, I.S.;Kim, I.C.;Kim, S.J.;Kim, I.H.;Kim, S.K.
    • Journal of Embryo Transfer
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    • v.22 no.2
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    • pp.121-126
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    • 2007
  • The objective of this study was carried out to examine the selection effects of in vitro matured porcine follicular oocytes with polar body extrusion and early cleavage as non-invasive marker to know the developmental competence in advance. The porcine oocytes matured for 48 h were examined the polar body extrusion. The examined oocytes were matured for additional $16{\sim}18h$ and activated with 7% ethanol and cultured in $5{\mu}g/ml$ cytochalasin B for 5 h for diploid formation. The treated oocytes were cultured and examined the cleavage after 48 h and continued culturing for 5 days. The oocytes of 21.9% were discarded in morphological selection and 32.1% oocytes were discarded by failure of first polar body extrusion. The selected oocytes were matured and activated and then after 48 h the cleavage rates were examined. In morphologically selected oocytes, 15.8% oocytes were not cleaved and 52.6% oocytes were normally cleaved and 31.6% oocytes were hyper-cleaved over 8-cell stage. However in the first polar body extruded oocytes, 7.1% oocytes were not cleaved and 73.1% oocytes were normally cleaved and 19.8% oocytes were hyper-cleaved. The morphologically selected embryos that not cleavage-selected were developed in 16.7% up to blastocyst and the morphologically selected and cleavage-selected embryos were developed in 31.7%. The polar body extruded oocytes that were not carried out cleavage selection were developed in 39.0% and the polar body extruded and cleavage-selected embryos were developed 49.0%. The first cleavage timing was examined with 12 h interval after activation. In $0{\sim}12,\;12{\sim}24,\;24{\sim}36,\;and\;36{\sim}48h$ intervals, 4.1%, 68.6%, 19.1%, and 2.3% oocytes were cleaved and 5.9% oocytes were not cleaved until 48 after activation. The cleaved oocytes in each interval were cultured and developed upto blastocyst with 0, 39.1, 9.5, and 0%, respectively. This results suggests that polar body extruded and cleaved at $12{\sim}36h$ embryo has higher developmental potential than the others.

Tc-99m ECD Brain SPECT in MELAS Syndrome and Mitochondrial Myopathy: Comparison with MR findings (MELAS 증후군과 미토콘드리아 근육병에서의 Tc-99m ECD 뇌단일 광전자방출 전산화단층촬영 소견: 자기공명영상과의 비교)

  • Park, Sang-Joon;Ryu, Young-Hoon;Jeon, Tae-Joo;Kim, Jai-Keun;Nam, Ji-Eun;Yoon, Pyeong-Ho;Yoon, Choon-Sik;Lee, Jong-Doo
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.6
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    • pp.490-496
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    • 1998
  • Purpose: We evaluated brain perfusion SPECT findings of MELAS syndrome and mitochondrial myopathy in correlation with MR imaging in search of specific imaging features. Materials and Methods: Subjects were five patients (four females and one male; age range, 1 to 25 year) who presented with repeated stroke-like episodes, seizures or developmental delay or asymptomatic but had elevated lactic acid in CSF and serum. Conventional non-contrast MR imaging and Tc-99m-ethyl cysteinate dimer (ECD) brain perfusion SPECT were Performed and imaging features were analyzed. Results: MRI demonstrated increased T2 signal intensities in the affected areas of gray and white matters mainly in the parietal (4/5) and occipital lobes (4/5) and in the basal ganglia (1/5), which were not restricted to a specific vascular territory. SPECT demonstrated decreased perfusion in the corresponding regions of MRI lesions. In addition, there were perfusion defects in parietal (1 patient), temporal (2), and frontal (1) lobes and basal ganglia (1) and thalami (2). In a patient with mitochondrial myopathy who had normal MRI, decreased perfusion was noted in left parietal area and bilateral thalami. Conclusion: Tc-99m ECD SPECT imaging in patients with MELAS syndrome and mitochondrial myopathy showed hypoperfusion of parieto-occipital cortex, basal ganglia, thalamus and temporal cortex, which were not restricted to a specific vascular territory. There were no specific imaging features on SPECT. The significance of abnormal perfusion on SPECT without corresponding MR abnormalities needs to be evaluated further in larger number of patients.

