A nomogram predicting the risks of distant metastasis following postoperative radiotherapy for uterine cervical carcinoma: A Korean radiation oncology group study (KROG 12-08)

Je, Hyoung Uk,Han, Seungbong,Kim, Young Seok,Nam, Joo-Hyun,Kim, Hak Jae,Kim, Jae Weon,Park, Won,Bae, Duk-Soo,Kim, Jin Hee,Shin, So Jin,Kim, Juree,Lee, Ki-Heon,Yoon, Mee Sun,Kim, Seok Mo,Kim, Ji-Yoon,Y Elsevier 2014 Radiotherapy and oncology Vol.111 No.3

<P><B>Abstract</B></P> <P><B>Purpose</B></P> <P>To develop a nomogram predicting the risks of distant metastasis following postoperative adjuvant radiation therapy for early stage cervical cancer.</P> <P><B>Materials and methods</B></P> <P>We reviewed the medical records of 1069 patients from ten participating institutions. Patients were divided into two cohorts: a training set (<I>n</I> =748) and a validation set (<I>n</I> =321). The demographic, clinical, and pathological variables were included in the univariate Cox proportional hazards analysis. Clinically established and statistically significant prognostic variables were utilized to develop a nomogram.</P> <P><B>Results</B></P> <P>The model was constructed using four variables: histologic type, pelvic lymph node involvement, depth of stromal invasion, and parametrial invasion. This model demonstrated good calibration and discrimination, with an internally validated concordance index of 0.71 and an externally validated c-index of 0.65. Compared to FIGO staging, which showed a broad range in terms of distant metastasis, the developed nomogram can accurately predict individualized risks based on individual risk factors.</P> <P><B>Conclusions</B></P> <P>The devised model offers a significantly accurate level of prediction and discrimination. In clinical practice it could be useful for counseling patients and selecting the patient group who could benefit from more intensive/further chemotherapy, once validated in a prospective patient cohort.</P>

A 10-year clinical outcome of radiotherapy as an adjuvant or definitive treatment for primary tracheal adenoid cystic carcinoma

Je, Hyoung Uk,Song, Si Yeol,Kim, Dong Kwan,Kim, Yong-Hee,Jeong, Seong-Yun,Back, Geum Mun,Choi, Wonsik,Kim, Su Ssan,Park, Seung-Il,Choi, Eun Kyung BioMed Central 2017 Radiation oncology Vol.12 No.-

<P><B>Background</B></P><P>To evaluate the role of radiotherapy (RT) as an adjuvant or definitive treatment in primary tracheal adenoid cystic carcinoma (ACC) for local tumor control and survival.</P><P><B>Methods</B></P><P>A retrospective chart review was performed in 22 patients treated with adjuvant or definitive RT for primary tracheal ACC at a single center between November 1994 and December 2008.</P><P><B>Results</B></P><P>Thirteen and 9 patients received adjuvant and definitive RT, respectively. Microscopic residual disease after surgery was pathologically reported in 11 patients. The median RT dose was 59.4 Gy for adjuvant and 74.4 Gy for definitive RT. The overall response rate for definitive RT was 77.8%. Six patients in the definitive RT group exhibited local progression (LP), whereas 14 patients in both groups exhibited distant metastasis. The most common recurrence site in cases of treatment failure was the lung parenchyma. The median follow-up duration was 123 months, and the 10-year overall survival (OS) rate was 54.2%. Although LP was the most common cause of death (4 patients), two-thirds of the patients treated with definitive RT lived for >5 years. The 5-year and 10-year LP-free survival (LPFS) rates in the definitive RT group were 66.7 and 26.7%, respectively. Patients with higher RT dose by brachytherapy boost had good 5-year OS, 83.3%, and showed no local progression till 5-years. Most of the RT-induced side-effects were mild and tolerable, but 2 patients died of tracheal stenosis without any tumor recurrence.</P><P><B>Conclusions</B></P><P>Adjuvant RT may be suitable for controlling microscopic residual disease, whereas definitive RT may yield appropriate long-term survival in >50% patients with unresectable tracheal ACC. Dose escalation should be considered to warrant long-term survival in definitive RT.</P>

