비회귀성 후두 신경; 수술 전 경부 CT를 통한 신경 손상의 예방

김진성,소상수,최동일,양윤수,홍기환,Kim, Jin-Sung,So, Sang-Soo,Choi, Dong-Il,Yang, Yun-Su,Hong, Ki-Hwan 대한후두음성언어의학회 2007 대한후두음성언어의학회지 Vol.18 No.1

Background and Objectives: The nonrecurrent laryngeal nerve(NRLN) is exceedingly rare nerve anomaly that is associated with developmentally aberrant subclavian artery. The presence of NRLN is associated with an increased risk of vocal cord palsy in thyroid surgery. The purpose of this study is to investigate its prevalence, associated vascular anomaly and necessity of recognizing its possibility for prevention of intraoperative nerve damage. Materials and Methods: Between January 2004 and December 2006, 583 thyroidectomy were performed at our hospital. Of these cases, 529 cases(90.7%) were checked preoperative neck CT. Results: Patients with preopreative neck CT, 6 cases show the retroesophageal abberant right subclavian artery that arising directly form the aortic arch. 5 cases of these 6 cases(5/6, 83.3%) and of 583 patients(5/583, 0.8%) performed thyroid surgery were identified NRLN per-operatively. All of them are identified on the right side. There were 4 women and 1 man. In all cases, there were no clinical symptoms. I case was performed only left hemithyroidectomy, so we cannot identified NRLN. No vocal cord palsy was observed. Conclusion: It is possible to predict NRLN from preoperative neck CT. When NRLN is suspected, careful, complete dissection of the nerve is always advocated. These process can reduce the operative morbidity.

만성 B형 간질환 환자의 정신사회적 측면

김진성,Kim, Jin-Sung 한국정신신체의학회 2000 정신신체의학 Vol.8 No.1

연구목적 : 저자는 만성 B형 간질환 환자의 정신과학적 측면과 사회학적 측면을 관찰해 보고자 본 연구를 실시하였다. 방법 : 저자는 1966년부터 1999년까지의 Medline database에 등록된 B형 간질환에 관한 모든 문헌들을 고찰하였다. 결과 : 만성 B형 간질환 환자와 관계되는 정신과학적 측면은 섬망, 전반적인 의학적 상태에 기인하는 정신병(특히 조증), 불안, 우울, 적응장애, 알코올 남용과 의존, 및 약물남용과 의존 등이다. 만성 B형 간질환 환자와 관계되는 사회학적 측면은 간염보균자로서의 낙인문제, 감염과 연관된 죄책감, 증가된 가족들의 부담에 대한 죄책감, 대인관계의 소외와 철수, 성장애, 직업상실 및 의료진의 치료 거부등이다. 결론 : 만성 경과를 거치는 B형 간염환자의 여러 가지 정신과학적 사회학적 문제로 볼 때, 적절한 조기의 교육적 상담 개업이 필요하다고 하겠다. 적절한 교육적 상담 개입은 간염으로부터 간경화 간암으로의 진행과정에 B형 간염환자의 치료의 순응도를 높이고 나아가 악화의 과정을 예방할 수 있다. Objectives : The author wanted to summarize the psychiatric and social aspects of the patients with hepatitis B virus infection. Methods : The author reviewed all pertinent citations in the Medline database from 1966 to 1999. Results : Psychiatric problems in this population include delirium, psychotic disorder due to general medical condition(especially mania), anxiety, depression, adjustment disorder, alcohol abuse/dependence, and drug abuse/dependence. Social aspects of the patients with hepatitis B viral infection relate to the stigma of being a carrier, guilty feeling about infection, guilty feeling about increased family burden, impacts of having hepatitis on interpersonal relations, sexual difficulties, and job loss with increased financial burden, and health care worker's refusal. Conclusions : Appropriate early educational counseling interventions regarding the expected course and psychosocial intervention should be tailored to the sociocultural needs of special populations. Those interventions will increase compliance of treatment and prevent progression to hepatocellalar carcinoma from hepatitis.

Knowledge Conversion between Conceptual Graph Model and Resource Description Framework

김진성,Kim, Jin-Sung Korean Institute of Intelligent Systems 2007 한국지능시스템학회논문지 Vol.17 No.1

On the Semantic Web, the content of the documents must be explicitly represented through metadata in order to enable contents-based inference. In this study, we propose a mechanism to convert the Conceptual Graph (CG) into Resource Description Framework (RDF). Quite a large number or representation languages for representing knowledge on the Web have been established over the last decade. Most of these researches are focused on design of independent knowledge description. On the Semantic Web, however, a knowledge conversion mechanism will be needed to exchange the knowledge used in independent devices. In this study, the CG could give an entire conceptual view of knowledge and RDF can represent that knowledge on the Semantic Web. Then the CG-based object oriented PROLOG could support the natural inference based on that knowledge. Therefore, our proposed knowledge conversion mechanism will be used in the designing of Semantic Web-based knowledge representation and inference systems.

