• The Journal of Korean Society for Radiation Therapy
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• v.22 no.1
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• pp.47-51
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• 2010

Purpose: In the treatment of high-energy protons Air gap (the distance between the patient and the exit Beam) Lateral Penumbra of the changes to the increase in the radiation fields can form unnecessary and Increase the maximum dose at the site of treatment and reduced the minimum dose homogeneity of dose distributions can decline. Air gap due to this change in dose distribution compared to investigate studied. Materials and Methods: Received proton therapy at our institution Lung, Liver patients were selected and the size of six other Air gap in Field A and Field B 2, 4, 6, 8, 10 cm Proton external beam planning system by setting up a treatment plan established. Air gap according to the Lateral Penumbra area and DVH (Dose Volume Histogram) to compare the maximum dose and minimum dose of PCTV areas were compared. In addition, the dose homogeneity within PCTV Homogeneity index to know the value and compared. Results: Air gap (2, 4, 6, 8, 10 cm) at each change in field size were analyzed according to the Lateral Penumbra region Field A Change in the Air gap 2~10 cm by 1.36~1.75 cm, the average continuously increased about 28.7% and Field B Change in the Air gap 2~10 cm by 1.36~1.75 cm, the average continuously increased about 31.6%. The result of DVH analysis for relative dose of the maximum dose According to Air gap 2~10 cm is the mean average of 110.3% from 108.1% to a sustained increased by approximately 2.03% and The average relative dose of minimum dose is the mean average of 93.9% percent to 90.8 percent from the continuous decrease of about 3.31 percent. The result of Homogeneity index value to the according to Air gap 2~10 cm is the 2-fold increase from 1.09 to 2.6. Conclusion: In proton therapy case, we can see the increasing of lateral penumbra area when airgap getting increase. And increasing of Dmax and decreasing Dmin in the field are making increase homogeneity index, So we can realize there are not so good homogeneity in the PCTV. Therefore we should try to minimize air gap in proton therapy case.

• Progress in Medical Physics
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• v.13 no.4
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• pp.195-201
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• 2002

Several investigators have presented the effects of external magnetic fields on the dose distributions for clinical electron and photon beams. We focus the low energy electron beam with more lateral scatter In this study we calculated the beam profiles for an clinical electron beam of 6 MeV with longitudinal magnetic fields of 0.5 T-3.0 T using a Monte Carlo code. The principle of dose enhancements in the penumbra region is to deflect the laterally scattered electrons from its initial direction by the skewness of the laterally scattered electrons along the direction of magnetic field lines due to Lorentz force under longitudinal magnetic field. To discuss the dose enhancement effect on the penumbra area from the calculated results, we introduced the simple term of penumbra reduction ratio (PRR), which is defined as the percentage difference between the penumbra with and without magnetic field at the same depth. We found that the average PRR are 33%, and 49% over the depths of 1.5 cm, 2.0 cm, and 2.4 cm for the magnetic fields of 2.0 T and 3.0 T respectively. For the case of 0.5 T and 1.0 T the effects of magnetic filed were not observed significantly. In order to obtain the dose enhancement effects by the external magnetic field, we think that its strength should be more than 2 T approximately. We expect that the PRR would be saturated to 50-60% with magnetic fields of 3 T-5 T As a result of these calculations we found that the penumbra widths can be reduced with increased magnetic fields. This Penumbra reduction is explained as a result of electron lateral spread outside the geometrical edges of the beam in a longitudinal magnetic field. This means that the electron therapy benefits from the external magnetic fields.

• Journal of Korean Medicine Rehabilitation
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• v.19 no.3
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• pp.1-13
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• 2009

Objectives : This study evaluates neuroprotective effect of Gastrodiae Rhizoma on apoptosis in the cerebral infarct. Methods : Cerebral infarct was induced by the middle cerebral artery occlusion (MCAO) for 2 hours with intraluminal thread method in Sprague-Dawley rats. Then ethanol extract of Gastrodiae Rhizoma was administered orally for 3 days. Infarct area and volume were evaluated with TTC staining. Neuronal apoptosis was identified with TUNEL labeling. Apoptosis modulatory effect was observed with immunohistochemical Bax, Bcl-2, iNOS, and MMP-9 expressions in penumbra. Results : 1. Ethanol extract of Gastrodiae Rhizoma reduced infarct size partly and volume significantly of in the MCAO rat brain. 2. Ethanol extract of Gastrodiae Rhizoma reduced TUNEL positive cell ratio in the penumbra of MCAO rat brain significantly. 3. Ethanol extract of Gastrodiae Rhizoma suppressed Bax, iNOS and MMP-9 expression in the penumbra of MCAO rat brain significantly. 4. Ethanol extract of Gastrodiae Rhizoma did not change Bcl-2 expression in the penumbra of MCAO rat brain. But expression ratio of Bcl-2 against Bax was increased in the Gastrodiae Rhizoma group. Conclusions : These results suggest that Gastrodiae Rhizoma plays an anti-apoptotic neuroprotective effect through suppression of Bax, iNOS, and MMP-9 expressions and relative up-regulation of Bcl-2 in the ischemic brain tissue.

