• Title/Summary/Keyword: Organ size

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Surgical outcome and risk scoring to predict survival after hepatic resection for hepatocellular carcinoma with portal vein tumor thrombosis

  • Tae-Seok Kim;Kwangho Yang;Gi Hong Choi;Hye Yeon Yang;Dong-Sik Kim;Hye-Sung Jo;Gyu-Seong Choi;Kwan Woo Kim;Young Chul Yoon;Jaryung Han;Doo Jin Kim;Shin Hwang;Koo Jeong Kang
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.28 no.2
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    • pp.134-143
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    • 2024
  • Backgrounds/Aims: The hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) is classified as the advanced stage (BCLC stage C) with extremely poor prognosis, and in current guidelines is recommended for systemic therapy. This study aimed to evaluate the surgical outcomes and long-term prognosis after hepatic resection (HR) for patients who have HCC combined with PVTT. Methods: We retrospectively analyzed 332 patients who underwent HR for HCC with PVTT at ten tertiary referral hospitals in South Korea. Results: The median overall and recurrence-free survival after HR were 32.4 and 8.6 months, while the 1-, 3-, and 5-year overall survival rates were 75%, 48%, and 39%, respectively. In multivariate analysis, tumor number, tumor size, AFP, PIVKA-II, neutrophil-to-lymphocyte ratio, and albumin-bilirubin (ALBI) grade were significant prognostic factors. The risk scoring was developed using these seven factors-tumor, inflammation and hepatic function (TIF), to predict patient prognosis. The prognosis of the patients was well stratified according to the scores (log-rank test, p < 0.001). Conclusions: HR for patients who have HCC combined with PVTT provided favorable survival outcomes. The risk scoring was useful in predicting prognosis, and determining the appropriate treatment strategy for those patients who have HCC with PVTT.

Experiences of the First 130 Patients in Gangnam Severance Hospital (강남세브란스병원 토모테라피를 이용한 치료환자의 130예 통계분석 및 경험)

  • Ha, Jin-Sook;Jeon, Mi-Jin;Kim, Sei-Joon;Kim, Jong-Dae;Shin, Dong-Bong
    • The Journal of Korean Society for Radiation Therapy
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    • v.20 no.1
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    • pp.45-53
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    • 2008
  • Purpose: We are trying to analyze 130 patients' conditions by using our Helical Tomotherapy, which was installed in our center in Oct. 2007. We will be statistically approach this examination and analyze so that we will be able to figure out adaptive plans according to the change in place of the tumor, GTV (gross tumor volume), total amount of time it took, vector (${\upsilon}=\surd$x2+y2+z2) and the change in size of the tumor. Materials and Methods: Objectives were the patients who were medicated with Tomotherapy in our medical center since Oct. 2007 August 2008. The Average age of the patients were 53 years old (Minimum 25 years old, Maximum 83 years old). The parts of the body we operated were could be categorized as Head&neck (n=22), Chest (n=47), Abdomen (n=25), Pelvis (n=11), Bone (n=25). MVCT had acted on 2702 times, and also had acted on our adaptive plan toward patients who showed big difference in the size of tumor. Also, after equalizing our gained MVCT and kv-CT we checked up on the range of possible mistake, using x, y, z, roll and vector. We've also investigated on Set-up, MVCT, average time of operation and target volume. Results: Mean time on table was 22.8 minutes. Mean treatment time was 13.26 minutes. Mean correction (mm) was X=-0.7, Y=-1.4, Z=5.77, roll=0.29, vector=8.66 Head&neck patients had 2.96 mm less vector value in movement than patients of Chest, Abdomen, Bone. In increasing order, Head&neck, Bone, Abdomen, Chest, Pelvis showed the vector value in movement. Also, there were 27 patients for adaptive plan, 39 patients, who had long or multiple tumor. We could know that When medical treatment is one cure plan, it takes 32 minutes, and when medical treatment is two cure plan, it takes 40 minutes that one medical treatment takes 21 minutes, and the other medical treatment takes 19 minutes. Conclusion:With our basic tools, we could bring more accurate IMRT with MVCT. Also, through our daily image, we checked up on the change in tumor so that adaptive plan could work. It was made it possible to take the cure of long or multiple tumor, the cure in a nearby OAR, and the complicated cure that should make changes of gradient dose distribution.

