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The Effect of a Bypass Operation for Atherosclerotic Arterial Obstructive Disease at the Lower Extremity (동맥경화성 하지 동맥 폐색증에 대한 우회로 수술의 효과)

  • Choi, Won-Suk;Park, Jae-Min;Lee, Yang-Haeng;Han, Il-Yong;Jun, Hee-Jae;Yoon, Young-Chul;Hwang, Youn-Ho;Cho, Kwang-Hyun
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.610-618
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    • 2008
  • Background: There are various treatment modalities for atherosclerotic arterial obstructive disease at the lower limbs, for example, conservative physical therapy, medication, operation etc. Yet it has been established that an arterial bypass operation is the most effective treatment. The aim of this study is to evaluate the effect of arterial bypass operation within our experience and to determine the indicators of treatment. Material and Method: Ninety six patients received arterial bypass operation for atherosclerotic arterial obstructive disease from June 2002 to April 2006. We evaluated the feasibility of arterial bypass operation based on the improvement of symptoms and the ankle-brachial index (ABI) and the surgical outcomes, as based on the complications, the amputation rates and the patency rates. We also assessed the possible risk factors such as gender, age, a smoking history, co-morbidities, the anastomotic sites, the graft size and the graft type. We retrospectively reviewed the medical records of the patients. The total mean follow-up period was $29.4{\pm}13.1$ months. Result: The mean age was $65.95{\pm}9.61$ and there were 88 male patients. The most common clinical manifestation was ischemic resting pain in the lower extremities. The underlying combined diseases were hypertension (61%), diabetes (43%), cardiac problems (35%) and smoking (91.7%). The most frequent site of arterial obstruction was the superficial femoral artery (44 cases, 40%). A femoropopliteal artery bypass operation with a Polytetrafluoroethylene(PTFE) synthetic graft was done in 44 cases (40%) and the great saphenous vein graft was used in 11 cases. The postoperative ABI increased significantly from $0.30{\pm}0.11$ preoperatively to $0.63{\pm}0.11$ (p<0.001) postoperatively. In 8 cases, amputations above the ankle level were necessary. The graft patency rates were 86.4% and 68.0% after 1 and 3 years, respectively. There were 29 cases (30.21%) of patency failure; the male gender, smokers and hypertension were significantly more frequent in the failure group. Of these, hypertension was the most powerful risk factor (p=0.042). Conclusion: The arterial bypass operation is an effective treatment modality for controlling the symptoms such as pain and claudication, and for preventing major amputations for the patients with atherosclerotic arterial obstructive disease. This study suggests quitting smoking, strict blood pressure control, selection of an appropriate graft, regular outpatient follow up and proper medication would offer higher patency rates and more favorable outcomes.

Effect of Temperature During Grain Filling Stage on Grain Quality and Taste of Cooked Rice in Mid-late Maturing Rice Varieties (등숙기 온도변이가 중만생종 벼의 쌀 품질과 식미치에 미치는 영향)

