Primary chemotherapy for newly diagnosed nonsmall cell lung cancer patients with synchronous brain metastases compared with whole-brain radiotherapy administered first : Result of a randomized pilot study

Lee, Dae Ho,Han, Ji-Youn,Kim, Heung Tae,Yoon, Sung Jin,Pyo, Hong Ryull,Cho, Kwan Ho,Shin, Sang-Hoon,Yoo, Heon,Lee, Seung-Hoon,Lee, Jin Soo Wiley Subscription Services, Inc., A Wiley Company 2008 Cancer Vol.113 No.1

<B>BACKGROUND.</B><P>This randomized pilot trial investigated whether primary chemotherapy was feasible in terms of efficacy, survival, toxicity profile, and quality of life compared with whole-brain radiotherapy (WBRT) given first in chemotherapy-naive patients nonsmall cell lung cancer (NSCLC) with synchronous brain metastasis when neurologic symptoms or signs are absent or controlled by supportive care.</P><B>METHODS.</B><P>After stratification by Eastern Cooperative Oncology Group performance status (ECOG PS) (0–1 vs 2), the number of intracranial metastases (<3 vs 3≤), and the presence of extrathoracic extracranial metastasis, eligible patients were randomized to the primary chemotherapy arm or the WBRT-first arm. World Health Organization (WHO) response criteria, National Cancer Institute Common Toxicity Criteria (NCI-CTC; version 2.0), and the European Organization for Research and Treatment of Cancer (EORTC) C-30/LC-13 questionnaire were used.</P><B>RESULTS.</B><P>A total of 48 patients were enrolled between August 2002 and November 2005. The response rate of chemotherapy and survival outcomes in the primary chemotherapy arm were not statistically different from those in the WBRT-first arm (overall response rate, 28.0% vs 39.1%; progression-free survival, 3.6 months vs 4.4 months; overall survival, 9.1 months vs 9.9 months). There was close correlation noted between intracranial and extracranial tumor responses (k = 0.82). However, in the WBRT-first arm, grade 3 of 4 neutropenia was more frequent (79% vs 40%) during chemotherapy and 4 patients (17.4%) did not receive further chemotherapy because of early death or poor performance after WBRT. Cognitive function appeared to deteriorate during primary chemotherapy, but was also found to deteriorate after WBRT.</P><B>CONCLUSIONS.</B><P>Primary chemotherapy is more feasible and can be an appropriate option for patients with synchronous brain metastasis when neurologic symptoms or signs are absent or controlled. The role and timing of WBRT should be defined in further studies in this clinical setting. Cancer 2008. © 2008 American Cancer Society.</P>

Carbon and Nitrogen Primary Productivities in the Weddell Sea and the Bransfield Strait, Antarctica

Sung Ryull Yang,Sung-Ho Kang,SangHoon Lee 한국해양과학기술원 1998 KOREAN JOURNAL of Polar Research Vol.9 No.1

Catheter를 이용한 지속적 성상신경절 차단경험

이상률(Sang Ryull Lee) 대한통증학회 1997 The Korean Journal of Pain Vol.10 No.2

Stellate ganglion block has been used to treat diseases such as peripheral vascular disease, sympathetic dystrophy, and various pain syndromes involving the head or arm. Raynaud's disease is a syndrome manifested by attacks of pallor, cyanosis, numbness and pain of the digits in response to cold or emotional change. report one case who was given Stellate ganglion block using 18G teflon Catheter(4.5 cm in length) for Raynaud's disease. Continuous stellate ganglion block is more convinient to inpatient than repeated needle punctures and may reduce major complications and more useful to patient who needs continuous sympathetic block about one week duration,

Evaluation of Parotid G land Function following Intensity Modulated Radiation Therapy for Head and Neck Cancer

