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      • KCI등재

        Concurrent Chemoradiotherapy Shows Long-Term Survival after Conversion from Locally Advanced to Resectable Hepatocellular Carcinoma

        이익재,성진실,김준원,한광협,김자경,김경식,최진섭,박영년 연세대학교의과대학 2014 Yonsei medical journal Vol.55 No.6

        Purpose: For locally unresectable hepatocellular carcinoma (HCC) patients, concurrentchemoradiotherapy (CCRT) has been applied as a loco-regional treatment. After shrinkage of tumors in selected patients, surgical resection is performed. The aim of this study was to evaluate prognostic factors and long-term survivors in such patients. Materials and Methods: From January 2000 to January 2009, 264 patients with HCC were treated with CCRT (45 Gy with fractional dose of 1.8 Gy), and intra-arterial chemotherapy was administered during radiotherapy. Eighteen of these patients(6.8%) underwent hepatic resection after showing a response to CCRT. Cases were considered resectable when tumor-free margins and sufficient remnant volumeswere obtained without extrahepatic metastasis. Prior to operation, there were six patients with complete remission, 11 with partial remission, and six with stable disease according to modified Response Evaluation Criteria in Solid Tumors. Results:In pathologic review, four patients (22.2%) showed total necrosis and seven patients (38.9%) showed 70‒99% necrosis. A high level of necrosis (≥80%) was correlatedwith low risk for extrahepatic metastasis and long-term survival. In univariate analyses, vessel invasion and capsular infiltration were significantly correlated with disease free survival (DFS) (p=0.017 and 0.013, respectively), and vessel invasion was significantly correlated with overall survival (OS) (p=0.013). In multivariate analyses, capsule infiltration was a significant factor for DFS (p=0.016) and vessel invasion was significant for OS (p=0.015). Conclusion: CCRT showed favorable responsesand locally advanced HCC converted into resectable tumor after CCRT in selected patients. Long-term survivors showed the pathological features of near total necrosis, as well as negative capsule and vessel invasion.

      • KCI등재

        Altered Biological Potential and Radioresponse of Murine Tumors in Different Microenvironments

        이익재,이은정,박효진,김원우,하상준,신유근,성진실 대한암학회 2016 Cancer Research and Treatment Vol.48 No.2

        Purpose This study was conducted to evaluate the biological features of murine hepatocarcinoma according to different tumor microenvironmental models and to determine the change in molecular and immunologic responses after radiation. Materials and Methods Tumor models were established in the liver (orthotopic) and thigh (heterotopic) of male C3H/HeN mice. Tumor growth and lung metastasis were assessed in these models. To evaluate the radiation effect, the tumors were irradiated with 10 Gy. Factors associated with tumor microenvironment including vascular endothelial growth factor (VEGF), cyclooxygenase- 2 (COX-2), transforming growth factor beta1 (TGF-!1), CD31, and serum interleukin- 6 (IL-6) were evaluated. Tumor-infiltrating regulatory immune cells, regulatory T cells (Tregs), and myeloid-derived suppressor cells (MDSCs) were also analyzed. Results A higher number of lung metastases were observed in the orthotopic tumor model than in the heterotopic tumor model. VEGF, CD31, COX-2, and TGF-!1 expression was more prominent in the orthotopic tumor model than in the heterotopic tumor model. Expression of the angiogenic factor VEGF and key regulatory molecules (TGF-!1 and COX-2) decreased following radiation in the orthotopic tumor model, while the serum IL-6 level increased after radiation. In the orthotopic tumor model, the number of both Tregs and MDSCs in the tumor burden decreased after radiation. Conclusion The orthotopic tumor model showed higher metastatic potential and more aggressive molecular features than the heterotopic tumor model. These findings suggest that the orthotopic tumor mouse model may be more reflective of the tumor microenvironment and suitable for use in the translational research of radiation treatment.

      • KCI등재후보

        3차원입체조형방사선치료 계획 시 간종괴의 위치에 따른 최적 조사 방향의 결정

        이익재,성진실,정경근,조광환,심수정 대한방사선방어학회 2006 방사선방어학회지 Vol.31 No.4

        본 연구는 간암 환자의 방사선치료 시에 정상 조직과 간암의 위치에 따른 적절한 조사 방향을 찾고자 하였다. 간암의 위치는 Couinaud에 의한 분류법을 이용하여 4군으로 나누었고, 각 군의 용적을 가상의 표적 용적으로 정해서 여러 개의 방사선 치료계획을 세워 정상조직합병증발생률(normal tissue complication probability, NTCP)을 비교하였다. 그룹 I에서는 조사 수를 늘릴수록 정상 간의 NTCP가 감소되었으나 6개 이상부터는 일정하였다. 그룹 II에서는 PA(posterior to anterior) 조사가 추가 되었을 때 정상 간의 NTCP가 증가하였다. 그룹 III는 표적용적 주변에 정상조직이 많아 조사 방향의 설정에 어려움이 있었고 여러 방향에서의 조사 보다는 RAO(right anterior oblique)와 PA를 이용한 2개의 조사만이 시행되었을 때 정상 간의 NTCP가 가장 낮았다. 그룹 IV에서도 RAO와 PA의 2개 조사로 이루어진 치료계획에서 정상 간의 NTCP가 가장 낮았다. 본 연구를 통해 간암의 방사선 치료계획 시 간암의 위치와 정상조직의 위치에 따라 NTCP가 다양하게 나타남을 알 수 있었고, 간암의 방사선치료 계획 시 최적 조사 방향의 설정을 통해 임상적으로 방사선치료를 적용하는 데 유용한 지침이 될 수 있을 것으로 생각된다.