적응화된 콘텐츠를 서비스하기 위한 사용자 단말기 프레임워크 설계 및 구현

김진성,이재동,Kim, Jin-Sung,Lee, Jae-Dong 한국정보처리학회 2009 정보처리학회논문지D Vol.16 No.5

인터넷의 발달과 멀티미디어 콘텐츠 수요의 증가에 따라 콘텐츠 산업이 발달하고 있다. 하지만 현재 콘텐츠 산업은 제한된 환경(사용자 디바이스 환경, 네트워크 환경 등)에서 동일화된 콘텐츠를 제공하고 있다. 또한, 사용자의 상황 및 감성에 맞는 콘텐츠를 서비스하기 위해서는 사용자가 콘텐츠를 검색하여 찾아야하는 어려움이 있다. 이에 사용자의 상황 및 감성에 따라 콘텐츠를 제공하는 시스템에 대한 필요가 대두되고 있다. 이에 본 논문에서는 유비쿼터스 환경에서 사용자가 언제, 어디서든지, 다양한 디바이스를 통해 사용자의 상황 및 감성 정보에 따라 적응화된 콘텐츠를 제공할 수 있는 시스템을 제안하고 사용자 단말기 상에서 적응화된 콘텐츠를 제공받을 수 있는 사용자 단말기 프레임워크를 설계하고 구현한다. According to development of internet and an increase in demand of multimedia contents, the contents industry is being developed. However, they are served same contents in the limited environment(user device environment, network environment) of the present contents industry. And users have difficulties in searching and finding contents since they are served contents they want and contents suitable to diverse context and affection. Therefore, it is necessary to make a system offering contents according to context and affection of users. The study proposes the system to offer contents suitable to context and affection of users whenever and wherever through diverse devices in a ubiquitous environment and designs/implementation a user device framework system that users can be offered contents suitable to their devices.

호흡동조 방사선치료의 2차원 선량 분포 정도관리를 위한 4D 정도관리 시스템 개발

김진성,신은혁,신정석,주상규,한영이,박희철,최두호,Kim, Jin-Sung,Shin, Eun-Hyuk,Shin, Jung-Suk,Ju, Sang-Gyu,Han, Young-Yih,Park, Hee-Chul,Choi, Doo-Ho 한국의학물리학회 2010 의학물리 Vol.21 No.2

Emerging technologies such as four-dimensional computed tomography (4D CT) is expected to allow clinicians to accurately model interfractional motion and to quantitatively estimate internal target volumes (ITVs) for radiation therapy involving moving targets. A need exists for a 4D radiation therapy quality assurance (QA) device that can incorporate and analyze the patient specific intrafractional motion as it relate to dose delivery and respiratory gating. We built a 4D RT prototype device and analyzed the patient-specific 4D radiation therapy QA for 2D dose distributions successfully. With more improvements, the 4D RT QA prototype device could be an integral part of a 4D RT decision process to confirm the dose delivery. 최근 시행되고 있는 호흡동조 방사선치료는 환자의 호흡의 주기를 이용하여 일정 주기에만 방사선을 조사하는 최신 방사선치료기술로 4D Computed Tomography와 RPM (Real-time Position Management) 시스템과 같은 호흡 모니터링 시스템의 개발로 환자들에게 시행이 되고 있다. 그러나 이러한 호흡동조 방사선치료에 대한 정도 관리는 아직 체계적으로 수행되고 있지 않으며 특히 환자에게 계획된 방사선치료선량이 환자의 호흡에 따라서 치료계획된 대로 조사되는지에 대한 정도관리에 대한 필요성이 요구되고 있다. 따라서 본 기관에서는 환자의 호흡신호를 사용하여 환자의 움직임을 동일하게 모사할 수 있는 팬텀을 제작하여 호흡동조 방사선치료의 2차원적 선량 분포를 평가할 수 있는 시스템을 구축하였고 특정환자의 호흡신호와 방사선치료계획을 이용하여 검증하였다. 환자의 호흡신호는 LabVIEW 7.0을 이용하여 모사하였고, 자체 제작한 팬텀 및 Kodak EDR2 필름을 사용하여 방사선을 조사한 뒤 gamma index를 사용하여 2차원 선량 분포를 비교 분석하였다. 본 연구에서 개발된 4D 정도관리 시스템을 좀 더 보완하여 호흡동조 방사선치료 과정에 있어서 조사선량의 적정성을 평가할 수 있는 정도관리 시스템으로 사용할 수 있을 것이라 생각된다.

