• Journal of radiological science and technology
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• v.37 no.4
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• pp.331-339
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• 2014

To test feasibility of proton arc therapy (PAT) in the treatment of para-aortic lymph node tumor and compare its dosimetric properties with advanced radiotherapy techniques such as intensity modulated radiation therapy (IMRT) and conventional 3D conformal proton beam therapy (PBT). The treatment plans for para-aortic lymph node tumor were planned for 9 patients treated at our institution using IMRT, PBT, and PAT. Feasibility test and dosimetric evaluation were based on comparisons of dose volume histograms (DVHs) which reveal mean dose, $D_{30%}$, $D_{60%}$, $D_{90%}$, $V_{30%}$, $V_{60%}$, $V_{90%}$, organ equivalent doses (OEDs), normal tissue complication probability (NTCP), homogeneity index (HI) and conformity index (CI). The average doses delivered by PAT to the liver, kidney, small bowel, duodenum, stomach were 7.6%, 3%, 17.3%, 26.7%, and 14.4%, of the prescription dose (PD), respectively, which is higher than the doses delivered by IMRT (0.4%, 7.2%, 14.2%, 15.9%, and 12.8%, respectively) and PBT (4.9%, 0.5%, 14.12%, 16.1% 9.9%, respectively). The average homogeneity index and conformity index of tumor using PAT were 12.1 and 1.21, respectively which were much better than IMRT (21.5 and 1.47, respectively) and comparable to PBT (13.1 and 1.23, respectively). The result shows that both NTCP and OED of PAT are generally lower than IMRT and PBT. This study demonstrates that PAT is better in target conformity and homogeneity than IMRT and PBT but worse than IMRT and PBT for most of dosimetric factor which indicate that PAT is not recommended for the treatment of para-aortic lymph node tumor.

• Radiation Oncology Journal
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• v.21 no.3
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• pp.216-221
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• 2003

Purpose: To investigate the modulation of radiosensitivity by celecoxib, a selective cyclooxygenase-2 (COX-2) inhibitor, on cancer cells over- and under-expressing COX-2. Materials and Methods: A clonogenic radiation survival analysis was performed on A549 human lung and MCF-7 human breast cancer cell lines incubated in both 1 and $10\%$ fetal bovine serum (FBS) containing media. The apoptosis in both cell lines was measured after treatment with radiation and/or celecoxib. Results: Celecoxib enhanced the radiation sensitivity of the A549 cells in the medium containing the $10\%$ FBS, with radiation enhancement ratios of 1.58 and 1.81 respectively, at surviving fractions of 0.1, with $30\muM\;and\;50\muM$ celecoxib. This enhanced radiosensitivity disappeared in the medium containing the $1\%$ FBS. Celecoxib did not change the radiation sensitivity of the MCF-7 cells in either media. The induction of apoptosis by celecoxib and radiation was not synergistic in either cell line. Conclwsion: Celecoxib, a selective COX-2 inhibitor, preferentially enhanced the effect of radiation on COX-2 over-expressing cancer cells compared to the cells with a low expression, and this effect disappeared on incubation of the cells during drug treatment in the medium with suboptimal serum concentration. Apoptosis did not appear to be the underlying mechanism of this radiation enhancement effect due to celecoxib on the A549 cells. These findings suggest radiosensitization by a selective COX-2 inhibitor is COX-2 dependent.

• Journal of East-West Nursing Research
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• v.7 no.1
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• pp.68-81
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• 2002