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Changes of Distribution of Vascular Hydrophytes in the Nakdong River Estuary and Growth Dynamics of Schenoplectus triqueter, Waterfowl Food Plant (낙동강 하구의 수생관속식물의 분포 변화와 수금류(고니류)의 먹이식물인 세모고랭이의 성장 변화)

  • Kim, Gu-Yeon;Lee, Chan-Woo;Yoon, Hae-Soon;Joo, Gea-Jae
    • The Korean Journal of Ecology
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    • v.28 no.5
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    • pp.335-345
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    • 2005
  • A study on changes on the distribution of vascular hydrophytes and the growth pattern of Schenoplectus triqueter (Scirpus triqueter) was undertaken at the Nakdong River estuary from 2002 to 2004. The change was due to physical alteration of the estuary for the past 25 years. These plant species are the major food sources for winter waterfowl. A total of 32 species of vascular hydrophytes from 17 families were found in the West Nakdong River (freshwater), the main channel of Nakdong River (freshwater) and the Nakdong River Estuary (brackish water). After the construction of the barrage on the estuary in 1987, the number of hydrophytes has remarkably increased to 17 species (5 species in 1985) in the main channel of the River. In particular, a community of Eurale ferox was found at the backwater wetland of the Daejeo side of the main channel. The introduced species of Eichhornia crassipes and Pistia stratiotes that were epidemic in 2001 at West Nakdong River was not found any more. The other species such as Nymphoides indica, Myriophyllum spicatum, Ruppia spp. were rediscovered. The large area (about 1,300ha) of Zostera spp. was the main sources of food for swans, but disappeared because of direct and indirect impacts of reclamation in the River estuary. Currently, there remains a small patch of Zostera spp. and about 250ha of S. triqueter. Schenoplectus triqueter grew mostly between April-September and tuber formed, between September-October. The growth of S. triqueter up to $60\sim80cm$ in length was observed in 5 sites out of the 7 sites in brackish area. Tubers of S. triqueter were eaten by waterfowls such as swans as winter food. In five sites, tubers took $44\sim57%$ of total biomass in October. Tubers were found in deep layers; $5\sim15cm$ (9%), $15\sim25cm$ (28%), $25\sim40cm$ (55%), below 40cm $(6\sim7%)$. The distribution of vascular hydrophytes has remarkably changed in the Nakdong River Estuary due to the reclamation of the area. In order to determine the extent of changes of the distribution of these plants and the carrying capacity of the area for waterfowl, an intensive research is urgently needed.

Optimization and Development of Prediction Model on the Removal Condition of Livestock Wastewater using a Response Surface Method in the Photo-Fenton Oxidation Process (Photo-Fenton 산화공정에서 반응표면분석법을 이용한 축산폐수의 COD 처리조건 최적화 및 예측식 수립)

  • Cho, Il-Hyoung;Chang, Soon-Woong;Lee, Si-Jin
    • Journal of Korean Society of Environmental Engineers
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    • v.30 no.6
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    • pp.642-652
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    • 2008
  • The aim of our research was to apply experimental design methodology in the optimization condition of Photo-Fenton oxidation of the residual livestock wastewater after the coagulation process. The reactions of Photo-Fenton oxidation were mathematically described as a function of parameters amount of Fe(II)($x_1$), $H_2O_2(x_2)$ and pH($x_3$) being modeled by the use of the Box-Behnken method, which was used for fitting 2nd order response surface models and was alternative to central composite designs. The application of RSM using the Box-Behnken method yielded the following regression equation, which is an empirical relationship between the removal(%) of livestock wastewater and test variables in coded unit: Y = 79.3 + 15.61x$_1$ - 7.31x$_2$ - 4.26x$_3$ - 18x$_1{^2}$ - 10x$_2{^2}$ - 11.9x$_3{^2}$ + 2.49x$_1$x$_2$ - 4.4x$_2$x$_3$ - 1.65x$_1$x$_3$. The model predicted also agreed with the experimentally observed result(R$^2$ = 0.96) The results show that the response of treatment removal(%) in Photo-Fenton oxidation of livestock wastewater were significantly affected by the synergistic effect of linear terms(Fe(II)($x_1$), $H_2O_2(x_2)$, pH(x$_3$)), whereas Fe(II) $\times$ Fe(II)(x$_1{^2}$), $H_2O_2$ $\times$ $H_2O_2$(x$_2{^2}$) and pH $\times$ pH(x$_3{^2}$) on the quadratic terms were significantly affected by the antagonistic effect. $H_2O_2$ $\times$ pH(x$_2$x$_3$) had also a antagonistic effect in the cross-product term. The estimated ridge of the expected maximum response and optimal conditions for Y using canonical analysis were 84 $\pm$ 0.95% and (Fe(II)(X$_1$) = 0.0146 mM, $H_2O_2$(X$_2$) = 0.0867 mM and pH(X$_3$) = 4.704, respectively. The optimal ratio of Fe/H$_2O_2$ was also 0.17 at the pH 4.7.

