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.

화피추출물 복합제 화장품의 여드름에 대한 임상적 연구

박수연,나창수,정원철,이종철,Park, Soo-Yeon,Na, Chang-Soo,Jeong, Won-Cheol,Lee, Jong-Cheol 대한한방안이비인후피부과학회 2013 한방안이비인후피부과학회지 Vol.26 No.3

Objective : The primary purpose of present study is to evaluate the effect of herbal cosmetics containing Cortex Betulae Platyphyllae extract complex on acne. The second is to comparatively evaluate safety of this cosmetics. Methods : We opened collecting of applicant that men and women(the 18~35-year-old) with acne on face. We selected subjects who came up to entire inclusion criteria and were not included in the exclusion criteria. We checked changes of Acne Global score, skin sebum, moisture, pores counts, Skindex-29 for 8 weeks. Results : 1. Comparison of changes in Global score, it declined in both experimental group and control group. But Experimental group showed a statistically significant decline than control group. 2. Comparison of changes in sebum and moisture, it declined in both experimental group and control group. But there was no statistically significant difference between those two groups. 3. Comparison of changes in erythema normal area, it declined in both experimental group and control group. But there was no statistically significant difference between those two groups. 4. Comparison of changes in pore counts, it increased statistically significantly in both experimental group and control group. 5. Comparison of changes in Skindex-29, it declined in both experimental group and control group. But there was no statistically significant difference between those two groups. Conclusion : Considering the above experiments, it is suggested that herbal cosmetics containing Cortex Betulae Platyphyllae extract complex have a positive effect on acne.

취미건강-상쾌한 아침 베드민턴과 더불어 건강을

박수연,Park, Su-Yeon 한국건강관리협회 1983 건강소식 Vol.7 No.5

면역세포(免疫細胞) 및 종양세포(腫瘍細胞)에 미치는 가미십기산(加味十奇散)의 효과(效果)

박수연,김종한,최정화,이명진,Park, Su-Yeon,Kim, Jong-Han,Choi, Jung-Hwa,Lee, Myung-Jin 대한한방안이비인후피부과학회 2006 한방안이비인후피부과학회지 Vol.19 No.1

Objective : Gamisibgi-San was a drug that treated carbuncle and cellulitis. So, the purpose of this Study was to investigate effects of Gamisibgi-San on the anti-cancer and proliferation of immunocytes. Materials and Method : We used Gamisibgi-San extract(GMSGS) with freeze-dried, 8wks-old male mice and cancer cell lines(L1210, S-180) for this Study. The cytotoxicity and proliferation of cells wat tested using a colorimetric tetrazoliun assay(MIT assay). Results and Conclusion : The results of this Study were obtained as follow ; 1. GMSGS was significantly showed cytotoxicity on the L1210 cell lines and S-180 cell lines. 2. GMSGS was significantly increased in the proliferation of thymocytes and splenocytes in vitro. 3. GMSGS was significantly decreased in the proliferation of L1210 cells in L1210 cells transplanted mice. 4. GMSGS was significantly decreased in the Weight of Sarcoma in S-180 cells transplanted mice. 5. GMSGS was significantly increased in the Period of Survive in S-180 cells transplanted mice. The present author thought that GMSGS had action of anti-cancer by becoming immunocytes activity(proliferation of thymocytes and splenocytes).

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

실리콘 파브리-페로 파장가변 열광학 필터

박수연,강동헌,김영호,길상근,Park, Su-Yeon,Kang, Dong-Heon,Kim, Young-Ho,Gil, Sang-Keun 한국전기전자학회 2008 전기전자학회논문지 Vol.12 No.3

실리콘 박막 코팅을 이용한 WDM용 파장가변 실리콘 파브리-페로 열광학 필터를 제안하고 실험하였다. 실리콘 파브리-페로 파장가변 필터는 일반적인 실리콘 웨이퍼를 CMP 공정을 통해 100${\mu}m{\pm}$1%의 두께로 가공하여 양면에 거울면을 갖도록 박막 코팅하고 온도를 변화시키기 위해 PTC 써미스터를 부착하여 제작하였다. 거울면의 형성은 1550nm를 중심 파장을 갖도록 양면에 굴절율이 다른 물질 $SiO_2$($n_{low}$=1.44)와 a-Si($n_{high}$=3.48)을 ${\lambda}$/4의 두께로 증착시켜 2층 박막과 3층 박막의 거울면을 제작하였다. 실험결과, 2층 박막의 경우 FSR이 3.61nm, FWHM이 0.56nm, finesse가 6.4로 나타났고, 3층 박막의 경우 FSR이 3.36nm, FWHM이 0.13nm, finesse가 25.5로 나타났다. 열광학 효과에 의한 파장 이동은 2층 박막 거울을 가진 필터의 경우 온도가 $23^{\circ}C$에서 투과 중심 파장이 1549.73nm $30^{\circ}C$에서 1550.91nm, $60^{\circ}C$에서 1553.46nm로 파장 이동을 하였고, 3층 박막 거울을 가진 필터의 경우는 온도가 $23^{\circ}C$에서 투과 중심 파장이 1549.83nm, $30^{\circ}C$에서 1550.92nm, $60^{\circ}C$에서 1553.07nm로 파장 이동을 하였다. A silicon Fabry-Perot tunable thermo-optic filter for WDM using the thin film silicon coating is proposed and experimented. The filter is implemented by using the CMP process and polishing both sides of the commercial silicon wafer with normal thickness of 100${\mu}m{\pm}$1%. The filter also has 2-layer or 3-layer dielectrics thin film coating mirror which are alternated ${\lambda}$/4 layers of $SiO_2$($n_{low}$=1.44) and a-Si($n_{high}$=3.48) for the central wavelength of 1550nm by RF sputtering. The experiment shows that FSR is 3.61nm and FWHM is 0.56nm and the finesse is 6.4 for 2-layer mirror with the reflection of 61%, and that FSR is 3.36nm and FWHM is 0.13nm and the finesse is 25.5 for 3-layer mirror with the reflection of 89%. According to thermo-optic effect, the transmitted central wavelength of 1549.73nm at $23^{\circ}C$ is shifted to 1550.91nm at $30^{\circ}C$ and 1553.46nm at $60^{\circ}C$ for 2-layer mirror, and the transmitted central wavelength of 1549.83nm at $23^{\circ}C$ is shifted to 1550.92nm at $30^{\circ}C$ and 1553.07nm at $60^{\circ}C$ for 3-layer mirror.

