전립선암 치료를 위한 세기조절 양성자 로버스트 치료계획

박수연,김종식,박주영,박원,주상규,Park, Su Yeon,Kim, Jong Sik,Park, Ju Young,Park, Won,Ju, Sang Gyu 대한방사선치료학회 2013 대한방사선치료학회지 Vol.25 No.1

목 적: 양성자선의 유효비정 변화와 환자 자세의 재현성을 고려한 로버스트(robust-IMPT) 세기조절양성치료와 플레인 세기조절양성자치료(plain-IMPT) 계획과 광자선 세기조절방사선치료(photon-IMRT, step & shoot) 계획의 선량분포 특성을 비교, 분석하고자 한다. 대상 및 방법: 다섯 명의 전립선암 환자를 대상으로 표적에 70 Gy를 조사하도록 photon-IMRT (7문, step & shoot)와 plain-IMPT (2문, 4문, 7문) 및 robust-IMPT (유효 비정 오차 ${\pm}5%$ & 환자 자세 오차 0.5 cm 적용) 치료계획을 수립했다. 세 가지 치료계획으로 얻은 선량 분포 비교를 위해 PTV에 대한 선량조형지수(Conformity Index, CI), 선량균등지수(Homogeneity Index, HI) 및 최대선량, 최소선량, 평균선량과 OAR에 대한 선량-체적을 평가했다. 결 과: 모든 환자에 대해 photon-IMRT, plain-IMPT, robust-IMPT에서 PTV의 평균 최대선량은 각각 76.75 Gy (109.6%), 71.92 Gy (102.7%), 72.09 Gy (103%)였으며, 평균 최소선량은 68.21 Gy (97.4%), 68.89 Gy (98.42%), 68.13 Gy (98.13%)였으며, 전체 평균선량은 각각 71.02 Gy (101.4%), 71.32 Gy (100.4%), 70.75 Gy (101%)였다. PTV에 대한 CI 및 HI 값은 plain-IMPT가 photon-IMRT와 robust-IMPT에 비하여 1.02, 1.00으로 가장 낮았다. 또한, 정상장기에 있어 plain-IMPT가 photon-IMRT에 비하여 대부분 낮은 선량 분포를 보였으며, robust-IMPT 적용 시 정상 장기에 대한 선량 분포가 다소 변동의 폭은 있었지만 photon-IMRT에 비하여 대체로 낮은 선량 분포를 보였다. 결 론: 전립선암의 IMPT 치료 시 정확한 유효비정의 오차와 환자 자세 재현성오차를 고려한 robust-IMPT를 적용한다면 plain-IMPT의 선량학적 불확도를 줄이고 photon-IMRT에 비해 효과적인 치료를 제공할 수 있을 것이다. Purpose: The aim of this study is to evaluate the dosimetric properties of robust planning strategy for plain intensity-modulated proton therapy (IMPT) taking into account of the uncertainties of effective proton range and set up error as compared to photon intensity-modulated radiation therapy (photon-IMRT) in prostate cancer treatment. Materials and Methods: The photon-IMRT (7 beams, step & shoot), plain-IMPT (2, 4, and 7 portals), and robust- IMPT plans, which was recalculated the plain-IMPT based on the uncertainties of range error (${\pm}5%$) and set up error (0.5 cm), were evaluated for five prostate cancer patients prescribed by 70 Gy/35 fractions. To quantitatively evaluate the dose distributions, several parameters such as maximum dose, minimum dose, mean dose, conformity index (CI), and homogeneity index (HI) for PTV as well as dose-volume index of VxGy for OARs were calculated from dose-volume histograms. Results: Robust-IMPT showed superior dose distributios in the PTV and OARs as compared to plain-IMPT and photon-IMRT. Like plain-IMPT, robust-IMPT were resulted in dose fluctuation around OARs, while better homogeneity and conformity in PTVs and lower mean dose in OARs as compared to photon-IMRT. Conclusion: In consideration with the effective range correction and set up movement using robustness in IMPT plan, the dosimetric uncertainties from plain-IMPT could substantially reduce and suggest more effective solutions than photon-IMRT in prostate cancer treatment.

