간과 비장의 체적을 구하기 위한 3차원 영역 확장 기반 자동 영상 분할 알고리즘의 동물팬텀을 이용한 성능검증

김진성,조준식,신경숙,김진환,전호상,조규성,Kim, Jin-Sung,Cho, June-Sik,Shin, Kyung-Sook,Kim, Jin-Hwan,Jeon, Ho-Sang,Cho, Gyu-Seong 한국의학물리학회 2008 의학물리 Vol.19 No.3

간경변 및간암 환자의 증가로 간이식술의 필요성이 점점 증가되고 있고, 특히 공여자의 생체 간이식은 간이식술의 주된 분야를 차지하고 있으며 간이식 수술 전 공여자에서 간체적의 정확한 측정은 수술 후 공여자와 수여자의 간기능을 예측하는데 있어 중요한 자료가 되며, 성공적인 수술과 환자의 예후에 밀접한 영향을 미친다. 그러나 현재 환자의 간체적을 구하는 과정은 환자의 모든 CT 영상위의 간을 수작업을 통해 영상분할한 후에 3차원 간체적을 구하고 있으며 많은 시간과 노력이 필요한 작업이다. 이러한 문제를 해결하기 위해서 본 논문에서는 자동으로 간과 비장을 문턱값처리, 형태학적 영상처리, 3차원 영역확장법등의 기법을 이용하여 분할하는 알고리즘을 개발하여 체적을 구하는 시간을 단축하였다. 이러한 알고리즘의 정확성을 평가하기 위해서 동물의 실제 간과 비장을 팬텀으로 제작하여 실제 측정한 체적과 알고리즘으로 분할된 영상의 결과를 비교 평가하였다. 문턱치값의 설정에 따라 다른 결과를 보이는 특성이 있지만 자동으로 문턱치를 결정했을 때 비장과 간의 체적측정 오차는 9.27%, -4.52%이었으며, 수동으로 문턱치를 결정했을 때 최소 오차가 각각 0.2%, 0.17%의 결과를 보였다. 이러한 팬텀 연구를 통해 자동 분할 알고리즘으로 얻은 체적의 결과가 정확성과 재현성을 보여주어 추후 간체적을 구하는 보조수단으로 활용될 수 있을 것이라 예상된다. Living donor liver transplantation is increasingly performed as an alternative to cadaveric transplantation. Preoperative screening of the donor candidates is very important. The quality, size, and vascular and biliary anatomy of the liver are best assessed with magnetic resonance (MR) imaging or computed tomography (CT). In particular, the volume of the potential graft must be measured to ensure sufficient liver function after surgery. Preoperative liver segmentation has proved useful for measuring the graft volume before living donor liver transplantations in previous studies. In these studies, the liver segments were manually delineated on each image section. The delineated areas were multiplied by the section thickness to obtain volumes and summed to obtain the total volume of the liver segments. This process is tedious and time consuming. To compensate for this problem, automatic segmentation techniques have been proposed with multiplanar CT images. These methods involve the use of sequences of thresholding, morphologic operations (ie, mathematic operations, such as image dilation, erosion, opening, and closing, that are based on shape), and 3D region growing methods. These techniques are complex but require a few computation times. We made a phantom for volume measurement with pig and evaluated actual volume of spleen and liver of phantom. The results represent that our semiautomatic volume measurement algorithm shows a good accuracy and repeatability with actual volume of phantom and possibility for clinical use to assist physician as a measuring tool.

영상유도 양성자치료를 위한 콘빔 CT 재구성 알고리즘: 기하학적 보정방법에 관한 연구

김진성,조민국,조영빈,윤한빈,김호경,윤명근,신동호,이세병,이레나,박성용,조관호,Kim, Jin-Sung,Cho, Min-Kook,Cho, Young-Bin,Youn, Han-Bean,Kim, Ho-Kyung,Yoon, Myoung-Geun,Shin, Dong-Ho,Lee, Se-Byeung,Lee, Re-Na,Park, Sung-Yong,Cho, Kwan- 한국의학물리학회 2008 의학물리 Vol.19 No.4