The purpose of this study is to analyze the type of ego states and stress coping style on female college students who are in the course of nursing study. This study is performed in the view of Transactional Analysis and designed to scrutinize descriptive correlations between the type of ego states and stress coping style. The subject is consists of 144 freshmen and sophomore, 138 junior and senior students group, who are students of K nursing college located in Seoul. The sampling investigation period is on Sept. 14, 2002 to Oct. 26, 2002. The measuring instrument used for Transactional Analysis ego state is 50 items Ego-gram research paper devised by Dusay(1997). For studying coping style, Folkman & Lazarus's measurement(1984) was adopted, which is translated and modified by Han, and Oh,(1990). Health states is adopted by standardized health inspecting instrumental table (Cornell Medical Index:CMI) which is designed for Korean people by Ko and Park(1980) Statistic average and standard deviation were generated by using SPSS PC+, t=test and Pearson correlation. The results were as follows: 1) In the type of ego states on both groups indicated the arithmetic apex NP(maximum value), then the point A was high and the data made a down slope to point AC. In the comparison to type of ego states between two groups, only at point CP, the data value of upper year students represented higher than that of lower year ones by c(t=2.28, p=.023). 2) Stress coping style of whole students were highly and affirmatively dedicated to research. Especially hopeful aspect(t=.67, p=.05), relaxation of tension(t=-2.16, p=.03) made significant difference each other in the view of arithmetic calculation. 3) In view of nursing students' physical health states, there is significant difference in past history(t=2.50, p=.013) and in case of mental health states, there are considerable discrepancies between lower group(73.52) and upper group(75.11)(p<.05). In view of all field, state of tension(t=2.13, p=.048) has difference. 4) While verifying coping style in terms of ego states level between lower and upper students group, In type CP, high level ego states group indicated significant difference on stress coping style area than low leveled group and made such sequences as the central point of problem, In type NP, sequences such as the central point of problem, In type A, the central point of problem, In type FC, hopeful aspect and In type AC, hopeful aspect and indifference were derived significantly different (p<.05). 5) While verifying health state differences in the level of lower and upper ego states, In type FC, low level group(150.29) marked higher point than upper group(145.19), there is remarkable discrepancy and so did whole health state(p=.014), In type AC both mental state(p=.000) and whole health state (p=.015) showed differences. 6) When analyzing correlations between whole students' ego states, copying style and health state, all type of ego state showed differences(p<.001). In correlations between ego state and health state, in type FC physical state had an apex and there are inverse correlations among the other types. Especially, type FC showed inverse correlations with great discrepancies(p<.05). In mental state, type NP(${\gamma}=.198$, p<.001) and type A(${\gamma}=.166$, p<.05) represented straight correlations with remarkable differences. Especially, In type AC showed inverse correlations(${\gamma}=.282$, p<.001). In case of correlations between copying style and health state, indifference(${\gamma}=-.157$) and relaxation of tension(${\gamma}=-.158$) presented great difference(p<.05). In mental state, central point of problem and search for social support showed straight correlations with great discrepancies(p<.05), hopeful aspect and indifference showed inverse correlations with considerable differences(p<.001).

• Journal of Hospice and Palliative Care
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• v.13 no.1
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• pp.13-23
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• 2010

Purpose: This study was to identify the role of general hospice palliative nurse through job analysis (duties, task, and task elements). Methods: The sample consisted of 136 nurses or professors who were performing duties related to hospice care areas in Korea. A survey method was used, and the questionnaire included frequencies, criticality, and difficulties of task elements in job description by the DACUM method. Descriptive statistics were performed by using SPSS WIN 17.0. Results: The job description of general hospice palliative nurse was identified 8 duties, 36 tasks, and 137 task elements. As for the 8 duties, the average scores of frequency, criticality, and difficulty were 2.94, 3.66, and 2.80, respectively. The role of ‘pain assessment’ was the most important task element among frequency and criticality. The lowest score at the frequency and criticality were ‘manage public finance’ and ‘collect datum through diagnostic test & lab', respectively. Furthermore, the role of 'identify spiritual needs of patients and family' was the most difficult task, whereas the role of 'manage documents and information' was the least. Conclusion: In this study, we could recognize the reality of general hospice palliative nurse's performances. For general hospice palliative nurse, therefore, concrete practice guide lines of psychosocial and spiritual care, communication skills, and bereavement care with qualifying system are critically needed.

• Journal of Preventive Medicine and Public Health
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• v.32 no.3
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• pp.383-394
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• 1999

Objectives: This study was conducted to identify the factors influencing the mortality of Koreans over the age of 40 by a nested case-control study. Methods: The cohort consisted of the beneficiaries of Korea Medical Insurance Corporation for Government Employees & Private School Teachers and Staff(KMIC) who received health examinations of KMIC in 1992 and 1993 retrospectively. At that time, they were more than 40 years old. The cases were 19,258 cohort members who had died until December 31, 1997. The controls were 19,258 cohort members who were alive until December 31, 1997. Controls were matched with age and sex distribution of the cases. The data used in this study were the funeral expenses requesting files, and the files of health examinations and health questionnaires gathered in 1992 and 1993. To assess the putative risk factors of death, student t-test, chi-square test, multiple logistic regression analysis were used. Results : In multiple logistic regression analysis, independent risk factors of death were as follows; systolic blood pressure, diastolic blood pressure, blood glucose, AST, urine glucose, urine protein, alcohol drinking(frequency), cigarette smoking and perceived health status, intake of restoratives and blood transfusion showed positive associations with death; coffee consumption showed negative associations with death; and body mass index and serum total cholesterol showed J-shaped association with death. Conclusions: Regarding the direction of association, the result of analysis on the data restricted to '96-'97 was same as that of '93-'97. But in some variables such as obesity, serum cholesterol, the odds ratios of death in the data of '96-'97 were higer than those of '93-'94, which suggested that the data of '93-'94 was bearing effect-cause relationship. We concluded that it suggested further researches using long-term follow-up data to be needed in this area.