  • Choi, Kyung-Jin;Park, Tae-Shik;Lee, Choon-Ki;Kim, Jung-Tae;Kim, Jun-Hwan;Ha, Ki-Yong;Yang, Woon-Ho;Lee, Chung-Keun;Kwak, Kang-Su;Park, Hong-Kyu;Nam, Jeong-Kwon;Kim, Jeong-Il;Han, Gwi-Jung;Cho, Yong-Sik;Park, Young-Hee;Han, Sang-Wook;Kim, Jae-Rok;Lee, Sang-Young;Choi, Hyun-Gu;Cho, Seung-Hyun;Park, Heung-Gyu;Ahn, Duok-Jong;Joung, Wan-Kyu;Han, Sang-Ik;Kim, Sang-Yeol;Jang, Ki-Chang;Oh, Seong-Hwan;Seo, Woo-Duck;Ra, Ji-Eun;Kim, Jun-Young;Kang, Hang-Won
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.56 no.4
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    • pp.404-412
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    • 2011
  • This experiment was conducted to clarify the effect of the temperature for grain filling duration on quality and taste of cooked rice cultivated in different region in Korea. In 2006 and 2007, 4 mid-late maturing group of rice varieties (Nampyeongbyeo, Ilpumbyeo, Junambyeo and Dongjin 1) were cultivated in 28 experimental plots of 27 different regions located in 8 provinces. The taste of cooked rice were positively correlated with 1,000 grain weight but negatively correlated with protein content of brown rice. Mean temperature for 30 days from heading was more closely correlated with grain filling and tastes of cooked rice than those for 40 days. Though, the optimum mean temperature for the best taste of cooked rice for 30 days after heading was 22.1 to $23.1^{\circ}C$ depending on varieties, in general, 1,000 grain weight and cooked rice taste were the highest in the mean temperature of $22.2^{\circ}C$ for 30 days from heading. But grains were poorly ripened in case of the mean temperature lower than $21.0^{\circ}C$ for 30 days after heading. Therefore, for the better taste of cooked rice in Korea, the developing new rice varieties and cultivation method should be focused to adjust the mean temperature within $22-23^{\circ}C$ during the period of 30 days after heading.

A Study on Growth Type of Comic strips Heroes through Journey of Life (삶의 여정을 통한 만화 히어로 성장유형 연구)

  • Kim, MiRim
    • Cartoon and Animation Studies
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    • s.29
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    • pp.173-207
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    • 2012
  • The four-phased plot which consists of introduction, development, turn and conclusion in the long-story structure tends to be patterned and schematized. The behavior of characters is in line with the beginning of human beings and the plot of comic strips basically has four phases. It is, however, not a simple arrangement but a complex one which was developed by organizing patterns of human power, behavior and emotions. With the results from a survey with college students studying comic strips, this study aims to categorize four characters from the archetypal system by Carol Pearson, four phases of the hero's journey by Joseph Campbell, and the four phases of the plot based on Aristotle's theory, which is the frame of the comic strip structure through supporting evidence extracted from comic strips in an integrated way. In this study, the categorization is performed by simplifying and systemizing a character's life cycle, which is a factor of a story structure in complex comic strips. This study is to identify what comic strip writers express by using the metaphor in the complicated long-story structure of comic strips This study reveals that the structure of introduction, development, turn and conclusion based on the plot theory by Aristotle is the metaphor of human life and fate and that the phases of development in the archetypal system by Carol Pearson, a Jung researcher influenced by Jung's theory are the metaphor of human life and fate. Also, the theories of Joseph Campbell, who also was influenced by Jung, are the metaphor of human life and fate as they projected complex emotions of joy, anger, sorrow, and pleasure onto the archetype of heroes and used the metaphor of the hero's journey. Lastly, the theories are introduced with the approach of 'guide to screenwriters' by Christopher Vogler. Meanwhile, this metaphor is the objective and goal of this study. The comic strips selected for this study seem to have long complex stories which have characters leaving their homes, going through adventures and difficulties, meeting the world in another way, experiencing tension, competition, wars, and hardship and returning home with compensation. They grow mentally and psychologically through their journeys and finally become heroes. They express the meaning of our introspection in a narrative through plots and images of comic strips. This appears complex but the basic structure of long comic strips has four phases of plot. The life style of an extraordinary character traveling for adventures and growing in long comic strips can be divided into four phases symbolizing childhood, adolescence, adulthood, and senescence and it is a psychological growth process. The archetypes of the character can be divided into four phases and the growth process can be explained. The hero's journey symbolized by the character can be also divided into four phases. Through theories, the complex arrangement of four-phased plots in comic strips corresponds with the growth process of introduction, development, turn and conclusion through the stages of life. At the same time, this study found that the characters becoming heroes are the metaphor of introspection and that the characters' growth and life correspond with the four phases in life through long comic strips. Long stories in long comic strips written by comic strip writers show that characters go on their journeys and change their lives through hardship and difficulty by logical construction of plot and their growth processes are presented in archetypal images and they reach introspection as heroes. The readers share time and space through images in comic strips and realize that they had the same experience as the characters emotionally by being moved by the stories.