Evaluating efficiency of Split VMAT plan for prostate cancer radiotherapy involving pelvic lymph nodes (골반 림프선을 포함한 전립선암 치료 시 Split VMAT plan의 유용성 평가)

  • Mun, Jun Ki;Son, Sang Jun;Kim, Dae Ho;Seo, Seok Jin
    • The Journal of Korean Society for Radiation Therapy
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    • v.27 no.2
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    • pp.145-156
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    • 2015
  • Purpose : The purpose of this study is to evaluate the efficiency of Split VMAT planning(Contouring rectum divided into an upper and a lower for reduce rectum dose) compare to Conventional VMAT planning(Contouring whole rectum) for prostate cancer radiotherapy involving pelvic lymph nodes. Materials and Methods : A total of 9 cases were enrolled. Each case received radiotherapy with Split VMAT planning to the prostate involving pelvic lymph nodes. Treatment was delivered using TrueBeam STX(Varian Medical Systems, USA) and planned on Eclipse(Ver. 10.0.42, Varian, USA), PRO3(Progressive Resolution Optimizer 10.0.28), AAA(Anisotropic Analytic Algorithm Ver. 10.0.28). Lower rectum contour was defined as starting 1cm superior and ending 1cm inferior to the prostate PTV, upper rectum is a part, except lower rectum from the whole rectum. Split VMAT plan parameters consisted of 10MV coplanar $360^{\circ}$ arcs. Each arc had $30^{\circ}$ and $30^{\circ}$ collimator angle, respectively. An SIB(Simultaneous Integrated Boost) treatment prescription was employed delivering 50.4Gy to pelvic lymph nodes and 63~70Gy to the prostate in 28 fractions. $D_{mean}$ of whole rectum on Split VMAT plan was applied for DVC(Dose Volume Constraint) of the whole rectum for Conventional VMAT plan. In addition, all parameters were set to be the same of existing treatment plans. To minimize the dose difference that shows up randomly on optimizing, all plans were optimized and calculated twice respectively using a 0.2cm grid. All plans were normalized to the prostate $PTV_{100%}$ = 90% or 95%. A comparison of $D_{mean}$ of whole rectum, upperr ectum, lower rectum, and bladder, $V_{50%}$ of upper rectum, total MU and H.I.(Homogeneity Index) and C.I.(Conformity Index) of the PTV was used for technique evaluation. All Split VMAT plans were verified by gamma test with portal dosimetry using EPID. Results : Using DVH analysis, a difference between the Conventional and the Split VMAT plans was demonstrated. The Split VMAT plan demonstrated better in the $D_{mean}$ of whole rectum, Up to 134.4 cGy, at least 43.5 cGy, the average difference was 75.6 cGy and in the $D_{mean}$ of upper rectum, Up to 1113.5 cGy, at least 87.2 cGy, the average difference was 550.5 cGy and in the $D_{mean}$ of lower rectum, Up to 100.5 cGy, at least -34.6 cGy, the average difference was 34.3 cGy and in the $D_{mean}$ of bladder, Up to 271 cGy, at least -55.5 cGy, the average difference was 117.8 cGy and in $V_{50%}$ of upper rectum, Up to 63.4%, at least 3.2%, the average difference was 23.2%. There was no significant difference on H.I., and C.I. of the PTV among two plans. The Split VMAT plan is average 77 MU more than another. All IMRT verification gamma test results for the Split VMAT plan passed over 90.0% at 2 mm / 2%. Conclusion : As a result, the Split VMAT plan appeared to be more favorable in most cases than the Conventional VMAT plan for prostate cancer radiotherapy involving pelvic lymph nodes. By using the split VMAT planning technique it was possible to reduce the upper rectum dose, thus reducing whole rectal dose when compared to conventional VMAT planning. Also using the split VMAT planning technique increase the treatment efficiency.

