• Radiation Oncology Journal
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• v.19 no.1
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• pp.34-39
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• 2001

Purpose : It is not common to evaluate the response of the fractionated stereotactic radiotherapy (SRT) to primary hepatoma as compared with conventional radiotherapy. The purpose of the study was to take the preliminary result on the clinical trial of primary hepatoma by SRT. Materials and Methods : From July 1999 to March 2000, thirty three patients were hospitalized in the St. Mary's Hospital, and treated with SRT for extracranial tumors. Among them, 13 patients were diagnosed to primary hepatoma and then applied by frameless SRT using 6 MV linac accelerator. There were 12 male and 1 female patients. They had the age of $ 44\~66$ year old (median : 59) and the tumor size of $10\~825\;cc$ (median : 185 cc). SRT was given to them $3\~5$ fractions a week (5 Gy/fraction, $90\%$ isodose line) for $2\~3$ weeks. Median dose of SRT was 50 Gy and the range was $30\~50\;Gy$. Results : Follow-up period ranged from 3 months to 13 months with median of 8 months. After treating SRT to thirteen patients with primary hepatoma, the response of the tumor was examined by abdominal CT : they are classified by 1 complete regression $(7.7\%)$, 7 partial regression $(53.8\%)$, 4 minimal regression $(30.8\%)$, 1 stable disease $(7.7\%)$. The positive responses more than partial remission were 8 patients $(61.5\%)$ after the treatment. The level of serum alpha-fetoprotein (AFP) after the treatment as compared with pretreatment had been $92.3\%$ decreased. There was no severe complication except dyspepsia $84.6\%$, mild nausea $69.2\%$, transient decreased of hepatic function $15.4\%$ and fever $7.7\%$. Conclusion : SRT to the patients with primary hepatoma was potentially suggested to become the safe and more effective tool than the conventional radiotherapy even though there were relatively short duration of follow-up and small numbers to be tested.

• Journal of radiological science and technology
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• v.32 no.3
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• pp.299-306
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• 2009

Purpose : To compare radiation dose for coronary CT angiography (CTA) obtained with 6 examination protocols such as a retrospectively ECG gated helical scan, a prospectively ECG gated sequential scan, low kVp technique, and cardiac dose modulation technique. Materials and Methods : Coronary CTA was performed by using 6 current clinical protocols to evaluate effective dose and organ dose in primary beam area with anthropomorphic female phantom and glass dosimetric system in 64 channel multi-detector CT. After acquiring topograms of frontal and lateral projection with 80 kVp and 10 mA, main coronary scan was done with 0.35 sec tube rotation time, 40 mm collimation ($0.625\;mm{\times}64\;ea$), small scan field of view (32 cm diameter), 105 mm scan length. Heart beat rate of phantom was maintained 60 bpm in ECG gating. In constant mAs technique 120 kVp, 600 mA was used, and 100 kVp for low kVp technique. In a retrospectively ECG gated helical CT technique 0.22 pitch was used, peak mA (600 mA) was adopted in range of $40{\sim}80%$ of R-R interval and 120mA(80% reduction) in others with cardiac dose modulation. And 210 mAs was used without cardiac dose modulation. In a prospectively ECG gated sequential CT technique data were acquired at 75% R-R interval (middle diastolic phase in cardiac cycle), and 120 msec additional padding of the tube-on time was used. For effective dose calculation region specific conversion factor of dose length product in thorax was used, which was recommended by EUR 16262. Results : The mean effective dose for conventional coronary CTA without cardiac dose modulation in a retrospectively ECG gated helical scan was 17.8 mSv, and mean organ dose of heart was 103.8 mGy. With low kVp and cardiac dose modulation the mean effective dose showed 54.5% reduction, and heart dose showed 52.3% reduction, compared with that of conventional coronary CTA. And at the sequential scan(SnapShot pulse mode) under prospective ECG gating the mean effective dose was 4.9 mSv, this represents an 72.5% reduction compared with that of conventional coronary CTA. And heart dose was 33.8 mGy, this represents 67.4% reduction. In the sequential scan technique under prospective ECG gating with low kVp the mean effective dose was 3.0 mSv, this represents an 83.2% reduction compared with that of conventional coronary CTA. And heart dose was 17.7 mGy, this represents an 82.9% reduction. Conclusion : In coronary CTA at retrospectively ECG gated helical scan, cardiac dose modulation technique using low kVp reduced dose to 50% above compared with the conventional helical scan. And the prospectively ECG gated sequential scan offers substantially reduced dose compared with the traditional retrospectively ECG gated helical scan.