      • KCI등재

        Structural and Electronic Characteristics of ZnO Thin Films dc Sputtered on Sapphire (0001) Substrates

        이익재,Jae-Yong Kim,Chung-Jong Yu,Hyung-Kook Kim,Yun-Sik Yu 한국물리학회 2008 THE JOURNAL OF THE KOREAN PHYSICAL SOCIETY Vol.52 No.5

        Using reactive dc magnetron sputtering, we observed the epitaxial growth of ZnO films on Al2O3 (0001) substrates at several temperatures ranging from 300 to 600℃. The structural properties and the quality of the ZnO thin films were characterized by using X-ray diffraction (XRD). XRD measurements showed that the ZnO films were highly c-axis-oriented with in-plane epitaxy and that the linewidth of the (0002) peak was sensitive to a variation in the substrate temperature. Based on the full-width at half-maximum of (0002) peak, the best crystal quality of the ZnO films was obtained at a growth temperature of 500℃ and the lattice strain was linearly relaxed as the growth temperature increased. Near-edge X-ray absorption ne structure (NEXAFS) spectra confirmed the XRD result for the growth orientation by showing that the c-axis of the ZnO film was normal to the surface of the film, at least in the neighborhood of the absorbing atom. The Hall-effect measurement revealed that the mobility of the deposited films was 4.14 cm2V..1s..1.e=JPIWO0601 Using reactive dc magnetron sputtering, we observed the epitaxial growth of ZnO films on Al2O3 (0001) substrates at several temperatures ranging from 300 to 600℃. The structural properties and the quality of the ZnO thin films were characterized by using X-ray diffraction (XRD). XRD measurements showed that the ZnO films were highly c-axis-oriented with in-plane epitaxy and that the linewidth of the (0002) peak was sensitive to a variation in the substrate temperature. Based on the full-width at half-maximum of (0002) peak, the best crystal quality of the ZnO films was obtained at a growth temperature of 500℃ and the lattice strain was linearly relaxed as the growth temperature increased. Near-edge X-ray absorption ne structure (NEXAFS) spectra confirmed the XRD result for the growth orientation by showing that the c-axis of the ZnO film was normal to the surface of the film, at least in the neighborhood of the absorbing atom. The Hall-effect measurement revealed that the mobility of the deposited films was 4.14 cm2V..1s..1.e=JPIWO0601

      • KCI등재

        Study on the PAL-XFEL Beamline

        이익재,유청종,구태영 한국물리학회 2007 THE JOURNAL OF THE KOREAN PHYSICAL SOCIETY Vol.51 No.I

        The Pohang Accelerator Laboratory - X-ray Free Electron Laser (PAL-XFEL) beamline will provide opportunities for highly advanced experiments, such as femto-second chemistry, singleprotein scattering, and non-destructive cell imaging, at a resolution of the X-ray wavelength. It will use photons of a fundamental wavelength of 3 °A and its higher harmonics from an undulator with a fixed gap. We consider the PAL-XFEL beamline in two major parts, a front end (FE) and an experimental hall, and the beamline concept will be similar to that of the Linac Coherent Light Source (LCLS).

      • KCI등재후보

        The Optimal Selection of Radiotherapy Treatment for Hepatocellular Carcinoma

        이익재,성진실 거트앤리버 소화기연관학회협의회 2012 Gut and Liver Vol.6 No.2

        The majority of patients who present with hepatocellular carcinoma (HCC) are already at an advanced stage, and the tumors are unresectable. Radiotherapy (RT) technology can safely provide focused high-dose irradiation to these patients. A wide spectrum of RT technologiesis currently available, including internal RT consisting of Yttrium-90(90Y), Iodine-131 (131I) anti-ferritin antibody and Homium-199(199Ho) and external RT, such as three-dimensional conformal RT, intensity-modulated RT, helical tomotherapy, stereotactic body RT, and image-guided RT. However, it may be diffi cult for physicians to understand all of the available options and to select the optimal RT treatment. Physicians frequently query radiation oncologists on the practical indications of RT for managing patients with HCC. According to the Korean Liver Cancer Study Group practice guidelines, RT is considered appropriate for unresectable, locally advanced HCC without extrahepatic metastasis, a Child-Pugh class A or B, and tumors that occupy less than two-thirds of the liver with level II evidence. In this review, we discuss the application of various RT modalities based on disease status and the detailed indications for RT according to the Barcelona Clinic Liver Cancer staging system.

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