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Comparative analysis of food intake according to the family type of elderly women in Seoul area (서울 일부지역 여자 노인들의 가구유형에 따른 영양소 섭취실태 및 식사의 질 평가)

  • Lee, Yeon Joo;Kwon, Min Kyung;Baek, Hee Joon;Lee, Sang Sun
    • Journal of Nutrition and Health
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    • v.48 no.3
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    • pp.277-288
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    • 2015
  • Purpose: As the rate of senior citizens living alone increases in the current aging society, there is much concern regarding the health and nutritional intake of solitary senior citizens. Therefore, this study compared the nutritional intake of senior citizens according to their family type. Methods: In July and August of 2011, two senior citizen welfare centers in Seoul were visited to survey 267 elderly women. Excluding 54 subjects for which the data were incomplete, information from 213 subjects was analyzed. The subjects were divided into three family types, living alone (LA, n = 74), living with spouse (LS, n = 78), and living with children (LC, n = 61). Results: The mean age of the LA group was the highest, while the mean age of the LS group was the lowest (p < 0.001), and WHR of the LC group was the highest (p = 0.049). Income was the highest in the LS group (p < 0.001). Frequency of eating out was the lowest in the LA group (p = 0.031). By Duncan's multiple analysis, the amounts of energy intake, vegetable protein, fat, calcium, phosphorus, potassium, selenium, Vit D, Vit E, $Vit\;B_2$, niacin, $Vit\;B_6$, $Vit\;B_{12}$, and cholesterol were significantly higher in the LS group compared with the LA or LC group (p < 0.05). The intakes of calcium, Vit D, $Vit\;B_{12}$, and cholesterol were still significantly different among the three groups, even after adjustment for age and monthly income. The LA group ate less fruit and fish than the LS or LC group (p < 0.05). The LA group showed the lowest dietary diversity and the LS group showed the highest diversity (p = 0.014), however, the significance of dietary diversity score among the three groups disappeared after adjustment for age and monthly income. Conclusion: Elderly women living with spouse were receiving better nutrition than elderly women living alone or living with children. Therefore, solitary elderly women who do not live with their spouse or children should be offered greater opportunities to receive a balanced meal at a congregational kitchen or welfare center. To ensure their healthy diet, it is essential to provide continuous nutrition education with these groups in mind.

A Study on the Distribution Status and Management Measures of Naturalized Plants Growing in Seongeup Folk Village, Jeju Island (제주 성읍민속마을의 귀화식물 분포현황 및 관리방안)

