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Immunohistochemical Study of Phosphatase and Tensin Homolog Deleted on Chromosome Ten in Gefitinib Treated Nonsmall Cell Lung Cancer Patients (폐암 조직에서의 PTEN 발현 정도와 Gefitinib의 반응율과의 관계)

  • Lee, Sung Yong;Lee, Ju Han;Jung, Jin Yong;Lee, Kyoung Ju;Lee, Seung Hyeun;Kim, Se Joong;Lee, Eun Joo;Hur, Gyu Young;Jung, Ki Hwan;Jung, Hye Cheol;Lee, Sang Yeub;Kim, Je Hyeong;Shin, Chol;Shim, Jae Jeong;In, Kwang Ho;Kang, Kyung Ho;Yoo, Se Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.5
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    • pp.473-479
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    • 2005
  • Background : Gefitinib targets the epidermal growth factor receptor r(EGFR), and Gefitinib has antitumor activity in patient with non-small cell lung cancer (NSCLC). However, only 10 to 20 percent of patients show a clinical response to this drug, and the molecular mechanisms underlying patient sensitivity to gefitinib are unknown. PTEN (Phosphatase and tensin homolog deleted on chromosome Ten) plays a role for the modulation of the phosphatidylinositol 3-kinase pathway (PI3K), which is involved in cell proliferation and survival, so that it can inhibit cell cycle progression and induce G1 arrest. Therefore, we analyzed the relationship between PTEN expression and gefitinib's responsiveness in patients having advanced non small cell lung cancer that had progressed after previous chemotherapy. Methods : The expression of PTEN was studied by immunohistochemistry in paraffin-embedded tumor blocks that were obtained from 22 patients who had been treated with gefitinib from JAN, 2001 to AUG. 2004. For the evaluation of the relationships between the PTEN expression, the clinical stage and the basal characteristics, those cases that showed the respective antigen expression in >50% of the tumor cells were considered positive. Results : The positive rate of PTEN staining was 55% of the total of 22 patients. There was a significant relationship between the increased expression of PTEN and the response group (p=0.039). However, there was no significant relationship between the expression of PTEN and other clinicopathologic characteristics. Conclusion: The expression of PTEN in patients with advanced non small cell lung cancer that has progressed after previous chemotherapy may play a role in gefitinib's responsiveness.

Tumor Prosthetic Replacement for the Metastatic Bone Tumors Involving the Proximal Femur (대퇴골 근위부 전이성 종양 환자의 종양 대치물 삽입술)

  • Sung, Ki-Sun;Chang, Moon-Jong
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.1
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    • pp.48-54
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    • 2007
  • Purpose: To evaluate clinical results of the tumor prosthetic replacement for pathologic fracture of the proximal femur with extensive bony destruction due to metastatic bone tumors. Materials and Methods: From 2005 October to 2006 October, resection of proximal femur and tumor prosthesis replacement was performed for metastatic bone tumors extensively involving trochanteric area in 6 patients. The mean age of overall patients was 61(range, 48~77). Mean clinical follow up was 10.5 months (range, 6~16). Primary tumor consisted with multiple myeloma in 2 patients, lung cancer in 1, breast cancer in 1, transitional cell carcinoma of the renal pelvis in 1, unknown origin in 1 patient. $MUTARS^{(R)}$ proximal femur (Implantcast, Munster, Germany) were used in all cases. The functional evaluation in the lower extremities was performed with Musculoskeletal Tumor Society 1993 scores. The degree of pain relief after surgical treatment was assessed with Visual Analogue Scale (VAS). Results: At the final follow up, all of the patients survived. The mean lower extremities functional score of Musculoskeletal Tumor Society 1993 was 17.8(59.3%)(range, 12~25). VAS was improved to 2.5 from 8.5 after the surgical treatment. Ambulation was encouraged as soon as possible and mean duration after surgery for ambulation was 7.3(range, 3~16) days. Post-operatively, there was no surgical infection, periprosthetic fracture or loosening. Dislocation occurred in one out of six cases. Conclusion: Resection of proximal femur and tumor prosthesis replacement for metastatic bone tumors around proximal femur extensively involving trochanteric area seems to be safe procedure in view of post-operative complication, and effective for functional restoration as well as pain relief. Thus, it is accordant to the treatment principle of the metastatic bone tumors.

