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Purpose The purpose of this study was to develop automated planning for whole‐brain radiation therapy (WBRT) using a U‐net‐based deep‐learning model for predicting the multileaf collimator (MLC) shape bypassing the contouring processes. Methods A dataset of 55 cases, including 40 training sets, five validation sets, and 10 test sets, was used to predict the static MLC shape. The digitally reconstructed radiograph (DRR) reconstructed from planning CT images as an input layer and the MLC shape as an output layer are connected one‐to‐one via the U‐net modeling. The Dice similarity coefficient (DSC) was used as the loss function in the training and ninefold cross‐validation. Dose‐volume‐histogram (DVH) curves were constructed for assessing the automatic MLC shaping performance. Deep‐learning (DL) and manually optimized (MO) approaches were compared based on the DVH curves and dose distributions. Results The ninefold cross‐validation ensemble test results were consistent with DSC values of 94.6 ± 0.4 and 94.7 ± 0.9 in training and validation learnings, respectively. The dose coverages of 95% target volume were (98.0 ± 0.7)% and (98.3 ± 0.8)%, and the maximum doses for the lens as critical organ‐at‐risk were 2.9 Gy and 3.9 Gy for DL and MO, respectively. The DL technique shows the consistent results in terms of the DVH parameter except for MLC shaping prediction for dose saving of small organs such as lens. Conclusions Comparable with the MO plan result, the WBRT plan quality obtained using the DL approach is clinically acceptable. Moreover, the DL approach enables WBRT auto‐planning without the time‐consuming manual MLC shaping and target contouring.

Stereotaxic instruments are increasingly used in research animals for the study of disease, but typically require restraints and anesthetic procedures. A stereotaxic head mount that enables imaging of the anterior chamber of the eye in alert and freely mobile mice is presented in this study. The head mount is fitted based on computed tomography scans and manufactured using 3D printing. The system is placed noninvasively using temporal mount bars and a snout mount, without breaking the skin or risking suffocation, while an instrument channel stabilizes the ocular probes. With a flexible micro-endoscopic probe and a confocal scanning laser microscopy system

Purpose As computed tomography (CT) imaging is the most commonly used modality for treatment planning in radiation therapy, metal artifacts in the planning CT images may complicate the target delineation and reduce the dose calculation accuracy. Although current CT scanners do provide certain correction steps, it is a common understanding that there is not a universal solution yet to the metal artifact reduction (MAR) in general. Particularly noting the importance of MAR for radiation treatment planning, we propose a novel MAR method in this work that recruits an additional tilted CT scan and synthesizes nearly metal‐artifact‐free CT images. Methods The proposed method is based on the facts that the most pronounced metal artifacts in CT images show up along the x‐ray beam direction traversing multiple metallic objects and that a tilted CT scan can provide complementary information free of such metal artifacts in the earlier scan. Although the tilted CT scan would contain its own metal artifacts in the images, the artifacts may manifest in a different fashion leaving a chance to concatenate the two CT images with the metal artifacts much suppressed. We developed an image processing technique that uses the structural similarity (SSIM) for suppressing the metal artifacts. On top of the additional scan, we proposed to use an existing MAR method for each scan if necessary to further suppress the metal artifacts. Results The proposed method was validated by a simulation study using the pelvic region of an XCAT numerical phantom and also by an experimental study using the head part of the Rando phantom. The proposed method was found to effectively reduce the metal artifacts. Quantitative analyses revealed that the proposed method reduced the mean absolute percentages of the error by up to 86% and 89% in the simulation and experimental studies, respectively. Conclusions It was confirmed that the proposed method, using complementary information acquired from an additional tilted CT scan, can provide nearly metal‐artifact‐free images for the treatment planning.

One of the challenges in temperature measurements in the upper air using a radiosonde is the correction of solar radiation effects. A prerequisite for the correction is in situ measurements of solar radiation. In this study, a new technique for the measurement of solar irradiation followed by the temperature correction was developed using dual temperature sensors with different emissivities. The principle is that the radiation intensity is calculated by using the temperature difference between two thermistors coated with different materials (one with graphite and the other with aluminium) and then the irradiance obtained is used for the correction. As a first stage, the effect of air pressure on the temperature correction process using dual thermistors was examined. The temperature difference between the two sensors was found to be linearly proportional only to the irradiance up to 360 W m−2, regardless of air pressure from 10 to 1000 hPa at room temperature. This provides a way to calculate the irradiance by simply measuring the temperature difference between the two sensors. The calculated irradiance showed a difference of less than 45 W m−2 (13% of the maximum irradiance) compared to the irradiance measured with a calibrated pyranometer. The extended uncertainty of the calculated irradiance was 53.5 W m−2 (coverage factor k = 2). A reference temperature sensor in the shade was used to obtain a correction formula as a function of air pressure and calculated irradiance. When the temperature was corrected using the calculated irradiance, the extended uncertainty of the corrected temperature was 0.98 K (k = 2).