  • Rho, Jae-Hyun;Oh, Hyun-Kyung;Han, Yun-Hee;Choi, Yung-Hyun;Byun, Mu-Sup;Kim, Young-Suk;Lee, Won-Ho
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.32 no.1
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    • pp.107-119
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    • 2014
  • The purpose of this study is to examine the current status of vascular plants and naturalized plants growing in the Seongeup Folk Village in Jeju and to consider and compare their distribution patterns and the characteristics of emergence of naturalized plants in other folk villages and all parts of Jeju, thereby exploring measures to well manage naturalized plants. The result of this study is as follows.11) The total number of vascular plants growing in Seongeup Folk Village is identified to be 354 taxa which include 93 families, 260 genus, 298 species, 44 varieties and 12 breeds. Among them, the number of naturalized plants is 55 taxa in total including 22 families, 46 genus, 53 species, and 2 varieties, which accounts for 21.7% of the total of 254 taxa identified all over the region of Jeju. The rate of naturalization in Seongeup Folk Village is 15.5%, which is far higher than the rates of plant naturalization in Hahoi Village in Andong, Yangdong Village in Gyeongju, Hangae Village in Seongju, Wanggok Village in Goseong, and Oeam Village in Asan. Among the naturalized plants identified within the targeted villages, the number of those growing in Jeju is 9 taxa including Silene gallica, Modiola caroliniana, Oenothera laciniata, Oenothera stricta, Apium leptophyllum, Gnaphalium purpureum, Gnaphalium calviceps, Paspalum dilatatum and Sisyrinchium angustifolium. It is suggested that appropriate management measures that consider the characteristics of the gateway to import and the birthplace of the naturalized plants are necessary. In the meantime, 3 more taxa that have not been included in the reference list of Jeju have been identified for the first time in Seongeup Folk Village, which include Bromus sterilis, Cannabis sativa and Veronica hederaefolia. The number of naturalized plants identified within the gardens of unit-based cultural properties is 20 taxa, among which the rate of prevalence of Cerastium glomeratum is the highest at 62.5%. On the other hand, the communities of plants that require landscape management are Brassica napus and other naturalized plants, including Cosmos bipinnatus, Trifolium repens, Medicago lupulina, Oenothera stricta, O. laciniata, Lotus corniculatus, Lolium perenne, Silene gallica, Hypochaeris radicata, Plantago virginica, Bromus catharticus and Cerastium glomeratum. As a short-term measure to manage naturalized plants growing in Seongeup Folk Village, it is important to identify the current status of Cosmos bipinnatus and Brassica napus that have been planted for landscape agriculture, and explore how to use flowers during the blooming season. It is suggested that Ambrosia artemisiifolia and Hypochaeris radicata, designated as invasive alien plants by the Ministry of Health and Welfare, should be eradicated initially, followed by regular monitoring in case of further invasion, spread or expansion. As for Hypochaeris radicata, in particular, some physical prevention measures need to be explored, such as for example, identifying the habitat density and eradication of the plant. In addition, it is urgent to remove plants, such as Sonchus oleraceus, Houttuynia cordata, Crassocephalum crepidioides, Erigeron annuus and Lamium purpureum with high index of greenness visually, growing wild at around high Jeongyi town walls. At the same time, as the distribution and dominance value of the naturalized plants growing in deserted or empty houses are high, it is necessary to find measures to preserve and manage them and to use the houses as lodging places.

The Benefit of Individualized Custom Bolus in the Postmastectomy Radiation Therapy : Numerical Analysis with 3-D Treatment Planning (유방전절제술 후 방사선치료를 위한 조직보상체 개발 및 3차원 치료계획을 통한 유용성 분석)

  • Cho Jae Ho;Cho Kwang Hwan;Keum Kichang;Han Yongyih;Kim Yong Bae;Chu Sung Sil;Suh Chang Ok
    • Radiation Oncology Journal
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    • v.21 no.1
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    • pp.82-93
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    • 2003
  • Purpose : To reduce the Irradiation dose to the lungs and heart in the case of chest wail irradiation using an oppositional electron beam, we used an Individualized custom bolus, which was precisely designed to compensate for the differences In chest wall thickness. The benefits were evaluated by comparing the normal tissue complication probablilties (NTCPS) and dose statistics both with and without boluses. Materials and Methods : Boluses were made, and their effects evaluated in ten patients treated using the reverse hockey-stick technique. The electron beam energy was determined so as to administer 80% of the irradiation prescription dose to the deepest lung-chest wall border, which was usually located at the internal mammary lymph node chain. An individualized custom bolus was prepared to compensate for a chest wall thinner than the prescription depth by meticulously measuring the chest wall thickness at 1 emf intervals on the planning CT Images. A second planning CT was obtained overlying the individuailzed custom bolus for each patient's chest wall. 3-D treatment planning was peformed using ADAC-Pinnacle$^{3}$ for all patients with and without bolus. NTCPS based on 'the Lyman-Kutcher' model were analyzed and the mean, maximum, minimum doses, V$_{50}$ and V$_{95}$ for 4he heari and lungs were computed. Results .The average NTCPS in the ipsliateral lung showed a statistically significant reduction (p<0.01), from 80.2${\pm}$3.43% to 47.7${\pm}$4.61%, with the use of the individualized custom boluses. The mean lung irradiation dose to the ipsilateral iung was also significantly reduced by about 430 cGy, Trom 2757 cGy to 2,327 cGy (p<0.01). The V$_{50}$ and V$_{95}$ in the ipsilateral lung markedly decreased from the averages of 54.5 and 17.4% to 45.3 and 11.0%, respectively. The V$_{50}$ and V$_{95}$ In the heart also decreased from the averages of 16.8 and 6.1% to 9.8% and 2.2%, respectively. The NTCP In the contralateral lung and the heart were 0%, even for the cases with no bolus because of the small effective mean radiation volume values of 4.4 and 7.1%, respectively Conclusion : The use of an Individualized custom bolus in the radiotherapy of postrnastectorny chest wall reduced the NTCP of the ipsilateral lung by about 24.5 to 40.5%, which can improve the complication free cure probability of breast cancer patients.