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A Study of Dose Stability at Low Monitor Unit Setting for Multiple Irradiated Field (다중 조사면 치료 시 기계적 입력치(MU)에 따른 선량적 안정성에 대한 연구)

  • Kim Joo-Ho;Lee Sang-Gyu;Shin Hyun-Kyung;Lee Suk;Na Soo-Kyung;Cho Jung-Hee;Kim Dong-Wook
    • The Journal of Korean Society for Radiation Therapy
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    • v.17 no.2
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    • pp.155-160
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    • 2005
  • Purpose : Many authors have been introduced field in field technique and 3-D conformal radiotherapy that increased the tumor dose as well as decreased the dose of abutting critical organ. These technique have multiple beam direction and small beam segments even below 10 MU(monitor unit)for each field. we have confirmed the influence of low MU on dose output and beam stability. Materials and Methods : To study the dose output, the dose for each field was always 90MU, but it divided into different segment size: 1, 2, 3, 5, 10, 15 segments, 90, 45, 30, 18, 9, 6 MU the measurements were carried out for X-ray energy 4 MV, 6 MV, 10 MV of three LINAC(Varian 600C, 2100C, 2100C, 2100C/D), in addition each measurement was randomly repeated three times for each energy. To study the field symmetry and flatness, X-omat V films were irradiated. After being developed, films were scanned and analyzed using densitometer. Results : Influence of low MU on dose is slightly more increase output about $1.2{\sim}2.9%$ in cGy/mu than 90MU, but may not changed beam quality(flatness or symmetry), Output stability depends on dose rate(PRF)rather than beam energy, field size. Conclusion : Presented result are under the limits(out put<3%, flatness<${\pm}3%$, symmetry<2%). The 3 accelerators are safe to use and to perform conformal radiotherapy treatments in small segments, small MU around 10MU. but Even if the result presented here under the limits, continuous adjustments and periodic QA should be done for use of small MU

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Status and Characteristics of the Newly Established Cooperatives in Agricultural Sector (농업분야 신생 협동조합의 현황과 유형별 특징)

  • Choi, Kyung Sik;Nam, Gi Pou;Hwang, Dae Yong
    • Journal of Agricultural Extension & Community Development
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    • v.21 no.4
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    • pp.967-1006
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    • 2014
  • This study attempted to provide policy recommendations in promoting new cooperatives established in agriculture based on the 2012 Cooperative Act. A questionnaire survey was conducted with 195 newly established cooperatives as the policy target of this study. The new cooperatives were classified as three kinds namely as 'Business' Cooperatives', 'Consumers' Cooperatives', 'Social Cooperatives' based on their member attributes and objectives. Interesting to note that, all of these new cooperatives born by the new Act has taken the marketing business as their main stream business. Among the three types, 'Business Cooperatives' are ranked the highest amount of capital shares per person in average, having about 30 members in size. In categorization, 'Business Cooperatives' include farmer cooperatives as majority and employee cooperatives. They are usually involved in both production and marketing and even in processing activities, and have tried to secure their business performance by e-commerce and stable business contracts. Their diverse activities are highly associated with their local community. Consumers' Cooperatives include consumer cooperatives and stakeholder cooperatives in achieving welfare of members. This type has lower share in capital but has over 30 members in a cooperative, taking marketing (distribution) business as main and often take advantage of their social network and physical store. Regional relationships are less than producer cooperatives. 'Social Cooperatives' are established by public interest and have around 10 members and lowest per capital. their business and community activity is similar to the consumer cooperatives. This study recommends the needs of designing suitable business models by these three types of cooperatives in the future, while appropriating their membership size for their tangible business operations. The government policy direction should aim to develop their new business opportunities and its management stabilization, especially in conjunction with the existing agricultural cooperatives (Nonghyup). It must be rather than to provide simply policy supports for establishment. An in-depth study is recommended in this regard.