Aims This study attempted to investigate the association between lower urinary tract symptoms (LUTS) and cardiovascular disease (CVD) risk using International Prostate Symptom Score (IPSS) and CVD risk scores and to overcome the limitations of previous relevant studies. Methods A total of 2994 ostensibly healthy males, who participated in a voluntary health check in a health promotion center from January 2010 to December 2014, were reviewed. CVD risk scores were calculated using Framingham risk score and American College of Cardiology (ACC)/American Heart Association (AHA) score. Correlation and multivariate logistic regression analysis to predict the CVD risk severity were performed. Results Correlation between total IPSS with CVD risk scores demonstrated significant positive associations, which showed higher correlation with ACC/AHA score than the Framingham score (r = 0.18 vs 0.09, respectively). For ACC/AHA score, the partial correlation after adjustment of body mass index (BMI) showed significant positive correlations between all LUTS parameters and PSA. For the Framingham score, all variables, except IPSS Q2 and IPSS Q6, showed significant positive correlations. After adjustment of BMI, prostate volume and PSA, only the severe LUTS group showed significant relationship with intermediate-high CVD risk severity, as compared with normal LUTS group (OR = 2.97, 95%CI (1.35-6.99)). Conclusion Using two validated CVD risk calculators, we observed that LUTS is closely associated with future CVD risk. To predict the intermediate-high CVD risk severity, severe LUTS was a sentinel sign, the presence of which warrants the importance of an earlier screening for CVD.

Background The purpose of this study was to identify the prevalence of cancer cachexia and its prognostic impact in patients with advanced head and neck squamous cell carcinoma (HNSCC). Methods The prevalence of cancer cachexia was analyzed according to the follow-up periods during the first year after curative initial treatment. Recurrences, noncancer health events (NCHEs), and cause-specific survival outcomes were also analyzed according to the incidence of cancer cachexia during follow-up. Results Cancer cachexia was identified in 22 (6.1%), 148 (41%), 66 (18.4%), and 65 (18.7%) of 361 enrolled patients at pretreatment, immediately after treatment, 6-months after treatment, and 12-months after treatment, respectively. Sustained or newly developed cachexia at 6 and 12 months showed a significant association with recurrence and NCHE occurrence (p

Although a protective cap on the humidity sensor of radiosondes is an effective tool to prevent the sensor from wetting by rain and/or clouds, the cap is thought to be responsible for poor ventilation and thereby induces a time delay in the measurement of relative humidity in upper air. In the present study, a new type of the protective cap having a double cap configuration has been developed for improving the ventilation of air. The double cap consists of an outer cap and an inner cap with holes and windows on the top and sides of each cap, respectively, that are designed not to face each other, between two caps for blocking the penetration of water droplets. The wetting of the double cap was tested by artificial water droplets as well as during flying tests on rainy days and the humidity sensor in a double cap was not wet in both cases. In addition, the response of sensors to indoor humidity changes as well as during balloon-borne measurements was found to be faster in the case of double caps than conventional closed caps, suggesting the enhancement of ventilation when using the double cap. The present study provides an efficient way to improve the performance of humidity sensors of radiosondes by simply modifying the design of protective caps.

Introduction The present study evaluated the threshold dose for hepatic parenchymal changes on gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance (MR) images after stereotactic body radiation therapy (SBRT) for hepatocellular carcinoma (HCC). Methods Twenty patients with available data of follow-up MR images acquired 2–4 months after completion of SBRT were selected among the registered patients. SBRT was performed using multiple coplanar and non-coplanar beams with energies of 6 or 15 MV. All patients were treated with doses of 45 Gy administered in three fractions over 3 consecutive days. For image registration between planning computed tomography (CT) and MR images, landmark-based rigid body registration was performed using MIM software. Results Seventeen patients were included in the analysis. The median discrepancies between planning CT and MR images in the left–right, anterior–posterior and superior–inferior directions were 1.38 mm, 1.24 mm and 1.72 mm, respectively. The median D50 value for the defect in the hepatobiliary phase of Gd-EOB-DTPA-enhanced MR images after SBRT was 19.8 Gy (range, 14.2–28.7 Gy), with R2 values ranging from 0.76 to 0.99. Conclusions The threshold dose for parenchymal changes in the hepatobiliary phase of Gd-EOB-DTPA-enhanced MR images performed 2–4 months after 45 Gy of SBRT in three fractions was approximately 20 Gy. Our results provide the basis for further research on the functional loss of liver parenchyma after SBRT.

Although serum beta-2 microglobulin (B2M) has been suggested as a prognostic factor for mantle cell lymphoma (MCL), additional data are necessary to confirm its role. Between November 2005 and July 2014, a total of 52 patients with MCL were identified from the database of Asan Medical Center, Seoul, Korea. Pretreatment serum B2M information was available in 50 patients (96%). Overall survival (OS) was compared according to the serum B2M level with a cut-off value of 2.5 mg/L. The median MCL international prognostic index (MIPI) score was 5.84 (range 4.72–7.80), and the median biologic MIPI (MIPI-b) score was 6.27 (4.93–8.47). Pretreatment serum B2M was elevated in 30 patients (60%) and was significantly related to advanced stage (p = 0.02) and high MIPI (p = 0.03) and MIPI-b (p = 0.03) scores. With median follow-up duration of 29.8 months (range 0.8–87.0 months), the median OS was 56.2 months [95% confidence interval (CI) 36.6-75.9 months] in all patients, and serum B2M was significantly associated with OS (p = 0.001). In multivariate analyses adjusted for MIPI or MIPI-b scores and rituximab, elevated serum B2M was significantly associated with poor OS (when adjusting MIPI, hazard ratio = 26.4, 95% CI 2.9–241.3, p = 0.004; when adjusting MIPI-b, hazard ratio = 20.1, 95% CI 2.4–170.1, p = 0.006). Thus, pretreatment serum B2M may be an independent and significant prognostic factor in patients with MCL. Copyright © 2015 John Wiley & Sons, Ltd.

