• 한국방사선학회논문지
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• 제6권5호
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• pp.343-349
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• 2012

세기조절방사선치료(intensity modulated radiation therapy ; IMRT)는 주변 정상장기 선량을 최소화하면서 종양에 집중적으로 고선량을 조사할 수 있는 장점으로 인하여 최근 그 사용이 급격히 증가하고 있다. 기능강화 동적쐐기 (enhanced dynamic wedge; EDW) 사용 시 기하학적 변화에 따른 Mapcheck에서의 선량분포를 측정 평가하고자 한다. Clinac ix에서 IMRT를 이용하여 EDW angle($10^{\circ}$, $15^{\circ}$, $20^{\circ}$, $25^{\circ}$, $30^{\circ}$, $45^{\circ}$, $60^{\circ}$), field size(asymmetric field), depth 변화(1,5 cm, 5 cm)에 따른 선량분포를 검증하기 위해 Mapcheck위에 고체팬텀을 올려놓고 6 MV, 10MVX-ray로 100MU를 조사하였다. 6MV, 10MV의 에너지를 사용하여 기하학적변화에 따라 최대선량깊이(1.5 cm)와 5 cm 깊이에서 심부 선량백분율(percentage depth dose; PDD)은 치료계획장치에서 계산한 값의 차이가 최대 0.6%로 1%미만의 값으로 나타났다. 심부선량백분율은 조사야 중앙에서 최대선량깊이의 선량을 100%로 보았을 경우, 2.4%에서 7.2%의 범위에 있다. 또한 심부선량백분율 차이의 최대값은 Y2-OUT 방향에서 4.1%로 나타났고 Y1-IN 방향으로 1.7%로 나타났다. 동적쐐기를 사용하여 환자를 치료할 경우, 조사야 주변부의 불필요한 피폭을 유발하여 산란되는 선량을 줄이기 위하여 기능 강화 동적쐐기를 사용하는 것이 바람직할 것으로 사료된다. 특히 임상에서 환자를 치료할 경우, 쐐기의 toe방향 선량이 heel방향 선량보다 높다는 것을 염두에 두고 치료를 수행해야 할 것으로 사료된다.

• Journal of Gastric Cancer
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• 제2권3호
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• pp.157-162
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• 2002

Purpose: The prognosis of stage IV gastric cancer is very grave. However, some of these patients survive long periods after surgery. This study was undertaken to investigate various clinico-pathological profiles related to the prognosis for these long-term survivors. Materials and Methods: One hundred fifty-five patients with stage IV gastric cancer who underwent a gastric resection from 1992 to 1997 at Hanyang University Hospital were evaluated. Thirty-three patients who survived more than 5 years after surgery were designated as long-term survivors (LTS); on the other hand, one hundred twenty-two patients who died within 5 years after surgery were named as short-term survivors (STS). Results: The rate of the patients with T4, preoperative serum level of CA19-9 greater than 37 U/g protein, and peritoneal dissemination was lower for the LTS than in for the STS (P=0.002, P=0.045, and P=0.0000, respectively). Tumors were smaller (7.3 cm vs. 8.9 cm, P=0.030) and metastatic lymph node were fewer (19.7 vs. 28.8, P=0.019) for the LTS than for the STS. Curative surgery ($\76\%\;vs.\;\46\%$, P=0.002) and a subtotal gastrectomy ($\76\%\;vs.\;46\%$, P=0.026) were performed more frequently for the LTS than for the STS. From a univariate survival analysis, depth of invasion, distant metastasis, extent of gastric resection, postoperative chemotherapy, and curability were statistically significant factors. From a multivariate survival analysis, curability, depth of invasion, and extent of gastric resection were independent prognostic factors. Conclusions: If feasible, we have to exert our efforts to achieve curative surgery although the tumor is considered to be a stage IV gastric cancer. Thereafter, multi-modality treatments including chemotherapy can be considered to improve the prognosis.