• Childhood Kidney Diseases
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• v.14 no.2
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• pp.143-153
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• 2010

Purpose: Recently, massive proteinuria has been observed in some transplant patients after switching cyclosporine A (CsA) to sirolimus. To evaluate the pathogenesis of sirolimus-associated proteinuria, we investigated the early changes in slit diaphragm molecules by various administrative conditions of sirolimus and CsA. Methods: In vitro-Mouse podocytes were incubated with buffer (C), sirolimus ($10\;{\mu}g/mL$) after CsA ($10\;{\mu}g/mL$) (C-S), sirolimus only (S) and CsA and sirolimus simultaneously (C+S) for 12, 24, and 48 hours. In vivo- twenty four SPF female Wistar rats were divided into 4 groups buffer (C), sirolimus after 2 weeks of CsA (C-S), sirolimus only (S) and CsA and sirolimus simultaneously (C+S). All groups were treated by intraperitoneal injection every other day for 4 weeks (CsA: 25 mg/kg, sirolimus: 0.5 mg/kg). The changes in mRNA of slit diaphragm molecules were examined by RT-PCR. Results: The mRNA of nephrin was significantly decreased in group C-S and C+S in vitro. In vivo, the mRNA of nephrin in all groups using sirolimus and the mRNA of podocin in group C-S and C+S were decreased. Microscopically, group C-S and C+S showed small vacuolization and calcification in proximal tubular epithelial cells. Immunohistochemistry using nephrin and podocin antibodies did not show remarkable decrease of staining along the glomerular capillaries. Electron-microscopically, focal fusion of foot processes was seen in group C-S and C+S. Conclusion: This study suggests the decrease of slit diaphragm molecules (nephrin and podocin) in podocyte may be one of the causes of sirolimus associated proteinuria, and podocyte injury by sirolimus may need a primary hit by CsA to develop the proteinuria.

• Radiation Oncology Journal
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• v.20 no.4
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• pp.303-308
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• 2002

Purpose : To determine the optimal radiation dose in a localized non-Hodgkin's lymphoma of the head and neck in the treatment setting for combined chemoradiotherapy. Materials an Methods :Fifty-three patients with stage I and II diffuse large ceil non-Hodgkin's lymphoma of the head and neck, who were treated with combined chemoradiotherapy between 1985 and 1998 were retrospectively reviewed. The median age was 49 years, and the male-to-female ratio was approximately 1.6. Twenty-seven patients had stage 1 disease and 26 had stage II. Twenty-three patients had bulky tumors $(\geq5\;cm)$ and 30 had non-bulky tumors (<5 cm). The primary tumors arose mainly from an extranodal organ $(70\%)$, most cases involving Waldeyer's ring $(90\%)$. All patients except one were initially treated with $3\~6$ cycles of chemotherapy, which was followed by radiotherapy. Radiation was delivered either to the primary tumor area alone $(9\%)$ or to the primary tumor area plus the bilateral neck nodes $(91\%)$ with a minimum dose of 30 Gy $(range\;30\~60\;Gy)$. The failure patterns according to the radiation field were analyzed, and the relationship between the dose and the in-field recurrence was evaluated. Results : The 10-year overall survival and the 10-year disease free survival rates were similar at $75\%\;and\;76\%$, respectively. A complete response (CR) after chemotherapy was achieved in 44 patients $(83\%)$. Subsequent radiotherapy showed a CR in all patients. Twelve patients $(23\%)$ had a relapse of the lymphoma after the initial treatment. Two of these patients had a recurrence inside the radiation field. No clear dose response relationship was observed and no significant prognostic factors for the in-field recurrences were identified because of the small number of in-field recurrences. However, for patients with tumors <5 cm in diameter, there were no in-field recurrences after a radiation dose 30 Gy. The 2 in-field recurrences encountered occurred in patients with a tumor $\geq5\;cm$. Conclusion .A dose of 30 Gy is sufficient for local control in patients with a non-bulky (<5 cm), localized, diffuse large cell non-Hodgkin's lymphoma when combined with chemotherapy. An additional boost dose in the primary site is recommended for patients with bulky tumors $(\geq5\;cm)$.