Background To evaluate the usefulness of metabolic tumor volume (MTV) and total lesion glycolysis (TLG) measured by pretreatment fluorine 18-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) as predictors of clinical outcome in hypopharyngeal squamous cell carcinoma (HPSCC). Methods Seventy-eight patients with HPSCC treated with definitive radiotherapy with or without chemotherapy underwent 18F-FDG PET/CT. Maximum standardized uptake value (SUVmax), MTV, and TLG were measured. For calculation of MTV, 3-D regions of interest were drawn and a SUV threshold of 2.5 was used for defining region. Univariate and multivariate analyses identified variables associated with disease-free survival (DFS) and overall survival (OS). Results Median SUVmax, MTV, and TLG were 9.0 (range, 1.7–24.5), 20.5 (0.3–339.9) ml, and 98.9 (0.8–1877.1) g, respectively. The four-year DFS and OS were 56.1% and 52.6%, respectively. On univariate and multivariate analyses, MTV (P = 0.014) and TLG (P = 0.029) were independent prognostic factors for DFS, and MTV (P = 0.002) and TLG (P = 0.002) were independent prognostic factors for OS. Conclusion MTV and TLG measured by pretreatment 18F-FDG PET/CT may be useful in predicting the clinical outcomes of HPSCC patients undergoing radiotherapy. J. Surg. Oncol. 2014 110:869–875. © 2014 Wiley Periodicals, Inc.

This study was conducted to evaluate the effects of foam dressing with human recombinant human epidermal growth factor (rhEGF) on the healing process in head and neck cancer patients who experience radiation-induced dermatitis (RID). Seven patients, including three with oropharyngeal, two with nasopharyngeal and one each with hypopharyngeal and laryngeal carcinoma, who underwent radiotherapy (RT) for head and neck cancer at the Asan Medical Center from March to December 2008 were prospectively included in this study. Patients who showed severe RID (more than wet desquamation) on the supraclavicular fossa or neck areas were treated by wound cleaning and debridement of granulation tissue, followed by daily rhEGF spray and foam dressing. Median time to stop exudates and reepithelialisation was 4 days. Within 14 days (median 8 days), all patients showed complete healing of RID and no longer required dressings. This new method of treatment with dressing containing rhEGF may have the potential to accelerate the healing process in patients with RID. A case-control study is needed to confirm this finding.

Purpose To identify power motion-mode Doppler (PMD) patterns and assess their diagnostic value for the diagnosis of middle cerebral artery (MCA) stenosis. Methods Retrospective analyses of PMD data were performed for the identification of specific patterns related to MCA stenosis. The interrater reliability and the validity of these patterns were studied, using magnetic resonance angiography and conventional transcranial Doppler sonography as gold standards. Results Three PMD patterns were identified: the so-called black-hole, the white-hole, and the diastolic-band patterns in 58 among 178 MCAs. The mean flow velocity was significantly higher in arterial segments with the black-hole patterns and lower in segments with the diastolic-band pattern compared with the segments with normal patterns. The interrater reliability was good for each pattern. The black-hole pattern or its combination with the white-hole pattern showed the highest validity. Conclusion Despite some limitations, the black-hole PMD pattern or its combination with the white-hole pattern appeared as a reliable and valid marker for the diagnosis of MCA stenosis. © 2014 Wiley Periodicals, Inc. J Clin Ultrasound 42:348–354, 2014

Background We compared clinical outcomes between patients with salivary gland carcinomas preoperatively misdiagnosed as benign lesion and properly diagnosed as malignant lesion. Methods The outcomes were compared between patients with benign lesion and malignant lesion (44 each) on preoperative fine-needle aspiration cytology diagnosis who underwent conservative or radical surgery. Results Five-year lesion-free survival (DFS) rates were 86.8% for benign lesion and 76.3% for malignant lesion (p = .128). Surgical extent did not significantly affect locoregional recurrence and DFS (p = .360). Univariate analysis showed that sublingual gland tumor, positive resection margin, and extraparenchymal extension (EPE) were significantly associated with DFS (p < .05 each). On multivariate analysis, EPE remained an independent variable (p = .047, hazard ratio = 6.621, 95% confidence interval = 1.393–31.474). Conclusions The clinical outcomes of patients with salivary gland carcinomas misdiagnosed as benign are relatively favorable. Conservative surgery may be sufficient for patients with low-grade and T1–2 salivary gland carcinomas. © 2013 Wiley Periodicals, Inc. Head Neck 35: 1764–1770, 2013

Objective The clinical features of extranodal natural killer (NK)/T-cell lymphoma (ENKL) that originates in extranasal sites are less well defined than those of ENKL that originates in nasal sites. Therefore, we compared the clinical characteristics and prognoses of patients with nasal ENKL and patients with extranasal ENKL. Methods We retrospectively analyzed 117 consecutive patients with ENKL that included 89 (76.1%) with nasal and 28 (23.9%) with extranasal disease. Results Extranasal ENKL was associated with more adverse clinical features than nasal ENKL, which included the presence of B symptoms, stage III/IV disease, ≥2 extranodal sites, and involvement of regional lymph nodes and bone marrow. After a median follow-up of 33.1 months (range, 0.7–152.2 months), the median overall survival (OS) of patients with extranasal and nasal NK/T-cell lymphoma was 8.6 and 86.5 months, respectively. Multivariate analysis revealed that extranasal NK/T-cell lymphoma was a significant factor that affects OS. When patients with extranasal ENKL were classified into low-risk and high-risk categories according to the Korean Prognostic Index (KPI) and International Prognostic Index (IPI), these indices categorized the two groups with significantly different survival outcomes (P = 0.025 and 0.035, respectively). Conclusions Patients with extranasal ENKL have worse clinical outcomes than those with nasal ENKL. The KPI and IPI appear useful for the prognosis of patients with extranasal ENKL.