• Journal of Nutrition and Health
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• v.31 no.8
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• pp.1295-1306
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• 1998

Recent research indicates that the n-3 fatty acid , docosahexaenoic acid(22 : 6n 3, DHA) plays an essential role in infant brain development . DHA is highly concentrated in brain and retinal tissues and accumulates during late fetal and early neonatal life. Diets deficient in DHA are associated with reduced levels of DHA in brain and retinal tissues. The purpose of this study is to investigate the long term effects of DHA supplementation on the growth and mental development of full-term infants. THirty four healty infants were recruited from those who were delivered at Kyung Hee Medical Center. The experimental groups were the breast milk+DHA(-) group who were fed human milk for 20 weeks after birth and thereafter were fed placebo formula for 28 weeks, the breast milk+DHA(+) group who were fed human milk for 20 weeks after birth and thereafter were fed DHA supplemented formula for 28 weeks, DHA(-) group who were fed placebo formula for 48 weeks, and DHA(+) group who were fed DHA supplemented formula for 48 weeks. The daily average intake of DHA for the breast milk+DHA(-) , breast milk+DHA(+), DHA(-) and DHA(+) groups were 39.1mg, 89.9mg, 17.7mg, and 160.224mg, respectively. The results showed that measurements of infant weight, length, head, and chest circumferncewere all in normal range and they were not influenced by the DHA supplements in their diets. There was a significant correlation between dietary DHA intake and erythrocyte DHA level. The results of flash visual evoke potential (VEP) test were not correlated with eerythrocyte DHA and dietary DHA levels at 48 weeks of age. No differences were found in Bayley mental and Psychomotor Development lndex scores among the four experimental groups at 48 weeks of age. Unlike the short-term effects there was no long-term effect of relatively small amounts of dietary DHA supplements on the scores for flash VEP and Bayley test, even thour호 there was an elevated DHA supplements on the scores for flash VEP and Bayley test, even through there was an elevated DHA content in the infants erythrocytes.

• Journal of radiological science and technology
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• v.30 no.1
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• pp.53-59
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• 2007

A safety management rule of the diagnosis radiation system which opened a court 2006 February 10th was promulgated for safety of the radiation worker, patients and patients' family members. The purpose of this study is to minimize injury by radiation that can happen to patients and people around a sick ward when managing mobile X-ray system. This study analyzed sickroom environment of mobile X-ray examination and the statistical data of the Konkuk medical Information System(KIS) and the Picture Archiving Communication System(PACS). This study also investigated patient conditions, infection, relation information and related data, when the sickroom mobile X-ray examination is used. Through data analysis, many problems were expected such as restriction of space side, manpower and expense of business side, satisfaction degree decline of patient and protector of operation side. Therefore, we tried to restrict examination of multi bed sickroom, and to use treatment room in each ward to solve problem mentioned. As a result, the whole sickroom mobile X-ray examination rate decreased to near 50%, and mobile X-ray examination rate for inpatients decreased to more than 85%. This study shows that several attempts we did should be helpful for manpower, patients satisfaction and expenses. Also, they should protect patients in sickroom from unnecessary radiation exposure and could minimize inconvenience of patients and their family members from x-ray examination.