• Journal of Korean Neurosurgical Society
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• v.59 no.4
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• pp.352-356
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• 2016

Objective : The efficacy and safety of manual aspiration thrombectomy using Penumbra in an acute occlusion of large intracranial arteries has been proven in many previous studies. Our study aimed to retrospectively assess the efficacy and safety of manual aspiration thrombectomy using Penumbra in patients with small vessel occlusions (M2 segment of the MCA). Methods : We conducted a retrospective review of 32 patients who underwent manual aspiration thrombectomy using the Penumbra 4 MAX Reperfusion Catheter for treatment of an M2 occlusion between January 2013 and November 2014. We evaluated immediate angiographic results and clinical outcomes through review of patient electronic medical records. Results : There were slightly more men in this study (M : F=18 : 14) and the median age was 72.5 (age range : 41-90). The rate of successful recanalization (TICI grade ${\geq}2b$) was 84% (27/32). NIHSS at discharge and favorable clinical outcomes at 3 months were significantly improved than baseline. Median initial NIHSS score was 10 (range : 4-25) and was 4 (range : 0-14) at discharge. Favorable clinical outcomes (mRS score ${\leq}2$ at 3 months) were seen in 25 out of 32 patients (78%). There were no procedure-related symptomatic intracerebral hemorrhages. One patient expired after discharge due to a cardiac problem. Conclusion : Manual aspiration thrombectomy might be safe and is capable of achieving a high rate of successful recanalization and favorable clinical outcomes in patients with distal cerebral vessel occlusion (M2).

• Journal of Physiology & Pathology in Korean Medicine
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• v.20 no.3
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• pp.596-602
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• 2006

This study evaluated neuroprotective effect of Sunghyangjungki-San (SHS) on the focal cerebral ischemia. The rats were induced infarct in cerebral cortex and caudoputamen by using temporal occlussion of the middle cerebral artery (MCAO), then water extract of SHS was treated for MCAO rats. Neuroprotective effect was evaluated by neurological score, infarct sizes and total volume, positive neurons against Bax, Caspase-3, HSP-72, and $HIF-1{\alpha}$ in infarct area with immunohistochemistry. The results obtained were as follows: Treatment of SHS improved neurological score of MCAO rats, but there was not a statistical significance. Treatment of SHS reduced significantly infarct sizes in the brain sections of MCAO rats. Treatment of SHS reduced significantly total volume of infarct of MCAO rats. Treatment of SHS reduced significantly Bax positive neurons in penumbra of cerebral cortex of MCAO rats. Treatment of SHS reduced significantly Caspase-3 positive neurons in caudoputamen and penumbra of cerebral cortex of MCAO rats. Treatment of SHS reduced significantly HSP-72 positive neurons in penumbra of cerebral cortex of MCAO rats. Treatment of SHS reduced significantly $IF-1{\alpha}$ positive neurons in penumbra of cerebral cortex of MCAO rats.

• The Journal of Korean Society for Radiation Therapy
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• v.28 no.1
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• pp.35-46
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• 2016

Purpose : BoS(Base of Skull) Frame, the fixation tool which is used for the proton of brain cancer increases the lateral penumbra by increasing the airgap (the distance between patient and beam jet), due to the collision of the beam of the posterior oblique direction. Thus, we manufactured the fixation tool per se for improving the limits of BoS frame, and we'd like to evaluate the utility of the manufactured fixation tool throughout this study. Materials and Methods : We've selected the 3 patients of brain cancer who have received the proton therapy from our hospital, and also selected the 6 beam angles; for this, we've selected the beam angle of the posterior oblique direction. We' ve measured the planned BoS frame and the distance of Snout for each beam which are planned for the treatment of the patient using the BoS frame. After this, we've proceeded with the set-up that is above the location which was recommended by the manufacturer of the BoS frame, at the same beam angle of the same patient, by using our in-house Bos frame fixation tool. The set-up was above 21 cm toward the superior direction, compared to the situation when the BoS frame was only used with the basic couch. After that, we've stacked the snout to the BoS frame as much as possible, and measured the distance of snout. We've also measured the airgap, based on the gap of that snout distance; and we've proceeded the normalization based on each dose (100% of each dose), after that, we've conducted the comparative analysis of lateral penumbra. Moreover, we've established the treatment plan according to the changed airgap which has been transformed to the Raystation 5.0 proton therapy planning system, and we've conducted the comparative analysis of DVH(Dose Volume Histogram). Results : When comparing the result before using the in-house Bos frame fixation tool which was manufactured for each beam angle with the result after using the fixation tool, we could figure out that airgap than when not used in accordance with the use of the in-house Bos frame fixation tool was reduced by 5.4 cm ~ 15.4 cm, respectively angle. The reduced snout distance means the airgap. Lateral Penumbra could reduce left, right, 0.1 cm ~ 0.4 cm by an angle in accordance with decreasing the airgap while using each beam angle in-house Bos frame fixation tool. Due to the reduced lateral penumbra, Lt.eyeball, Lt.lens, Lt. hippocampus, Lt. cochlea, Rt. eyeball, Rt. lens, Rt. cochlea, Rt. hippocampus, stem that can be seen that the dose is decreased by 0 CGE ~ 4.4 CGE. Conclusion : It was possible to reduced the airgap by using our in-house Bos frame fixation tool for the proton therapy; as a result, it was possible to figure out that the lateral penumbra reduced. Moreover, it was also possible to check through the comparative analysis of the treatment plan that when we reduce the lateral penumbra, the reduction of the unnecessary irradiation for the normal tissues. Therefore, Using the posterior oblique the Brain cancer proton therapy should be preceded by decreasing the airgap, by using our in-house Bos frame fixation tool; also, the continuous efforts for reducing the airgap as much as possible for the proton therapy of other area will be necessary as well.

