• Title/Summary/Keyword: Young-Hun Kim

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The Results of Postoperative Radiation Therapy for Perihilar Cholangiocarcinoma (간문부 담도암에서 수술 후 방사선 치료의 결과)

  • Lee, Yu-Sun;Park, Jae-Won;Park, Jin-Hong;Choi, Eun-Kyung;Ahn, Seung-Do;Lee, Sang-Wook;Song, Si-Yeol;Lee, Sung-Gyu;Hwang, Shin;Lee, Young-Joo;Park, Kwang-Min;Kim, Ki-Hun;Ahn, Chul-Soo;Moon, Deok-Bog;Chang, Heung-Moon;Ryu, Min-Hee;Kim, Tae-Won;Lee, Jae-Lyun;Kim, Jong-Hoon
    • Radiation Oncology Journal
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    • v.27 no.4
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    • pp.181-188
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    • 2009
  • Purpose: The aim of this study was to evaluate the results of postoperative radiotherapy in a case of perihilar cholagiocarcinoma by analyzing overall survival rate, patterns of failure, prognostic factors for overall survival, and toxicity. Materials and Methods: Between January 1998 and March 2008, 38 patients with perihilar cholangiocarcinoma underwent a surgical resection and adjuvant radiotherapy. The median patient age was 59 years (range, 28 to 72 years), which included 23 men and 15 women. The extent of surgery was complete resection in 9 patients, microscopically positive margins in 25 patients, and a subtotal resection in 4 patients. The tumor bed and regional lymphatics initially received 45 Gy or 50 Gy, but was subsequently boosted to a total dose of 59.4 Gy or 60 Gy in incompletely resected patients. The median radiotherapy dose was 59.4 Gy. Concurrent chemotherapy was administered in 30 patients. The median follow-up period was 14 months (range, 6 to 45 months). Results: The 3-year overall survival and 3-year progression free survival rates were 30% and 8%, respectively. The median survival time was 28 months. A multivariate analysis showed that differentiation was the only significant factor for overall survival. The 3-year overall survival was 34% in R0 patients and 20% in R1 patients. No statistically significant differences in survival were found between the 2 groups (p=0.3067). The first site of failure was local in 18 patients (47%). No patient experienced grade 3 or higher acute toxicity and duodenal bleeding developed in 2 patients. Conclusion: Our results suggest that adjuvant RT might be a significant factor in patients with a positive margin following a radical resection. However, there was still a high locoregional recurrence rate following surgery and postoperative radiotherapy. Further study is necessary to enhance the effect of the adjuvant radiotherapy.

Chemical Composition, Cholesterol, Trans-Fatty Acids Contents, pH, Meat Color, Water Holding Capacity and Cooking Loss of Hanwoo Beef (Korean Native Cattle) Quality Grade (한우육의 육질등급에 따른 부위별 일반성분, pH, 육색, 보수력, 가열감량, 콜레스테롤 및 트랜스지방산 함량)