Microbiological Studies of Korean Native Soy-sauce Fermentation -A Study on the Microflora Changes during Korean Native Soy-sauce Fermentation- (한국재래식(韓國在來式) 간장의 발효미생물(醱酵微生物)에 관(關)한 연구(硏究)(제2보(第二報)) -한국재래식(韓國在來式) 간장의 담금중(中)에 있어서의 발효미생물군(醱酵微生物群)의 소장(消長)에 관(關)한 연구(硏究)-)

  • Lee, Woo-Jin;Cho, Duck-Hiyon
    • Applied Biological Chemistry
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    • v.14 no.2
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    • pp.137-148
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    • 1971
  • Studies were carried out to investigate the main fermentation microorganisms and their flora changes during Korean native soy-sauce fermentation. Korean native Maeju loaves collected from 5 Do's were separated into surface and inner parts. Four different soy-sauces-the surface part Maeju fermented soy-sauce, the inner part, the surface and inner part combined Maeju fermented soy-sauce, and the semi-Japanese type soy-sauce were fermented and the changes of fermentation microorganism flora and the various chemical components during the period of their fermentations were studied. Besides, 14 home-made soy-sauces collected from 14 different places all over Korea were examined in comparison with the laboratory soy-sauces and to determine the characteristics of Korean native soy-sauce. The results were as follows: 1. The main microorganisms in Korean native soy-sauce fermentation were determined as; Aerobic bacteria: Bacillus subtilis, Bacillus pumilus Lactic acid bacteria: Pediococcus halophilus, Leuconostoc mesenteroides Yeasts: Torulopsis datila, Saccharomyces rouxii 2. Microflora changes during Korean native soy-sauce fermentation were as follows; Aerobic bacteria increased until the 2nd week of fermentation and then gradually decreased. The lactic acid bacteria increased until the 3rd week, after which decreased. When the lactic acid fermentation lowered the pH value to below the 5.4, yeasts were able to grow and participate the fermentation. As the production of organic acids amounted, to a certain height, the growth of all microorganisms lead to the period of decline or death at about the 2nd month of fermentation. After boiling of soy-sauce most microorganisms except a few of Bacillus sp. disappeared. Occosionally yeasts and lactic acid bacteria survived depending upon the composition of soy-sauce. 3. Changes of general chemical components influencing the microflora were investigated for the period of Korean native soy-sauce fermentation. Tetal acidity, salt concentration and total nitrogen were increasing steadily over the entire period of fermentation. pH values were dropping to a certain degree of about 4.5. Salt concentration and pH value seemed to be the important factors influencing the microflora. 4. The microflora were influenced by chemical components of soy-sauce. Aerobic bacteria were able to survive in all soy-sauce as they made spores. Growth of lactic acid bacteria was inhited at 23-26% of salt concentration and pH 4.8. Soy-sauce yeasts started to grow only at pH below 5.4 and seemed to be inhibited at around 26% of salt concentration under pH 4.5-4.7. 5. The open kettle boiling of soy-sauce, the characteristic process of Korean native soy-sauce manufacturing, was effective to sterilize microorganisms, increase the salt concentration, and coagulate proteins. 6. The average viable cell counts of microorganism found in collected samples of home-made Korean native soy-sauces were; Aerobic bacteria: $53{\times}10^2\;cell/ml$ Lactic acid bacteria: 34 cell/ml Yeasts: 14 cell/ml The average values of chemical compositions of samples of home-made Korean native soy-sauce were; Salt concentration: 28.9% pH value: 4.79 Total acidity(lactic acid): 0.91g/100ml Total nitrogen: 1.09g/100ml

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Effects of Activation Treatments and Culture Condition on In Vitro Development of Caprine In Vivo and In Vitro Oocytes (재래산양의 체내 및 체외유래 난자의 활성화 처리방법 및 배양조건이 단위발생란의 체외발달에 미치는 영향)

