• Journal of the Korean Society of Radiology
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• v.10 no.7
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• pp.521-529
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• 2016

Since Gamma Knife(R) radiosurgery(GKRS) is based on a single-fraction high dose treatment strategy, independent verification for the results of Leksell GammaPlan(R) (LGP) is an important procedure in assuring patient safety and minimizing the risk of treatment errors. Several verification methods have been developed and reported previously. Thus these methods were tested statistically and tried on Leksell Gamma Knife(LGK) target treatments through the embodiment of the previously proposed algorithms(PPA). The purpose of this study was to apply and evaluate the accuracy of verification methods for LGK target treatments using PPA. In the study 10 patients with intracranial lesion treated by GKRS were included. We compared the data from PPA and LGP in terms of maximum dose, arbitrary point dose, and treatment time at the isocenter locations. All data were analyzed by Paired t-test, which is statistical method used to compare two different measurement techniques. No statistical significance in maximal dose at 10 cases was observed between PPA and LGP. Differences in average maximal dose ranged from -0.53 Gy to 3.71 Gy. The arbitrary point dose calculated by PPA and LGP was not statistically significant too. But we found out the statistical difference with p=0.021 between TMR and LGP for treatment time at the isocenter locations. PPA can be incorporated as part of a routine quality assurance(QA) procedure to minimize the chance of a wrong overdose. Statistical analyses demonstrated that PPA was in excellent agreement with LGP when considering the maximal dose and the arbitrary point dose for the best plan of GKRS. Due to the easy applicability we hope PPA can be widely used.

• Polymer(Korea)
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• v.32 no.1
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• pp.49-55
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• 2008

It is recognized that Schwann cells (SC) are essential for peripheral nerve development and regeneration. SIS (small intestinal submucosa) consists of some growth factors which can stimulate cell activity without immune rejection responges. SCs were harvested from the femurs and tibias of female Fischer rat and then suspended with $2{\times}10^6$ cell/sponge in SIS sponge. Fischer rat received an implant consisting of the SCs and the SIS sponge at the place of a 5 mm gap created by the sciatic nerve resection. Thin sections were stained with H &E staining and immunostaining of S-100, GFAP and NF after 1, 2, and 4 weeks. It was observed that the effects of the SIS sponge with SCs on neuroinduction(Group II, with scaffold & cell) are strong as much as uninjured model(Control I), and significantly stronger than SIS sponge model (Group 1, with scaffold only) and blank model (Control II). In conclusion, these results suggest that SIS sponge filled with SCs may have an important role for peripheral nerve regeneration of tissue engineering.

• Progress in Medical Physics
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• v.18 no.4
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• pp.194-201
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• 2007

Although Gamma Knife irradiates much more radiation in a single session than conventional radiotherapy, there were only a few studies to measure absolute dose of a Gamma Knife. Especially, there is no report of application of International Atomic Energy Agency (IAEA) TRS-398 which requires to use a water phantom in radiation measurement to Gamma Knife. In this article, the authors reported results of the experiments to measure the absorbed dose to water of a Gamma Knife Model C using the IAEA TRS-398 protocol. The absorbed dose to water of a Gamma Knife model C was measured using a water phantom under conditions as close as possible to the IAEA TRS-398 protocol. The obtained results were compared with values measured using the plastic phantom provided by the Gamma Knife manufacturer. Two Capintec PR-05P mini-chambers and a PTW UNIDOS electrometer were used in measurements. The absorbed dose to water of a Gamma Knife model C inside the water phantom was 1.38% larger than that of the plastic phantom. The current protocol provided by the manufacturer has an intrinsic error stems from the fact that a plastic phantom is used instead of a water phantom. In conclusion, it is not possible to fully apply IAEA TRS-398 to measurement of absorbed dose of a Gamma Knife. Instead, it can be a practical choice to build a new protocol for Gamma Knife or to provide a conversion factor from a water phantom to the plastic phantom. The conversion factor can be obtained in one or two standard laboratories.