• Radiation Oncology Journal
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• v.21 no.2
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• pp.112-117
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• 2003

Purpose: The effects of hypefractionation radiation therapy, such as the failure pattern and survival, on the treatment results in advanced stage head and neck cancer were studied. Materials and Methods: Between September 1990 and October 1998, 24 patients with advanced stage (III, IV) head and neck cancers, were treated using hyperfractionation radiation therapy in the Department of Radiation Oncology at the Keimyung University Dongsan Medical Center. The male to female ratio was 7 : 1, and the age range from 38 to 71 years with the median of 56 years. With regard to the TNM stage, 11 patients were stage III and 13 were stage IV. The sites of primary cancer were the nasopharynx in six, the hypopharynx in 6, the larynx in five, the oropharynx in three, the maxillary sinus in three, and the oral cavity in one patient. The radiotherapy was delivered by 6 MV X-ray, with a fraction size of 1.2 Gy at two fractions a day, with at least 6 hours inter-fractional interval. The mean total radiation doses was 72 Gy, (ranging from 64.4 to 75.8 Gy). Follow-up periods ranged between 3 and 136 months, with the median of 52 months. Results: The overall survival rates at 3 and 5 years in all patients were 66.7$\%$, and 52.4$\%$. The disease-free survival rates at 3 and S years (3YDFS, 5YDFS) in all patients were 66.7$\%$ and 47.6$\%$. The 3YDFS and 5YDFS in stage III patients were 81.8$\%$ and 63.6$\%$, and those in stage IV patients were 53.8$\%$ and 32.3$\%$. Ten patients were alive with no local nor distant failures at the time of analyses. Six patients (25$\%$) died due to distant metastasis and 12.5$\%$ died due to local failure. Distant metastasis was the major cause of failure, but 2 patients died due to unknown failures and 3 of other diseases. The distant metastasis sites were the lung (3 patients), the bone (1 patient), and the liver (2 patients). One patient died of second esophageal cancer. There were no severe late complications, with the exception of 1 osteo-radionecrosis of the mandible 58 months after treatment. Conclusion: Although this study was peformed on small patients group, we considered hypefractionated radiation therapy for the treatment of advanced stage head and neck cancer might improve the disease free survival and decrease the local failure with no increase in late complications despite of the slight Increase in acute complications.

• Journal of Educational Research in Mathematics
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• v.22 no.1
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• pp.1-22
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• 2012

The purpose of this study is to understand Korea students' characteristics as well as to give important information of improving our education using comparative analysis of framework, test booklets, test results between PISA 2009 and NAEA 2009. PISA 2009 was administered on May of 2009 and NAEA was administered on October of same year. The summary of the results of comparing two assessment is as follows First, cut score of NAEA Advance level is bigger than the cut score of level 5, which is considered as high achievement level. The cut score of Basic level of NAEA is also higher than the level 2 of PISA, which is considered as basic achievement level. This phenomenon can show that NAEA achievement level is set little bit higher than the achievement level of PISA in mathematics domain. Second, the percentage of female students on higher level was higher than that of male students. In suburban area, the percentage of high level was small and the percentage of low level was big. Third, students of Advanced level are distributed concentrating in PISA levels 4~6, Proficient achievement level concentrating in PISA levels 3~5, Basic achievement level concentrating in PISA levels 2~4, and below basic achievement levels concentrating in below level 1 and level 3 of PISA. Fourth, the correlation between NAEA 2009 and PISA 2009 achievement scores are significantly positive. However, the correlation of subscales were low. Fifth, analysis of non-equivalent group, 11 items located in 'change and relationship', 'uncertainty', 'connection cluster' domains found to be significantly different. The percent correct showed very big difference. The analysis results presents the implication of mathematics curriculum, teaching and learning methods as well as National Assessment of Educational Achievement.

• Applied Microscopy
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• v.7 no.1
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• pp.21-43
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• 1977