  • Lee, Yeon-Jung;Kim, Cheon-Jei;Park, Beom-Young;Seong, Pil-Nam;Kim, Jin-Hyoung;Kang, Geun-Ho;Kim, Dong-Hun;Cho, Soo-Hyun
    • Food Science of Animal Resources
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    • v.30 no.6
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    • pp.997-1006
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    • 2010
  • The objective of this study was to investigate the proximate composition, pH, meat color, water holding capacity (WHC), cooking loss (CL), cholesterol content, and trans-fatty acid content of Hanwoo beef according to quality grade and cut. Five cuts [Cheggt (strip loin), Dngsim (loin), Moksim (chuck roll), Udoon (top round), Yanggi (brisket)] were obtained from 15 Hanwoo animals [3 bulls and 12 steers, 24-30 months old]. Three animals were selected from each quality grade of $1^{++}$, $1^+$, 1, 2, and 3. The protein and moisture contents (%) were significantly higher, and the fat contents (%) were significantly lower in 3 quality grade compared to the other grades (p<0.05). pH values of chuck roll and strip loin were significantly lower in $1^+$ quality grade (5.61 and 5.51) than those in 3 quality grade (5.88 and 5.92) (p<0.05). CIE L* values were significantly higher in the $1^{++}$ quality grade group (38.52-42.69%) than in 3 quality grade (33.02-36.08) (p<0.05). In the $1^{++}$ and 2 quality grade groups, CIE $L^*$ values of loin were significantly higher than those of other cuts (p<0.05). CIE $a^*$ values of loin (28.11) in 1 quality grade were the highest, whereas those of strip loin (15.36) in 3 quality grade were the lowest (p<0.05). WHC was not significantly different among the five cuts or quality grades. In CL, loin and strip loin were significantly lower in $1^{++}$ quality grade than in 3 quality grade (p<0.05), and they were also significantly lower (22.21-24.81%) than the other cuts in the same quality grade (p<0.05). The loin in $1^{++}$ (41.26 mg/100 g), $1^+$ (43.23), and 1 quality grades (48.63) had higher cholesterol contents (%) than in 2 (36.02) and 3 quality grades (29.84) (p<0.05). Cholesterol contents of the five cuts in $1^{++}$ quality grade (39.44-43.31%) were significantly higher than those in 3 quality grade (28.09-32.39%). The trans-fatty acid contents of the five cuts were 1.08-2.72%. The loin, strip loin, brisket, and top round in 3 quality grade had significantly higher trans-fatty acid contents than those of the other grades (p<0.05).

Warner-Bratzler Shear Force, Sarcomere Length, Total Collagen Contents and Sensory Characteristics of Hanwoo Beef (Korean Native Cattle) Quality Grade (한우육의 육질등급에 따른 부위별 전단력, 근절길이, 콜라겐의 함량 및 관능 특성)

  • Lee, Yeon-Jung;Kim, Cheon-Jei;Park, Beom-Young;Seong, Pil-Nam;Kim, Jin-Hyong;Kang, Guen-Ho;Kim, Dong-Hun;Cho, Soo-Hyun
    • Food Science of Animal Resources
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    • v.29 no.6
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    • pp.726-735
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    • 2009
  • This study was conducted to investigate the Warner-Bratzler shear force (WBS), sarcomere length, total collagen contents and consumer tests of different cuts of Hanwoo beef based on quality grade. Five cuts [Cheggt (striploin), Dngsim (loin), Moksim (chuck roll), Udoon (top round), Yanggi (brisket)] were obtained from Hanwoo beef (bulls and steers, 24-30 months old) and grouped by their quality grades ($1^{++}$, $1^+$, 1, 2 and 3). The WBS values of chuck cut in $1^{++}$, $1^+$ and 1 quality grade groups were 5.47 (kg/0.5 $inch^2$), 5.46 (kg/0.5 $inch^2$) and 6.54 (kg/0.5 $inch^2$), respectively, which were significantly lower than those of chuck in quality grade 3, which was 8.41 (kg/0.5 $inch^2$) (p<0.05). The sarcomere length of the quality grade groups were significantly longer for brisket (3.72 ${\mu}m$) of $1^{++}$ quality grade than for that of 3 quality grade brisket (p<0.05). Brisket of $1^{++}$ and 2 quality grade had significantly greater sarcomere lengths than strip loin and top round in the same quality grade (p<0.05). The total collagen contents of strip loins in the $1^{++}$, $1^+$, and 1 quality grade groups (1.17, 1.18 and 1.14 g/100 g, respectively) were significantly lower than those of the 3 quality grade group (1.63 g/100 g) (p<0.05). The overall sensory scores of tenderness and juiciness for the five cuts of $1^{++}$ quality grade were significantly higher than those of the other quality grade (p<0.05). Among the five cuts, loin had the highest tenderness and juiciness scores (p<0.05), whereas top round had the lowest tenderness and juiciness scores (p<0.05). Overall, there were significant differences in the WBS and sensory properties among quality grades and cuts (p<0.05). However, the sarcomere length and total collagen contents of chuck roll, top round and loin did not differ among quality grades.