Seok Ho Lee,Tae Hyun Kim,Joo Young Kim,Sung Yong Park,Hong Ryull Pyo,Kyung Hwan Shin,김대용,조관호 대한암학회 2006 Cancer Research and Treatment Vol.38 No.2

Purpose: This study was undertaken to determine the parotid gland tolerance dose levels following intensity modulated radiation therapy (IMRT) for treating patients who suffered with head and neck cancer.Materials and Methods: From February 2003 through June 2004, 34 head and neck patients with 6 months of follow-up were evaluated for xerostomia after being treated by IMRT. Their median age was 59 years (range: 29~78). Xerostomia was assessed using a 4-question xerostomia questionnaire score (XQS) and a test for the salivary flow rates (unstimulated and stimulated: USFR and SSFR, respectively). The patients were also given a validated LENT SOMA scale (LSS) questionnaire. Evaluations were performed before IMRT and at 1, 3 and 6 months after IMRT.Results: All 34 patients showed significant changes in the XQS, LSS and Salivary Flow rates (USFR and SSFR) after IMRT. No significant changes in the XQS or LSS were noted in 12 patients who received a total parotid mean dose of ≤3,100 cGy at 1, 3 and 6 months post-IMRT relative to the baseline values. However, for the 22 patients who received 〉3,100 cGy, significant increases in the XQS and LSS were observed. The USFR and SSFR from the parotid glands in 7 patients who received ≤2,750 cGy were significantly preserved at up to 6 months after IMRT. However, the USFR and SSFR in 27 patients who were treated with 〉2,750 cGy were significantly lower than the baseline values at all times after IMRT.Conclusion: We suggest that the total parotid mean dose should be limited to ≤2,750 cGy to preserve the USFR and SSFR and so improve the subsequent quality of life. (Cancer Res Treat. 2006;38:84-91)

Initial Experience of Patient-Specific QA for Wobbling and Line-Scanning Proton Therapy at Samsung Medical Center

Jo, Kwanghyun,Ahn, Sung Hwan,Chung, Kwangzoo,Cho, Sungkoo,Shin, Eun Hyuk,Park, Seyjoon,Hong, Chae-Seon,Kim, Dae-Hyun,Lee, Boram,Lee, Woojin,Choi, Doo Ho,Lim, Do Hoon,Pyo, Hong Ryull,Han, Youngyih Korean Society of Medical Physics 2019 의학물리 Vol.30 No.1

Purpose: To report the initial experience of patient-specific quality assurance (pQA) for the wobbling and line-scanning proton therapy at Samsung Medical Center. Materials and Methods: The pQA results of 89 wobbling treatments with 227 fields and 44 line-scanning treatments with 118 fields were analyzed from December 2015 to June 2016. For the wobbling method, proton range and spread-out Bragg peak (SOBP) width were verified. For the line-scanning method, output and two-dimensional dose distribution at multiple depths were verified by gamma analysis with 3%/3 mm criterion. Results: The average range difference was -0.44 mm with a standard deviation (SD) of 1.64 mm and 0.1 mm with an SD of 0.53 mm for the small and middle wobbling radii, respectively. For the line-scanning method, the output difference was within ${\pm}3%$. The gamma passing rates were over 95% with 3%/3 mm criterion for all depths. Conclusions: For the wobbling method, proton range and SOBP width were within the tolerance levels. For the line-scanning method, the output and two-dimensional dose distribution showed excellent agreement with the treatment plans.