변형기체포장에 의한 어묵의 저장성 향상 및 유통기한 연장

박수연,안덕순,강준수,이동선,Park, Su Yeon,An, Duck Soon,Kang, Jun Soo,Lee, Dong Sun 한국포장학회 2017 한국포장학회지 Vol.23 No.2

반찬이나 간식으로 이용되는 소비성이 높은 튀김어묵에 대해서 진공, 60% $N_2/40%$ $CO_2$, 100% $N_2$ 및 100% $CO_2$의 변형기체포장조건을 사용하여 저장성 향상과 유통기한 연장을 얻을 수 있는 가능성을 검토하였다. $5^{\circ}C$, $10^{\circ}C$, $15^{\circ}C$의 온도 조건에서 저장하면서 품질변화를 측정한 결과 주요 품질열화요소로서 호기성 세균 증식임이 인지되었다. 호기성 세균수 성장을 Huang의 수학적 모델을 통하여 표현하고, 포장 및 저장온도조건에 따른 모델 parameter를 구하였고, 이를 사용하여 한계 미생물 수준에 도달하는 기간으로서 포장 및 온도 조건에 따른 저장유통기한을 설정하여 제시하였다. Arrhenius 방정식으로 표현된 미생물 성장의 온도의존성에서는 유도기의 역수에 대해서 활성화 에너지 139.4 kJ/mol, 성장속도에 대한 활성화 에너지는 41.8 kJ/mol로 얻어졌다. 변형기체포장의 효과에서, $10^{\circ}C$에서 100% 이산화탄소 포장이 호기성 세균 증식을 효과적으로 억제하여 함기포장에 비하여 약 2배의 유통기한을 확보하여 저장성을 향상시킬 수 있었다. 고이산화탄소 상태에서 저온의 온도 조건을 활용하여 저장유통기한을 연장할 수 있을 것으로 확인되었다. Modified atmosphere packaging (MAP) of vacuum, 60% $N_2/40%$ $CO_2$, 100% $N_2$ and 100% $CO_2$ were examined to preserve fried fish cakes and extend their shelf life. When product packages in air were stored at 5, 10, and $15^{\circ}C$ with measurement in quality attributes, aerobic bacterial growth was found to be primary quality factor to determine the shelf life of the product. Huang's model was adopted to obtain the parameters for use in shelf life determination for a variety of packaging and storage conditions. Temperature dependence expressed in Arrhenius equation showed activation energies of 139.4 and 41.8 kJ/mol for inverse of lag time and growth rate of the microbial spoilage, respectively. MAP of 100% $CO_2$ could double the product shelf life at $10^{\circ}C$ compared to air package. High $CO_2$ concentration MAP at low temperature was found to be effective to prolong the shelf life.

탁리화중탕(托裏和中湯)이 암세포(癌細胞) 및 면역세포(免疫細胞)에 미치는 실험적(實驗的) 효과(效果)

박수연,김종한,최정화,이준헌,Park, Su-Yeon,Kim, Jong-Han,Choi, Jung-Hwa,Lee, Jun-Hun 대한한방안이비인후피부과학회 2006 한방안이비인후피부과학회지 Vol.19 No.1

Objective : The purpose of this study was to investigate effects of Taklihwajung-Tang on the proliferation of cancer cells land immunocytes focusing around combined effects of anticarcinogen. Materials and Method : We used Taklihwajung-Tang extract(THT) with freeze-dried, 8wks-old male balb/c mice and cancer cell lines(L1210, S-180) for this study. The proliferation of cells was tested using a colorimetric tetrazoliun assay(MIT assay). Results and Conclusion : The results of this study were obtained as follow ; 1. THT was significantly showed cytotoxicity on the L1210 cell lines and S-180 cell lines. 2. THT was significantly increased in the proliferation of thymocytes and splenocytes in vitro. 3. In combined effects of THT and vincristine(0.005mg/kg), THT was significantly inhibited proliferation of S-180 cell lines compared with positive control group. 4. In combined effects of THT and vincristine(0.005mg/kg), THT was significantly decreased in the weight of sarcoma compared with positive control group. 5. In combined effects of THT and vincristine, THT was significantly inhibited the hematological side reaction compared with positive control group. The present author thought that THT had action of anti-cancer and immune-activity, and in combined effects of vincristine, THT had recoverable effects on damage by anticarcinogen.

전신성(全身性) 건선(乾癬) 치험 1례(治驗 1例)

박수연,김대수,최정화,김종한,Park, Soo-Yeon,Kim, Dae-Su,Choi, Jeong-Hwa,Kim, Jong-Han 대한한방안이비인후피부과학회 2007 한방안이비인후피부과학회지 Vol.20 No.3

Objective : This study is designed to investigate the effect of Oriental medical therapy on psoriasis. Methods : We applied Aroma ointment to abnormal skin two times a day. For herbal medicine, Bangpungtongsungsan-gami was given. We checked involvement in scaly skin, erythematosus papules and infiltration according to psoriasis area and severity(PASI) Results : After treatment, the patient showed that itching symptoms was disappeared and score of PASI changed from 27 to 0.8 Conclusions : According to the result, Oriental medical therapy and Aroma therapy has a good effect on psoriasis. But further studies are required to definitely prove the effectiveness of Aroma therapy