운전하중 조건에서 소형 풍력 발전기용 사출 나선형 블레이드 구조특성 평가

길영욱(Young-Uk Gil),조영관(Young-Kwan Jo),지호성(Ho-Seong Ji),양형근(Hyoung-Keun Yang),백준호(Joon-Ho Baek),제덕근(Duk-Geun Je),정호승(Ho-Seung Jeong),박상후(Sang-Hu Park) 한국기계가공학회 2020 한국기계가공학회지 Vol.19 No.2

The purpose is to evaluate the structural characteristics of 750 mm diameter injection spiral blades under various operating conditions. A fiber-glass reinforced polypropylene material was employed to the injection blades, and mechanical tests on two kinds of glass-reinforced polypropylene were performed to evaluate the mechanical properties and to select a suitable candidate material. Also, three kinds of spiral blade geometries were studied to observe the influence of fixing rods between blades. For this, structural analyses were conducted to understand the role of fixing rods under a range of rotating speed. In addition, modal analysis was performed to confirm the resonance in the operating speed range. One-way fluid-structure interaction (FSI) analysis was carried out to know its mechanical integrity under dangerous wind speed conditions. Through this work, the structural characteristics of the proposed spiral blade geometries were studied under various operating conditions, and the requirements of mechanical properties of blades were determined.

Effects of 1-methylcyclopropene on the Postharvest Life and Quality Changes of Asparagus

Jung-Soo Lee,Je Uk Lee,Su-Hyoung Park,Ki Cheol Seong,Youn-Suk Lee,Changhoo Chun 한국원예학회 2008 한국원예학회 기타간행물 Vol.- No.-

Distortion of the Bottom Surface in Micro Cavity Machining Using MEDM

Jong Hoon Lim,Sung Uk Je,Shi Hyoung Ryu,Chong Nam Chu 한국정밀공학회 2005 International Journal of Precision Engineering and Vol.6 No.4

As mechanical components are miniaturized, the demands' on micro die/mold are increasing. Micro mechanical components usually have high hardness and good conductivity. Micro electrical discharge machining (MEDM) call thus be an effective way to machine those components. In micro cavity fabrication using MEDM, it is observed that the bottom surface of the cavity is distorted. Electric charges lend to be concentrated at the sharp edge, and debris cannot be drawn off easily at the center of the bottom surface. These two phenomena make the bottom surface of electrode and workpiece distort. As machining depth increases, the distorted shape of the electrode approaches hemisphere. This process is affected by both capacitance and the size of electrode. By using a smaller electrode than the desired cavity size and appropriate tool movement, bottom shape distortion can he prevented.

Distortion of the Bottom Surface in Micro Cavity Machining Using MEDM

Lim Jong Hoon,Je Sung Uk,Ryu Shi Hyoung,Chu Chong Nam Korean Society for Precision Engineering 2005 International Journal of Precision Engineering and Vol.6 No.4

As mechanical components are miniaturized, the demands on micro die/mold are increasing. Micro mechanical components usually have high hardness and good conductivity. Micro electrical discharge machining (MEDM) can thus be an effective way to machine those components. In micro cavity fabrication using MEDM, it is observed that the bottom surface of the cavity is distorted. Electric charges tend to be concentrated at the sharp edge, and debris cannot be drawn off easily at the center of the bottom surface. These two phenomena make the bottom surface of electrode and workpiece distort. As machining depth increases, the distorted shape of the electrode approaches hemisphere. This process is affected by both capacitance and the size of electrode. By using a smaller electrode than the desired cavity size and appropriate tool movement, bottom shape distortion can be prevented.