We previously showed that hematopoietic progenitor cell (HPC) count is a useful surrogate for the timing of autologs stem cell collection (ASCC). We investigated the role of HPC count increment in predicting the time for optimal ASCC in patients with multiple myeloma (MM). Between May 2002 and January 2011, 138 patients with MM who underwent ASCC after mobilization with cyclophosphamide (4 g/m2) and granulocyte-colony stimulating factor at Asan Medical Center. HPC monitoring was started on the 10th day of cyclophosphamide administration and ASCC was performed when HPC count reached at least 10/mm3. Velocity of HPC increment (/mm3/day) was calculated as HPC count on the first day of ASCC/number of days from cyclophosphamide infusion to the first day of ASCC. A total of 422 leukapheresis were performed in 136 patients (median per patient: 3; range: 2–8). Of these patients, 131 (94.9%) successfully achieved optimal ASCC (≥5 × 106 CD34+ cells/kg). The median velocity of HPC increment was 2.17/mm3/day (range: 0.07–144.2/mm3/day). The mean ± standard error numbers of apheresis procedures in patients with velocity of HPC increment ≤2.0/mm3/day and >2.0/mm3/day were 3.43 ± 0.17 and 2.70 ± 0.11, respectively, and their median times to optimal ASCC were 15 and 13 days, respectively, with a hazard ratio of 0.47 (95% confidence interval, 0.32–0.68; P < 0.001) on multivariate analysis. Therefore, a slower increase of HPC of ≤2.0/mm3/day is associated with larger number of apheresis procedures for optimal ASCC. J. Clin. Apheresis 27:229–234, 2012. © 2012 Wiley Periodicals, Inc.

Background: Limited progress had been made in prognostic stratification of patients with Hodgkin lymphoma (HL) until recent studies suggested that the number of CD68-expressing macrophages is prognostic in classical HL. However, its significance in Asian patients with HL has not been explored yet perhaps because of its low incidence in Asia. Methods: In this work, we performed immunohistochemical analysis of CD163, as well as CD68, in 144 Korean patients with HL treated between November 1990 and December 2009 in a single center. The relative percentages of CD68+ and CD163+ cells with respect to the overall cellularity (CD68 index and CD163 index, respectively) were correlated with clinical outcomes. Results: Both high CD68 and CD163 indices (>20%) were associated with a rise in treatment-related deaths and poorer event-free survival (P = 0.009 and P = 0.0023, respectively), disease-specific survival (P = 0.011 and P = 0.001), and overall survival (P = 0.023 and P = 0.001). In particular, a high CD163 index was related to lower complete response (CR) rate (P = 0.022) and shorter duration of CR (P = 0.030). Conclusions: High index of either CD68 or CD163 (>20%) is significantly correlated with poor prognosis in Korean patients with HL. CD163, a specific marker of macrophages, seems to be another prognostic factor for classical HL.

Small interfering RNA (siRNA) has specific and effective gene silencing effects and has rapidly emerged as a potent strategy for cancer therapy.[1] Naked siRNA cannot readily cross cellular membranes, and the delivery of siRNA to its target remains the biggest hurdle to clinical translation.[2] Various types of synthetic nanovectors have been investigated for siRNA delivery.[3] Although many promising systems for the delivery of siRNA have been reported, clinical translation of siRNA therapeutics remains a challenge. Herein, we report a nanoparticle-based system for delivering siRNA into cells that uses a biodegradable conjugate with a high cell permeability for targeting tumors, and a universal phosphate-binding analogue for high siRNA binding affinity.

An augmented reality book (AR book) is an application in which such multimedia elements as virtual 3D objects, movie clips, or sound clips are augmented to a conventional book using augmented reality technology. It can provide better understanding about the contents and visual impressions for users. For AR books, this paper presents a markerless tracking method, which recognizes and tracks a large number of pages in real-time, even on PCs with low computation power. For fast recognition with respect to a large number of pages, we propose a generic randomized forest that is an extension of a randomized forest. In addition, we define the spatial locality of the subregions in an image to resolve the problem of a dropping recognition rate under a complex background. For tracking with minimal jittering, we also propose the adaptive keyframe-based tracking method, which automatically updates the current frame as a keyframe when it describes the page better than the existing one. Copyright © 2011 John Wiley & Sons, Ltd.