Effect of Carbon Couch Side Rail and Vac-lok In case of Lung RPO irradiation (Lung RPO 선량전달시, Carbon Couch Side Rail과 Vac-lok이 미치는 영향)

  • Kim, Seok Min;Gwak, Geun Tak;Lee, Seung Hun;Kim, Jung Soo;Kwon, Hyoung Cheol;Kim, Yang Su;Lee, Sun Young
    • The Journal of Korean Society for Radiation Therapy
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    • v.30 no.1_2
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    • pp.27-34
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    • 2018
  • Purpose : To evaluate the effect of carbon couch side rail and vacuum immobilization device in case of lung RPO irradiation. Materials and Methods : The 10, 20, 30 mm thickness of vac-lok's right side were obtained. To measure of doses, glass dosimeters were used and measured reference point is left lung center at the phantom. A, B, C, and D points are left, right, down, and up directions based on the center point. In the state of Side-Rail-Out, place the without vac-lok, with the thickness of 10, 20, and 30 mm vac-lok. After the glass dosimeters was inserted in center, A, B, C, and D points, 100 MU of 6 MV X-ray were irradiated to the referenced center point in the condition of $10{\times}10cm^2$ field size, SAD 100 cm, gantry angle 225, 300 MU/min dose rate. Five measurements were made for each point. In the state of Side-Rail-In, five measurement were made for each point under the same conditions. The average is measured on each of the five Side-Rail-Out and Side-Rail-In measurements. Results : In the presence of side rail, the dose reduction ratio was -11.8 %, -12.3 %, -4.1 %, -12.3 %, -7.3 % for each A, B, C, and D points. In the state of Side-Rail-Out, the dose reduction ratio for the using 10 mm thickness of vac-lok was -0.9 % than without vac-lok. The dose reduction ratio for the using 20 mm thickness of vac-lok was -2.0 %, for the using 30 mm thickness of the vac-lok was -3.0 % than without vac-lok. In the state of Side-Rail-In, the dose reduction ratio for the using 10 mm thickness of vac-lok was -1.0 % than without vac-lok. The dose reduction ratio for the using 20 mm vac-lok was -2.1 %, for the using 30 mm vac-lok was -3.0 % than without vac-lok. Based on the value of no vac-lok dose in the Side-Rail-In state, The dose reduction ratios for the using 10 mm, 20 mm and 30 mm thickness of vac-loks In the Side-Rail-Out that the center point were -12.7 %, -13.7 %, -14.2 % and -12.8 %, -13.8 %, -14.5 % respectively at point A. The dose reduction ratios for the same conditions to the B point were -4.9 %, -6.1 %, -7.1 % and -13.4 %, -14.4 %, -15.5 % respectively at point C. The dose reduction ratios for the same conditions to the D point were -8.4 %, -9.0 %, -10.4 % respectively. Conclusion : The attenuation was caused by presence of side rails and thickness of vac-lok. Pay attention to these attenuation factors, making it a more effective radiation therapy.

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Lipopolysaccharide-induced Synthesis of IL-1beta, IL-6, TNF-alpha and TGF-beta by Peripheral Blood Mononuclear Cells (내독소에 의한 말초혈액 단핵구의 IL-1beta, IL-6, TNF-alpha와 TGF-beta 생성에 관한 연구)

