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Evaluating the Dosimetric Characteristics of Radiation Therapies according to Head Elevation Angle for Head and Neck Tumors (두 경부 종양 치료 시 거상각도에 따른 치료기법 별 선량특성 평가)

  • Cheon, Geum-Seong;Kang, Seong-Hee;Kim, Dong-Su;Kim, Tae-Ho;Suh, Tae-Suk
    • Progress in Medical Physics
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    • v.27 no.1
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    • pp.14-24
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    • 2016
  • Since the head and neck region is densely located with organs at risk (OAR), OAR-sparing is an important issue in the treatment of head and neck cancers. This study-in which different treatment plans were performed varying the head tilt angle on brain tumor patients-investigates the optimal head elevation angle for sparing normal organs (e.g. the hippocampus) and further compares the dosimetric characteristics of different types of radiation equipment. we performed 3D conformal radiation therapy (3D-CRT), intensity-modulated radiation therapy (IMRT), and tomotherapy on 10 patients with brain tumors in the frontal lobe while varying the head tilt angle of patients to analyze the dosimetric characteristics of different therapy methods. In each treatment plan, 95% of the tumor volume was irradiated with a dose of 40 Gy in 10 fractions. The step and shoot technique with nine beams was used for IMRT, and the same prescription dose was delivered to the tumor volume for the 3D-CRT and tomotherapy plans. The homogeneity index, conformity index, and normal tissue complication probability (NTCP) were calculated. At a head elevation angle of $30^{\circ}$, conformity of the isodose curve to the target increased on average by 53%, 8%, and 5.4%. In 3D-CRT, the maximum dose received by the brain stem decreased at $15^{\circ}$, $30^{\circ}$, and $40^{\circ}$, compared to that observed at $0^{\circ}$. The NTCP value of the hippocampus observed in each modality was the highest at a head and neck angle of $0^{\circ}$ and the lowest at $30^{\circ}$. This study demonstrates that the elevation of the patients' head tilt angle in radiation therapy improves the target region's homogeneity of dose distribution by increasing the tumor control rate and conformity of the isodose curve to the target. Moreover, the study shows that the elevation of the head tilt angle lowers the NTCP by separating the tumor volume from the normal tissues, which helps spare OARs and reduce the delivered dose to the hippocampus.

Effect of the Paclitaxel and Radiation on the Large Bowel Mucosa of the Rat (횐쥐의 대장점막에 Paclitaxel(Taxol)과 방사선조사의 효과)

  • Lee Kyung-Ja
    • Radiation Oncology Journal
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    • v.17 no.1
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    • pp.57-64
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    • 1999
  • Purpose : Paclitaxel is a chemotherapeutic agent with a potent microtubule stabilizing activity that arrests mitosis at G2-M phase of cell cycle which is the most radiosensitive period. Therefore paclitaxel is considered as a cell cycle-specific radiosensitizer. This study investigates the effect of paclitaxel on the radiation response of the normal large bowel mucosa of the rat. Materials and Methods: The rats were divided into the three groups i.e., single intraperitoneal infusion of paclitaxel (10 mg/kg), a single fraction of irradiation (8 Gy, x-ray) to the whole abdomen, and a combination of irradiation (8 Gy, x-ray) given 24 hours after paclitaxel infusion. The histological changes as well as kinetics of mitotic arrest and apoptosis were evaluated on the large bowel mucosa at 6 hours, 1 day, 3 days and 5 days after treatment with paclitaxel alone, radiation alone and combination of paclitaxel and radiation. Results : The incidence of the mitotic arrest was not increased by paclitaxel infusion. The apoptosis appeared in 24 hours after paclitaxel infusion, and the histopathologic changes such as vesiculation, atypia and reduction of the goblet cell of the mucosa of the large bowel were demonstrated during the period from 6 hours to 3 days after, and returned to normal in 5 days after paclitaxel infusion. In irradiated group, the apoptosis was increased in 6 and 24 hours after irradiation, and the histopathologic changes of the mucosa were appeared in 24 hours and markedly increased in 3 days and returned to normal in 5 days. In combined group of irradiation and paclitaxel infusion, the apoptosis was appeared in 3 days and the histopathologic changes appeared during the period from 6 hours to 3 days after infusion. On the basis of the incidence of apoptosis and the degree of the histopathologic changes of the large bowel mucosa, there seemed to be additive effect by paclitaxel on radiation rather than sensitizing effect. Conclusions: The histopathological changes of large bowel mucosa in combined group compared to radiation alone group suggested an additive effect of paclitaxel on radiation response in the large bowel of rat.