선택적 경부 절제술 후 발생한 비동맥염성 앞허혈시신경병증 1예

박수연,노승수,정승아.Suyoun Park. MD. Seungsoo Rho. MD. Seung Ah Chung. MD 대한안과학회 2012 대한안과학회지 Vol.53 No.1

Purpose: To report a case of non-arteritic anterior ischemic optic neuropathy after bilateral selective neck dissection. Case summury: A 48-year-old man presented with a visual field defect in his right eye 11 days after bilateral selective neck dissection. His corrected visual acuity in the right eye was 20/20; fundus photographs revealed a segmental optic disc swelling in the superior half of the right eye, and the Humphrey visual field test showed an inferior altitudinal defect in the right eye, corresponding to the disc swelling. The fluorescein angiography revealed a delayed filling on the superior half of the optic disc in the right eye. The diagnosis was non-arteritic anterior ischemic optic neuropathy. Orbital and brain MRIs showed an increase in caliber of the right optic nerve, but no other mass or enhanced lesion was noted. After 3 months, the patient’s visual acuity and visual field were maintained, but segmental atrophy developed on the superior half of the right optic disc. Conclusions: With the risk factors of ischemic optic neuropathy, the possibility of postoperative visual impairment or field defect should be considered after a selective head and neck surgery. J Korean Ophthalmol Soc 2012;53(1):180-185

정상인과 녹내장 환자에서 수술 전 안구 계측치와 백내장 수술 후 안압 하강과의 관계

박수연,이마빈,안재홍,Suyoun Park,Marvin Lee,Jaehong Ahn 대한안과학회 2012 대한안과학회지 Vol.53 No.1

Purpose: To investigate the relationships between preoperative factors and intraocular pressure (IOP) reduction after phacoemulsification in normal, open-angle glaucoma (OAG) and angle-closure glaucoma (ACG) patients. Methods: IOP was measured before and 3 months after cataract surgery in 30 normal, 24 OAG and 31 ACG patients. The relationship between IOP reduction after cataract surgery and preoperative parameters including anterior chamber depth (ACD), axial length (AL), preoperative IOP/ACD ratio (PD ratio), preoperative IOP/AL ratio (PL ratio) were investigated in the 3 groups. Results: Significant IOP reduction was observed in all 3 groups after surgery (paired sample t-test; p < 0.05), and IOP reduction was correlated with preoperative IOP level in all 3 groups (Pearson’s correlation; p < 0.05). Other preoperative parameters such as ACD and AL were not correlated with IOP reduction, and PD ratio was significantly correlated with IOP reduction only in the OAG group (Pearson’s correlation; p < 0.001). PL ratio was significantly correlated with IOP reduction in all 3 groups (Pearson’s correlation; p < 0.05) and showed the best sensitivity and specificity to predict significant reduction in IOP after cataract surgery among parameters including preoperative IOP, PD ratio and PL ratio. Conclusions: PL ratio was significantly correlated with IOP reduction after cataract surgery in all 3 groups and showed a higher predictive value for IOP reduction in the OAG group than in the other groups. J Korean Ophthalmol Soc 2012;53(1):111-119

톡소플라스마 망맥락막염에서 유리체강내 클린다마이신 주입술

박수연,유호민,송지훈.Suyoun Park. MD. Ho Min Lew. MD. Ji Hun Song. MD 대한안과학회 2012 대한안과학회지 Vol.53 No.7

Purpose: To present cases of toxoplasmic retinochoroiditis (TRC) treated successfully with intravitreal clindamycin injection. Case summary: (Case 1) A 41-year-old man presented with blurred left eye vision for several months. The patient had a large chorioretinal scar with infiltrations at the boundaries, and fluorescein angiography (FA) showed active retinochoroiditis. Antitoxoplasmosis (antiTX) immunoglobulin G (IgG) was positive, and the patient was started on antiTX medication. Despite several weeks of treatment with maximum doses of antiTx, the TRC progressed and visual acuity worsened. Pars plana vitrectomy (PPV) with intravitreal clindamycin injection (1.0 mg/0.1 ml) was performed, and an additional injection was given 4 weeks later. Six weeks after the second injection, TRC wascompletely resolved with 20/20 vision. (Case 2) A 67-year-old man presented with decreased left eye vision for 1 year. Fundus examinations showed vitreous opacity and epiretinal membranes. The FA revealed retinochoroiditis and the antiTX IgG titer was elevated. The presumed diagnosis was TRC, and oral medications of trimethoprim-sulfamethoxazole, clindamycin, and prednisolone was administered. Inflammation began to improve however, as the patient was not tolerating systemic antiTx medications, an intravitreal injection of clindamycin (1.0 mg/0.1 ml) was administered with PPV. The patientdiscontinued oral medication after surgery, and the inflammation resolved 5 weeks later. Conclusions: Intravitreal clindamycin injections may be an additional treatment option for TRC in patients who are unable to tolerate systemic therapy or whose disease progresses despite systemic therapy. J Korean Ophthalmol Soc 2012;53(7):1046-1052