  • Jung, Sung-Hwan;Park, Choon-Sik;Kim, Mi-Ho;Kim, Eun-Young;Chang, Hun-Soo;Ki, Shin-Young;Uh, Soo-Taek;Moon, Seung-Hyuk;Kim, Yang-Hoon;Lee, Hi-Bal
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.4
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    • pp.846-860
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    • 1998
  • Background: Endotoxin (LPS : lipopolysaccharide), a potent activator of immune system, can induce acute and chronic inflammation through the production of cytokines by a variety of cells, such as monocytes, endothelial cells, lymphocytes, eosinophils, neutrophils and fibroblasts. LPS stimulate the mononucelar cells by two different pathway, the CD14 dependent and independent way, of which the former has been well documented, but not the latter. LPS binds to the LPS-binding protein (LBP), in serum, to make the LPS-LBP complex which interacts with CD14 molecules on the mononuclear cell surface in peripheral blood or is transported to the tissues. In case of high concentration of LPS, LPS can stimulate directly the macrophages without LBP. We investigated to detect the generation of proinflammatory cytokines such as interleukin 1 (IL-1), IL-6 and TNF-$\alpha$ and fibrogenic cytokine, TGF-$\beta$, by peripheral blood mononuclear cells (PBMC) after LPS stimulation under serum-free conditions, which lacks LBPs. Methods : PBMC were obtained by centrifugation on Ficoll Hypaque solution of peripheral venous bloods from healthy normal subjects, then stimulated in the presence of LPS (0.1 ${\mu}g/mL$ to 100 ${\mu}g/mL$ ). The activities of IL-1, IL-6, TNF, and TGF-$\beta$ were measured by bioassaies using cytokines - dependent proliferating or inhibiting cell lines. The cellular sources producing the cytokines was investigated by immunohistochemical stains and in situ hybridization. Results : PBMC started to produce IL-6, TNF-$\alpha$ and TGF-$\beta$ in 1 hr, 4 hrs and 8hrs, respectively, after LPS stimulation. The production of IL-6, TNF-$\alpha$ and TGF-$\beta$ continuously increased 96 hrs after stimulation of LPS. The amount of production was 19.8 ng/ml of IL-6 by $10^5$ PBMC, 4.1 ng/mL of TNF by $10^6$ PBMC and 34.4 pg/mL of TGF-$\beta$ by $2{\times}10^6$ PBMC. The immunoreactivity to IL-6, TNF-$\alpha$ and TGF-$\beta$ were detected on monocytes in LPS-stimulated PBMC. Some of lymphocytes showed positive immunoreactivity to TGF-$\beta$. Double immunohistochemical stain showed that IL-1$\beta$, IL-6, TNF-$\alpha$ expression was not associated with CD14 postivity on monocytes. IL-1$\beta$, IL-6, TNF-$\alpha$ and TGF-$\beta$mRNA expression were same as observed in immunoreactivity for each cytokines. Conclusion: When monocytes are stimulated with LPS under serum-free conditions, IL-6 and TNF-$\alpha$ are secreted in early stage of inflammation. In contrast, the secretion of TGF-$\beta$ arise in the late stages and that is maintained after 96 hrs. The main cells releasing IL-1$\beta$, IL-6, TNF-$\alpha$ and TGF-$\beta$ are monocytes, but also lymphocytes can secret TGF-$\beta$.

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Tenderness Survey of Branded Hanwoo Beef - 2007: Assessment of Warner-Bratzler Shear for Hanwoo Beef by Quality Grade and Subprimal Cuts (브랜드 한우고기 연도 조사 - 2007 : 육질등급 및 소분할 부위별 전단력 평가)