  • Park H. S.;Kim T. S.;Lee Y. H.;Jung S. Y.;Lee M. Y.;Jin J. I.;Park J. K.;Lee J. S.;Kim C. H.
    • Reproductive and Developmental Biology
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    • v.28 no.3
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    • pp.181-185
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    • 2004
  • This study was conducted to examine whether activation treatments, source of oocytes and culture conditions affect in vitro developmental ability of caprine oocytes. Mature Korean native goats were pretreated with intravaginal CIDR for 10 days. The goats were then treated with a single intramuscular injection of 1,000 IU PMSG on Day 8 or twice daily injection of a total of 70 mg FSH for 3 days from Day 8 of CIDR insertion for superovulation. All the goats were injected with 10 mg PGF/sub 2a/ on Day 8 and 400 IU hCG on Day 10 of CIDR. Oocytes were surgically collected by oviduct flushing(in vivo maturation) or direct follicle aspiration(in vitro maturation) through mid-ventral incision at 35 h after hCG injection. Fifteen to twenty oocytes were placed in TCM-199 medium containing 25 mM Hepes and hormones under mineral oil at 39℃ in a humudified atmosphere of 5% CO₂ in air for 22 to 24 h. After maturation, the oocytes were activated by electric stimulation or ionomycin + 6-DMAP. The activated oocytes were then cultured in M16, TCM-199 and mSOF media supplemented with proteins at 39℃ for 6 to 7 days. Activation treatments did not affect cleavage of the oocytes. The cleavage rates were 64.1% (41/64) in oocytes activated by electric stimulation and 76.5% (218/285) in oocytes activated by ionomycin + 6-DMAP. The proportion of development to blastocyst was 15.6% (34/218) in oocytes activated by ionomycin + 6-DMAP, but activation by electric stimulation did not support embryos developed beyond morula stage. There were no differences in the cleavage rates of activated oocytes experiencing in vivo (86.8%, 66/76) and in vitro maturation (69.0%, 127/184). However, the development rate to blastocyst stage was significantly (P<0.05) higher for oocytes matured in vivo (50.0%, 33/66) compared to in vitro (0.8%, 1/127). Culture conditions did not affect the cleavage of -activated oocytes. The cleavage rates were 51.6% (49/95) in M16, 64.3% (18/28) in TCM-199 and 81.0% (145/179) in mSOF, respectively. By contrast, the development rate of activated oocytes to stage was greater (P<0.05) for oocytes cultured in mSOF medium (23.4%, 34/145) than in M16 or TCM-199 (0.0%). Our results suggest that source of oocytes and culture conditions are major factors affecting in vitro development of caprine parthenogenetic oocytes.

Effects of Natural Honeybee (Apis mellifera ligustica) Venom Treatment on the Humoral Immune Response in Pigs (Beevenom 처리가 돼지의 체내 면역반응에 미치는 효과)