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Reliability and Validity of the Fatigue Severity Scale among University Student in South Korea (대학교 재학생에서 Fatigue Severity Scale의 신뢰도 및 타당도 연구)

  • Lee, Junghyun H.;Jeong, Hyeonseok S.;Lim, Soo Mee;Cho, Han Byul;Ma, Ji-Young;Ko, Eun;Im, Jooyeon J.;Lee, Sun Hea;Bae, Sujin;Lee, Yu-Jin;Lyoo, In Kyoon;Jeong, Do-Un
    • Korean Journal of Biological Psychiatry
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    • v.20 no.1
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    • pp.6-11
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    • 2013
  • Objectives There are only a limited number of studies on instruments assessing fatigue in university students, although fatigue exerts negative influences on their health and academic performances and fatigue-related complaints are more frequently reported in young adults than middle-aged adults. The aim of this study was to validate the 9-item Fatigue Severity Scale (FSS) among university students including both undergraduate and graduate students in South Korea. Methods A total of 176 university students completed a battery of self-report questionnaires, including the FSS, the Brief Fatigue Inventory (BFI), the Beck Depression Inventory-II (BDI-II), the Beck Anxiety Inventory (BAI), the Medical Outcomes Study Short Form 36 version 2 (MOS-SF36v2), and the Inclusion of Community in the Self Scale (ICS). The data were collected from February of 2012 to June of 2012. The reliability, convergent validity, divergent validity, and exploratory factor analyses were conducted to assess psychometric properties of the FSS. Results The mean FSS score was 3.20 (standard deviation = 1.43). The FSS demonstrated an excellent internal consistency (Cronbach's ${\alpha}$ = 0.93) and item-total correlations ranged from 0.56 to 0.90. Correlations of the FSS with the BFI (r = 0.71, p < 0.01), BDI-II (r = 0.54, p < 0.01), BAI (r = 0.46, p < 0.01), MOS-SF36v2 physical component summary (r = -0.28, p < 0.01), MOS-SF36v2 mental component summary (r = -0.55, p < 0.01), and ICS (Spearman's rho = -0.07, p = 0.33) showed acceptable convergent and divergent validity. Exploratory factor analysis defined one underlying factor (eigenvalue = 5.67) that explained 93.50% of the total variance. Conclusions To the best of our knowledge, this is the first study to investigate reliability and validity of the FSS in university students. The FSS exhibits good psychometric properties for evaluation of fatigue among university students in South Korea. Since the FSS is easy to administer, score, and interpret, it could be a useful tool in research and practice for assessing fatigue among university students.

Evaluation of Fabricated Semiconductor Sensor for Verification of γ-ray Distribution in Brachytherapy (근접치료용 방사성 동위원소의 선량분포 확인을 위한 디지털 반도체 센서의 제작 및 평가)

  • Park, Jeong-Eun;Kim, Kyo-Tae;Choi, Won-Hoon;Lee, Ho;Cho, Sam-Joo;Ahn, So-Hyun;Kim, Jin-Young;Song, Yong-Keun;Kim, Keum-bae;Huh, Hyun-Do;Park, Sung-Kwang
    • Progress in Medical Physics
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    • v.26 no.4
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    • pp.280-285
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    • 2015
  • In radiation therapy fields, a brachytherapy is a treatment that kills lesion of cells by inserting a radioisotope that keeps emitting radiation into the body. We currently verify the consistency of radiation treatment plan and dose distribution through film/screen system (F/S system), provide therapy after checking dose. When we check dose distribution, F/S systems have radiation signal distortion because there is low resolution by penumbra depending on the condition of film developed. In this study, We fabricated a $HgI_2$ Semiconductor radiation sensor for base study in order that we verify the real dose distribution weather it's same as plans or not in brachytherapy. Also, we attempt to evaluate the feasibility of QA system by utilizing and evaluating the sensor to brachytherapy source. As shown in the result of detected signal with various source-to-detector distance (SDD), we quantitatively verified the real range of treatment which is also equivalent to treatment plans because only the low signal estimated as scatters was measured beyond the range of treatment. And the result of experiment that we access reproducibility on the same condition of ${\gamma}$-ray, we have made sure that the CV (coefficient of variation) is within 1.5 percent so we consider that the $HgI_2$ sensor is available at QA of brachytherapy based on the result.