  • Kim, Jin-Hyoung;Seong, Pil-Nam;Cho, Soo-Hyun;Jeong, Da-Woon;In, Tae-Sik;Jeong, Jin-Hyung;Park, Beom-Young;Lee, Jong-Moon;Kim, Dong-Hun;Ahn, Chong-Nam
    • Food Science of Animal Resources
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    • v.28 no.3
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    • pp.283-288
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    • 2008
  • Eight subprimal cuts purchased from the branded Hanwoo beef of 3 quality grades ($1^{++}$, $1^+$, 1) at 13 stores were evaluated the tenderness using Warner-Bratzler shear (WBS). The beef frequency ratio (%) depending on postmortem aging periods were investigated. The 37.5 (quality grade $1^{++}$), 45.8 (quality grade $1^+$), and 36.4% (quality grade $1^{++}$) of branded beef were aged for < 7 d, 26.6 (quality grade $1^{++}$), 47.2 (quality grade $1^+$) and 36.4% (quality grade 1) were aged for $7{\sim}13$ d, and 31.3 (quality grade $1^+$), 4.2 (quality grade $1^+$) and 25.8% (quality grade $1^+$) were aged for 14 to 20 d. The temperature of cold room in stores was ranged average 2.27 to $2.42^{\circ}C$. WBS values for ansimsal (tenderloin), witdngsimsal (ribeye), cheggtsal (shortloin), doganisal (knuckle) and moongchisatae (hind shank) from branded Hanwoo beef of quality grade $1^{++}$ were tender than those from branded Hanwoo beef of quality grade 1 (p<0.05). WBS values for ansimsal (tenderloin) were 2.56 (quality grade $1^{++}$), 2.76 (quality grade $1^+$) and 3.10 kg (quality grade 1), respectively, and those for doganisal (knuckle, quality grade $1^{++}$), hongdukesal (eye of round, quality grade $1^+$) and bosupsal (top sirloin, quality grade 1) were 4.76, 4.96 and 5.66kg, respectively (p<0.05). The frequency ratio (%) of WBS < 3.9 kg in the all subprimal cuts from branded Hanwoo beef of quality grade $1^{++}$ were 100 [ansimsal (tenderloin) and cheggtsal (shortloin)], 87.5 [witdngsimsal (ribeye)] and 62.5% [bosupsal (top sirloin)], whereas that of WBS > 4.6 kg were 50.0% [hongdukesal (eye of round) and doganisal (knuckle)]. The frequency ratio of WBS < 3.9 kg in the an subprimal cuts of quality grade $1^+$ were 100 [ansimsal (tenderloin) and witdngsimsal (ribeye)] and 44.4% [cheggtsal (shortloin) and gurisal (chuck tender)], whereas that of WBS > 4.6 kg were 66.7 [hongdukesal (eye of round)], 55.6 [doganisal (knuckle)] and 44.4% [bosupsal (top sirloin)]. The frequency ratio (%) of WBS < 3.9 kg in the all subprimal cuts of quality grade 1 were 88.9 [ansimsal (tenderloin)], 62.5 [cheggtsal (shortloin)] and 44.4% [witdngsimsal (ribeye)], whereas that of WBS > 4.6 kg were 100.0 [doganisal (knuckle)] 62.7 [hongdukesal (eye of round)], 62.5 [gurisal (chuck tender)] and 55.6% [moongchisatae (hind shank)]. From these results, subprimal cuts from branded Hanwoo beef were marketed with short aging periods and high frequency ratio (%) of WBS > 4.6 kg.

Assessment of Estimated Daily Intakes of Artificial Sweeteners from Non-alcoholic Beverages in Children and Adolescents (어린이와 청소년의 비알콜성음료 섭취에 따른 인공감미료 섭취량 평가)

  • Kim, Sung-Dan;Moon, Hyun-Kyung;Lee, Jib-Ho;Chang, Min-Su;Shin, Young;Jung, Sun-Ok;Yun, Eun-Sun;Jo, Han-Bin;Kim, Jung-Hun
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.43 no.8
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    • pp.1304-1316
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    • 2014
  • The aims of this study were to estimate daily intakes of artificial sweeteners from beverages and liquid teas as well as evaluate their potential health risks in Korean children and adolescents (1 to 19 years old). Dietary intake assessment was conducted using actual levels of aspartame, acesulfame-K, and sucralose in non-alcoholic beverages (651 beverages and 87 liquid teas), and food consumption amounts were drawn from "The Fourth Korea National Health and Nutrition Examination Survey (2007~2009)". To estimate dietary intake of non-alcoholic beverages, a total of 6,082 children and adolescents (Scenario I) were compared to 1,704 non-alcoholic beverage consumption subjects (Scenario II). The estimated daily intake of artificial sweeteners was calculated based on point estimates and probabilistic estimates. The values of probabilistic artificial sweeteners intakes were presented by a Monte Carlo approach considering probabilistic density functions of variables. The level of safety for artificial sweeteners was evaluated by comparisons with acceptable daily intakes (ADI) of aspartame (0~40 mg/kg bw/day), acesulfame-K (0~15 mg/kg bw/day), and sucralose (0~15 mg/kg bw/day) set by the World Health Organization. For total children and adolescents (Scenario I), mean daily intakes of aspartame, acesulfame-K, and sucralose estimated by probabilistic estimates using Monte Carlo simulation were 0.09, 0.01, and 0.04 mg/kg bw/day, respectively, and 95th percentile daily intakes were 0.30, 0.02, and 0.13 mg/kg bw/day, respectively. For consumers-only (Scenario II), mean daily intakes of aspartame, acesulfame-K, and sucralose estimated by probabilistic estimates using Monte Carlo simulation were 0.52, 0.03, and 0.22 mg/kg bw/day, respectively, and 95th percentile daily intakes were 1.80, 0.12, and 0.75 mg/kg bw/day, respectively. For scenarios I and II, neither aspartame, acesulfame-K, nor sucralose had a mean and 95th percentile intake that exceeded 5.06% of ADI.