A new homogeneity index based on statistical analysis of the dose–volume histogram

Yoon, Myonggeun,Park, Sung Yong,Shin, Dongho,Lee, Se Byeong,Pyo, Hong Ryull,Kim, Dae Yong,Cho, Kwan Ho unknown 2007 Journal of applied clinical medical physics Vol.8 No.2

<P>The goal of the present study was to develop a new dose–volume histogram (DVH)– based homogeneity index for effectively evaluating the dose homogeneity of intensity‐modulated radiotherapy plans. The new index, called the sigma‐index (“<I>S</I>‐index”) is defined as the standard deviation of the normalized differential DVH curve. In a study of 16 patients with brain tumors at our institution, the <I>S</I>‐index was found to vary from 0.80 to 3.15. Our results showed that the <I>S</I>‐index provides a more reliable and accurate measure of dose homogeneity than that given by conventional methods. A guideline for evaluating the dose homogeneity of treatment plans based on the <I>S</I>‐index and its relation to equivalent uniform dose is discussed.</P><P>PACS numbers: 87.53.Xd, 87.53.Tf</P>

신경교(神經膠) 성상세포(星狀細胞)의 세포자감사(細胞自減死)에 있어서 박하오일의 효과(效果)

이성률,김태헌,류영수,Lee Sung-Ryull,Kim Tae-Hun 대한한방신경정신과학회 1999 동의신경정신과학회지 Vol.10 No.2

Recently, essential oils are used for aromatherapy. Most essential oils are said to be anti-bacterial; some may be anti-viral or anti-fungal. I investigated the effects of peppermint pure essential oil on the heat shock-induced apoptosis in human astrocyte cell line CCF-STTGI. In previous studies, heat shock has been reported to induce the apoptosis or programmed cell death through the activation of caspase-3. We studied the heat shock-induced apoptosis through flow cytometry, DNA electrophoresis, and giemsa staining. Interestingly, these events were inhibited by pretreatment of peppermint pure essential oils in CCF-STTGl cells. Peppermint oil also inhibited the heat shock-induced apoptosis in primary cultured rat astrocytes. In addition, this Peppermint essential oil inhibited the heat shock-induced activation of caspase-3. These results suggest that peppermint pure essential oils may modulate the apoptosis through the activation of the interleukin-I -converting enzyme-like protease.

세기조절방사선치료를 시행받은 두경부암 환자군에서 구강건조증지표 분석

이석호(Seok Ho Lee),김태현(Tae Hyun Kim),지의규(Eui Kyu Chie),임현선(Hyun Shil Im),임은실(En Shil Im),류준선(Jun Sun Ryu),정유석(Yoo Seok Jung),박성용(Sung Yong Park),김주영(Joo Young Kim),표흥렬(Hong Ryull Pyo),신경환(Kyung Hwan Shi 대한방사선종양학회 2004 Radiation Oncology Journal Vol.22 No.2