Quantitative Evaluation of Gated Radiation Therapy Using Gamma Index Analysis (감마지표 분석을 통한 호흡연동방사선치료의 정량적 평가)

  • Ma, Sun Young;Choi, Ji Hoon;Jeung, Tae Sig;Lim, Sangwook
    • Progress in Medical Physics
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    • v.24 no.3
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    • pp.198-203
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    • 2013
  • Generally, to evaluate gated radiation therapy, moving phantoms are used to simulate organ motion. Since the target moves in every direction, we need to take into account motion in each direction. This study proposes methods to evaluate gated radiation therapy using gamma index analysis and to visualize adequate gating window sizes according to motion ranges. The moving phantom was fabricated to simulate motion in the craniocaudal direction. This phantom consisted of a moving platform, the I'm MatriXX, and solid water phantoms. A 6 MV photon filed with a field size of $4{\times}4cm^2$ was delivered to the phantom using the gating system, while the phantom moved in the 1-, 2-, 3-, 4-, and 5-cm motion ranges. The gating windows were set at 40~60%, 30~40%, and 0~90%, respectively. The I'm MatriXX acquired the dose distributions for each scenario and the dose distributions were compared with a $4{\times}4cm^2$ static filed. The tolerance of the gamma index was set at 3%/3 mm. The greater the gating window, the lower the pass rate, and the greater the motion range, the lower the pass rate in this study. In case treatment without gated radiation therapy for the target with motion of 2 cm, the pass rate was less than 96%. But it was greater than 99% when gated radiation therapy was used. However gated radiation therapy was used for the target with motion greater than 4 cm, the pass rate could not be greater than 97% when gating window was set as 30~70%. But when the gating window set as 40~60%, the pass rate was greater than 99%.

Plant Architecture and Dry Matter Production in Large-Grain Rice Variety (대립벼의 생산구조 특성과 물질생산)

  • 김정곤;전병태;김진기
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.40 no.5
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    • pp.655-661
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    • 1995
  • This study was conducted to get basic information of dry matter production and agronomic characteristics for increasing grain ripening in rice cultivar with large grains. Three cultivars which have different grain size were used. Of the two large grain cultivars, SR7796-3-1-5-1-l(SR7796F$_{7}$) had long culm and SR11269-13-3-4-2(SR11269F$_{6}$) had short culm. On the other hand, Tamjinbyeo was recommended cultivar had medium size of grain and culm. LAI was highest in Tamjinbyeo, followed by the SR11269F$_{6}$ and SR7796F$_{7}$, LAI decrement was higher in large grain cultivars than that of Tamjinbyeo after 20days after heading. Total dry weight(TDW) of areal part was highest in SR11269F$_{6}$, followed by the Tamjinbyeo and SR7796F$_{7}$. Dry weight (DW) of stem (leaf sheath+culm) at harvesting stage was decreased 15%, 12% in Tamjinbyeo, SR11269F$_{6}$, respectively, but was increased 5% in SR7796F$_{7}$ compared to heading stage. In distribution rate of each organ to TDW, distribution rate of leaf blade was low in large grain cultivar, but that of stem in Tamjinbyeo, SR7796F$_{7}$ and SR11269F$_{6}$ was 36%, 38% and 42%, respectively. In canopy architecture leaf blade weight was the highest 30~40cm, 40~50cm and 70~8Ocm above the ground in SR11269F$_{6}$, Tamjinbyeo and SR7796F$_{7}$, respectively. Range of panicle distribution in the canopy was 40cm in Tamjinbyeo, and was 70cm in large-grain cultivars. The results suggest that it has to take a growing interest in developing culture method for increasing LAI during growth stage, especially, around heading, in keeping green leaf till ripening stage and also in growing unformly plant within rice hill in large grain cultivars.cultivars.ltivars.