Induction chemotherapy (ICT) may reduce rates of distant metastases and enhance organ preservation and survival rates in patients with hypopharyngeal cancer. The authors compared survival data in patients who underwent chemoradiotherapy or surgery after ICT and investigated whether response to ICT is a predictive marker for outcome in patients with hypopharyngeal cancer.Historical cohort study.Tertiary-care hospital.The authors enrolled 97 patients (89 men, 8 women; mean age 61.2 years; range, 29-80 years) with previously untreated hypopharyngeal cancer who underwent ICT between January 1997 and December 2006 at Asan Medical Center. Disease-free survival (DFS), overall survival (OS), and laryngectomy-free survival (LFS) were analyzed.At a mean follow-up of 38.0 months, the 3-year DFS and OS for all patients were 48.3% and 49.2%, respectively. The 3-year LFS rate of patients who underwent nonsurgical therapy (n = 85) after ICT was 48.0%. Only response to ICT was associated with DFS (P = .047), OS (P = .003), and LFS (P = .009) in multivariate analysis. When the authors compared survival data in patients who underwent surgical and nonsurgical treatments after ICT, they found that there was no statistical difference in terms of the 3-year DFS in partial response (42.9% vs 50.5%, P = .77) and nonresponse groups (50.0% vs 0%, P = .43) between the 2 treatment types.ICT permits assessment of tumor responsiveness and alters subsequent therapy accordingly. Response to ICT may be useful in the prediction of ultimate outcomes and organ conservation in patients with hypopharyngeal cancer.

We have demonstrated the feasibility of thin-film coatable type polarizer for high contrast. New liquid crystalline materials were developed and the manufacturing process was optimized to achieve high performance polarization characteristics. We made a 9.7 inch XGA prototype with our newly developed polarizer, and obtained good image quality and high electro-optical performance. More approaches to get higher polarization performance in terms of materials and manufacturing process were discussed.

Objective: We carried out a nationwide epidemiological study to evaluate the prevalence and effect of varicoceles on testicular volume in South Korean adolescents. We also investigated the correlation between varicoceles and body mass index (BMI). Methods: In this prospective study, physical examinations were carried out to assess the presence and severity of varicoceles in middle school boys from six regions of South Korea. Testicular volume, height and weight of all boys were measured. The prevalence of varicoceles was assessed. The associations between age, testicular volume, BMI, and the presence and severity of varicoceles were examined. Results: A total of 1938 boys with a mean age of 14.1 years (range 13–16 years) were screened. A varicocele was found on the left side in 295 (15.2%) boys and on the right side in 8 (0.4%) boys. Bilateral varicoceles were found in 17 (0.9%) individuals. Of the subjects with a left varicocele, 151 (51.2%), 80 (27.1%) and 64 (25.1%) boys had a grade 1, 2 or 3 varicocele, respectively. The prevalence of varicoceles did not increase with age. The proportion of boys with testicular size discrepancies increased with the severity of the varicocele. After adjusting for age, BMI had a negative correlation with the presence of varicoceles. Conclusions: The prevalence of varicoceles in South Korean middle school boys is 16.5%. The presence of varicoceles seems to have a negative effect on testicular growth. BMI has a significant inverse relationship with the occurrence of varicoceles.

This study proposed a way to design femur fracture fixation plates made of shape memory alloy based on computed tomography (CT) images of Korean cadaveric femurs. To this end, 3 major design factors of femur fracture fixation plates (circumference angle, thickness, and inner diameter) were selected based on the contact pressure when a femur fracture fixation plate was applied to a cylinder model using the Taguchi method. Then, the effects of the design factors were analyzed. It was shown that the design factors were statistically significant at a level of p = 0.05 concerning the inner diameter and the thickness. The factors affecting the contact pressure were inner diameter, thickness, and circumference angle, in that order. Particularly, in the condition of Case 9 (inner diameter 27 mm, thickness 2.4 mm, and circumference angle 270°), the max. average contact pressure was 21.721 MPa, while the min. average contact pressure was 3.118 MPa in Case 10 (inner diameter 29 mm, thickness 2.0 mm, and circumference angle 210°). When the femur fracture fixation plate was applied to the cylinder model, the displacement due to external sliding and pulling forces was analyzed. As a result, the displacement in the sliding condition was at max. 3.75 times greater than that in the pulling condition, which indicated that the cohesion strength between the femur fracture fixation plate and the cylinder model was likely to be greater in the pulling condition. When a human femur model was applied, the max. average contact pressure was 10.76 MPa, which was lower than the yield strength of a human femur (108 MPa). In addition, the analysis of the rib behaviors of the femur fracture fixation plate in relation to the recovery effect of the shape memory alloy showed that the rib behaviors varied depending on the arbitrarily curved shapes of the femur sections.

This study focuses on the development of a multiplex pathogen-detection platform based on polydiacetylene (PDA) using a novel immobilization procedure. PDA liposome-based solid sensors have a critical drawback as the PDA liposomes are not stably immobilized onto the solid substrate. Therefore, to overcome this problem, an interlinker, ethylenediamine, is introduced, which acts as a cross-linker between individual PDA liposomes. The quantity of ethylenediamine added was optimized to 1 mM, as measured by the fluorescence signal emitted by the stably immobilized PDA liposomes, a concentration at which the fluorescence signal is 10 times higher than for the resulting PDA chips made without the interlinker. This procedure is used to manufacture PDA liposome-based multiplex biosensor arrays for well-known water and food-borne pathogens. The fabricated biosensor was able to perform the simultaneous and quantitative detection of 6 species of pathogens. As such, the results demonstrated from this research can be exploited for the development of more advanced PDA-based biosensors and diagnostics.