• Quality Improvement in Health Care
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• v.10 no.1
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• pp.28-41
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• 2003

Background : Because unplanned readmissions to intensive care unit(ICU)might be related with undesirable patient outcomes, we investigated the pattern of and reason for unplanned ICU readmission to provide baseline data for reducing unplanned returns to ICU. Methods : The subjects included all patients who readmitted to ICU during the same hospitalization at a tertiary referral hospital between January 1st and June 30th 2002. Quality improvement(QI) nurse collected the data through medical records and a medical director reviewed the data collected. Results : 1) The average unplanned ICU readmission rate was 5.6%(gastroenterology 14.6%, pediatrics 12.7%, pulmonology 11.9%, neurosurgery 6.3%, general surgery 5.3%, chest surgery 3.9%, and cardiology 3.3%). 2) Among the unplanned readmissions, more than 50% of cases were from patients older than 60 years, and the main categories of diagnose at hospital admission were neurologic disease(29.9%) and cardiovascular disease(27.6%). 3) Of unplanned ICU readmissions, 41.8% had recurrence of the initial problems, 44.8% had occurrence of new problems. And 9.7% required post-operative care after unplanned operations. 4) The most common cause responsible for unplanned ICU readmission were respiratory problem(38.3%) and cardiovascular problem(14.3%). 5) About 40% of unplanned ICU readmission occurred within 3 days after ICU discharge. 6) Average length of stay of the readmitted patients to ICUs were much longer than that of non-readmitted patients. 7) Hospital mortality rate was much higher for unplanned ICU readmitted patients(23.6%) than for non-readmitted patients(1.5%) (P<0.001). Conclusions : This study showed that the unplanned ICU readmitted patients had poor outcomes(high morality and increased length of stay). In addition study results suggest that more attention should be paid to patients in ICU with poor respiratory function or elderly patients, and careful clinical decisions are required at discharged from ICU to general ward.

• Progress in Medical Physics
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• v.24 no.4
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• pp.290-294
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• 2013

Stereotactic Radiosurgery require high accuracy and precision of patient positioning and target localization. We evaluate the real time positioning accuracy of isocenter using optic guided patient positioning system, ExacTrac (BrainLab, Germany), during spinal radiosurgery procedure. The system is based on real time detect multiple body markers attached on the selected patient skin landmarks. And a custom designed patient positioning verification tool (PPVT) was used to check the patient alignment and correct the patient repositioning before radiosurgery. In this study, We investigate the selected 8 metastatic spinal tumor cases. All type of tumors commonly closed to thoracic spinal code. To evaluate the isocenter positioning, real time patient alignment and positioning monitoring was carried out for comparing the current 3-dimensional position of markers with those of an initial reference positions. For a selected patient case, we have check the isocenter positioning per every 20 millisecond for 45 seconds during spinal radiosurgery. In this study, real time average isocenter positioning translation were $0.07{\pm}0.17$ mm, $0.11{\pm}0.18$ mm, $0.13{\pm}0.26$ mm, and $0.20{\pm}0.37$ mm in the x (lateral), y (longitudinal), z (vertical) directions and mean spatial error, respectively. And body rotations were $0.14{\pm}0.07^{\circ}$, $0.11{\pm}0.07^{\circ}$, $0.03{\pm}0.04^{\circ}$ in longitudinal, lateral, table directions and mean body rotation $0.20{\pm}0.11^{\circ}$, respectively. In this study, the maximum mean deviation of real time isocenter positioning translation during spinal radiosurgery was acceptable accuracy clinically.

• Polymer(Korea)
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• v.32 no.6
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• pp.529-536
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• 2008

We manufactured poly (L-lactide-co-glycolide) (PLGA) scaffolds impregnated demineralized bone particle (DBP) and hyaluronic acid (HA) by ice-particle leaching method and tested their ability of sustained release of brain derived neurotrophic factor (BDNF). BDNF (50 and 200 ng) mixed with PLGA, DBP/PLGA, HA/PLGA and DBP/HA/PLGA scaffold. The release profiles of BDNF from BDNF loaded scaffolds were assayed using ELISA. Morphological changes of scaffolds by BDNF release were also observed by SEM. BDNF stably and sustainedly released from DBP/HNPLGA than from PLGA and DBP/PLGA scaffolds. DBP/HA/PLGA scaffolds showed the great structural changes, which demonstrated BDNF release amount from DBP/HA/PLGA scaffolds were highest in all groups. We suggest that BDNF loaded DBP/HNPLGA scaffold would be very useful for nerve regeneration.

• Progress in Medical Physics
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• v.24 no.4
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• pp.265-270
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• 2013

Correct target volume delineation is an important part of radiosurgery treatment planning process. We designed head phantom and performed target delineation to evaluate the volume differences due to radiosurgery treatment planning systems and image acquisition system, CT/MR. Delineated mean target volume from CT scan images was $2.23{\pm}0.08cm^3$ on BrainSCAN (NOVALS), $2.13{\pm}0.07cm^3$ on Leksell gamma plan (Gamma Knife) and $2.24{\pm}0.10cm^3$ on Multi plan (Cyber Knife). For MR images, $2.08{\pm}0.06cm^3$ on BrainSCAN, $1.94{\pm}0.05cm^3$ on Leksell gamma plan and $2.15{\pm}0.06cm^3$ on Multi plan. As a result, Differences of delineated mean target volume due to radiotherapy planning system was 3% to 6%. And overall mean target volume from CT scan images was 6.36% larger than those of MR scan images.