양성자치료용 보상체의 영상기반 정도 관리 기반 프로그램 개발

김진성,윤명근,김동욱,임영경,곽정원,박소아,신동호,신정욱,이세병,박성용,조관호,Kim, Jin-Sung,Yoon, Myong-Geun,Kim, Dong-Wook,Lim, Young-Kyung,Kwak, Jung-Won,Park, So-Ah,Shin, Dong-Ho,Shin, Jung-Wook,Lee, Se-Byeong,Park, Sung-Yong,Cho, 한국의학물리학회 2008 의학물리 Vol.19 No.1

양성자치료는 양성자의 물리적 특성으로 인해 인체 내의 특정범위에 모든 에너지를 전달하고 감쇠되어 타겟조직 뒤에 존재하는 정상조직에는 방사선이 조사되지 않는 큰 장점을 가진 치료법이다. 이 방법은 인체 내의 암 조직을 타겟으로 했을 때, 빔 방향에서의 타겟의 2차원적인 모양은 황동으로 제작된 블럭을 통해 정상조직에 들어가는 방사선을 차폐하고 마진을 주어서 GTV (eross Tumor Volume)에 90% 이상의 선량이 전달되도록 조절한다. 그리고, 양성자 빔의 날줄방향 (longitudinal)에서의 타겟의 3차원적인 모양을 고려하여 PMMA로 이루어진 보상체(compensator)를 밀링머신으로 조각하여 타겟에 방사선이 정확하게 분포되도록 한다. 이러한 보상체의 정확한 정도 관리를 위해 현재 사용되는 수동적인 방법을 보완하여 X선 영상으로 해당하는 보상체의 영상을 획득하여 이 영상을 기반으로 정도관리를 할 수 있는 방법을 제안하였고, 제안한 방법으로 보상체의 각각의 깎여진 평면의 모양과 두께를 정성적으로 비교 및 평가할 수 있었으며 두 영상의 차이가 80% 이상 맞는 것으로 확인되었다. 이를 바탕으로 영상을 이용한 정도관리 프로그램을 보완하여 추후 실제 양성자치료 정도관리에 사용될 예정이다. The main benefit of proton therapy over photon beam radiotherapy is the absence of exit dose, which offers the opportunity for highly conformal dose distributions to target volume while simultaneously irradiating less normal tissue. For proton beam therapy two patient specific beam modifying devices are used. The aperture is used to shape the transverse extension of the proton beam to the shape of the tumor target and a patient-specific compensator attached to the block aperture when required and used to modify the beam range as required by the treatment plan for the patient. A block of range shifting material, shaped on one face in such a way that the distal end of the proton field in the patient takes the shape of the distal end of the target volume. The mechanical quality assurance of range compensator is an essential procedure to confirm the 3 dimensional patient-specific dose distributions. We proposed a new quality assurance method for range compensator based on image processing using X-ray tube of proton therapy treatment room. The depth information, boundaries of each depth of plan compensatorfile and x-ray image of compensator were analyzed and presented over 80% matching results with proposed QA program.

반모가 대장암세포에 미치는 영향

김진성,윤상협,류봉하,류기원,김현일,Kim, Jin-Sung,Yoon, Sang-Hyub,Ryu, Bong-Ha,Ryu, Ki-Won,Kim, Hyeon-Yil 대한한방내과학회 2004 大韓韓方內科學會誌 Vol.25 No.2

The study examines the anti-cancer effects of the hot water extract of Mylabris phalerata(MP) using SNU-C5 cell lines. Microscopic analysis showed that 12 hours after MP treatment, the number of dead cells increased prominently. Significant cell death was observed 12, 24, and 48 hours after MP treatment through trypan blue exclusion testing. This suggests that MP is time-dependently cytotoxic. Mitotracker Red CMXRos staining and flowcytometry revealed that MP decreased mitochondrial membrane potentials. The absence of peaks on PI staining showed that DNA damage occurred in MP treated cells. Taken together, measurements suggest that MP has a strong anti-cancer effect on SNU-5 cell lines, and that this is likely to be due to the destruction of mitochondria and DNA damage.