The Effect of Two Terpenoids, Ursolic Acid and Oleanolic Acid on Epidermal Permeability Barrier and Simultaneously on Dermal Functions (우솔릭산과 올레아놀산이 피부장벽과 진피에 미치는 영향에 대한 연구)

  • Suk Won, Lim;Sung Won, Jung;Sung Ku, Ahn;Bora, Kim;In Young, Kim;Hee Chang , Ryoo;Seung Hun, Lee
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.30 no.2
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    • pp.263-278
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    • 2004
  • Ursolic acid (UA) and Oleanolic acid (ONA), known as urson, micromerol and malol, are pentacyclic triterpenoid compounds which naturally occur in a large number of vegetarian foods, medicinal herbs, and plants. They may occur in their free acid form or as aglycones for triterpenoid saponins, which are comprised of a triterpenoid aglycone, linked to one or more sugar moieties. Therefore UA and ONA are similar in pharmacological activity. Lately scientific research, which led to the identification of UA and ONA, revealed that several pharmacological effects, such as antitumor, hepato-protective, anti-inflammatory, anticarcinogenic, antimicrobial, and anti-hyperlipidemic could be attributed to UA and ONA. Here, we introduced the effect of UA and ONA on acutely barrier disrupted and normal hairless mouse skin. To evaluate the effects of UA and ONA on epidermal permeability barrier recovery, both flanks of 8-12 week-old hairless mice were topically treated with either 0.01-0.1mg/mL UA or 0.1-1mg/mL ONA after tape stripping, and TEWL (transepidermal water loss) was measured. The recovery rate increased in those UA or ONA treated groups (0.1mg/mL UA and 0.5mg/mL ONA) at 6h more than 20% compared to vehicle treated group (p < 0.05). Here, we introduced the effects of UA and ONA on acute barrier disruption and normal epidermal permeability barrier function. For verifying the effects of UA and ONA on normal epidermal barrier, hydration and TEWL were measured for 1 and 3 weeks after UA and ONA applications (2mg/mL per day). We also investigated the features of epidermis and dermis using electron microscopy (EM) and light microscopy (LM). Both samples increased hydration compared to vehicle group from 1 week without TEWL alteration (p < 0.005). EM examination using RuO4 and OsO4 fixation revealed that secretion and numbers of lamellar bodies and complete formation of lipid bilayers were most prominent (ONA=UA > vehicle). LM finding showed that thickness of stratum corneum (SC) was slightly increased and especially epidermal thickening and flattening was observed (UA > ONA > vehicle). We also observed that UA and ONA stimulate epidermal keratinocyte differentiation via PPAR Protein expression of involucrin, loricrin, and filaggrin increased at least 2 and 3 fold in HaCaT cells treated with either ONA (10${\mu}$M) or UA (10${\mu}$M) for 24 h respectively. This result suggested that the UA and ONA can improve epidermal permeability barrier function and induce the epidermal keratinocyte differentiation via PPAR Using Masson-trichrome and elastic fiber staining, we observed collagen thickening and elastic fiber elongation by UA and ONA treatments. In vitro results of collagen and elastin synthesis and elastase inhibitory activity measurements were also confirmed in vivo findings. These data suggested that the effects of UA and ONA related to not only epidermal permeability barrier functions but also dermal collagen and elastic fiber synthesis. Taken together, UA and ONA can be relevant candidates to improve epidermal and dermal functions and pertinent agents for cosmeseutical applications.