• Progress in Medical Physics
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• v.5 no.2
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• pp.49-55
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• 1994

Multileaf Collimator is an essential tool for conformal therapy. We have measured the scallop penumbars of a poligon-shape field produced by Multileaf Collimator(MLC) with various leaf widths and the penumbra from conventional block, and compared the difference between them for the energy of photons, leaf widths, and angle of filed edges in order to find out the optimum leaf width. In addition, we have simulated a treatment of 20 factionations with errors of patient positioning. Optimum cost-benefit balanced leaf width is 8 mm.

• Journal of Korean Neurosurgical Society
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• v.57 no.5
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• pp.342-349
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• 2015

Background : Higher reperfusion rates have been established with endovascular treatment for acute ischemic stroke patients. There are limited data on the comparative performance of mechanical thrombectomy devices. This study aimed to analyse the efficacy and safety of the stent retriever device (Solitaire stent) by comparing procedure time, angiographic outcome, complication rate and long term clinical outcome with previous chemical thrombolysis and mechanical thrombectomy using penumbra system. Method : A retrospective single-center analysis was undertaken of all consecutive patients who underwent chemical thrombolysis and mechanical thrombectomy using Penumbra or Solitaire stent retriever from March 2009 to March 2014. Baseline characteristics, rate of successful recanalization (modified Thrombolysis in Cerebral Infarction score 2b-3), symptomatic intracerebral hemorrhage, procedure time, mortality and independent functional outcomes ($mRS{\leq}2$) at 3 month were compared across the three method. Results : Our cohort included 164 patients, mechanical thrombectomy using stent retriever device had a significant impact on recanalization rate and functional independence at 3 months. In unadjusted analysis mechanical thrombectomy using Solitaire stent retriever showed higher recanalization rate than Penumbra system and chemical thrombolysis (75% vs. 64.2% vs. 49.4%, p=0.03) and higher rate of functional independence at 3 month (53.1% vs. 37.7% vs. 35.4%, p=0.213). In view of the interrelationships between all predictors of variables associated with a good clinical outcome, when the chemical thrombolysis was used as a reference, in multiple logistic regression analysis, the use of Solitaire stent retriever showed higher odds of independent functional outcome [odds ratio (OR) 2.62, 95% confidence interval (CI) 0.96-7.17; p=0.061] in comparison with penumbra system (OR 1.57, 95% CI 0.63-3.90; p=0.331). Conclusion : Our initial data suggest that mechanical thrombectomy using stent retriever is superior to the mechanical thrombectomy using penumbra system and conventional chemical thrombolysis in achieving higher rates of reperfusion and better outcomes. Randomized clinical trials are needed to establish the actual benefit to specific patient populations.

• Journal of The Korean Astronomical Society
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• v.16 no.1
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• pp.19-22
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• 1983

The reduced profiles of $C_2$ 5150.56, CN 3864.32, MgH 5150.20 and FeI 5150.84 lines, representing the penumbra, the penumbra-umbra boundary and the umbra of spa 6403 have been analyzed by comparing them with the synthetic profiles computed from a set of umbral and penumbral models. The results are presented and discussed. It is suggested that there may be a significant lateral flow of pbotospheric radiation into the umbral and penumbral regions of the sunspots.

• Korean Journal of Remote Sensing
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• v.33 no.6_3
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• pp.1197-1213
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• 2017

This study was carried out to correct shadow area in urban area on KOMPSAT-3 satellite image. For this study, we analyzed characteristics of the shadow area represented by artificial structures in urban area. The proposed shadow correction method divides shadow area into umbra and penumbra areas according to intensity of darkness. The umbra area was detected through the histogram analysis and the statistical method of the NIR image, and then penumbra area and the sunlit area were detected from around the detected umbra area. The correction of the detected umbra and penumbra area were performed by applying the linear correlation correction method. As a result, it was confirmed that the proposed shadow correction method was visually performed well. Quantitative analysis was performed through profile analysis. It is proved that proposed method is useful for shadow area correction.