수종 한약제의 위암세포에 대한 항암작용 효능 검색 및 약리작용에 관한 분자생물학적 연구

김진성,이지향,류봉하,박재훈,지성길,유진화,Kim, Jin-Seong,Lee, Ji-Whyang,Ryu, Bong-Ha,Park, Jae-Hoon,Ji, Sung-Gil,Yoo, Jin-Hwa 대한암한의학회 1999 大韓癌韓醫學會誌 Vol.5 No.1

Traditional oriental medicines have been used for treatment of various kinds of human cancers for long times and some of them proven to be effective clinically. However, the pharmacological actions and mechanisms related to cancer treatment are generally unknown. In an effort to clarify the action mechanisms of several oriental medicines used for cancer treatments, we planned this experimental procedures. We selected Cordyceps sinensis (冬蟲下草), Punellae Herba (夏枯草), Rehmanniae Radix (熟地黃), Paeoniae Radix (白芍藥), Oldenlandiae Herba (白花蛇舌草), Partulaceae Herba (馬齒? ), Scdopendra subspinipes mutilans (蜈蚣), Mylabris Phalerara (班蟄), Phellinus igniarius(桑黃), Ganodermae Lignum(靈芝) for evaluation, which have been used for patients of gastric cancers. The twenty grams of medicines were boiled in 100ml of water for 1 hour and filtered with $0.2\;{\mu}m$ pore-sized filter unit to remove insoluble particles. Initially we evaluated the effects oriental medicines on growth inhibition in stomach cancer cells. The gastric cancer cell line, AGS, was cultured in RPMI 1640 supplemented with l0% heat-inactivated fetal bovine serum and treated with $10{\mu}l$ oriental medicines per 1ml of medium up to 48 hours. The specimens were subjected to MTT assay for evaluation of growth inhibition. We found mat Mylabris phalerata (班蟄) markedly suppressed the growth of cancer cells as shown in results. Next, we checked the effects of oriental medicines on cancer on cell cycles and apptosis. Mylabrls phalerata (班蟄) inhibited cell cycle progression of cancer cells a compared with control cells and cells treated with other medicines. In addition, Mylabri phalerata (班蟄) induced apoptosis in 30-40% of stomch cancer cells within 24 hours. Other oriental medicines used for this experiments did not show apoptosis-inducing effects on cancer cells. Finally, we determined the expression levels of genes associated with cell cycle and apoptosis. The expressions of Bcl-2 and bcl-XL were downregulated by the treatment of Mylabris phalerata (班蟄). However, the expression levels of genes related to cell cycles were not altered significantly. In conclusion, we found that Mylabris phalerata (班蟄) has in vivo gowth-inhibiting and apptosis-inducing effects on stomach cancer cells. However, we think that at least animal experiments are necessay for evduations.

보두(寶豆)의 수치법(修治法)에 따른 독성(毒性) 및 소화기계(消化器系)에 미치는 영향(影響)

김진성,윤상협,류봉하,류기원,조유경,Kim, Jin-Sung,Yoon, Sang-Hyub,Ryu, Bong-Ha,Ryu, Ki-Won,Cho, Yu-Kyung 대한한방내과학회 2002 大韓韓方內科學會誌 Vol.23 No.1

Objective : These experiments were designed to investigate the effects of Strychni Ignatii Semen on the gastrointestinal system and declining of toxicity. About experiments of acute toxicity, I investigated the quantity of Strychni $(C_{21}H_{22}N_2O_2)\;and\;LD_{50}$. In order to study the effects on gastrointestinal tract, I investigated the changes of gastric juice, discharging level of pepsin, inhibiting effects of ulceration, and transporting of intestine. Methods : Sample I : No making Strychni Ignatii Semen Sample II : Depositing for three days in water and then dry it. Sample III : Depositing for one hour in sesame oil and bum it. The results were as follows : 1. The average values of Strychnine decreased in Sample III. 2. The levels of $LD_{50}$ increased in Sample Ⅲ by about 70%. 3. In Sample III, inhibiting effects of ulceration and discharging level of pepsin were great. 4. In the level of gastric juice decreased in Sample I.II.III. 5. The transporting ability of large intestine elevated in Sample I.II.III. According to the results, making Strychni Ignatii Semen, especially Sample 3, toxicity decreased and has good effects on the gastrointestinal system.