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Estimation of Internal Motion for Quantitative Improvement of Lung Tumor in Small Animal (소동물 폐종양의 정량적 개선을 위한 내부 움직임 평가)

  • Yu, Jung-Woo;Woo, Sang-Keun;Lee, Yong-Jin;Kim, Kyeong-Min;Kim, Jin-Su;Lee, Kyo-Chul;Park, Sang-Jun;Yu, Ran-Ji;Kang, Joo-Hyun;Ji, Young-Hoon;Chung, Yong-Hyun;Kim, Byung-Il;Lim, Sang-Moo
    • Progress in Medical Physics
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    • v.22 no.3
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    • pp.140-147
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    • 2011
  • The purpose of this study was to estimate internal motion using molecular sieve for quantitative improvement of lung tumor and to localize lung tumor in the small animal PET image by evaluated data. Internal motion has been demonstrated in small animal lung region by molecular sieve contained radioactive substance. Molecular sieve for internal lung motion target was contained approximately 37 kBq Cu-64. The small animal PET images were obtained from Siemens Inveon scanner using external trigger system (BioVet). SD-Rat PET images were obtained at 60 min post injection of FDG 37 MBq/0.2 mL via tail vein for 20 min. Each line of response in the list-mode data was converted to sinogram gated frames (2~16 bin) by trigger signal obtained from BioVet. The sinogram data was reconstructed using OSEM 2D with 4 iterations. PET images were evaluated with count, SNR, FWHM from ROI drawn in the target region for quantitative tumor analysis. The size of molecular sieve motion target was $1.59{\times}2.50mm$. The reference motion target FWHM of vertical and horizontal was 2.91 mm and 1.43 mm, respectively. The vertical FWHM of static, 4 bin and 8 bin was 3.90 mm, 3.74 mm, and 3.16 mm, respectively. The horizontal FWHM of static, 4 bin and 8 bin was 2.21 mm, 2.06 mm, and 1.60 mm, respectively. Count of static, 4 bin, 8 bin, 12 bin and 16 bin was 4.10, 4.83, 5.59, 5.38, and 5.31, respectively. The SNR of static, 4 bin, 8 bin, 12 bin and 16 bin was 4.18, 4.05, 4.22, 3.89, and 3.58, respectively. The FWHM were improved in accordance with gate number increase. The count and SNR were not proportionately improve with gate number, but shown the highest value in specific bin number. We measured the optimal gate number what minimize the SNR loss and gain improved count when imaging lung tumor in small animal. The internal motion estimation provide localized tumor image and will be a useful method for organ motion prediction modeling without external motion monitoring system.

Egg Development and Morphological Change of Larvae and Juveniles of the Starry Flounder, Platichthys stellatus (강도다리, Platichthys stellatus의 난발생과 자치어의 형태발달)

  • Byun, Soon-Gyu;Lee, Bae-Ik;Lee, Jong-Ha;Ku, Hak-Dong;Park, Sang-Un;Yun, Seong-Min;Hwang, Seon-Young;Kim, Yi-Cheong;Han, Hyung-Gyun
    • Korean Journal of Ichthyology
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    • v.19 no.4
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    • pp.350-359
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    • 2007
  • The egg development and morphological change of larvae and juveniles of the starry flounder, Platichthys stellatus were observed in laboratory. Fertilized eggs of the species, 1.09~1.19 mm (mean $1.13{\pm}0.03mm$, n=50) in diameter, were floating, colorless, transparent in shape and lacked in oil globules. The eggs hatched out 121 hours after fertilization at water temperature $8.2{\sim}11.2^{\circ}C$. The size of the hatched larvae were 2.58~2.89 mm (mean $2.67{\pm}0.09mm$) in total length, their mouth and anus were not open yet and myotome number was 14+27=41. Melanophore and xanthophore appeared on the notochord and digestive organ and the margin of membrane fin, on the yolk sac and eyes were lacking in pigment cells. 5 days after hatching the larvae attained 4.30~4.97 mm (mean$4.74{\pm}0.21mm$) in TL, and their mouth and anus were open. 10 days after hatching the larvae transformed to postlarval stage and they were 4.67~5.75 mm in TL (mean $5.30{\pm}0.31mm$), and absorbing the yolk completely. Feeding activity increased as the mouth became larger. At 23 days, the larvae attained 6.69~8.82 mm in TL (mean $7.85{\pm}0.75mm$), and the right eye was started moving to the left side of the head. At 52 days, the juveniles attained 10.99~17.06 mm in TL (mean $13.50{\pm}1.67mm$). The right eye was moved completely onto the left side. All of the fins had completed set of the fin rays (D. 64~67: A. 45~51: P. 11: V. 6: C. 19).