• 대한방사선기술학회지:방사선기술과학
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• 제43권1호
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• pp.9-14
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• 2020

Commercial plate bolus is generally used for treatment of surface tumor and required surface dose. We fabricated 3D-printed bolus by using 3D printing technology and usability of 3D-printed bolus was evaluated. RT-structure of contoured plate bolus in the TPS was exported to DICOM files and converted to STL file by using converting program. The 3D-printed bolus was manufactured with rubber-like translucent materials using a 3D printer. The dose distribution calculated in the TPS and compared the characteristics of the plate bolus and the 3D printed bolus. The absolute dose was measured inserting an ion chamber to the depth of 5 cm and 10 cm from the surface of the blue water phantom. HU and ED were measured to compare the material characteristics. 100% dose was distributed at Dmax of 1.5 cm below the surface when was applied without bolus. When the plate bolus and 3D-plate bolus were applied, dose distributed at 0.9 cm and 0.8 cm below the surface of the bolus. After the comparative analysis of the radiation dose at the reference depth, differences in radiation dose of 0.1 ~ 0.3% were found, but there was no difference dose. The usability of the 3D-printed bolus was thus confirmed and it is considered that the 3D-printed bolus can be applied in radiation therapy.

• 대한두개안면성형외과학회지
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• 제21권4호
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• pp.219-224
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• 2020

Background: Repair of the orbital floor following trauma or tumor removal remains a challenge because of its complex three-dimensional shape. The purpose of the present study is to understand normal orbital floor anatomy by investigating its differences across four groups (Caucasian American and East Asian, males and females) via facial bone computed tomography (CT). Methods: A total of 48 orbits in 24 patients between 20 and 60 years of age were evaluated. Although most patients underwent CT scanning following trauma, the orbital walls were intact in all patients. Linear and angular measurements of the orbital floor were obtained from CT images. Results: Orbital floor width, length, angle between the orbital floor and medial wall, and distance from the inferior orbital rim to the lowest point of the orbital floor did not show a statistically significant difference between groups. Angles made by the infraorbital rim, the lowest point of the floor, and the anterior border of the infraorbital fissure were statistically significantly wider in East Asian females than in male groups. The floor depth in East Asian females was significantly smaller compared to all the other groups. Conclusion: East Asian female population had smaller curvature and depth of an orbital floor than the other groups, which means racial and sex-related differences should be considered in the orbital floor reconstruction.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제46권2호
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• pp.99-107
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• 2020

Objectives: We accessed the various clinico-histopathological factors, and their association with occult metastasis (OM) in oral tongue squamous cell carcinoma (OTSCC). Materials and Methods: One hundred-nine patients with OTSCC were divided into the elective neck dissection (END) group and the watchful waiting (WW) group. Age, sex, T-stage, depth of invasion and differentiation were evaluated to determine the correlation between clinico-histopathological factors and OM. For immunohistochemical analysis, paraffin-embedded blocks of 41 OTSCC specimens were examined with antibodies (VEGF-c, c-Met, and ROR1). Results: The group with tumor thickness of oral tongue cancer ≥3 mm had higher incidence of OM than those with a thickness of <3 mm. The depth of invasion was statistically correlated with OM (P=0.022). Immunohistochemical analysis showed that high expression of VEGF-c (P=0.043), c-Met (P=0.009), and ROR-1 (P=0.003) were statistically correlated with OM. Conclusion: The analysis of these clinico-histopathological and immunohistochemical factors can help to determine neck dissection in clinically negative (cN0) patients.