IMRT, 양성자 치료와 같이 방사선 치료 기술이 발전할수록 치료 시 환자의 위치를 확인하고 그 정확성을 평가하는 기술의 중요성이 강조되고 있다. 현재 국립암센터 양성자치료센터에 설치되어 있는 양성자 치료기의 단순 X-선 영상시스템을 이용하여 콘빔 CT (cone-beam CT) 3차원 영상을 획득, 영상유도 방사선 치료의 가능성을 확인하고자 하였다. 양성자 치료기에 설치되어있는 X-선 영상시스템(SDD: 2,108 mm, SOD: 1,511 mm, Varian a277 x-ray tube & Varian Paxscan 4030: a-Si+DRZ screen)을 이용하여 양성자 갠트리를 $2^{\circ}$씩 회전시켜가면서 기하학적인 오차 측정을 위한 팬톰과 인체 팬톰 (Humanoid phantom, Rando, CA, USA)의 투사영상을 획득하였다. 현재 시스템적으로 연속적인 회전과 영상획득이 지원되지 않아서 영상획득 후 갠트리를 회전하는 방법으로 투사영상을 획득하였다. 기하학적 오차측정을 위한 팬텀과 두경부 팬텀에 대해서 $360^{\circ}$를 회전하며 180장의 투사영상($2,304{\times}3,200$, 14 bit with 127${\mu}m$ pixel pitch)을 관전압 85 kVp, 관전류 80 mA, 조사시간 0.5 s의 조건으로 촬영하였다. 콘빔 CT 영상재구성을 위해 Ram-Lak filter를 적용한 Feldkamp cone-beam 알고리즘을 사용하였으며, 획득한 180장의 투사영상을 사용하여 $0.4{\times}0.4{\times}0.4mm^3$의 voxel size를 가진 $512{\times}512{\times}512$ CT영상을 재구성하였다. 기하학적인 오차 측정방법을 통해 X-선 선원, 검출기와 갠트리의 기하학적 정보를 측정하였다. 측정된 결과에 의하면 검출기가 $0.25^{\circ}$ 회전된 오차를 보이는 것을 발견하였다. 기하학적 교정으로 재구성된 콘빔 CT 영상을 multi-planar view (axial, sagittal and coronal view) 및 3차원 영상으로 재구성하여 비교 평가 하였다. 현재 양성자치료기에 설치되어있는 단순 X-선 영상 시스템에서 기하학적 오차 측정을 위한 볼 팬텀을 이용하여 시스템의 오차를 측정하였다. 측정한 오차를 바탕으로 기하학적 교정을 통해서 두경부 및 복부 팬텀에 대한 3차원 영상인 콘빔 CT 영상들을 재구성하였다. 추후 연속적인 회전을 통한 영상획득이 가능하게 된다면, 보다 정확하고 신속한 영상재구성이 가능 하며 콘빔 CT가 영상유도 양성자 치료에 매우 유용할 것으로 사려된다. According to improved radiation therapy technology such as IMRT and proton therapy, the accuracy of patient alignment system is more emphasized and IGRT is dominated research field in radiation oncology. We proposed to study the feasibility of cone-beam CT system using simple x-ray imaging systems for image guided proton therapy at National Cancer Center. 180 projection views ($2,304{\times}3,200$, 14 bit with 127 ${\mu}m$ pixel pitch) for the geometrical calibration phantom and humanoid phantoms (skull, abdomen) were acquired with $2^{\circ}$ step angle using x-ray imaging system of proton therapy gantry room ($360^{\circ}$ for 1 rotation). The geometrical calibration was performed for misalignments between the x-ray source and the flat-panel detector, such as distances and slanted angle using available algorithm. With the geometrically calibrated projection view, Feldkamp cone-beam algorithm using Ram-Lak filter was implemented for CBCT reconstruction images for skull and abdomen phantom. The distance from x-ray source to the gantry isocenter, the distance from the flat panel to the isocenter were calculated as 1,517.5 mm, 591.12 mm and the rotated angle of flat panel detector around x-ray beam axis was considered as $0.25^{\circ}$. It was observed that the blurring artifacts, originated from the rotation of the detector, in the reconstructed toomographs were significantly reduced after the geometrical calibration. The demonstrated CBCT images for the skull and abdomen phantoms are very promising. We performed the geometrical calibration of the large gantry rotation system with simple x-ray imaging devices for CBCT reconstruction. The CBCT system for proton therapy will be used as a main patient alignment system for image guided proton therapy.