Development of Video Image-Guided Setup (VIGS) System for Tomotherapy: Preliminary Study

김진성,주상규,홍채선,정재원,손기홍,신정석,신은혁,안성환,한영이,최두호,Kim, Jin Sung,Ju, Sang Gyu,Hong, Chae Seon,Jeong, Jaewon,Son, Kihong,Shin, Jung Suk,Shin, Eunheak,Ahn, Sung Hwan,Han, Youngyih,Choi, Doo Ho Korean Society of Medical Physics 2013 의학물리 Vol.24 No.2

초고압 전산화단층촬영(megavoltage computed tomography, MVCT)이 단층치료(Tomotherapy) 환자의 치료 자세 교정 방법으로 사용되고 있다. MVCT는 부가적인 방사선 피폭뿐만 아니라 전체 치료 시간이 길어지는 단점을 가지고 있다. 이러한 문제점 해결을 위해 비디오 영상기반 환자 치료 자세 교정 시스템(video image-guided setup system, VIGS)을 개발했다. 단층치료 장치내 갠트리에 직각으로 2대의 비디오 카메라를 장착하고 이로부터 얻은 영상을 이용하여 환자의 자세 오차를 측정하는 프로그램을 자체 개발했다. 개발된 시스템은 사용자에 의해 정의된 관심 영역에서의 에지 검출(edge detection) 결과를 기반으로 자동 정합을 통해 자세 오차를 찾도록 고안되었다. 두경부 환자를 묘사하기 위해 휴먼 팬톰을 이용하여 컴퓨터 단층 치료계획 영상을 획득한 후 전산화 치료계획을 수행했다. 실제 치료 상태를 재현하기 위해 고정 용구를 이용하여 팬톰을 고정했으며 전산화치료계획 결과로 부터 팬톰 자세 검증을 위한 기준 MVCT 영상을 획득했다. 팬톰을 치료 위치에 위치시킨 후 MVCT 영상을 얻고 이를 기준 MVCT영상과 비교하여 치료계획시와 동일환 자세가 되도록 위치를 교정했다. 교정된 자세에서 VGIS를 이용하여 기준 비디오 영상을 획득했다. 10회 걸쳐 MVCT 영상을 이용한 자세 교정과 VIGS를 이용한 비디오 영상기반 자세 교정을 각각 수행하여 두 방법간의 교정 값 차이(상관 분석)와 분석 시간을 비교했다. 팬톰 위치 교정 시간은 VIGS 시스템($41.7{\pm}11.2$ seconds)이 MVCT 방법($420{\pm}6$ seconds)에 비해 현저히 적게 조사됐다(p<0.05). 하지만 두 방법간의 위치 오차 분석 결과 통계적으로 유의한 차이는 보이지 않았다(x=0.11 mm, y=0.27 mm, z=0.58 mm, p>0.05). VIGS시스템이 짧은 시간에 정확한 위치 오차 감지 능력을 보여 이의 개발이 단층치료의 절차를 효율적으로 개선하는데 효과적일 것으로 생각된다. At present, megavoltage computed tomography (MVCT) is the only method used to correct the position of tomotherapy patients. MVCT produces extra radiation, in addition to the radiation used for treatment, and repositioning also takes up much of the total treatment time. To address these issues, we suggest the use of a video image-guided setup (VIGS) system for correcting the position of tomotherapy patients. We developed an in-house program to correct the exact position of patients using two orthogonal images obtained from two video cameras installed at $90^{\circ}$ and fastened inside the tomotherapy gantry. The system is programmed to make automatic registration possible with the use of edge detection of the user-defined region of interest (ROI). A head-and-neck patient is then simulated using a humanoid phantom. After taking the computed tomography (CT) image, tomotherapy planning is performed. To mimic a clinical treatment course, we used an immobilization device to position the phantom on the tomotherapy couch and, using MVCT, corrected its position to match the one captured when the treatment was planned. Video images of the corrected position were used as reference images for the VIGS system. First, the position was repeatedly corrected 10 times using MVCT, and based on the saved reference video image, the patient position was then corrected 10 times using the VIGS method. Thereafter, the results of the two correction methods were compared. The results demonstrated that patient positioning using a video-imaging method ($41.7{\pm}11.2$ seconds) significantly reduces the overall time of the MVCT method ($420{\pm}6$ seconds) (p<0.05). However, there was no meaningful difference in accuracy between the two methods (x=0.11 mm, y=0.27 mm, z=0.58 mm, p>0.05). Because VIGS provides a more accurate result and reduces the required time, compared with the MVCT method, it is expected to manage the overall tomotherapy treatment process more efficiently.