• Asian-Australasian Journal of Animal Sciences
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• 제29권1호
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• pp.134-141
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• 2016

To investigate the role of polysaccharide from Acanthopanax senticosus (ASPS) in preventing lipopolysaccharide (LPS)-induced intestinal injury, 18 mice (at 5 wk of age) were assigned to three groups with 6 replicates of one mouse each. Mice were administrated by oral gavage with or without ASPS (300 mg/kg body weight) for 14 days and were injected with saline or LPS at 15 days. Intestinal samples were collected at 4 h post-challenge. The results showed that ASPS ameliorated LPS-induced deterioration of digestive ability of LPS-challenged mice, indicated by an increase in intestinal lactase activity (45%, p<0.05), and the intestinal morphology, as proved by improved villus height (20.84%, p<0.05) and villus height:crypt depth ratio (42%, p<0.05), and lower crypt depth in jejunum (15.55%, p<0.05), as well as enhanced intestinal tight junction proteins expression involving occludin-1 (71.43%, p<0.05). ASPS also prevented intestinal inflammation response, supported by decrease in intestinal inflammatory mediators including tumor necrosis factor ${\alpha}$ (22.28%, p<0.05) and heat shock protein (HSP70) (77.42%, p<0.05). In addition, intestinal mucus layers were also improved by ASPS, as indicated by the increase in number of goblet cells (24.89%, p<0.05) and intestinal trefoil peptide (17.75%, p<0.05). Finally, ASPS facilitated mRNA expression of epidermal growth factor (100%, p<0.05) and its receptor (200%, p<0.05) gene. These results indicate that ASPS can prevent intestinal mucosal barrier injury under inflammatory conditions, which may be associated with up-regulating gene mRNA expression of epidermal growth factor and its receptor.

• Journal of Yeungnam Medical Science
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• 제19권2호
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• pp.116-125
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• 2002

자궁내막암 환자의 예후와 치료의 측면에서 수술 전 병기 설정은 매우 중요하다. 본 연구는 자궁내막암의 수술 전 병기 설정에 있어서 자기공명영상의 유용성을 평가하기 위하여 수술 1-2주 전에 자기공명영상을 시행한 28 예를 대상으로 하였다. 자궁 내의 침범은 자궁내막에 국한된 경우, 표재성 자궁근층 침범, 심부성 자궁근층 침범의 세 경우로 나누었으며, 그 외 자궁경부 침범, 양측 부속기 침범, 골반강내 침범 및 림프절 병증를 평가하였다. 저 병기의 자궁내막암에서 근층의 침범 여부와 정도를 평가하는데 있어서 4 예에서 과소, 1 예에서 과대 병기 설정이 되었다. 28 예중 22 예에서 조직학적 소견과 일치된 병기 설정을 해서 정확도는 78.6%였다. 수술 전 자기공명영상을 통한 병기 설정은 수술 후의 예후를 예측할 수 있으며, 근층 침범, 자궁경부, 양측 부속기, 골반강 및 림프절 침범 등을 동시에 평가를 할 수 있는 유용한 방법으로 판단되었다.

• Archives of Plastic Surgery
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• 제38권4호
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• pp.415-420
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• 2011

Purpose: The reconstruction of a soft tissue defect of the heel pad can be challenging. One vital issue is the restoration of the ability of the heel to bear the load of the body weight. Many surgeons prefer to use local flaps or free tissue transfer rather than a skin graft. In this study, we evaluated the criteria for choosing a proper flap for heel pad reconstruction. Methods: In this study, 23 cases of heel pad reconstruction were performed by using the flap technique. The etiologies of the heel defects included pressure sores, trauma, or wide excision of a malignant tumor. During the operation, the location, size and depth of the heel pad defect determined which flap was chosen. When the defect size was relatively small and the defect depth was limited to the subcutaneous layer, a local flap was used. A free flap was selected when the defect was so large and deep that almost entire heel pad had to be replaced. Results: There was only one complication of poor graft acceptance, involving partial flap necrosis. This patient experienced complete recovery after debridement of the necrotic tissue and a split thickness skin graft. None of the other transferred tissues had complications. During the follow-up period, the patients were reported satisfactory with both aesthetic and functional results. Conclusion: The heel pad reconstructive method is determined by the size and soft-tissue requirements of the defect. The proper choice of the donor flap allows to achieve satisfactory surgical outcomes in aesthetic and functional viewpoints with fewer complications.