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.

척추뼈전이암 환자의 체부정위방사선치료계획 비교: 동시통합추가치료법 대 RTOG 0631 프로토콜

박수연,오동렬,박희철,김진성,김종식,신은혁,김혜영,정상훈,한영이,Park, Su Yeon,Oh, Dongryul,Park, Hee Chul,Kim, Jin Sung,Kim, Jong Sik,Shin, Eun Hyuk,Kim, Hye Young,Jung, Sang Hoon,Han, Youngyih 한국의학물리학회 2014 의학물리 Vol.25 No.3

척추뼈전이암 환자를 대상으로 본원의 동시통합추가치료법(SIB)과 RTOG 0631 프로토콜에 따른 체부정위방사선치료계획을 세우고, 선량분포를 비교하였다. 간암 원발인 척추 뼈 전이암 환자 5명을 대상으로 전산화단층촬영 영상과 자기공명영상(T1, T2)를 바탕으로 영상융합을 시행하였다. 본원에서 시행하는 SIB방법은 영상에서 보이는 종양을 GTV로 설정하고, GTV를 포함한 전체 척추체부(entire vertebral body, VB)를 CTV1로 정의하였고 GTV에 18 Gy CTV1에 10 Gy를 1회 처방하였다. RTOG 0631 프로토콜 방법은 GTV의 침윤 정도에 따라 주변부의 추근, 좌우 횡돌기 및 극돌기 등을 선택적으로 포함하여 CTV2로 정의하였고 18 Gy 1회 처방하여 체부정위방사선치료계획을 시행하였다. 선량체적화 결과값을 선량-체적 히스토그램을 통해 분석한 결과, 두 방법 모두 표적에 대하여 처방 선량을 만족하였으며, 척수 및 정상 장기에 대하여는 SIB방법이 RTOG 0631프로토콜보다는 낮은 값을 보였다. 또한, 전체 VB의 조사선량분포를 정량화한 결과, RTOG 0631프로토콜에서도 SIB방법과 동일한 처방선량 허용치 85%이상을 포함하는 것으로 나타났다. 하지만 정상 장기에 대한 선량은 RTOG 0631 프로토콜에 따른 치료 방법이 높은 편이었다. 주변부 장기의 부작용이 우려되는 임상적 상황의 경우 조사 체적이 적은 SIB방법이 좋은 선택이 될 수 있을 것이다. 결론적으로 SIB방법이나 RTOG 0631 프로토콜에 따른 표적체적 설정을 통한 체부정위방사선치료계획 모두 유사한 결과를 보였으며, 향후 다양한 연구를 통해 종양제어확률 및 부작용 확률의 차이를 분석해야 할 것이다. In this study, we compared dose distributions from simultaneously integrated boost (SIB) method versus the RTOG 0631 protocol for spine radiosurgery. Spine radiosurgery plans were performed in five patients with localized spinal metastases from hepatocellular carcinoma. The computed tomography (CT) and T1- and T2-weighted magnetic resonance imaging (MRI) were fused for delineating of GTV and spinal cord. In SIB plan, the clinical target volume (CTV1) was included the whole compartments of the involved spine, while RTOG 0631 protocol defines the CTV2 as the involved vertebral body and both left and right pedicles. The CTV2 includes transverse process and posterior element according to the extent of GTV. The doses were prescribed 18 Gy to GTV and 10 Gy to CTV1 in SIB plan, while the prescription of RTOG 0631 protocol was applied 18 Gy to CTV2. The results of dose-volume histogram (DVH) showed that there were competitive in target coverage, while the doses of spinal cord and other normal organs were lower in SIB method than in RTOG 0631 protocol. The 85% irradiated volume of VB in RTOG 0631 protocol was similar to that in the SIB plan. However, the dose to normal organs in RTOG 0631 had a tendency to higher than that in SIB plan. The SIB plan might be an alternative method in case of predictive serious complications of surrounded normal organs. In conclusion, although both approaches of SIB or RTOG 0631 showed competitive planning results, tumor control probability (TCP) and normal tissue complication probability (NTCP) through diverse clinical researches should be analyzed in the future.