목 적: 세기조절방사선치료 (IMRT) 를 시행받은 두경부암 환자군에서 구강건조증 지표들을 측정시점별로 비교분석 하고 이 지표들과 이하선에 ￡사된 방사선량과의 연관성을 분석하고자 하였다. 대상 및 방법 : 2003년 2월부터 10월까지 두경부암으로 IMRT를 시행받은 13명을 대상으로 하였다.IMRT군의 연령은 43-77세(중앙값 57서1) 01 었고, 구강건조증을 평가하는 주관적 지표로서 4항목으로 구성된 구강지표점수 (xerostomia questionnaire score: XQS) 와 객 관적 지 표로서 자극유무에 따른 saliva 의 분비 량(unstimulated & stimulated salivary flow rate: USFR & SSFR) 를 측정하였고, 주관적 그리고 객관적 통합지표로서 LENT SOMA scale(LSC) 을 측정하였다 측정시점은 치료 전, 치료 후 1 개월, 3개월이었다 IMRT 군 내에서 전체 환자군과 전체이하선에 조사된 평균방사선량을 기준으로 나눈 두 군에서의 측정시점에 따른 지표들 간 변화유무를 보았고 나아가 구강건조증지표들과 타액분비량 간의 상관관계를 분석하였다. 결 과 IMRT 군 전체 13 명 내에서 치료 전과 치료 후 1 개월, 3개월에 측정된 XQS, LSC, USFR &SSFR은 유의한 번 화가 없어 구강건조증의 발현이 관찰되지 않았다. 전체이하선에 조사된 평균선량 3,밍o cGy를 기준으로 환자군을 나누어 보았을 때, 3, 500 cGy 미만 조사받은 8명의 환자군에서는 유의한 변화가 없었으나 3,500 cGy 이상 조사받 은 5명의 환자군에서는 XQS, LSC, SSFR 그리고 USFRol 유의하게 증가되어 구강건조증의 발련이 관찰되었다- 또 한 각 지표들과 타액분비량 간의 상관관계를 보았을 때 치료 후 1 개월째에서 유의한 상관관계를 보이지 않았으 나, 치료 후 3개월째에서 XQS, LSC:가 커질수록 USFR, SSFROI 감소하는 유의한 상관관계를 보였다. 결 론 본 연구결과 IMRT는 구강건조증을 상당한 정도로 감소시킬 수 있는 것으로 나타났고, XQS와 LScol 유용한 임상지표로서의 가능성을 보였음을 알 수 있었다 삶의 질을 저하할 정도의 심한 구강건조증을 피하기 위해서는 양측 이하선 전체에 조사되는 평균선량을 가능한 한 3,500 cGy 미만으로 조사되도록 하여야 할 것으로 생각한다- 향후, 충분한 환자를 대상으로 하여 전체이하선의 평균선량에 대한 신뢰할 수 있는 결과와 나아가 타액의 분비량을 대신할 수 있는 임상적지표를 선정하는 연구가 진행되어야 할 것이다. Purpose: This study was done to evaluate xerostomia following intensity modulated radiotherapy for patients with head and neck cancer, and to analyze the correlation between the dosimetric parameters and xerostomia parameters. .Materials and Methods: From February till October 2003, t3 patients with 3 months of follow-up were evaluated for xerostomia after being treated for head and neck cancer with IMRT. Their median age was 57 years (range: 43 - 771. Xerostomia were assessed with a 4-question xerostomia questionnaire score (XQS) and a test for salivary flow rates (unstimulated and stimulated), The patients were also given a validated LENT SOMA scale (LSC) questionnaire. The evaluations were completed before radiation therapy (pre-RT) and at f and, 3 months after radiation therapy (RTI. We evaluated xerostomia at pre-RT, 1 and, 3 months after RT. The association between the xerostomia parameters (XQS and LSC) and salivary flow rates (unstimulated and stimulated: USFR and SSFR) was assessed at 1 and 3 months after RT. Results: All t3 patients showed no significant changes in XQS, LSe and Salivary How rates. As a result, we couldn't find out about xerostomia development. Based on the total mean parotid dose, 3,500 cGy, we divided these patients into two groups. The 8 patients « 3,500 cGy) showed no significant changes in XQS, LSC and Salivary Flow rates. However, in 5 patients (23,500 cGy), there was a significant increase in USFR and, SSFR at 3 months after RT, and for the XQS and, LSC at t and 3 months after RT. The correlation between XQS and, LSC, and USFR and, SSFR in all patients (t 3) was significant at 3 months after RT. The correlation had a tendency to the decrease for USFR and, SSFR In proportion to the Increase of XQS and, LSC. ,Conclusion: Based on the results of this study, IMRT seem to be an effective treatment to significantly decrease the xerostomia. XQS and, LSC seem to be a effective tool for predicting the xerostomia. A total parotid gland mean dose of <3,500 cGy should be a planning goal if substantial sparing of the gland function is desired. Furthermore, patients should be enrolled in a study to define a more accurate threshold dose for the parotid gland.