Preliminary Investigations of the Dosimetric Properties of a Normoxic Polymethacrylic Acid Gel Dosimeter Using a Respiration-Motion Simulator (호흡모의움직임장치를 이용한 정상산소 폴리메타크릴산 겔 선량계의 선량특성)

  • Park, Chae Hee;Cho, Yu Ra;Cho, Kwang Hwan;Park, Ji Ae;Kim, Kyeong Min;Kim, Kum Bae;Jung, Hai Jo;Ji, Young Hoon;Kwon, Soo-Il
    • Progress in Medical Physics
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    • v.23 no.3
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    • pp.138-144
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    • 2012
  • Dose distribution throughout the clinical organ range of motion was analyzed using a respiratory-motion simulator that was equipped with a polymer gel dosimeter and EBT2 film. The normoxic polymer gel dosimeter was synthesized from gelatin, MAA, HQ, THPC and HPLC. The gel dosimeter and EBT2 film were irradiated with Co-60 gamma rays that were moved along the x-axis and y-axis in ${\pm}1.5cm$ steps at five-second intervals. The field size was $5{\times}5cm^2$. The SSD was 80 cm and set to 10 Gy at a depth of 2 cm. The PDD at a depth of 50 mm was 75.2% in the ion chamber, 82.3% in the static state and 86.1% in the dynamic state in the gel dosimeter. The penumbra for the dynamic state target, which was measured using the gel dosimeter, averaged 10.89 mm, this is a 40.5% increase over the penumbra of the static state target of 7.74 mm. In addition, when measuring with gel dosimetry, the value for the penumbra is 36.6% smaller in the static state and 29.4% smaller in the dynamic state compared to measuring with film. The aim of this study was to investigate the dosimetric properties of a normoxic polymethacrylic acid gel dosimeter in static and dynamic states and to evaluate the potentiality as a relative dosimeter for dynamic therapeutic radiation.

Experimental Studies on Uterine Catecholamines (Catecholamines에 관(關)하여 -제5편(第五編) : 자궁(子宮) catecholamines에 관한 실험적(實驗的) 연구(硏究)-)