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The Validity and Reliability of 'Computerized Neurocognitive Function Test' in the Elementary School Child (학령기 정상아동에서 '전산화 신경인지기능검사'의 타당도 및 신뢰도 분석)

  • Lee, Jong-Bum;Kim, Jin-Sung;Seo, Wan-Seok;Shin, Hyoun-Jin;Bai, Dai-Seg;Lee, Hye-Lin
    • Korean Journal of Psychosomatic Medicine
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    • v.11 no.2
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    • pp.97-117
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    • 2003
  • Objective: This study is to examine the validity and reliability of Computerized Neurocognitive Function Test among normal children in elementary school. Methods: K-ABC, K-PIC, and Computerized Neurocognitive Function Test were performed to the 120 body of normal children(10 of each male and female) from June, 2002 to January, 2003. Those children had over the average of intelligence and passed the rule out criteria. To verify test-retest reliability for those 30 children who were randomly selected, Computerized Neurocognitive Function Test was carried out again 4 weeks later. Results: As a results of correlation analysis for validity test, four of continues performance tests matched with those on adults. In the memory tests, results presented the same as previous research with a difference between forward test and backward test in short-term memory. In higher cognitive function tests, tests were consist of those with different purpose respectively. After performing factor analysis on 43 variables out of 12 tests, 10 factors were raised and the total percent of variance was 75.5%. The reasons were such as: 'sustained attention, information processing speed, vigilance, verbal learning, allocation of attention and concept formation, flexibility, concept formation, visual learning, short-term memory, and selective attention' in order. In correlation with K-ABC to prepare explanatory criteria, selectively significant correlation(p<.0.5-001) was found in subscale of K-ABC. In the test-retest reliability test, the results reflecting practice effect were found and prominent especially in higher cognitive function tests. However, split-half reliability(r=0.548-0.7726, p<.05) and internal consistency(0.628-0.878, p<.05) of each examined group were significantly high. Conclusion: The performance of Computerized Neurocognitive Function Test in normal children represented differ developmental character than that in adult. And basal information for preparing the explanatory criteria could be acquired by searching for the relation with standardized intelligence test which contains neuropsycological background.

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Immunoelectron Microscopic Study on the Paneth Cell of Rabbit after the Common Bile Duct Ligation (총담관결찰후 집토끼 Paneth세포의 변화에 대한 면역전자현미경적 연구)

  • Park, Kyung-Ho;Cho, Hwee-Dong;Yang, Nam-Gil;Ahn, E-Tay;Ko, Jeong-Sik;Kim, Jin-Gook
    • Applied Microscopy
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    • v.24 no.2
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    • pp.78-92
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    • 1994
  • Lysozyme has been reported to be present in the secretory granules of the Paneth cell, and lysozyme immunoreactivity has been detected by immunogold method in Paneth cells of the intestine of human, mouse and rat. The present study was aimed at clarifying the intracellular distribution and changes of the lysozyme immunoreactivity in rabbit Paneth cell after common bile duct ligation of rabbit, using the electron microscope immunogold technique. Healthy adult rabbits weighing about 2kg body weight were divided into normal and bile duct ligated groups. Common bile duct ligation was performed aseptically under ether anesthesia. Experimental animals were sacrificed on the 1st, the 3rd, the 5th, the 7th and the 14th day after the operation. Mucosal specimens from the intestinal gland of ileum were fixed in 2.5% glutaraldehyde-1.5% paraformaldehyde, followed by 1% osmium tetroxide, embedded in araldite mixture, cut with LKB-V ultratome. Ultrathin sections were placed on parlodion coated nickel grids (200mesh). The section-bearing grids were floated upside down on the added substance in a moist chamber at room temperature except for the primary antibody step, which was at $4^{\circ}C$. Sections were etched with a saturated solution of sodium m-periodate for 60min. After etching, sections were pretreated with 0.02M tris buffered saline (TBS), pH 8.4, with 1% bovine serum albumin (BSA, Sigma) for 60min, then treated polyclonal rabbit anti-human lysozyme (Dakipatts) diluted 1 : 50 in TBS with 0.1% BSA for 20hr. Subsequently, grids were incubated 60min in biotinylated goat anti rabbit IgG (Amersham) diluted 1 : 100 in TBS with 0.1% BSA. After this, sections were incubated 60min on streptavidin gold G10 (Amersham) diluted 1 : 50 in TBS with 0.1% BSA. After each step, the grids were briefly rinsed with TBS with 0.1% BSA. After the strepavidin gold step, the sections were jet washed with distilled water. Counterstain of the sections performed by uranyl acetate and lead citrate, and observed with JEM 100 CX II electron microscope. Observed results were as follow; 1. Secretory granules of mouse Paneth cells have a lysozyme immunoreactivity and also eosinophil leucocyte of rabbit applied for the positive-control stain, are well labeld with gold particles. 2. Normal rabbit Paneth cells have a lysozyme immunoreactivity restricted on the secretory granules. 3. Amount lysosomes containing myelin figures in the Paneth cells were significantly increased from 5th day after the common bile duct ligation. 4. Immunoreactivity of Paneth cell secretory granules were more activated on the 3rd day after the common bile duct ligation as compared with those of the normal animal. But the lysozyme immunoreactivity were decreased from the 5th day after the common bile duct ligation. 5. Considering the above finding, lysozyme contained Paneth cell are affected following of common bile duct ligation, whereas lysosomes containing myelin-figure do not exhibit any immunoreactive relationship with those of secretory granules.