However, due to blurs and errorsinthelateraldefinitionoftheelementpatternsgeneratedbythosemethods, a new patterning and integration technology with highprecision in 2D and 3D is required for producing high-performance combinatorial arrays. Recently, a substrate pattern-ing method creating wetting contrast patterns for solutions wasdemonstrated to fabricate organic thin-film transistors

Background Cancers of the submandibular gland are uncommon and only a few small series have reported patient survival and prognosis. Methods We examined the treatment outcomes of 62 patients with surgically treated submandibular gland carcinomas. All patients underwent surgical excision with/without neck dissection, and 41 received postoperative radiotherapy for high-grade, invasive, positive margin, or regionally metastatic tumors. The locoregional control and survival rates were calculated by the Kaplan–Meier method and prognostic factors were calculated from uni- and multivariate analyses. Results Of the 62 submandibular gland carcinomas, 19 were adenoid cystic, 11 were mucoepidermoid, and 10 were salivary duct carcinomas, and 8 were carcinomas in pleomorphic adenoma. Actuarial 5-year locoregional control, distant metastasis-free survival, disease-free and overall survival rates were 69.7%, 65.8%, 52.8%, and 56.8%, respectively. In multivariate analysis, T category and histological grading were prognostic for disease-free survival (P

Adapting radiation fields to a moving target requires information continuously on the location of internal target by detecting it directly or indirectly. The aim of this study is to make the breathing regular effectively with minimizing stress to the patient. A system for regulating patient's breath consists of a respiratory monitoring mask (ReMM), a thermocouple module, a screen, inner earphones, and a personal computer. A ReMM with thermocouple was developed previously to measure the patient's respiration. A software was written in LabView 7.0 (National Instruments, TX), which acquires respiration signal and displays its pattern. Two curves are displayed on the screen: One is a curve indicating the patient's current breathing pattern; the other is a guiding curve, which is iterated with one period of the patient's normal breathing curve. The guiding curves were acquired for each volunteer before they breathed with guidance. Ten volunteers participated in this study to evaluate this system. A cycle of the representative guiding curve was acquired by monitoring each volunteer's free breathing with ReMM and was then generated iteratively. The regularity was compared between a free breath curve and a guided breath curve by measuring standard deviations of amplitudes and periods of two groups of breathing. When the breathing was guided, the standard deviation of amplitudes and periods on average were reduced from 0.0029 to 0.00139 (arbitrary units) and from 0.359 s to 0.202 s, respectively. And the correlation coefficients between breathing curves and guiding curves were greater than 0.99 for all volunteers. The regularity was improved statistically when the guiding curve was used.

This case report describes the first successful use of recombinant human epidermal growth factor (rh-EGF) in radiation-induced chronic wound of bone and skin which remains to be difficult to treat. Such wound on the chest of a 59-year-old female patient is presented lasting 3 years despite flap surgery and conventional treatment. The treatment with rh-EGF achieved healing within 16 weeks but further study to evaluate its potential for radiation-induced chronic wounds is warranted.

In order to develop more user-viable formats for polydiacetylene (PDA) biosensors, it is necessary to control the biochemical and physical properties of the PDA matrix. In this study, we prepare polydiacetylene liposomes from controlled mixtures of 10,12-pentacosadiynoic acid (PCDA) and PCDA–MI, a PCDA derivative with a maleimide headgroup. Both the chemical and physical properties of the liposome are easily manipulated by controlling the molar ratio of PCDA to PCDA–MI during liposome preparation. After preparing the liposomes, the activity of the maleimide headgroups increases linearly with the PCDA–MI content for concentrations in the range of 0–30 %. As a result, the antibody-binding characteristics of the PDA liposomes increase with PCDA–MI content. It is also possible to modulate the physical properties of the liposome. Differential scanning calorimetry measurements show that the phase organization of the liposome is progressively lost with increasing PCDA–MI content. Furthermore, the liposomes show an increased color change in response to temperature that is also dependent on PCDA–MI content, indicating increased membrane fluidity. When PCDA:PCDA–MI liposomes are conjugated with a cell-specific antibody the response to the antigen induces a color change that is dependent on the PCDA–MI content. Consequently, it is deduced that the increased sensitivity of the liposomes containing higher PCDA-MI content is due to increased antibody binding and membrane fluidity. From these experiments, we identify the factors controlling the colorimetric properties of the PDA matrix and demonstrate that it is possible to modulate the sensitivity and stability of PDA biosensors by controlling the ratio of constituent monomers.

It has been proposed that Wnt signaling pathway may be a key radioprotective mechanism in irradiated cancer cells; however, the specific radioresistance mechanisms remain not to be fully clarified. Here we elucidate a novel signaling pathway of radioresistance in head and neck cancer (HNC) cell lines involving interactions among the Wnt signaling pathway, cyclooxygenase-2 (COX-2) and Ku expression. Activation of the Wnt signaling pathway by (2'Z,3'E)-6-bromoindirubin-3'-oxime (BIO) resulted in beta-catenin cytoplasmic accumulation and translocation to the nucleus, upregulated Ku expression and increased radioresistance in the COX-2-expressing HNC cell line. In contrast, Wnt singaling activation by BIO had no effects on Ku expression and radiosensitivity in a HNC cell line negative for COX-2. Interactions between Wnt singaling and Ku were indirectly regulated by COX-2. Blockage of COX-2 signaling led to the suppression of beta-catenin-induced Ku expression, and to consequent recovery of the radiosensitivity in HNC cells. Our results conclusively suggest that beta-catenin plays a pivotal role in the regulation of Ku expression via the proposed COX-2 intracellular pathway, thus supporting a novel radioresistance mechanism of HNC.