The study on the scattering ratio at the edge of the block according to the increasing block thickness in electron therapy (전자선 치료 시 차폐블록 두께 변화에 따른 블록 주변 선량에 관한 연구)

  • Park, Zi On;Gwak, Geun Tak;Park, Ju Kyeong;Lee, Seung Hun;Kim, Yang Su;Kim, Jung Soo;Kwon, Hyoung Cheol;Lee, Sun Young
    • The Journal of Korean Society for Radiation Therapy
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    • v.31 no.1
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    • pp.57-65
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    • 2019
  • Purpose: The purpose is to clarify the effect of additional scattering ratio on the edge of the block according to the increasing block thickness with low melting point lead alloy and pure lead in electron beam therapy. Methods and materials: $10{\times}10cm^2$ Shielding blocks made of low melting point lead alloy and pure lead were fabricated to shield mold frame half of applicator. Block thickness was 3, 5, 10, 15, 20 (mm) for each material. The common irradiation conditions were set at 6 MeV energy, 300 MU / Min dose rate, gantry angle of $0^{\circ}$, and dose of 100 MU. The relative scattering ratio with increasing block thickness was measured with a parallel plate type ion chamber(Exradin P11) and phantom(RW3) by varying the position of the shielding block(cone and on the phantom), the position of the measuring point(surface ans depth of $D_{max}$), and the block material(lead alloy and pure lead). Results : When (depth of measurement / block position / block material) was (surface / applicator / pure lead), the relative value(scattering ratio) was 15.33 nC(+0.33 %), 15.28 nC(0 %), 15.08 nC(-1.31 %), 15.05 nC(-1.51 %), 15.07 nC(-1.37 %) as the block thickness increased in order of 3, 5, 10, 15, 20 (mm) respectively. When it was (surface / applicator / alloy lead), the relative value(scattering ratio) was 15.19 nC(-0.59 %), 15.25 nC(-0.20 %), 15.15 nC(-0.85 %), 14.96 nC(-2.09 %), 15.15 nC(-0.85 %) respectively. When it was (surface / phantom / pure lead), the relative value(scattering ratio) was 15.62 nC(+2.23 %), 15.59 nC(+2.03 %), 15.53 nC(+1.67 %), 15.48 nC(+1.31 %), 15.34 nC(+0.39 %) respectively. When it was (surface / phantom / alloy lead), the relative value(scattering ratio) was 15.56 nC(+1.83 %), 15.55 nC(+1.77 %), 15.51 nC(+1.51 %), 15.42 nC(+0.92 %), 15.39 nC(+0.72 %) respectively. When it was (depth of $D_{max}$ / applicator / pure lead), the relative value(scattering ratio) was 16.70 nC(-10.87 %), 16.84 nC(-10.12 %), 16.72 nC(-10.78 %), 16.88 nC(-9.93 %), 16.90 nC(-9.82 %) respectively. When it was (depth of $D_{max}$ / applicator / alloy lead), the relative value(scattering ratio) was 16.83 nC(-10.19 %), 17.12 nC(-8.64 %), 16.89 nC(-9.87 %), 16.77 nC(-10.51 %), 16.52 nC(-11.85 %) respectively. When it was (depth of $D_{max}$ / phantom / pure lead), the relative value(scattering ratio) was 17.41 nC(-7.10 %), 17.45 nC(-6.88 %), 17.34 nC(-7.47 %), 17.42 nC(-7.04 %), 17.25 nC(-7.95 %) respectively. When it was (depth of $D_{max}$ / phantom / alloy lead), the relative value(scattering ratio) was 17.45 nC(-6.88 %), 17.44 nC(-6.94 %), 17.47 nC(-6.78 %), 17.43 nC(-6.99 %), 17.35 nC(-7.42 %) respectively. Conclusions: When performing electron therapy using a shielding block, the block position should be inserted applicator rather than the patient's body surface. The block thickness should be made to the minimum appropriate shielding thickness of each corresponding using energy. Also it is useful that the treatment should be performed considering the influence of scattering dose varying with distance from the edge of block.