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.

이제마(李濟馬)의 우주론(宇宙論)과 사상적(四象的) 장부배속(臟腑配屬) 타당성(妥當性) 고찰(考察) (태극-심(太極-心), 사상(四象)-폐비간신(肺脾肝腎)의 사상적(四象的) 이해)

김진성,Kim, Jin Sung 사상체질의학회 1997 사상체질의학회지 Vol.9 No.1

The methodology of the Oriental philosophy is deductive and that of the of Occidental philosophy is inductive. Therefore study on the Oriental philosophy must start from right comprehension of fundamental premise before detailed analysis. The writer studied the meaning of the cosmology which forms the basis of Sa-sang constitutional philosophy and the propriety of visceral assignment by Sa-sang constitution which forms the theoletiacal basis of Sa-sang constitutional medicine. The results are following ; 1. The cosmology of Lee jae-ma has the existent principle but don't have the side of the formative principie. 2. The cosmology of Lee jae-ma is not that searchs for the objective rule of nature but that centers around a human being by subjective understanding system. 3. The cosmology consists of four elements, that is mind(心), body(身), events(事), and nature(物). Among them mind and body means a human being, nature means the natural environment containing time and space, events means not that of nature but that of human being. 4. The mind and body as Yin-yang(陰陽) means the state which objects and self become one. 5. The mind as the Great-Absolute(太極) has the possibility of two interpretation, Firstly it means the state of the source of life which nature and human being become one, and secondly it means that the mind of a human being becomes the cosmos or the center of the cosmos. 6. In the visceral assignment by Sa-sang constitution the position of heart, the Great-Absolute in center is immanent within four viscera and the function of it is that the undifferentiated unitary organic body, after it is diffrentiated still serves as the unitary organic whole by mutual connection, adjustment, unification and supervision. 7. The Great-Absolute in center is divided into the Great-Absolute of mind and that of body. And the Great-Absolute of body consists of the heart and the system of blood vessel, that of mind means the self-consciousness(自我).

Design and fabrication of the MMIC frequency doubler for 29 GHz local oscillator application

김진성,이성대,이복형,김성찬,설우석,임병옥,김삼동,박현창,박형무,이진구,Kim, Jin-Sung,Lee, Seong-Dae,Lee, Bok-Hyoung,Kim, Sung-Chan,Sul, Woo-Suk,Lim, Byeong-Ok,Kim, Sam-Dong,Park, Hyun-Chang,Park, Hyung-Moo,Rhee, Jin-Koo The Institute of Electronics and Information Engin 2001 電子工學會論文誌-TC (Telecommunications) Vol.38 No.11

밀리미터파 대역에서 안정적이고 경제적인 local oscillator (LO) 신호를 생성하기 위한 주파수 체배기를 설계 및 제작하였다. 주파수 체배기는 14.5 GHz를 입력받아 29 GHz를 생성하도록 설계되었으며, 측정 결과 14.5 GHz에서 S11이 -9.2 dB, 29 GHz에서 S22가 -18.6 dB 로 입력 측은 14.5 GHz에, 출력 측은 29GHz에 매칭이 되었다. 변환손실의 경우 14.5 GHz에서 입력전력 6 dBm일 때 최소 값인 18.2 dB를 보였으며, 출력 단에서의 주파수 스펙트럼 특성은 14.5 GHz에서 15.2dB의 값을 나타내었다. 또한 입력신호의 isolation특성은 10.5 GHz에서 18.5GHz까지 주파수 범위에서 30 dB이상의 값을 보였다. 제작된 MMIC(Microwave monolithic integrated circuits) 주파수 체배기의 칩 사이즈는 $1.5{\times}2.2\;mm^2$이다. We demonstrate the MMIC (monolithic microwave integrated circuit) frequency doublers generating stable and low-cost 29 GHz local oscillator signals from 14.5 GHz input signals. These devices were designed and fabricated by using the M MIC integration process of $0.1\;{\mu}m$ gate-length PHEMTs (pseudomorphic high electron mobility transistors) and passive components. The measurements showed S11 or -9.2 dB at 145 GHz, S22 of -18.6 dG at 29 GHz and a minimum conversion loss of 18.2 dB at 14.5 GHz with an input power or 6 dBm. Fundamental signal of 14.5 GHz were suppressed below 15.2 dBe compared to the second harmonic signal at the output port, and the isolation characteristics of fundamental signal between the input and the output port were maintained above :i0 dB in the frequency range 10.5 GHz to 18.5 GHz. The chip size of the fabricated MMIC frequency doubler is $1.5{\times}2.2\;mm^2$.