아산만 해역에서 장마기 전후 중형동물플랑크톤 군집의 변화

이두별,박철,양성렬,신용식,Lee, Doo-Byoul,Park, Chul,Yang, Sung-Ryull,Shin, Yong-Sik 한국해양학회 2007 바다 Vol.12 No.4

아산만에서 장마기 전 후 수온, 염분, 영양염, chlorophyll ${\alpha}$ 농도와 중형동물플랑크톤 등에 대해 분포의 특성과 이들 간의 관계를 파악해 보았다. 장마기에 담수 유입에 의한 환경 변화는 동물플랑크톤과 식물플랑크톤(chlorophyll ${\alpha}$) 분포에 직접적인 영향을 주었다. 장마기에 유입된 담수로 인해 영양염 농도는 높아졌고 동물플랑크톤 개체수는 크게 감소하였다. 반면, 식물플랑크톤(chlorophyll ${\alpha}$)은 장마기 종료 시점에 생체량이 증가하였다. 이는 방조제로부터 유출수 증가에 따른 동물플랑크톤 감소와 영양염 유입의 증가가 나타난 후 식물플랑크톤의 생체량이 증가하는 생물학적 과정이 연결되어 나타난 것으로 판단된다. 동물플랑크톤의 분포는 수온 변화에 따라 종별로 다른 양상을 보여 봄철 우점종과 여름철 우점종으로 구분 지을 수 있게 하였다. 이는 수온이 역시 중요한 분포요인이 됨을 보여준다. 그러나 장마로 인한 염분 변화는 전체 동물플랑크톤의 분포에 큰 영향을 주었으며 특히, Noctiluca scintillans, Acartia pacifica, Sagitta crassa에게는 수온보다 장마로 인한 염분 변화가 더 크게 작용한 것으로 판단되었다. Characteristics in distributions of T, S, nutrients, chlorophyll ${\alpha}$ concentrations and meso-zooplankton abundances and the relations among these parameters were investigated with the data collected in Asan Bay around the rainy season from May 24 till August 25, 2006 at about 10 days interval. Freshwater input during the rainy season clearly affected the distributions of zooplankton and phytoplankton (chlorophyll ${\alpha}$). Freshwater discharge resulted in high nutrients decreased zooplankton abundances. On the contrary, chlorophyll ${\alpha}$ concentrations increased at the end of the rainy season. It seemed that the increase of chlorophyll ${\alpha}$ concentrations was the result of the decreased zooplankton and enriched nutrients caused by freshwater discharges. Seawater temperatures were certainly the reason for the zooplankton succession. However, overall abundance of zooplankton and abundances of some zooplankton such as Noctiluca scintillans, Acartia pacifica, and Sagitta crassa seemed to be influenced by lowered salinity caused by heavy rain rather than seawater temperatures.

Effect of radiation scattering on dose uniformity in open and closed cell culture vessels

Yoon, Myonggeun,Park, Sung Yong,Shin, Jungwook,Kwak, Jungwon,Park, Junghun,Shin, Dongho,Park, Soah,Lee, Se Byeong,Lee, Doo Hyun,Shin, Kyung Hwan,Pyo, Hong Ryull,Kim, Joo-Young,Cho, Kwan Ho Informa Healthcare 2007 International Journal of Radiation Biology Vol.83 No.8

<P> Purpose: Dose uniformity in cell culture vessels such as Petri dishes and anoxic irradiation chambers is very important in radiobiological work as dose uniformity affects cell survival probabilities. In this study, we investigated X-ray dose inhomogeneity, caused by scattering, in typical culture vessels. Materials and methods: Three different cubic cell culture vessels, with side lengths of 10 cm, 15 cm and 20 cm, were designed and irradiated by X-rays of 6 MV and 15 MV at a source-to-surface distance (SSD) of 100 cm using a Varian 2100CD linear accelerator. Results: The relative X-ray dose distribution in a cell culture vessel depended strongly on whether the vessel had a lid. The percentage of the cell culture surface with the dose differing by more than 10% from the mean value of the dose was 43.4% in lidless vessels and 9.7% in lidded vessels. Conclusions: In radiobiological work, X-ray dose inhomogeneity within a cell culture vessel is not negligible and the placement of cells in the vessel should be carefully considered.</P>