A new device for reducing the amplitude of breathing motion by pressing a patient's abdomen using an air-injected blanket (AIB) for external beam radiation treatments has been designed and tested. The blanket has two layers sealed in all four sides similar to an empty pillow made of urethane. The blanket is spread over the patient's abdomen with both ends of the blanket fixed to the sides of the treatment couch or a baseboard. The inner side, or patient side, of the blanket is thinner and expands more than the outer side. When inflated, the blanket balloons and effectively puts an even pressure on the patient's abdomen. Fluoroscopic observation was performed to verify the usefulness of AIB for patients with lung, breast cancer, or abdominal cancers. Internal organ movement due to breathing was monitored and measured with and without AIB. With the help of AIB, the average range of diaphragm motion was reduced from 2.6 to 0.7 cm in the anterior-to-posterior direction and from 2.7 to 1.3 cm in the superior-to-inferior direction. The motion range in the right-to-left direction was negligible, for it was less than 0.5 cm. These initial testing demonstrated that AIB is useful for reducing patients' breathing motionmore » in the thoracic and abdominal regions comfortably and consistently.« less

Background: We investigated whether systemic chemotherapy increased episodes of acute pyelonephritis (APN) in patients with an indwelling double-J stent due to non-urological malignant ureteral obstruction. Methods: A retrospective study was performed on a total of 74 patients (16 men and 58 women; median age, 53.0; range, 34–84 years) with non-urological malignant ureteral obstruction, who were managed by double-J stenting between October 1997 and December 2001. The patients were divided into those who received (33 patients, group I) and those who did not receive systemic chemotherapy (41 patients, group II) during the stent indwelling period (median, 7.0; range, 1–44 month). Routine antibiotic prophylaxis was not administered to any patient. Median follow-up was 10.5 (range, 1–45) months. Clinical features, including the incidence of febrility and APN, were compared between the two groups. Results: Of the 74 patients, 18 patients (24.3%) experienced acute febrile episodes during ureteral stenting, but only five (6.8%) patients were diagnosed as having APN. No significant difference in the incidence of fever or APN was found between the two groups (P = 1.000 and P = 0.651, respectively). Univariate logistic analysis indicated that only the duration of follow-up was a risk factor for an episode of fever. Other parameters had no clinical significance. Conclusion: Our findings suggest that systemic chemotherapy may not predispose the risk of acute pyelonephritis in patients with an indwelling ureteral stent due to non-urological malignant ureteral obstruction.

Mesh simplification is the process of reducing the number of triangles in a mesh representation of object surface. For a given level of detail or error tolerance, the conventional mesh simplification algorithms maximize the edge length globally, without explicitly considering local object shape. In this paper, we present a shape-adaptive mesh simplification algorithm that locally maximizes edge length, depending on local shape. The proposed algorithm achieves shape-adaptive simplification by iteratively maximizing edges between vertices, based on comparison with the ‘optimal’ edge lengths derived from local directional curvatures for a given error tolerance. Edge-based processing facilitates the local shape adaptation and preserves sharp features. Experimental results demonstrate the efficacy of the proposed algorithm, by showing good visual quality and extremely small approximation error. Copyright © 2003 John Wiley & Sons, Ltd.

BACKGROUND The objectives of this study were to establish a correlation between granzyme B expression and the clinicopathologic characteristics of patients with angiocentric lymphomas of the head and neck and to determine whether the expression of granzyme B had any influence on the treatment outcomes of such patients. METHODS Fifty-seven patients with angiocentric lymphoma of the head and neck who were treated between 1987 and 1996 were divided into two groups according to whether their tumors were immunoreactive for granzyme B: the granzyme B negative group (n = 22 patients) and the granzyme B positive group (n = 35 patients). The clinicopathologic features, immunohistochemical findings, patterns of disease failure, and survival data for the granzyme B positive group were compared with those for the granzyme B negative group. RESULTS Greater than 60% of patients with angiocentric lymphoma of the head and neck were shown to have granzyme B positive tumors. All tumors that expressed granzyme B also consistently coexpressed CD56, indicating that they probably are the neoplastic equivalent of either natural killer (NK) cells or activated cytotoxic T cells. Although there were no significant differences in histopathologic features or expression of CD45RO and polyclonal CD3-ϵ between the groups, the Epstein–Barr virus genomes were detected more frequently in the granzyme B positive group compared with the granzyme B negative group. Despite a similar rate of complete remission after initial treatment, the locoregional recurrence rate of patients in the granzyme B positive group was much higher compared with patients in the granzyme B negative group. In addition, compared with patients in the granzyme B negative group, patients in the granzyme B positive group also had an increased risk of systemic disease recurrence and a decreased overall survival rate. CONCLUSIONS The data indicate that the cytotoxic granule-associated protein, granzyme B, may be used as an additional marker for identifying NK/T-cell lymphoma and as a prognostic indicator for risk assessment in patients with angiocentric lymphoma of the head and neck. Cancer 2001;91:2343–52. © 2001 American Cancer Society.