• Radiation Oncology Journal
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• v.9 no.1
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• pp.1-6
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• 1991

The effect of 2-deoxy-d-glucose (2-DDG) on $C_3H$ mouse fibrosarcoma(FSall) was studied. Metabolic status, especially for energy metabolism, was studied using in vivo $^{31}P$-MRS, proliferative capacity was observed on flow cytometry(FC) and growth rate was measured after transplantation of $10^6$ viable tumor cells in the dorsum of foot of $C_3Hf/Sed$ mice. One gram of 2-DDG Per kg of body weight was injected intraperitoneally on 12th day of implantation. Average tumor size on 12th day of implantion was $250mm^3$. Growth rate of Fsall tumor was measured by tumor doubling time and slope on semilog plot. After 2-DDG injection, growth rate slowed down. Tumor doubling time between tumor age 5-12 days was 0.84 days with slope 0.828 and tumor doubling time between tumor age 13-28 days was 3.2 days with slope 0.218 in control group. After 2-DDG injection, tumor doubling time was elongated to 5.1 days with slope 0.136. The effect of 2-DDG studied in vivo $^{31}P$-MRS suggested that the increase of phosphomonoester (PME) and inorganic phosphate (Pi) by increasing size of tumor, slowed down after 2-DDG injection. Flow cytometry showed significantly increased S-phase and $G_2+M$ phase fraction suggesting increased proliferative capacity of tumor cells in the presence of 2-DDG. Authors observed an interesting effect of 2-DDG on FSall tumor and attempt to utilize as an adjunct for radiotherapy.

• Radiation Oncology Journal
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• v.10 no.1
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• pp.27-34
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• 1992

Cis-Platinum (DDP) was utilized as a radiosensitizer in a pilot study for stage III and IV squamous cell carcinoma between 1984-1987, and DDP 20 $mg/M^2$/day was administered for 4 days at 3 week interval with concurrent radiotherapy. This study consisted of three phases: cytoreduction phase, eradicative treatment phase and adjuvant phase. Total 59 patients were subjected to evaluate a tumor response and its toxicity. During the eradicative phase,27 patients underwent surgery (group I ), 29 patients were treated with radiotherapy only (group II) and 3 patients did not complete the second phase of therapy. At the cytoreduction phase, $95\%$ response rate with complete response (CR) $47.5\%$ and partial response (PR) $47.5\%$ was observed. Complete tumor clearance (CTC) rate following 2nd phase of therapy was $84\%$ (47/56) with 26/27($96\%$) in group I achieved CTC with surgery and 21/29 ($72\%$) patients In group II achieved CTC following 2nd phase. $67\%$ of primary lesions and $70\%$ of nodal diseases in group I showed no tumor in the surgical specimen. $34\%$ of patiets who achieved CTC at 2nd phase developed recurrence and median time to recur was 8 months. Actuarial disease free survival at 4 years was $59\%$ and $51\%$(24/27) of patients who achieved CTC at 2nd phase were alive without any evidence of disease at median follow-up 31 months (range, 10-48 months). There was no significant difference in overall and disease free survival between group I and II between CR and PR group following 1st Phase. Only significant Prognostic factor in this study was the complete tumor clearance following 2nd phase theapy. In general, toxicity was not excessive. Author concludes that this study confirmed the significant radiosensitizing effect of DDP with the acceptable toxicity and warrant the prospective study to determine optimum scheduling for DDP and radiotherapy which maximizes the therapeutic gain.

• Journal of Biomedical Engineering Research
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• v.24 no.2
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• pp.133-140
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• 2003

In this study, muscle activity was measured using surface EMG (sEMG) during a voluntary maneuver (ankle dorsiflexion) in the supine position was compared pre and post gait training. Nine patients with incomplete spinal cord injury participated in a supported treadmill ambulation training (STAT), twenty minutes a day, five days a week for three months. Two tests, a gait speed test and a voluntary maneuver test, were made the same day, or at least the same week, pre and post gait training. Ten healthy subjects' data recorded using the same voluntary maneuvers were used for the reference. sEMG measured from ten lower limb muscles was used to observe the two features of amplitude and motor control distribution pattern, named response vector. The result showed that the average gait speed of patients increased significantly (p〈0.1) from 0.47$\pm$0.35 m/s to 0.68$\pm$0.52 m/s. In sEMG analysis, six out of nine patients showed a tendency to increase the right tibialis anterior activity during right ankle dorsiflexion from 109.7$\pm$148.5 $mutextrm{V}$ to 145.9$\pm$180.7 $mutextrm{V}$ but it was not significant (p〈0.055). In addition, only two patients showed increase of correlation coefficient and total muscle activity in the left fide during left dorsiflexion. Patients' muscle activity changes after gait training varied individually and generally depended on their muscle control abilities of the pre-STAT status. Response vector being introduced for quantitative analysis showed good Possibility to anticipate. evaluate, and/or guide patients with SCI, before and after gait training.