Accuracy Evaluation of Treatment Planning System Using Irregular-surface Water Phantom (요철 표면 팬텀을 이용한 치료계획시스템 선량계산 정확성 평가)

  • Jeong, Dong-Hyeok;Kim, Ki-Hwan;Lee, Kang-Kyoo;Moon, Sun-Rock;Kim, Jhin-Kee;Shin, Kyo-Chul;Oh, Young-Kee;Kim, Jeung-Kee;Cho, Moon-June;Kim, Jun-Sang
    • Progress in Medical Physics
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    • v.19 no.2
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    • pp.131-138
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    • 2008
  • We evaluated on the calculation accuracy of treatment planning system (TPS) with phantom having convex and concave surface. The TPS is Eclipse (Varian, USA) using both algorithms AAA and PBC for photon dose calculations. PBC algorithms have three corrections of Batho, modified Batho (M-Batho), and equivalent TAR (E-TAR). The field sizes were $10{\times}10\;cm^2$ and $20{\times}20\;cm^2$, and MLC-shaped fields for these fields. We measured doses at three depths 5, 10 and 15cm in phantom of SSD=90cm in the condition of inserted farmer chamber. For given conditions, we have calculated dose with these algorithms and compared them with measured doses. In AAA the calculated doses (dose/MU) were agreed to measured doses within ${\pm}1%$ in flat and convex surface and were under estimated with -1.9% maximum in concave surface. In PBC the calculated doses were over estimated with +1.7% and +4.1% respectively in flat and convex surface and the differences were from -3.1% to +2.1% in concave surface. In comparison of criteria from AAPM and IAEA reports, and statistical analysis for these results, it is found that the AAA's results are in good agreement with measured values and the M-Batho's results are generally good agreed with measured values among PBC algorithms.

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Effects of Korean Ginseng, Korean Red Ginseng and Fermented Korean Red Ginseng on Cerebral Blood Flow, Cerebrovascular Reactivity, Systemic Blood Pressure and Pulse Rate in Humans (인삼, 홍삼 및 발효 홍삼이 정상인의 뇌혈류, 평균혈압, 맥박수에 미치는 영향)

  • Jeong, Dong-Won;Hong, Jin-Woo;Shin, Won-Jun;Park, Young-Min;Jung, Jae-Han;Kim, Chang-Hyun;Min, In-Kyu;Park, Seong-Uk;Jung, Woo-Sang;Park, Jung-Mi;Go, Chang-Nam;Cho, Ki-Ho;Moon, Sang-Kwan
    • The Journal of Korean Medicine
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    • v.27 no.3 s.67
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    • pp.38-50
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    • 2006
  • Objectives: The aim of this study was to evaluate the effects of Korean ginseng (KG), Korean red ginseng (KRG) and fermented Korean red ginseng (FKRG) extracts on cerebral hemodynamics and to compare distinction of each extract. Methods: Ten healthy male volunteers $(26.0{\pm}1.8yrs)$ participated in the study according to double-blind and cross-over protocols. Each volunteer was blindly administered 500mg of KG, KRG, FKRG extract or placebo (Dextrin). Blinded researchers measured changes of hyperventilation-induced cerebrovascular reactivity (CVR), mean blood flow velocity (MBFV) of middle cerebral arteries (MCAs) and corrected blood flow velocity at $P_{ETCO2}=40mmHg$ (CV40) using transcranial Doppler ultrasound (DWL Co., Germany). Researchers also observed changes of mean blood pressure (MBP), pulse rate (PR) and expiratory $CO_2$ using S/5 Collector (Datex-Ohmeda Co., Finland). The evaluation was performed at basal condition, and repeated at 1, 2, 3, 4 and 5 hours after administration. Results: MBFV and CV40 in the KRG group tended to rise at I hour after administration, while those of the FKRG group tended to rise at 2 hours after administration. CVR increased significantly after 1 hour in the KRG group (p=0.009) and after 2 hours in the FKRG group (p=0.035), respectively. The KG group showed increasing tendency at 4 hours after administration. No group showed significant difference from the placebo in changes of MBP and PR. Conclusions: It is suggested that KG, KRG and FKRG extracts have effects of enhancing CVR and thus of increasing cerebral blood flow in human subjects.