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The Significance of $^{99m}Technetium$ Dimercaptosuccinic Acid(DMSA) Scan as a Substitute for Voiding Cystourethrography(VCUG) in Evaluating Children with first Febrile Urinary Tract Infection (생애 첫 발열성 요로 감염 환아에 대한 평가에서 배뇨성 방광 요도 조영술을 대체하기 위한 검사로서 $^{99m}technetium$ dimercaptosuccinic acid(DMSA) scan의 의의)

  • Han, Seung-Beom;Ko, Yong-Min;Lee, Sue-Young;Jeong, Dae-Chul;Kang, Jin-Han;Lee, Kyung-Yeon;Uhm, Mee-Ryung;Kim, Woong-Heum;Kim, Jung-Sue
    • Childhood Kidney Diseases
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    • v.11 no.2
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    • pp.220-228
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    • 2007
  • Purpose : We studied the value of clinical signs, laboratory findings and $^{99m}technetium$ dime-rcaptosuccinic acid(DMSA) scan in predicting the presence of vesicoureteral reflux(VUR) in children with first febrile urinary tract infection(UTI). Methods : A retrospective analysis of 84 hospitalized children with first febrile UTI was performed. They underwent DMSA scan and voiding cystourethrography(VCUG) during the acute phase, and were divided into three groups according to the results of the VCUG: absence of VUR, mild(grade I-II) and severe VUR(grade III-V). We studied the relation of VUR to age, gender, fever duration, causative organism, white blood cell count, serum C-reactive protein and result of DMSA scan. Results : Among 84 patients, 6 had mild and 17 had severe VUR. Thirty-eight had abnormal DMSA scan. results Patients with VUR were older than those without VUR(P<0.01). There was a lower probability of infection with Escherichia coli in patients with severe VUR than in those with mild and absent VUR(P<0.01). An abnormal DMSA scan correlated with the presence and severity of VUR(P<0.05). Severe VUR was present in 10.9% of patients with normal DMSA scan. The sensitivity, specificity, positive and negative predictive values of the DMSA scan in predicting the presence of VUR were 69.6%, 63.9%, 42.1%, and 84.8%, respectively. Conclusion : An abnormal DMSA scan correlated to the presence and severity of VUR, but the sensitivity, specificity and positive predictive value of the DMSA scan were low. There-fore, patient with an abnormal DMSA scan requires a VCUG. In order to prevent missing the 10.9% of patients with severe VUR but normal DMSA scans, a VCUG should be performed in patient with normal DMSA scan.