분심기음의 항암작용 및 면역기능에 관한 연구

김진성,윤상협,류봉하,류기원,여대원,Kim Jin-Sung,Yoon Sang-Hyub,Ryu Bong-Ha,Ryu Ki-Won,Yeo Dae-Won 대한한방내과학회 2003 大韓韓方內科學會誌 Vol.24 No.2

This study was performed to investigate the effect of Bunsimgieum on antitumor effect after sarcoma-180 cells transplantation into peritoneal cavity or left groin and immune responses on the depressed immunity induced by methotrexate in mice. The Bunsimgieum extract of 10mg/kg was orally administered 14 days for antitumor effects and 21 days for immune responses. 50% inhibitory concentration($IC_{50}$) of SUN-1, SUN-C4, and SUN-396 cancer cell, mean sunvival days and body weight of tumor bearing mice, and growth of tumor mass for antitumor effect; delayed type hypersentivity, hemagglutinin titer, hemolysis titer, rosette forming cells, natured killer cell activity, lymphocyte transformation, productivity of interleukin-2, and phagocytic activity for their immune responses were measured in ICR mice. Significance in antitumor effect is noted in the enlongation of mean life days and inhibition of tumor growth(p<0.01, respectively). Significance of immune responses is also noted in hemolysis titer, lymphocyte transfumotion, IL-2 productivity, phagocytic activity, and natural killer cell activity at E/T ratio 100:1(p<0.01, respectively). Significant in rosette cell formation was seen at dosage of 20mg/kg(p<0.01). However, Difference of body weight as antitumor effect, delayed type hypersensitivity, and hemagglutinin titer were not shown significantly. According to the above results, it could be suggested that Bunsimgieum has prominent antitumor and immunity enhancing effect.

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.

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.

반모가 수종의 인체 암세포에 미치는 영향

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

Object : Objective: This study was conducted to investigate the anti-cancer effects of Mylabris phalerata (반모) in some kinds of cancer cells. Materials and Methods: Some kinds of cancer cells lines were treated. We used nine kinds of cancer cell lines, such as stomach cancer cells (Kato), lung cancer cells (Calu-1, NCI-H 1395), urinary bladder cancer cells (HS789T), bone cancer cells (Saos-2), brain cancer cells (SK-N-MC), liver cancer cells (Hep-G2), skin cancer cells (Mo-1) and prostate cancer cells (PC-3) with the water decoction of Mylabris phalerata. The histological changes of all cell lines in the media (RPMI-1640) containing the decoction of Mylabris phalerata were observed and we examined cell death assay by trypan blue exclusion testing was examined. Finally, the change of mitochondrial membrane potential was measurd and the inhibitory effect of Mylabris phalerata on cell increase was examined by analyzing the cell cycle. Results: In histologic change all cancer cell lines showed withdrawn and floating appearance that is typical in cellular impairment. Most of the cell lines showed over 50% death rate after 24 hours in trypan blue exclusion tests. Especially the stomach, urinary bladder. brain and liver cell lines showed over 30% death rate after 12 hours. All cell lines treated with Mylabris phalerata were less stained than the control group and the mitochondrial membrane potential in the Mylabris phalerata treated cell lines was markedly lower than that in the control group. The measurement of DNA quantity in all cell lines showed the disappearance of the peak and the thickened left axis, which suggests that all cellular DNA degraded. Conclusion: Mylabris phalerata had cytotoxicity on various kinds of cancer cell lines and the mechanism of that was the impairment of mitochondria by the breakdown of the mitochondrial cell membrane. We propose that this is in part attributable to the destruction of DNA in cancer cells.

냉$\cdot$난방을 위한 축열시스템과 심야전력 요금제도

김진성,Kim, Jin-Sung 대한설비공학회 1989 설비저널 Vol.18 No.6