Diagnostic Approach to the Solitary Pulmonary Nodule : Reappraisal of the Traditional Clinical Parameters for Differentiating Malignant Nodule from Benign Nodule (고립성 폐결절에 대한 진단적 접근 : 악성결절과 양성결절의 감별 지표에 대한 재검토)

  • Kho, Won Jung;Kim, Cheol Hyeon;Jang, Seung Hun;Lee, Jae Ho;Yoo, Chul Gyu;Chung, Hee Soon;Kim, Young Whan;Han, Sung Koo;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.4
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    • pp.500-518
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    • 1996
  • Background : The solitary pulmonary nodule(SPN) presents a diagnostic dilemma to the physician and the patient. Many clinical characteristics(i.e. age, smoking history, prior history of malignancy) and radiological characteristics( i.e. size, calcification, growth rate, several findings of computed tomography) have been proposed to help to determine whether the SPN was benign or malignant. However, most of these diagnostic guidelines are based on the data collected before computed tomography(CT) has been introduced and lung cancer was not as common as these days. Moreover, it is not well established whether these guidelines from western populations could be applicable to Korean patients. Methods : We had a retrospective analysis of the case records and radiographic findings in 114 patients presenting with SPN from Jan. 1994 to Feb. 1995 in Seoul National University Hospital, a tertiary referral hospital. Results : We observed the following results ; (1) Out of 113 SPNs, the etiology was documented in 94 SP IS. There were 34 benign SP s and 60 malignant SPNs. Among which, 49 SPNs were primary lung cancers and the most common hi stologic type was adenocarcinoma. (2) The average age of patients with benign and malignant SPNs was $49.7{\pm}12.0$ and $58.1{\pm}10.0$ years, respectively( p=0.0004), and the malignant SPNs had a striking linear propensity to increase with age. (3) No significant difference in the hi story of smoking was noted between the patients with benign SPNs($13.0{\pm}17.6$ pack- year) and those with malignant SPNs($18.6{\pm}25.1$ pack-year) (p=0.2108). (4) 9 out of 10 patients with prior history of malignancy had malignant SPNs. 5 were new primary lung cancers with no relation to prior malignancy. (5) The average size of benign SPNs($3.01{\pm}1.20cm$) and malignant SPNs($2.98{\pm}0.97cm$) was not significantly different(p=0.8937). (6) The volume doubling time could be calculated in 22 SPNs. 9 SPNs had the volume doubling time longer than 400 days. Out of these, 6 were malignant SPNs. (7) The CT findings suggesting malignancy included the lobulated or spiculated border, air- bronchogram, pleural tail, and lymphadenopathy. In contrast, calcification, central low attenuation, cavity with even thickness, well-marginated border, and peri nodular micronodules were more suggestive for benign nodule. (8) The diagnostic yield of percutaneous needle aspiration and biopsy was 57.6%(19/33) of benign SPNs and 81.0%(47/58) of malignant SPNs. The diagnostic value of sputum analysis and bronchoscopic evaluations were relatively very low. (9) 42.3%(11/26) of SPNs of undetermined etiology preoperatively turned out to be malignant after surgical resection. Overall, 75.4%(46/61) of surgically resected SPNs were malignant. Conclusions : We conclude that the likelihood of malignant SPN correlates the age of patient, prior history of malignancy, some CT findings including lobulated or spiculated border, air-bronchogram, pleural tail and lymphadenopathy. However, the history of smoking, the size of the nodule, and the volume doubling time are not helpful to determent whether the SPN is benign or malignant, which have been regarded as valuable clinical parameters previously. We suggest that aggressive diagnostic approach including surgical resection is necessary in patient with SPNs.

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