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The Effect of Ginkgo Biloba Extract on Radiosensitivity of Mouse Skin and Jejunal Crypt (Ginkgo Biloba Extract가 마우스 피부 및 공장 소낭선의 방사선감수성에 미치는 영향)

  • Shin, Kyung-Hwan;Ha, Sung-Whan
    • Radiation Oncology Journal
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    • v.16 no.2
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    • pp.107-114
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    • 1998
  • Purpose : Ginkgo biloba extract(GBE) is known to increase the peripheral blood circulation. This study was designed to evaluate the effect of GBE on the acute normal tissue radiation reaction. Materials and Methods : mice were divided into two groups, radiation alone and two doses GBE plus radiation, for both acute skin reaction and jejunal crypt assay. GBE was given i.p. one hour before irradiation with priming dose given one day earlier. Thirty to Fifty Gy for acute skin reaction and 11 to 14 Gy for jejunal crypt were irradiated to right hind leg and whole body, respectively. Results : Radiation doses($RD_{50}$) for Peak skin score of 2.0 were 44.2Gy (40.6-48.2Gy) for radiation alone and 44.4Gy(41.6-47.4Gy) for two doses GBE plus radiation, showing no effect of GBE on acute radiation skin damage. The numbers of regenerating jejunal crypts per circumference were also almost the same for each radiation dose level(p=0.57-0.94), and the mean lethal doses($D_o$) were 1.800y(1.57-2.09Gy) for radiation alone and 1.88Gy(1.65-2.18Gy) for two doses GBE plus radiation, indicating no effect of GBE on jejunal crypt cell survival after radiation. Conclusion : GBE doesn't increase acute normal tissue radiation reaction in this model system. As GBE was verified to enhance radiation effect on tumor, high therapeutic gain is expected when GBE is combined with radiation therapy.

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Effects of BCG on Gastric Chief Cells of the Mouse Implanted with Ehrlich Carcinoma Cells (BCG가 Ehrlich 암세포를 이식한 생쥐 위점막 으뜸세포의 미세구조에 미치는 영향)

  • Ryoo, In-Sang;Ahn, E-Tay;Park, Kyung-Ho;Park, Dae-Kyoon;Kim, Myeong-Soo;Ko, Jeong-Sik
    • Applied Microscopy
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    • v.35 no.3
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    • pp.153-163
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    • 2005
  • This experiment was performed to evaluate the morphological responses of the gastric chief cells of the mouse, inoculated with Ehrlich carcinoma cells in the inguinal area, following administration of BCG (Bacillus Calmette-Guerin). Healthy adult ICR mice weighing 25 gm each were divided into normal and experimental groups (experimental control group and BCG treated group). In the experimental groups, each mouse was inoculated with $1x10^7$ Ehrlich carcinoma cells subcutaneously in the inguinal area. From next day after inoculations, 0.2 mL of saline or BCG (0.5 mL/25 g B.W.: $0.03{\times}10^8{\sim}0.32{\times}10^8$ CFU) were injected subcutaneously to the animals every other day, respectively. The day following the last injection, each mouse was sacrificed. Pieces of the tissue were taken from the stomach, prefixed with 2.5% glutaraldehyde-1.5% paraformaldehyde solution, followed by post-fixation with 1% osmium tetroxide solution. The ultrathin sections were stained with uranyl acetate and lead citrate. The size of zymogen granule and the size of the mitochondrion of the gastric chief cells were observed and calculated. In the BCG treated group, most chief cells did not show any difference in ultrastructure, except that myelin figures were more frequently observed, in comparison with that of nornmal control group. The size of zymogen granule in the gastric chief cells of normal control, experimental control and BCG-treated groups were $0.98({\pm}0.108){\mu}m,\;1.05({\pm}0.092){\mu}m\;and\;0.93({\pm}0.053){\mu}m$, respectively. And the mitochondrial size of the gastric chief cells of normal control, experimental control and BCG-treated groups were $0.80({\pm}0.130){\mu}m,\;0.83({\pm}0.143){\mu}m\;and\;0.72({\pm}0.078){\mu}m$, respectively. From the above results, it was concluded that BCG may slightly suppress function of the gastric chief cells.

The Clinical Significance of Serum CD23 and CD25 in Chronic Cough Patients (만성 기침환자에서 혈청 CD23와 CD25 측정의 임상적 의의)