• Journal of Gastric Cancer
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• 제9권3호
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• pp.143-151
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• 2009

목적: 위암은 한국에서 제일 흔한 암으로 저자들은 단일 술자에 의해 위절제술을 시행받은 환자들을 대상으로 임상병리학적 특성 및 5년 생존율과 이에 따른 예후인자를 알아보고자 한다. 대상 및 방법: 1998년 9월부터 2003년 8월까지 만 5년간 위암으로 진단되어 인제대학교 서울백병원 한국위암센터에서 위절제술을 시행한 위암환자 1,435예의 환자를 대상으로 성별 및 연령, 종양의 위치 및 크기, 육안적 분류 및 조직학적 분류, 위벽 침윤도, 림프절 전이, 혈관, 신경초, 림프관 침윤 및 수술 방법 등의 인자들을 후향적으로 조사하였다. 결과: 남녀 비는 2.29 : 1이었고 평균 연령은 56.7세였으며 UICC TNM Stage IA 35.4%, Stage IB 14.1%, Stage II 12.6%, Stage IIIA 12.3%, Stage IIIB 8.3%, Stage IV 17.3%였고 전체 5년 생존율은 69.6%였다. 단변량 분석 결과 연령, 종양의 위치, 종양의 크기, Borrmann type, 분화도, Lauren 분류, 위벽 침윤도, 림프절 전이, UICC TNM 변기, 신경초 침윤, 혈관 침윤, 림프관 침윤, 수술방법에 따라 생존율에 유의한 차이가 있었다. 다변량 분석결과 위벽 침윤도, 림프절 전이만0| 독립적인 예후인자였다. 결론: 다양한 임상병리학적 특성들이 위암환자의 예후에 영향을 주지만 이들 인자들 중 결국 위벽 침윤도와 림프절 전이, 즉 병기가 예후에 가장 중요함을 알 수 있었다. 따라서 위암환자 생존을 향상을 위해서 조기 검진을 통한 위암의 조기 발견과 예후 영향인자에 대한 다각적인 치료 방법이 연구, 개발되어야 하겠다.

• Journal of Gastric Cancer
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• 제1권2호
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• pp.92-99
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• 2001

Purpose: E-cadherin is an adhesion molecule essential for tight connection between cells, forming the cadherin/catenin complex. Truncated $\beta$-catenin disrupts the interaction between E-cadherin and $\alpha$-catenin, leading to the loss of intercellular adhesion. Met protein, the hepatocyte growth factor receptor, plays important roles in signal transduction. We investigated the relationships between the expressions of E-cadherin, $\beta$-catenin, and c-met protein and the clinicopathological and prognostic parameters in gastric adenocarcinomas. Materials and Methods: The patterns of E-cadherin, $\beta$-catenin, and c-met protein expression were studied using immunohistochemistry in formalin-fixed, paraffin-embedded archival tissues from 76 surgically resected gastric adenocarcinomas. Results: Increased expressions of E-cadherin, $\beta$-catenin, and c-met were more significantly correlated in early gastric cancers (EGC) than in advanced gastric cancers (AGC) (P=0.002, P=0.003 and P=0.026). The positive immunoreactivities of all three markers were markedly lower in signet ring-cell type and poorly differentiated type lesions than in intestinal-type lesions. Decreased expression of the $\beta$-catenin protein correlated well with increased tumor invasion depth (P=0.039), and increased lymph node metastasis correlated well with reduced expression of c-met (P=0.046). Conclusion: In gastric cancers, reduced expressions of the E-cadherin, $\beta$-catenin, and c-met proteins may play some role in poorer tumor differentiation, deeper tumor invasion, and increased lymph node metastasis. Also, the c-met gene is thought to play a specific role in the mechanism of the yet unknown catenin action.