  • 조성구;김경수;이석천
    • Journal of Animal Science and Technology
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    • v.48 no.6
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    • pp.933-942
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    • 2006
  • This experiment was carried out to investigate effects of honeybee venom treatment on the humoral immune response in pigs. Corresponding author : S. K. Cho, Dept. of Animal Sci. Chung-Buk National University, Kaesin-dong, Cheongju, 361-763, Korea. phone : 043-261-2551. E-mail : deercho@chungbuk.ac.kr To investigate effects of natural honeybee venom on the concentration of immunoglobulin G, A, and M, 20 piglets(LY×D) from 3 sows were allocated into two groups bee venom-treated group(10 piglets) and non-treated control(10 piglets). Natural honeybee venom was treated at 0, 3, 6 days after birth and the acupoints were Hai-men(ST-25), Du-kou(CV-8) and Jiao-chao(GV-1) points at 0, 3 days after birth and the regions of castration and tail amputation point at 6 days. Control group was injected 1㎖ of saline to the same site. Concentrations of IgG, A, and M were measured with immunoturbidimetric method at 0, 3, 7, 14, and 21 days after treatment. To investigate the effect of bee venom on the production of antibodies against hog cholera and atrophic rhinitis vaccines that were used as indicator antigens, 40 piglets(LYxD) from 5 sows were grouped as bee venom-treated group (20 piglets) and control group(20 piglets). Natural honeybee venom was treated at 0, 3days(castration, tail amputation) and 21days after birth. The acupoints were Hai-men(ST-25), Du-kou(CV-8) and Jiao-chao (GV-1) points at 0 day, the regions of castration and tail ampution at 3 days and Jiao-chao(GV-1) and Bai-hui(GV-20) points at 21days after birth(weaning). Control group was injected 1ml of saline to the same site. Atrophic rhinitis vaccine was injected twice at 24 and 44 days after birth and hog cholera vaccine was also injected twice at 44 and 64 days after birth. Antibody titers against Bordetella bronchiseptica and hog cholera virus were measured by using tube agglutination and ELISA tests at 24, 34, 44, 54 and 74 days after birth. Concentrations of IgG of treated group were 339.52, 366.48, 296.52, 242.06 and 219.06mg/dl at 0, 3, 7, 14 and 21 days after birth, respectively. In contrast, concentrations of IgG in control group were respectively 347.10, 334.14, 243.28, 205.18 and 191.58mg/dl during same periods with treated group. Concentrations of IgG at 0 day was not significantly different between the treated group and control group but treated group were significantly increased by 10.28% at 3 days after birth (P<0.02), 21.88% at 7 days after birth(P<0.01), 18.0% at 14 days after birth(P<0.07) and 14.3% at 21 days after birth(P<0.01). Concentrations of IgA and Ig M were not significantly different. Antibody titers against hog cholera virus were significantly increased by 57.0% at 24 days after birth(P<0.03), 74.6% at 34 days after birth (P<0.006), 48.6% at 44 days after birth(P<0.017), 45.0% at 54 days after birth(P<0.16) and 44.4% at 74 days after birth (P<0.006) in bee venom treated group in comparison with control group. Antibody titers against the Bordetella bronchiseptica was significantly increased in Beevenom treated group as 9.1% (P<0.32) at 24days, 39.7% (P<0.002) at 34days, 31.9% (P<0.02) at 44days, 33.4% (P<0.01) at 54days and 57.3% (P<0.007) at 74 days after birth when compared with those of control group pigs. Collecting together, the results in this study showed that immune responses were increased by treatment of natural honeybee venom to pigs. These results suggested that the treatment of bee venom could be used effectively for the increase of productivity in livestock industry.

Security and Safety Assessment of the Small-scale Offshore CO2 Storage Demonstration Project in the Pohang Basin (포항분지 해상 중소규모 CO2 지중저장 실증연구 안전성 평가)

  • Kwon, Yi Kyun;Chang, Chandong;Shinn, Youngjae
    • The Journal of Engineering Geology
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    • v.28 no.2
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    • pp.217-246
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    • 2018
  • During the selection and characterization of target formations in the Small-scale Offshore $CO_2$ Storage Demonstration Project in the Pohang Basin, we have carefully investigated the possibility of induced earthquakes and leakage of $CO_2$ during the injection, and have designed the storage processes to minimize these effects. However, people in Pohang city have a great concern on $CO_2$-injection-intrigued seismicity, since they have greatly suffered from the 5.4 magnitude earthquake on Nov. 15, 2017. The research team of the project performed an extensive self-investigation on the safety issues, especially on the possible $CO_2$ leakage from the target formation and induced earthquakes. The target formation is 10 km apart from the epicenter of the Pohang earthquake and the depth is also quite shallow, only 750 to 800 m from the sea bottom. The project performed a pilot injection in the target formation from Jan. 12 to Mar. 12, 2017, which implies that there are no direct correlation of the Pohang earthquake on Nov. 15, 2017. In addition, the $CO_2$ injection of the storage project does not fracture rock formations, instead, the supercritical $CO_2$ fluid replaces formation water in the pore space gradually. The self-investigation results show that there is almost no chance for the injection to induce significant earthquakes unless injection lasts for a very long time to build a very high pore pressure, which can be easily monitored. The amount of injected $CO_2$ in the project was around 100 metric-tonne that is irrelevant to the Pohang earthquake. The investigation result on long-term safety also shows that the induced earthquakes or the reactivation of existing faults can be prevented successfully when the injection pressure is controlled not to demage cap-rock formation nor exceed Coulomb stresses of existing faults. The project has been performing extensive studies on critical stress for fracturing neighboring formations, reactivation stress of existing faults, well-completion processes to minimize possible leakage, transport/leakage monitoring of injected $CO_2$, and operation procedures for ensuring the storage safety. These extensive studies showed that there will be little chance in $CO_2$ leakage that affects human life. In conclusion, the Small-scale Offshore $CO_2$ Storage Demonstration Project in the Pohang Basin would not cause any induced earthquakes nor signifiant $CO_2$ leakage that people can sense. The research team will give every effort to secure the safety of the storage site.