Aims Natural bladder filling by the production of urine could potentially influence the outcome of urodynamic investigations. In this prospective study, we determined the natural bladder filling rate during cystometry. Methods Between October 2005 and March 2006, we performed conventional urodynamic studies in 101 consecutive patients. We measured the exact volume infused during artificial filling, the volume voided and post-void residual urine (PVR) after a pressure flow study to examine the difference between the measured bladder volume (voided volume plus PVR) and the infused volume. We also measured the exact time required for the urodynamic investigation. Finally, we analyzed the natural filling rates in 34 patients after excluding inadequate cases. Results The mean volume of artificial filling was 304.4 ml (SD ± 100.5 ml) and the mean measured volume consisting of the voided volume plus PVR was 337.2 ml (SD ± 106.5 ml). The mean total time was 24.2 min (range: 15.0–41.5 min) and the mean time for artificial filling was 7.2 min. The mean volume of natural filling and the mean rate of natural bladder filling were 32.8 ml (12.1% of artificial filling) and 1.4 ml/min, respectively. Conclusions Natural filling by the production of urine can affect the results of cystometry considerably, and should be considered when performing urodynamic investigations and interpreting the results. Because the effects can increase with the time required to conduct the investigation, effort should be made to decrease the total duration of urodynamic investigations. Neurourol. Urodynam. 27:772–774, 2008, © 2008 Wiley-Liss, Inc.

The combined regimen of cyclophosphamide, doxorubi-cin, vincristine and prednisolone (CHOP) has beenemployed as standard chemotherapy to treat diffuse largeB-cell lymphoma (DLBCL) for several decades. Intro-duction of the anti-CD20 antibody, rituximab, toDLBCL therapy in recent years has significantlyimproved survival (1, 2) and altered the predictive valuesof known prognostic factors in DLBCL (3–6).Ki-67 is a nuclear antigen associated with cellular prolif-eration (7). The percentage of Ki-67-expressing cellsreflects the proportion of actively replicating tumor cells.The prognostic significance of Ki-67 staining in DLBCL iscurrently a controversial issue (8). A number of studieslink high expression of Ki-67 with poor prognosis (9–13);others correlate low Ki-67 with worse outcome (14, 15);and others refute the association of Ki-67 with prognosis(16–19). Higher Ki-67 was predictive of poor outcome inadvanced stage mantle cell lymphoma treated with anti-CD20 immunochemotherapy, and an inverse correlationwas observed between Ki-67 expression and response toimmunochemotherapy containing rituximab in follicularlymphomas (20, 21). However, only limited informationon prognostic significance of Ki-67 is available in patientswith DLBCL in the rituximab era, yet. In a recent studyincluding a proportion of patients treated with rituximabcontaining regimens, Ki-67 could provide further prognos-tic information in patients with a low International Prog-nostic Index (IPI) or bulky disease (13). However, a smallstudy involving 15 patients with DLBCL treated withrituximab failed to disclose a relationship between Ki-67AbstractBackground: Assessment of tumor cell proliferation based on Ki-67 expression yielded conflicting prognos-tic predictions of patients with diffuse large B-cell lymphoma (DLBCL). The introduction of rituximabto the DLBCL treatment regime has led to alterations in the significance of previous prognosticfactors. Methods: We analyzed Ki-67 expression and its correlation with prognosis in 144 patients withDLBCL treated with rituximab plus CHOP (R-CHOP) between July 2003 and January 2008. Results: Thecomplete response (CR) rates following R-CHOP administration were not significantly different, based onKi-67 expression status (P = 0.104). However, higher rates of relapse were observed in the high Ki-67expression group (Ki-67 ‡ 85%, n = 46) with 25.0%, compared to 10.0% in the low Ki-67 expressiongroup (Ki-67 < 85%, n = 88) (P = 0.040). The 2-yr event-free survival (EFS) rates were 44.3% and 74.1%in the high and low Ki-67 expression groups, respectively (P = 0.011). The 2-yr overall survival (OS) ratewas 66.4% in the high Ki-67 expression group and 82.2% in the low Ki-67 expression group (P = 0.016).In multivariate analysis, Ki-67 expression was a significant prognostic factor for EFS [hazard ratio(HR) = 2.909; 95% confidence interval (CI) 1.261–6.708; P = 0.012]. Ki-67 was associated with OS butwith borderline significance (HR = 2.876; 95% CI, 0.972–8.508; P = 0.056). Conclusion: Elevated Ki-67expression seems to be associated with higher relapse after CR and inferior EFS in patients with DLBCLtreated with R-CHOP.

As organic light-emitting diodes (OLEDs) and other optoelectronic materials are very vulnerable to moisture and oxygen, securing proper encapsulation is critical in the development of flexible OLED displays and other flexible electronic devices. This problem is typically solved by the use of barrier-coated polymeric films that are composed of alternating organic/inorganic multilayers. Precision devices testing for water vapor permeability in ultra-low range were developed in KRISS using water containing tritium. These devices are under operation to measure the range covering (10−7 to 10−2) g·m−2·day−1. In this study, various studies on water vapor permeability through barrier-coated flexible films were conducted with varying temperature and humidity, and it was observed that effects of temperature and humidity were significant. Permeability was increased a few hundred times and 15 times when increasing temperature from 23 to 80°C, and relative humidity (rh) from 6 to 72% rh, respectively. These results can provide valuable information on the reliability evaluation of flexible electronics products.

We demonstrated a silver gate hydrogenated amorphous silicon thin film transistor(a-Si:H TFT) using thin buffer layers of alumina(Al2O3) and aluminum-nitride(AlN). An Al2O3 layer on glass substrate was deposited so as to increase adhesion between APC(> 98 wt% silver) and glass substate. An AlN layer on APC was deposited to prevent it from plasma damage during silicon-nitride(SiNx) deposition. The Ag gate a-Si:H TFT with these buffer layers exhibited a field-effect mobility of 1.15 cm2/Vs, a gate voltage swing of 0.86 V/dec. and a threshold voltage of 2.5 V.