  • Lee, Woo-Choo
    • The Korean Journal of Pharmacology
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    • v.19 no.1
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    • pp.37-60
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    • 1983
  • The uterus receives adrenergic terminals from the mesenteric ganglia and considerably large amount of catecholamines have been shown to be contained in this organ. On the other hand, the activities of epinephrine, norepinephrine or adrenergic nerve on uterine motility is so complicated that many controversial results have been reporter. Recently, a large number of reports concerning the changes of uterine catecholamines content have appeared, but little is known about the role of uterine catecholamines in their activities on uterine motility. The present experiments were undertaken to determine the significance of the intrinsic uterine catecholamines in the physiology of uterus. Female albino rabbits weighing approximately 2 kg were employed in this experiment. uterine strip3 were prepared and suspended in a constant temperature $bath(38^{\circ}C)$ containing 100 ml of Locke's solution aerated with 95% oxygen and 5% carbon dioxide. Spontaneous motility was recorded on a smoked drum with an isotonic lever. The catecholamines concentration of the uterus was determined according to the Procedure described of Shore and Olin (1958). Human uterus obtained from patients was also used to determine the catecholam ines content of myometrium. Followings are summarized results. 1) On the non-pregnant rabbit uterine strips, epinephrine and norepinephrine significantly elevated the tonus and stimulated the spontaneous motility. Pretreatment with dichloroisoproterenol(DCI), an adrenergic beta-receptor blocker, enhanced the stimulatory activity of epinephrine or norepinephrine. On the other hand, pretreatment with dibenamine, an adrenergic alpha-receptor blocker, rendered the uterine muscle to exhibit inhibition after the administration of epinephrine or norepinephrine. Following the treatment with both DCI and dibenamine, epinephrine or norepinephrine produced no appreciable effects on the spontaneous motility of the uterus. These results suggest there exist both alpha and beta-adrenergic receptors in the uterine muscle and the response to epinephrine of the former is predominant over that of latter in the non-pregnant uterus of rabbits. The total catecholamines concentration of the non-pregnant uterus was $351\;m{\mu}g/g$ and the fractional concentrations of epinephrine and norepinephrine were $125\;m{\mu}g/g(35.7%)$ and $226\;m{\mu}g/g$ respectively. It is interesting to note that the catecholamines content of uterus was characterized by a high fractional corcentration of epinephrine relative to norepinephrine. 2) On the pregnant rabbit uterine strips, the effects of epinephrine and norepinephrine varied according to the period of pregnancy. The response to epinephrine of adrenergic beta receptor of uterus increased during pregnancy, and the effect of catecholamine was inhibitory in the early pregnancy but became stimulatory as the pregnancy progressed. This stimulating action on the uterine motility was found to occur through the action of norepinephrine. The uterine catecholamines concentration was markedly reduced during pregnancy. The catecholamines concentration was started to decrease in the early pregnancy, reached the lowest level in the mid-pregnancy and then started to increaae again in the late pregnancy when the total catecholamines content became the highest level of all. This increase of catefholamines in late pregnancy was chiefly due to the increase of norepinephrine. These results suggest that the uterine motility may be related to the catecholamines content, especially norepinephrine content in the uterus. 3) Bilateral oophorectomy of rabbits results in a marked shrink of the uterus in size. The spontaneous motility of the uterine segment of these animals was very weak and irregular. Norepinephrine produced inhibitory effect, whereas epinephrine was stimulatory or inhibitory effect on the uterine segment. The total catecholamines tontent in whole uterus was markedly reduced. The injection of estrogen into the oophorectornized rabbit increased the weight of uterus to approximately three times of that of oophorectornized animal. The apontaneous motility and the response to epinephrine and norepinephrine of the uterine segment were greatly enhanced. Both epinephrine and norepinephrine produced a marked stimulatory effects of the uterine motility. The uterine content of catecholamines, particularly epinephrine, was markedly increased. The injection of progesterone into the oophorectornized rabbit increaeed the weight of uterus to approximately 2.5 times of that of eophorectornized animal. The spontaneous motility of the uterine segment was weak and irregular. Epinephrine produced stimulatory effect at high concentrations but norepinephrine always prcdnced inhibitory effect on the uterine segment. The uterine content of catecholamines, particularly of norepinephrine, was markedly reduced. These results suggested that ovarian hormones play an important role not only on the growth and spontaneous norepinephrine of uterus but also on the catecholamines content and responee to epinephrine and norepinephrine of the uterus. 4) The intraperitoneal injection of reserpine(3 mg/kg) into the non-pregnant, pregnant and oophorectornieed rabbits markedly decreased the uterine content of catecholamines, particularly of the norepinephrine. The stimulatory response to epinephrine and. norepinephrine of the uterine segment of these reserpinized ratbits was markedly reduced whereas the inhibitory response to these catecholamines was enhanced. This finding further support the close relationship between the uterine catecholamines content and uterine response to epineptrire and norepinephrine. 5) In the human uterus, the concentration of epinephrine was actrally greater than that of norepinephrine and it was significantly greater during the proliferative phase of the menstrtal cycle. In the human pregnant uterus, the concentrations of toth epinephrine and ncrefinephrine were markedly reduced and showed about 45 percent rednction after 6-8 weeks of ectopic Pregnancy. At full term ana during labor, the concentrations of epinephrine and norepinephrine at placental sites were less than those found in the non-pregnant group. Of interest was the finding that the norepinephrine concentration of uterus from toxemic patients was two and half times higher than that of lower uterine segment of the nontoxemic pregnant individuals. Also the epinephrine concentraticn was slightly increaeed.

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