자동전류조절기능을 사용한 4D CT 촬영시 선량 및 위험도 저감 효과

고영은,제형욱,황연,박성호,Ko, Young Eun,Je, Hyoung Uk,Hwang, Yeon,Park, Sung Ho 한국의학물리학회 2015 의학물리 Vol.26 No.4

본 연구는 호흡에 따른 장기의 움직임을 고려하는 치료를 계획하는 4D CT를 촬영하는 환자에게 자동전류조절기능을 사용함에 따른 선량 및 위험도 감소를 평가하고자 하였다. 자동전류조절기능을 사용하지 않은 경우와 사용한 경우에 대하여 간암, 폐암 환자 남녀 각 10명씩에 대하여 4D CT 촬영시 조직선량, CTDI 선량, 유효선량을 CT-Expo 프로그램을 이용하여 개개 환자를 평가하였고, 방사선유발사망확률과 수명손실을 PCXMC 프로그램을 이용하여 평가하였다. 조직선량, CTDI 선량의 경우 간암, 폐암 환자의 경우 26.8%, 15.5%의 선량감소가 확인되었고, 방사선유발사망확률과 수명 손실은 간암, 폐암 환자의 경우 16.5%, 19.8%의 위험도 감소를 확인하였다. 본 연구를 통해 CT 촬영 인자를 개개 환자에 적용함으로 조직선량, 유효선량을 평가할 수 있었으며, 나이 및 성별을 고려한 위험인자를 평가할 수 있었다. 선량감소기법으로 제공되는 자동전류조절기능을 사용함으로 간암 및 폐암환자의 경우 21.2%의 선량감소와 18.2%의 위험도 감소가 있음을 확인하였다. In this study, the reduction of dose and risk was evaluated from using automatic mA control in 4D CT scan of patients whose organ movement was considered for gated radiotherapy. The organ doses, CTDI, effective doses from 4D CT with and without using automatic mA control were evaluated using CT-Expo program for each 10 patients of liver and lung cancer, and the risk of exposure induced death and loss of life expectancy were evaluated using PCXMC program. It was founded that there were 26.8%, and 15.5% dose reduction in organ doses and CTDI for liver and lung cancer patients and 16.5% and 19.8% risk reduction in liver and lung cancer patients. The organ doses and effective doses were evaluated for the parameter of each patient used in CT scans, and risks considering age and gender could be evaluated. It was founded that there were 21.2% dose reduction and 18.2% risk reduction in 4D CT scan using AEC for liver and lung cancer patients.

절제 불가능한 식도암의 근치적 항암화학방사선치료의 성적

노오규(O Kyu Noh),제형욱(Hyoung Uk Je),김성배(Sung Bae Kim),이진혁(Gin Hyug Lee),박승일(Seung Il Park),이상욱(Sang-wook Lee),송시열(Si Yeol Song),안승도(Seung Do Ahn),최은경(Eun Kyung Choi),김종훈(Jong Hoon Kim) 대한방사선종양학회 2008 Radiation Oncology Journal Vol.26 No.4