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Antibody persistence after Haemophilus influenzae type b (Hib) primary vaccination and response to boosters in Korean children (한국 소아에서 Haemophilus influenzae type b (Hib) 기초 예방 접종 후 항체 지속과 추가 접종에 대한 반응)

  • Lee, Hyunju;Park, So Eun;Lim, Soo Young;Choi, Kyong Min;Lee, Hoan Jong;Kim, Kyung Hyo
    • Clinical and Experimental Pediatrics
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    • v.50 no.5
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    • pp.449-456
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    • 2007
  • Purpose : Antibody persistence after primary series of Haemophilus influenzae type b (Hib) vaccine and responses to a boosters are little known in Korean children. We performed this study to evaluate the antibody titer in relation with a booster immunization of Hib vaccine in Korean children. Methods : One hundred forty-four children aged 12-23 months old were enrolled in three university hospitals. The immunogenicity of a boosters with Hib vaccine was assessed in children previously primed with Hib vaccine. Antibody persistence was also assessed in children who had received 3 doses of Hib vaccine without a booster. Anti-polyribosylribitol phosphate (PRP) IgG antibody levels and bactericidal titers were determined by enzyme immunoassay and bactericidal assay at the Center for Vaccine Evaluation and Study, Medical Research Institute, Ewha Womans University. Results : Prior to a booster in the second year of life, geometric mean antibody concentrations were $2.39{\mu}g/mL$ and the percent of subjects who had a anti-PRP antibody level ${\geq}1{\mu}g/mL$ was 68.6%. After boosting, antibody concentration was $19.09{\mu}g/mL$ and the percent of subjects who had a anti-PRP antibody level ${\geq}1{\mu}g/mL$ was 96.5%, which reflects previous immune priming. In subjects who had finished primary immunization only, the bactericidal titer was 3,946 and in subjects who had a booster, it was 11,205. Anti-PRP antibody level was correlated with serum bactericidal titer. Conclusion : Many children aged 12-23 month old still had protective antibodies after recommended primary immunization only. A booster dose seemed to induce good anamnestic antibody responses in Korean children.

Evaluation of the dose distribution in Mapcheck using Enhanced Dynamic Wedge (Enhanced Dynamic Wedge를 사용한 Mapcheck에서의 선량분포 평가)

  • Kang, Su-Man;Jang, Eun-Sun;Lee, Byung-Koo;Jung, Bong-Jae;Shin, Jung-Sub;Park, Cheol-Woo
    • Journal of the Korean Society of Radiology
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    • v.6 no.5
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    • pp.343-349
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    • 2012
  • Intensity Modulated Radiotherapy (IMRT) is increasing its use recently due to its benefits of minimizing the dose on surrounding normal organs and being able to target a high dose specifically to the tumor. The study aims to measure and evaluate the dose distribution according to its dynamic changes in Mapcheck. In order to verify the dose distribution by EDW angle($10^{\circ}$,$15^{\circ}$,$20^{\circ}$,$25^{\circ}$,$30^{\circ}$,$45^{\circ}$,$60^{\circ}$), field size (asymmetric field) and depth changes (1.5 cm, 5.0 cm) using IMRT in Clinac ix, a solid phantom was placed on the Mapcheck and 100MU was exposed by 6 MV, 10MV X-ray. Using a 6MV, 10MV energy, the percentage depth dose according to a dynamic changes at a maximum dose depth (1.5 cm) and at 5.0 cm depth showed the value difference of maximum 0.6%, less than 1%, which was calculated by a treatment program device considering the maximum dose depth at the center as 100%, the percentage depth dose was in the range between 2.4% and 7.2%. Also, the maximum value difference of a percentage depth dose was 4.1% in Y2-OUT direction, and 1.7% in Y1-IN direction. When treating a patient using a wedge, it is considered that using an enhanced dynamic wedge is effective to reduce the scattered dose which induces unnecessary dose to the surroundings. In particular, when treating a patient at clinic, a treatment must be performed considering that the wedge dose in a toe direction is higher than the dose in a heel direction.