  • Choi, Jae-Chol;Park, Young-Bum;Jee, Hyun-Suk;Kim, Jae-Yeol;Park, In-Won;Choi, Byoung-Whui;Hue, Sung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.4
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    • pp.471-477
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    • 2000
  • Background : Coughing is the most common complaint for which patients seek medical service. When caughing continues over 3 weeks in non-smokers who do not take cough-provoking drugs, they are classified as patients with chronic cough. Three well known main causes of chronic caugh are postnasal drip syndrome, bronchial asthma and gastroesophaseal reflux disease. Among them, postnasal drip syndrome is reported to be the most common cause of all in chronic cough diseases, and allergic inflammation plays an important role in the pathogenesis of postnasal drip syndrome. CD23 and CD25 which are low affinity receptor for IgE and IL-2 receptor alpha, respectively, are closely related to allergic inflammation and their roles were evaluated in chronic cough patients. Methods : We evaluated 105 patients with chronic cough and selected 56 patients for measurement of serum CD23 & CD25 levels. We selected 10 normal, medical students for comparison of serum CD23 & CD25 levels. Result : The postnasal drip syndrome was found to be the most common cause of chronic cough. Serum CD23 and CD25 did not increase in chronic cough patient compared to normal controls. However in bronchial asthma patient, serum CD23 level was increased relative to normal control (p<0.05). Conclusion : In bronchial asthma presented as chronic cough, lymphocyte mediated allergic inflammation may related with the pathogenesis of the disease.

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A Reliability Analysis of Shallow Foundations using a Single-Mode Performance Function (단일형 거동함수에 의한 얕은 기초의 신뢰도 해석 -임해퇴적층의 토성자료를 중심으로-)

  • 김용필;임병조
    • Geotechnical Engineering
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    • v.2 no.1
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    • pp.27-44
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    • 1986
  • The measured soil data are analyzed to the descriptive statistics and classified into the four models of uncorrelated-normal (UNNO), uncorrelated-nonnormal (VNNN), correlatedonnormal(CONN), and correlated-nonnormal(CONN) . This paper presents the comparisons of reliability index and check points using the advanced first-order second-moment method with respect to the four models as well as BASIC Program. A sin91e-mode Performance function is consisted of the basic design variables of bearing capacity and settlements on shallow foundations and input the above analyzed soil informations. The main conclusions obtained in this study are summarized as follows: 1. In the bearing capacity mode, cohesion and bearing-capacity factors by C-U test are accepted for normal and lognormal distribution, respectively, and negatively low correlated to each other. Since the reliability index of the CONN model is the lowest one of the four model, which could be recommended a reliability.based design, whereas the other model might overestimate the geotechnical conditions. 2. In the case of settlements mode, the virgin compression ratio and preccnsolidation pressure are fitted for normal and lognormal distribution, respectively. Constraining settlements to the lower ones computed by deterministic method, The CONN model is the lowest reliability of the four models.

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Measurement of Lactoferrin, IgA, IgG1, IgG2, Antibacterial Activity, and Lactic Acid Bacterial Growth in Holstein Colostrum (Holstein 초유 중 Lactoferrin, IgA, IgG1, IgG2 정량과 미생물의 성장에 미치는 영향)

  • Renchinthand, Gereltuya;Bae, Hyoung-Churl;Nam, Myoung-Soo
    • Food Science of Animal Resources
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    • v.27 no.4
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    • pp.522-530
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    • 2007
  • This experiment was carried out to measure the content of lactoferrin, IgA, $IgG_1,\;IgG_2$, in Holstein colostrum, and to test the effect of it's colostrum on the antibacterial activity to pathogenic bacteria and the growth stimulation of lactic acid bacteria. Colostrum was collected at the first, second, and third day after parturition in summer and winter season. The levels of lactoferrin, IgA, $IgG_1,\;and\;IgG_2$ in Holstein cow colostrum were 0.30 mg/mL, 0.37 mg/mL, 4.00 mg/mL, 0.37 mg/mL, respectively, on the first day of the summer season whereas they were 1.16 mg/mL, 2.60 mg/mL, 13.35 mg/mL, 1.30 mg/mL on the first day of the winter season, postpartum. Heat treated ($65^{\circ}C$ for 30 min) or non-treated colostrum showed antibacterial activity toward Escherichia coli. The growth of commercial mixed strains (Bifidobacterium longum, Lactobacillus acidophilus, Streptococcus themophilus), L. acidophilus, L. casei, L. bulgaricus, and L. lactis subsp. cremoris were improved in first, second and third day colostrum compared to normal milk. Commercial miked strains (B. longum, L. acidophilus S. themophilus) lowered the pH to 4.97-5.22 and 4.89 while increasing the titratable acidity to 0.75-0.88% and 0.70% in colostrum and normal milk, respectively. However, L. casei, L. bulgaricus, L. lactis subsp. cremoris lowered the pH to 5.96-6.47 and 6.5-6.8 while increasing the titratable acidity to 0.29-0.48% and 0.20-0.25% in colostrum and normal milk, respectively.