목 적: 절제 불가능한 식도암에서의 근치적 동시항암화학방사선치료의 치료 성적과 재발 양상에 대해 알아보고자 하였다. 대상 및 방법: 1994년 2월부터 2002년 12월까지 서울아산병원에서 절제불가능한 국소진행된 식도암으로 진단 받 거나 내과적으로 수술이 불가능한 식도암으로 진단 받은 후 근치적 목적의 동시항암화학방사선치료를 시행 받은 168명을 대상으로 하였다. 방사선치료는 원발병소와 종격동, 그리고 원발병소와 림프절 전이의 위치에 따라 쇄골 상부림프절과 복강림프절을 포함하여 42∼46 Gy의 외부방사선을 조사하였고, 이후 원발병소와 림프절 전이 부위에는 54∼66 Gy까지 추가 조사하였다. 분할조사 방법은 분할조사선량 1.8∼2 Gy씩 1일 1회 조사하거나, 1.2 Gy씩 1일 2회 조사하였다. 고선량률관내방사선치료를 실시하는 경우에는 Ir-192를 이용한 고선량률 방식으로 3 Gy씩 3∼4회 시행하였다. 항암치료는 5-FU와 cisplatin을 이용하여 동시항암화학방사선치료(5-FU 1,000 mg/m2/day, days 2∼6, 30∼34, cisplatin 60 mg/m2/day, days 1, 29)를 2주기 시행하고 방사선치료 후에 2 주기를 추가하여 시행하였다. 결 과: 분석 가능한 환자는 160명 이었으며, 추적관찰 기간은 1개월에서 149개월(중앙값 10개월)이었다. 환자의 AJCC 병기는 I, II, III, IV 기가 각각 5명(3.1%), 38명(23.8%), 68명(42.5%), 49명(30.6%)이었다. 26명(16.3%)의 환자에서는 9∼12 Gy의 추가 관내방사선치료를 시행하였다. 관내방사선치료를 포함하여 총 40 Gy 이상 조사받은 144명의 환자에서 외부 방사선조사량의 범위는 44.4∼66 Gy (중앙값 59.4)이었고, 총 방사선 조사량의 범위는 44.4∼72 Gy (중앙값 60)이었다. 분석가능한 160명의 환자 중에서 101명(63.1%)에서 재발하였으며, 재발 양상으 로는 국소 재발이 20명(12.5%), 지속적 병변 또는 국소 진행이 61명(38.1%), 원격전이가 15명(9.4%), 국소재발과 원격전이가 함께 있는 경우가 5명(3.1%)이었다. 전체환자의 중앙생존기간은 11.1개월이었고, 2년 및 5년 전체생 존율은 각각 31.8%, 14.2%이었다. 중앙무병 생존기간은 10.4개월이었고, 2년 및 5년 무병생존율은 각각 29.0%, 22.7%이었다. 항암화학방사선치료 후에 종양 반응 및 림프절 병기만이 전체생존율에 유의하게 영향을 미치는 예후인자였다. 방사선 조사량(≥50 Gy vs. <50 Gy), 관내방사선치료의 추가 유무, 분할조사(1회/day vs. 2회/day)에 따른 전체 생존율 및 무병생존율에 유의한 차이는 관찰되지 않았다.결 론: 식도암에서 근치적 동시 항암화학방사선치료의 성적은 다른 연구 결과와 유사한 결과를 보였다. 동시 항암화학 방사선치료 후의 주된 재발 양상은 국소 재발이었다. 방사선 조사량의 증가(≥50 Gy), 고선량률관내방사선치료 및 과분할조사법의 시행은 치료 성적을 향상시키지 못하였다. Purpose: To investigate the treatment outcome and failure patterns after definitive chemoradiation therapy in locally advanced, unresectable esophageal cancer. Materials and Methods: From February 1994 to December 2002, 168 patients with locally advanced unresectable or medically inoperable esophageal cancer were treated by definitive chemoradiation therapy. External beam radiation therapy (EBRT) (42∼46 Gy) was delivered to the region encompassing the primary tumor and involved lymph nodes, while the supraclavicular fossa and celiac area were included in the treatment area as a function of disease location. The administered cone-down radiation dose to the gross tumor went up to 54∼66 Gy, while the fraction size of the EBRT was 1.8-2.0 Gy/fraction qd or 1.2 Gy/fraction bid. An optional high dose rate (HDR) intraluminal brachytherapy (BT) boost was also administered (Ir-192, 9∼12 Gy/3 ∼4 fx). Two cycles of concurrent FP chemotherapy (5-FU 1,000 mg/m2/day, days 2∼6, 30∼34, cisplatin 60 mg/m2/day, days 1, 29) were delivered during radiotherapy with the addition of two more cycles. Results: One hundred sixty patients were analyzable for this review [median follow-up time: 10 months (range 1∼149 months)]. The number of patients within AJCC stages I, II, III, and IV was 5 (3.1%), 38 (23.8%), 68 (42.5%), and 49 (30.6%), respectively. A HDR intraluminal BT was performed in 26 patients. The 160 patients had a median EBRT radiation dose of 59.4 Gy (range 44.4∼66) and a total radiation dose, including BT, of 60 Gy (range 44.4∼72), while 144 patients received a dose higher than 40 Gy. Despite the treatment, the disease recurrence rate was 101/160 (63.1%). Of these, the patterns of recurrence were local in 20 patients (12.5%), persistent disease and local progression in 61 (38.1%), distant metastasis in 15 (9.4%), and concomitant local and distant failure in 5 (3.1%). The overall survival rate was 31.8% at 2 years and 14.2% at 5 years (median 11.1 months). Disease-free survival was 29.0% at 2 years and 22.7% at 5 years (median 10.4 months). The response to treatment and N-stage were significant factors affecting overall survival. In addition, total radiation dose (≥50 Gy vs. <50 Gy), BT and fractionation scheme (qd. vs. bid.) were not significant factors for overall survival and disease-free survival. Conclusion: Survival outcome after definitive chemoradiation therapy in unresectable esophageal cancer was comparable to those of other series. The main failure pattern was local recurrence. Survival rate did not improve with increased radiation dose over 50 Gy or the use of brachytherapy or hyperfractionation.