궁귀탁리산(芎歸托裏散)의 L1210과 S-180이 이식된 마우스에 대한 항암(抗癌) 작용(作用) 연구(硏究)

박수연,김종한,최정화,박용호,Park, Su-Yeon,Kim, Jong-Han,Choi, Jung-Hwa,Park, Yong-Ho 대한한방안이비인후피부과학회 2006 한방안이비인후피부과학회지 Vol.19 No.1

Objective : The purpose of this study was to investigate effect of Gungguitakli-San(GTS) on the anti-tumor, immunocytes. Methods : This study estimated the proliferation of L1210 and S-180 cell lines, mouse splenocytes and thymocytes in vitro, and estimated the proliferation of L1210 cell, S-180 cell, thymocytes and splenocytes and body weight in S-180 cells-transplanted mice. The cytotoxicity and proliferation of cells were tested using a colorimetric tetrazoliun assay(M1T assay). Results : The results of this study were obtained as follow ; 1. GTS was significantly increased in the proliferation of thymocytes and splenocytes In vitro. 2. GTS was significantly showed cytotoxicity on the L1210 cell lines and 8-180 cell lines in vitro. 3. GTS was significantly showed cytotoxicity on the L1210 cell lines in vivo. 4. GTS was significantly increased in the weight of mice and decreased weight of sarcoma, in S-180 cells transplanted mice. 5. GTS was significantly increased in the period of survive, in S-180 cells transplanted mice. Conclusions : The author thought that GTS had action of anti-cancer by becoming immunocytes activity and by cytotoxicity of cancer cells.

갑상선기능저하증 환자 一例에 관한 臨床報告

박수연,김홍진,김종한,최정화,Park, Su-Yeon,Kim, Hong-Jin,Kim, Jong-Han,Choi, Jung-Hwa 대한한방안이비인후피부과학회 2001 한방안이비인후피부과학회지 Vol.14 No.2

I researched clinically one patient with Hypothyroidism who was hospitalized in DongShin Univ Shunchun Oriental Hosp. from the 4th, November, 2000 to the 13th, December, 2000. The results were obtained as follows. 1. Hypothyroidism corresponds to edema of instep (浮腫), consumption (虛勞), infantile retardation of walking (行遲), retardation in speech (語遲), inactivity of Yang-Qi(결양증). It is caused to deficiency of both Qi and blood (氣血兩虛), insufficiency of Yang of the spleen and kidneys (脾腎陽虛), decline of the fire from the vital gate (命門火衰), deficiency of yang of the heart and kidneys (心腎陽虛) 2. In internal medication, it was thought that Yi qi bu xue tang(益氣補血湯). Shao yin ren Bu zhong yi qi tang(少陰人補中益氣湯), Jia wei ta bu tang (加味大補湯) were effective. 3. In acupunture therapy, zu san li(足三里), san yin jiao(三陰交), Ren ying (人迎), Fu tu (扶突), Tian tu(天突) were used frequently and in moxibustion therapy. qi hai(氣海), zhong wan(中脘). Guan yun(關元) were used for Hypothyroidism.

훈증요법을 병행한 말초성 안면신경마비 환자에 대한 임상적 고찰

박수연,김지수,정민영,김종한,최정화,Park, Soo-Yeon,Kim, Ji-Soo,Jeong, Min-Young,Kim, Jong-Han,Choi, Jeong-Hwa 대한한방안이비인후피부과학회 2014 한방안이비인후피부과학회지 Vol.27 No.4

Objective : This study was performed to investigate the effect of herbal steam therapy on peripheral facial paralysis. Method : 33 patients with peripheral facial paralysis were treated with Korean Medicine therapy including herbal steam therapy. We evaluated the effect of herbal steam therapy by Yanagihara grading system and satisfaction measurement. Results : 1. 33 patients were treated with korean medicine therapy and $27.85{\pm}16.44$ times of herbal steam therapy. 2. After treatment, Y-system score was significantly increased(p-value<0.001) from $18.45{\pm}6.5196$ to $35.42{\pm}5.2501$. 3. 87.88% of patients was satisfied with herbal steam therapy. Conclusions : Herbal stream therapy seem to be effective to improve symptoms of peripheral facial paralysis. Further studies will be needed to identify the beneficial of herbal steam therapy on peripheral facial paralysis.