• Progress in Medical Physics
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• v.13 no.3
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• pp.120-128
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• 2002

To investigate differences between the metabolic ratios of normal controls and brain tumors such as astrocytomas and glioblastoma multiforme (GM) by proton MR spectroscopy (MRS) at 37 high field system. Using 3T MRI/MRS system, localized water-suppressed single-voxel technique in patients with brain tumors was employed to evaluate spectra with peaks of N-acetyl aspartate (NAA), choline-containing compounds (Cho), creatine/phosphocreatine (Cr) and lactate. On the basis of Cr, these peak areas were quantificated as a relative ratio. The variation of metabolites measurements of the designated region in 10 normal volunteers was less than 10%. Normal ranges of NAA/Cr and Cho/Cr ratios were 1.67$\pm$018 and 1.16$\pm$0.15, respectively. NAA/Cr ratio of all tumor tissues was significantly lower than that of the normal tissues (P=0.005). Cho/Cr ratio of glioblastoma multiforme was significantly higher than that of astrocytomas (P=0.001). Lactate was observed in all tumor cases. The present study demonstrated that the neuronal degradation or loss was observed in all tumor tissues. Higher grade of brain tumors was correlated with higher Cho/Cr ratio, indicating a significant dependence of Cho levels on malignancy of gliomas. This results suggest that clinical proton MR spectroscopy could be useful to predict tumor malignancy.

• Investigative Magnetic Resonance Imaging
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• v.9 no.1
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• pp.43-49
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• 2005

A few studies have shown that the function of fusiform face area is selectively involved in the perception of faces including a race difference. We investigated the neural substrates of the face-selective region called fusiform face area in the ventral occipital-temporal cortex and same-race memory superiority in the fusiform face area by the event-related fMRI. In our fMRI study, subjects (Oriental-Korean) performed the implicit distinction of the race while they consciously made familiar-judgments, regardless of whether they considered a face as Oriental-Korean or European-American. For race distinction as an implicit task, the fusiform face areas (FFA) and the right parahippocampal gyrus had a greater response to the presentation of Oriental-Korean faces than for the European-American faces, but in the conscious race distinction between Oriental-Korean and European-American faces, there was no significant difference observed in the FFA. These results suggest that different activation in the fusiform regions and right parahippocampal gyrus resulting from superiority of same-race memory could have implicitly taken place by the physiological processes of face recognition.

• Journal of Life Science
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• v.30 no.1
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• pp.10-17
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• 2020

Kinesin-1 is microtubule-dependent plus-end direct molecular motor protein essential for intracellular transport. It is a member of the kinesin superfamily proteins (KIFs) which transport cargo, including organelles, vesicles, neurotransmitter receptors, cell-signaling molecules, and protein complexes through interaction between its light chain subunit and the cargo. Kinesin light chain 1 (KLC1) is a non-motor subunit that associates with the kinesin heavy chain (KHC). Although KLC1 interacts with many different adaptor proteins and scaffolding proteins, its binding proteins have not yet been fully identified. We used the yeast two-hybrid assay to identify proteins that interact with the tetratricopeptide repeat (TPR) domain of KLC1, and found an interaction between KLC1 and EH domain-binding protein 1 like 1 (EHBP1L1). EHBP1L1 bound to the region containing all six TPR repeats of KLC1 and did not interact with KIF5B (a motor protein of kinesin 1) or KIF3A (a motor protein of kinesin 2) in the yeast two-hybrid assay. The carboxyl-terminus of the coiled-coil domain of EHBP1L1 is essential for interaction with KLC1. However, another EHBP1L1 isoform, EHBP1, did not interact with KLC1 in the yeast two-hybrid assay. KLC1 interacted with GST-EHBP1L1 and its coiled-coil domain but not with GST only. When co-expressed in HEK-293T cells, EHBP1L1 co-localized with KLC1 and co-immunoprecipitated with KLC1 and KIF5B but not KIF3A. These results suggest that kinesin 1 motor protein may transport EHBP1L1-associated cargo in cells.