미세 캐비티 방전 가공에서 바닥면 형상 왜곡

임종훈(Jong Hoon Lim),류시형(Shi Hyoung Ryu),제성욱(Sung Uk Je),주종남(Chong Nam Chu) Korean Society for Precision Engineering 2003 한국정밀공학회지 Vol.20 No.12

Clinical outcome of fiducial-less CyberKnife radiosurgery for stage I non-small cell lung cancer

Jung, In-Hye,Song, Si Yeol,Jung, Jinhong,Cho, Byungchul,Kwak, Jungwon,Je, Hyoung Uk,Choi, Wonsik,Jung, Nuri Hyun,Kim, Su Ssan,Choi, Eun Kyung The Korean Society for Radiation Oncology 2015 Radiation Oncology Journal Vol.33 No.2

Purpose: To evaluate the treatment results in early stage non-small cell lung cancer patients who have undergone fiducial-less CyberKnife radiosurgery (CKRS). Materials and Methods: From June 2011 to November 2013, 58 patients underwent CKRS at Asan Medical Center for stage I lung cancer. After excluding 14 patients, we retrospectively reviewed the records of the remaining 44 patients. All analyses were performed using SPSS ver. 21. Results: The median age at diagnosis was 75 years. Most patients had inoperable primary lung cancer with a poor pulmonary function test with comorbidity or old age. The clinical stage was IA in 30 patients (68.2%), IB in 14 (31.8%). The mean tumor size was 2.6 cm (range, 1.2 to 4.8 cm), and the tumor was smaller than 2 cm in 12 patients (27.3%). The radiation dose given was 48-60 Gy in 3-4 fractions. In a median follow-up of 23.1 months, local recurrence occurred in three patients (2-year local recurrence-free survival rate, 90.4%) and distant metastasis occurred in 13 patients. All patients tolerated the radiosurgery well, only two patients developing grade 3 dyspnea. The most common complications were radiation-induced fibrosis and pneumonitis. Eight patients died due to cancer progression. Conclusion: The results showed that fiducial-less CKRS shows comparable local tumor control and survival rates to those of LINAC-based SABR or CKRS with a fiducial marker. Thus, fiducial-less CKRS using Xsight lung tracking system can be effectively and safely performed for patients with medically inoperable stage I non-small cell lung cancer without any risk of procedure-related complication.