Inhibitory Effects of Amitriptyline, Sertraline and Chlorpromazine on the Thrombin-induced Aggregation of Platelets (Thrombin성 혈소판응집에 대한 Amitriptyline, Sertraline 및 Chlorpromazine의 억제작용)

  • Choi, Sang-Hyun;Lee, Young-Jae;Shin, Kyung-Ho;Chun, Yeon-Sook;Chun, Boe-Gwun
    • The Korean Journal of Pharmacology
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    • v.31 no.3
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    • pp.299-311
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    • 1995
  • Platelets resemble monoaminergic neurons in several respects, i.e. the uptake of 5-HT and its inhibition, the subcellular storage and release of 5-HT, and the metabolism of aromatic amines brought about by monoamine oxidase. And the 5-HT content of rabbit platelets is well known to be about 40 times higher than that of human platelets. Therefore, this study was carried out to investigate the influences of amitriptyline (AMT) and sertraline (SRT) on the aggregation, contents of signaling second messengers, and protein phosphorylations of rabbit platelets in response to thrombin, 0.25 unit/ml, comparing with those of chlorpromazine (CPZ). Thrombin-induced aggregation was inhibited by SRT $(IC50:4.37{\times}10^{-5}\;M)$, CPZ $(IC50:5.76{\times}10^{-5}\;M)$, and AMT $(IC50:1.15{\times}10^{-4}\;M)$, respectively, and the aggregation by A23187 $(1.0\;{\mu}M)$ or PMA (320 nM) was also inhibited by SRT, CPZ, and AMT. AMT, SRT, and CPZ had little affects on basal contents of platelet $TXB_2$ and $PGE_2$, but all of them inhibited the thrombin-induced increase of $TXB_2$. Thrombin did not change the platelet contents of cAMP and cGMP. CPZ, AMT, and SRT produced the slight decrease of basal cAMP content, and their effects were not affected by thrombin-treatment. But SRT and AMT moderately increased the basal cGMP content, and the cGMP content of thrombin-stimulated platelets was gradually increased by the pretreatment with SRT, AMT, and CPZ. Particularly, the SRT-dependent increase of the cGMP content was notable. Platelet $Ins(1,4,5)P_3$ content was rapidly increased up to a plateau within 10 sec after thrombin-stimulation, AMT, SRT, and CPZ increased the basal $Ins(1,4,5)P_3$ content, and the thrombin-dependent increase was enhanced by pretreatment with CPZ and AMT, but was blunted by SRT. Platelet $[Ca^{2+}]_i$, was rapidly increased up to a peak level within 20 sec after thrombin-stimulation. The increase of $[Ca^{2+}]_i$ was sisnificantly inhibited by AMT, SRT, and CPZ. Thrombin- or PMA-induced phosphorylations of platelet $41{\sim}43\;kDa$ and 20 kDa proteins were significantly inhibited by AMT, SRT, and CPZ. These results suggest that the antiplatelet activities of AMT and CPZ may be considerably attributed to the inhibition of protein kinase C activity, and the activity of SRT may be associated with the inhibitory effect on the thrombin-induced increase of $Ins(1,4,5)P_3$ and the increasing effect on the cGMP content of ptatelets. Therefore, it seems to be evident that AMT and SRT may produce their antidepressant activity, at least, partly through the inhibition of protein kinase C activity or the increase of resting $Ins(1,4,5)P_3$, content and in case of SRT, to a lesser extent, via the increase of cGMP in the brain.