This experiment was undertaken in order to localize the labeled dbcAMP (dibutyryl cyclic AMP) in oocytes whose development has been suppressed by cold dbcAMP for 6 or 19 hours in vitro. Mouse oocytes were obtained from the ovaries of 3-4 week old A strain female mice, by puncturing the Graafian follicles in the modified Krebs-Ringer bicarbonate salt solution under the dissecting microscope. Those oocytes which have intact germinal vesicle were cultured in the basic culture medium supplemented with 0.4% bovine serum albumin (BSA). Cultivation of the oocytes was carried out in a microtube developed by Cho (1974). The cultures were then incubated in a humidified 5% $CO_2$ incubator maintained at $37^{\circ}C$ for 6 or 19 hours (Donahue, 1968). DbcAMP was added to culture medium for a final concentration of 100ug/ml, and $^3H-dbc$ AMP (specific activity 13 Ci/mM) for a final concentration of $40{\mu}Ci/ml$ was also added to the medium. For electron microscopic autoradiography, those oocytes recovered from the culture were washed with phosphate buffer (pH 7.4), and immediately prefixed in a 2.5% glutaraldehyde overnight and postfixed for 2 hours at $4 ^{\circ}C$ in 1% osmium tetroxide in phosphate buffer with pH 7.4 (Palade, 1952). After fixation, the materials were dehydrated in graded alcohol series and embedded in Epon 812 mixture based on the standard procedures (Luft, 1961). The thin sections $600-700{\AA}$ thick were mounted on the grids of 200 meshes. The grids containing sections were coated with a nuclear emulsion Kodak NTB-3 and stored in a cold dark box (at $4^{\circ}C$) for 3 weeks. After exposure, the samples were developed with Kodak D-19 and stained with uranyl acetate and lead citrate. Routine observation was made with Hitachi HU-11E electron microsocope. The results of the observation were as followings: 1. It was found that the labeled dbcAMP penetrated the egg plasma membrane and dispersed at random in the cytoplasm. 2. It was also observed that most of the labeled dbcAMP was attached to microfibrillar lattices portion of the oocyte cytoplasm. There fore, it is presumed that the receptor of the dbcAMP is localized in the microfibrillar lattices of the oocyte. 3. It also seems that some other cell organells such as mitochondria, Golgi complex, cortical granules are not directly related to the action of the dbcAMP. 4. The labeled dbcAMP was neither observed in the membrane nor in the nucleus. Therefore, it seems that there is no relationship between the concentration of dbcAMP and the nuclear membranous permeability. 5. There was no difference in number of dbcAMP particles when oocytes were cultured for 6 hours and 19 hours. 6. However, it was observed that, in same of the oocytes suppressed in germinal vesicle by dbcAMP for 19 hours, cell organells were moved and concentrated to a small portion of the cytoplasm, and that the morphology of the organells greatly changed to an abnormal. form. Therefore, it is supposed that those oocytes were in the process of degeneration. From the above results, it is expected that dbcAMP penetrated the egg membrane and was bound to the receptor which seems to be located in the microfibrillar lattiees portion, and that this dbcAMP-receptor complex inhibited some enzyme system of the oocytes which are essential for the germinal vesicle breakdown.

• The Journal of the Korean Society for Microbiology
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• v.3 no.1
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• pp.35-41
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• 1968

An outbreak of typhoid fever in Samchunpo city was surveyed and the results were summarized as follows: 1. 638 of clinical cases were detected in 17 Dongs(districts) of the city of Samchunpo,(54,064), during the epidemic period from 1st September to the end of November, 1967. 2. The morbidity rate was 1,189 per 100,000 population;(1,300 female, and 1,060 male). 3. The highest peak was reached in the third week of September and a second peak appeared at the end of September 1967. 4. The mode of infection was suspected strongly as a water-borne and the source of infection as an old public well called Gal-Dae-Saim, since the causative agent was found in close public latrine and the contaminated sewage ditch witch was connected with the well. 5. All patients and carriers were treated at their home under the supervision of local medical authorities. 6. The Gal-Dae-Saim was closed immediately on 7th October, 1967 by the order of the mayor. 7. At the end of November, 1967 when the outbreak in Samchunpo was almost ended, another small epidemic occurred in Koseong county which bordered the eastern outskirt of the city. 8. During the survey, a strain of Shigella flexneri was isolated from the sewage located three meters from Gal-Dae-Saim and also from one case. 9. It was reported by the local health center in May, 1968, that no carrier had been detected in the survey made among the persons who had had typhoid fever in 1967. Also thereafter no cases of typhoid fever were reported through October, 1968.

• Korean Journal of Health Education and Promotion
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• v.1 no.1
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• pp.57-71
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• 1983