Assessment of Patency of Coronary Artery Bypass Grafts Using Segmented K-space Breath-hold Cine Cardiovascular Magnetic Resonance Imaging: A Clinical Feasibility Study (호흡멈춤상태에서 K-space분할 CINE 자기공명 영상기법을 이용한 관상동맥우회로의 혈류개방성의 검사)

  • Oh-Choon Kwon;Sub Lee;Jong-Ki Kim
    • Investigative Magnetic Resonance Imaging
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    • v.7 no.1
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    • pp.22-30
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    • 2003
  • Purpose : The efficacy of magnetic resonance imaging for evaluating coronary artery disease has been reported. In this study, we evaluated the usefulness of breath-hold segmented K-space cine MR imaging for evaluating the patency of coronary artery bypass grafts (CABG). Materials and Method s : Thirty eight patients with a total of 92 CABGs (36 internal thoracic arteries and 56 saphenous vein grafts) were evaluated using segmented K-space cardiac-gated fast gradient echo sequence (2D-FASTCARD) MR imaging. MR magnitude images were evaluated from the hard copies by two independent observers. A graft was defined as patent if it was seen as a bright small round area on at least two consecutive images throughout the cardiac cycle at a position consistent with the expected location for that graft. Results : MR images were obtained successfully for 23 patients (61%). The sagittal planes were most helpful in visualizing the cross-section of sapheneous vein bypass graft to left circumflex artery branch, whereas the transverse planes were used for identification of internal mammary artery grafts to left anterior descending coronary artery or its branch and identification of saphenous vein grafts to right coronary artery. Forty five grafts were visible using this MR technique, while the grafts were not visible on seven saphenous vein grafts and two internal mammary artery grafts. In two patients showing symptoms of myocardial ischemia, one or two bypass grafts were not visible. Imaging, perpendicular plane to a CABG was important to visualize the flow inside the CABG with maximum sensitivity. Conclusion : Evaluation of patency of the bypass graft was clinically feasible by 2D-FASTCARD MR imaging, whereas any invisible bypass grafts should be further studied by contrast-enhanced MR angiography or by conventional angiography for confirmation of abnormalities.

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Comparison of the Clinical Performance between Two Pulse Oximeters in NICU: Nellcor $N-595^{(R)}$ versus Masimo $SET^{(R)}$ (신생아 중환자실에서 맥박산소측정기의 감지도 비교: Nellcor $N-595^{(R)}$ versus Masimo $SET^{(R)}$)

  • Lee, Heun-Ji;Choi, Jang-Hwan;Min, Sung-Ju;Kim, Do-Hyun;Kim, Hee-Sup
    • Neonatal Medicine
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    • v.17 no.2
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    • pp.245-249
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    • 2010
  • Purpose: Numerous false alarms by pulse oximetry, which is widely used in neonatal intensive care unit, can delay response to true alarms. Masimo $SET^{(R)}$ was introduced lately, to overcome false alarms by motion. We compared the clinical performance of two devices (Nellcor $N-595^{(R)}$ and Masimo $SET^{(R)}$) for the evaluation of the false alarm frequency during usual motion artifacts and stable state. Methods: A total of 20 preterm infants weighing 1,000-2,500 g were enrolled in the study. The sensors of two devices were placed on the different feet on the same infants, and both devices were programmed to emit an alarm for episode of hypoxemia (SpO2$\leq$85%). The false alarms were defined as episodes of poor correlation with ECG heart rate, poor waveforms, and the absence of obvious signs of hypoxia. We compared the frequency of false alarms between the two devices. Results: The mean chronological age was 20.8 days and the mean body weight was 1,668 g on the study day. The frequency of total false alarm was significantly fewer for Masimo $SET^{(R)}$ pulse oximetry (48 in Nellcor $N-595^{(R)}$, 27 in Masimo $SET^{(R)}$) although the false alarm during usual motion artifacts was not significantly between two devices (32 in Nellcor $N-595^{(R)}$, 19 in Masimo $SET^{(R)}$). Conclusion: The Masimo $SET^{(R)}$ pulse oximetry has fewer false alarm rates and identified more true hypoxic events than Nellcor $N-595^{(R)}$ pulse oximetry. Therefore, it is useful for adequate oxygen therapy and helps to decrease unnecessary handling by clinicians and nurses.