Gene Expression Profiles in Cervical Cancer with Radiation Therapy Alone and Chemo-radiation Therapy (자궁경부암의 방사선치료 및 방사선항암화학 병용치료에 따른 유전자발현 조절양상)

  • Lee Kyu Chan;Kim Meyoung-kon;Kim Jooyoung;Hwang You Jin;Choi Myung Sun;Kim Chul Yong
    • Radiation Oncology Journal
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    • v.21 no.1
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    • pp.54-65
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    • 2003
  • Purpose : To analyze the gene expression Profiles of uterine ceulcal cancer, and its variation after radiation therapy, with or without concurrent chemotherapy, using a CDNA microarray. Materials and Methods :Sixteen patients, 8 with squamous ceil carcinomas of the uterine cervix, who were treated with radiation alone, and the other 8 treated w14h concurrent chemo-radiation, were Included in the study. Before the starling of the treatment, tumor biopsies were carried out, and the second time biopsies were peformed after a radiation dose of 16.2$\~$27 Gy. Three normal cervix tissues were used as a control group. The microarray experiments were peformed with 5 groups of the total RNAs extracted individually and then admixed as control, pre-radiation therapy alone, during-radiation therapy alone, pre-chemoradiation therapy, and during-chemoradlation therapy. The 33P-iabeled CDNAS were synthesized from the total RNAs of each group, by reverse transcription, and then they were hybridized to the CDNA microarray membrane. The gene expression of each microarrays was captured by the intensity of each spot produced by the radioactive isotopes. The pixels per spot were counted with an Arrayguage, and were exported to Microsoft Excel The data were normalized by the Z transformation, and the comparisons were peformed on the Z-ratio values calculated. Results : The expressions of 15 genes, including integrin linked kinase (ILK), CDC28 protein kinase 2, Spry 2, and ERK 3, were increased with the Z-ratio values of over 2.0 for the cervix cancer tissues compared to those for the normal controls. Those genes were involved In cell growth and proliferation, cell cycle control, or signal transduction. The expressions of the other 6 genes, Including G protein coupled receptor kinase 5, were decreased with the Z-ratio values of below -2.0. After the radiation thorapy, most of the genes, with a previously Increase expressions, represented the decreased expression profiles, and the genes, with the Z-ratio values of over 2.0, were cyclic nucleotlde gated channel and 3 Expressed sequence tags (EST). In the concurrent chemo-radiation group, the genes involved in cell growth and proliferation, cell cycle control, and signal transduction were shown to have increased expressions compared to the radiation therapy alone group. The expressions of genes involved in anglogenesis (angiopoietln-2), immune reactions (formyl peptide receptor-iike 1), and DNA repair (CAMP phosphodiesterase) were increased, however, the expression of gene involved In apoptosls (death associated protein kinase) was decreased. Conclusion : The different kinds of genes involved in the development and progression of cervical cancer were identified with the CDNA microarray, and the proposed theory is that the proliferation signal stalls with ILK, and is amplified with Spry 2 and MAPK signaling, and the cellular mitoses are Increased with the increased expression oi Cdc 2 and cell division kinases. After the radiation therapy, the expression profiles demonstrated 4he evidence of the decreased cancer cell proliferation. There was no sigificant difference in the morphological findings of cell death between the radiation therapy aione and the chemo-radiation groups In the second time biopsy specimen, however, the gene expression profiles were markedly different, and the mechanism at the molecular level needs further study.