Sex education is necessary for the youth that they should have an adequate sexual knowledge, attitudes and behaviors in their adolescent period. Four major objectives of this study are as follows; 1. To know the level of sexual knowledge of commercial girl's high school students in Seoul. 2. To know their actual state for the attitudes and behaviors toward sex. 3. To compare the sexual knowledge, attitudes and behaviors of day time school students with those of night time school students. 4. To compare the factors associated with their sexual knowledge, attitudes and behaviors with the individual level. Data were collected on 986 students in Seoul from April 1 to April 10, 1983. As the result of this survey, the following conclusions were obtained. 1. The level of sexual knowledge. (1) The level of knowledge of day time high school students about the physiology of female and pregnancy is shown higher than those of night time students. 64.2% of the respondents are aware of the organ producing ovum. 56.4% the ovulation period. 95.6% the cause of pregnancy. 74.5% the pregnantable period and 12.7% the place of fetilization. (2) Out of 986 respondents. 71.8% knew about contraceptive method correctly, and day time school students knew litter better than night time school students, by showing 73.9% and 69.7% respectively. They knew about contraceptive method with 'oral pills'. 'menstrual cycles', 'condoms'. and 'loops' in the same order. 3) Kinds of veneral disease was correctly known by 37.9%. Day time students knew much better than night time school students. by showing 67.8% and 7.9%. respectively. Transmission method of veneral disease was correctly known by 28.3%. Day time students knew much better than night time students, by showing 51.2% and 5.3%, respectively. (4) The major information source of sexual knowledge was 'book and magazine' (39.9%) and 'friends' (27.4%). 2. Actual state of attitudes and behaviors toward sex. (1) Out of 986 respondents, 84.0% answered that premarital purity should be kept. (2) Out of 986 respondents, 60.8% had an acquaintance of the opposite sex. 45.2% of students with opposite sex reported introduction of their friends as the main channel of making an acquaintance of the opposite sex. (3) Of those who responded to this study 13.8% reported having masturbation, 21.5% kissing, 6.2% petting and 3.7% sex intercourse. (4) 64.8% had sexual problems, which was mensturance (27.2%), aquaintance of the opposite sex (25.4%). The main method to solve the problems were consultation with 'friends' and 'books and magazine' percentage being 39.1% and 30.8%, respectively, whereas very small students discussed with 'teachers' and 'parents' percentages being 0.3% and 5.9%, respectively. (5) Out of 986 respondents, 62.2% had experience in educating about sex, the percentage of day time school was higher than that of night time school. (6) 88.2% of students wanted sex education in school, which were 'general information about sex' (35.4%), 'sexual morality and solution of sexual desire' (18.5%), 'aquaintance of the opposite sex' (13.3%) and 'marriage and role of man and woman' (12.4%) in the same order. They wanted to be instructed about sexes in the lecture of physical education, home economics, biology, military training (59.9%), regular curriculum (17.5%), special lecture (16.9%) and by the counselor or school nurse (5.7%). 3. Analyse concerning the factors about the knowledge, attitudes and behaviors. (1) The better school record was, the higher the level of sexual knowledge. (2) Those who have the religion considered the permarital purity more important than those who have not, the percentage showing 86.7% and 80.7%, respectively. (3) The result of dyad analysis of making acquaintance of the opposite sex in the friendship network showed that a high index of the acquaintance of the opposite sex tends to be a high adoption of making one at the individual level in the group, while the low index tends to be a low adoption of making one in the group.

• Journal of Chest Surgery
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• v.30 no.11
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• pp.1077-1082
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• 1997

To assess the early results, risk factors and optimal timing for coronary artery bypass graft surgery(CABG) after an acute myocardial infarction(AMI), we reviewed our 19 patients who underwent CABG within 30 days after AMI, between June 1994 and October 1996. This study excluded 1 patient whose diagnosis was AMI with ventricular septal rupture. 14 of the patients were male and 5 were female. Their ages ranged from 41 to 77 years(mean age, 60.6$\pm$ 10.4 years), and the amount of time between AMI and CABG ranged from 8 hours to 24 days(mean time, 10.6$\pm$6.4 days). There were 11 anteroseptal infarctions and 8 inferior wall infarctions. 11 patients had trsnsmural infarctions and 8 had subendocardial infarctions. Indications of operations were p imary revascularization and postinfarction angina. Three patients required preoperative intra-aortic balloon pump(IABP) support, and 4 additional patients required IABP to be separated from cardiopulmonary bypass. An average of 3.6 $\pm$ 0.6 vessels per patient were bypassed. The early mortality rate for these 19 patients was 5.3% and late mortality rate was 5.5%, 1-year and 2-year actuarial survival rates were 89.5% Univariate analysis of mortality showed that an ejection fraction less than 30% and intraopretative IABP supports were associated with risk factors(p value=0.018 and 0.015 respectively). Age, sex, time to CABG, emergency operations, types and locations of infarctions were not significant. Although our studies have weak p.oints in that there was only a small number of patients and the lack of long-term results, we could conclude that early myocardial revascularization is relatively safe after AMI for those individuals with an ejection fraction greater than 30%.