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Evaluation of the Usefulness of Restricted Respiratory Period at the Time of Radiotherapy for Non-Small Cell Lung Cancer Patient (비소세포성 폐암 환자의 방사선 치료 시 제한 호흡 주기의 유용성 평가)

  • Park, So-Yeon;Ahn, Jong-Ho;Suh, Jung-Min;Kim, Yung-Il;Kim, Jin-Man;Choi, Byung-Ki;Pyo, Hong-Ryul;Song, Ki-Won
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.2
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    • pp.123-135
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    • 2012
  • Purpose: It is essential to minimize the movement of tumor due to respiratory movement at the time of respiration controlled radiotherapy of non-small cell lung cancer patient. Accordingly, this Study aims to evaluate the usefulness of restricted respiratory period by comparing and analyzing the treatment plans that apply free and restricted respiration period respectively. Materials and Methods: After having conducted training on 9 non-small cell lung cancer patients (tumor n=10) from April to December 2011 by using 'signal monitored-breathing (guided- breathing)' method for the 'free respiratory period' measured on the basis of the regular respiratory period of the patents and 'restricted respiratory period' that was intentionally reduced, total of 10 CT images for each of the respiration phases were acquired by carrying out 4D CT for treatment planning purpose by using RPM and 4-dimensional computed tomography simulator. Visual gross tumor volume (GTV) and internal target volume (ITV) that each of the observer 1 and observer 2 has set were measured and compared on the CT image of each respiratory interval. Moreover, the amplitude of movement of tumor was measured by measuring the center of mass (COM) at the phase of 0% which is the end-inspiration (EI) and at the phase of 50% which is the end-exhalation (EE). In addition, both observers established treatment plan that applied the 2 respiratory periods, and mean dose to normal lung (MDTNL) was compared and analyzed through dose-volume histogram (DVH). Moreover, normal tissue complication probability (NTCP) of the normal lung volume was compared by using dose-volume histogram analysis program (DVH analyzer v.1) and statistical analysis was performed in order to carry out quantitative evaluation of the measured data. Results: As the result of the analysis of the treatment plan that applied the 'restricted respiratory period' of the observer 1 and observer 2, there was reduction rate of 38.75% in the 3-dimensional direction movement of the tumor in comparison to the 'free respiratory period' in the case of the observer 1, while there reduction rate was 41.10% in the case of the observer 2. The results of measurement and comparison of the volumes, GTV and ITV, there was reduction rate of $14.96{\pm}9.44%$ for observer 1 and $19.86{\pm}10.62%$ for observer 2 in the case of GTV, while there was reduction rate of $8.91{\pm}5.91%$ for observer 1 and $15.52{\pm}9.01%$ for observer 2 in the case of ITV. The results of analysis and comparison of MDTNL and NTCP illustrated the reduction rate of MDTNL $3.98{\pm}5.62%$ for observer 1 and $7.62{\pm}10.29%$ for observer 2 in the case of MDTNL, while there was reduction rate of $21.70{\pm}28.27%$ for observer 1 and $37.83{\pm}49.93%$ for observer 2 in the case of NTCP. In addition, the results of analysis of correlation between the resultant values of the 2 observers, while there was significant difference between the observers for the 'free respiratory period', there was no significantly different reduction rates between the observers for 'restricted respiratory period. Conclusion: It was possible to verify the usefulness and appropriateness of 'restricted respiratory period' at the time of respiration controlled radiotherapy on non-small cell lung cancer patient as the treatment plan that applied 'restricted respiratory period' illustrated relative reduction in the evaluation factors in comparison to the 'free respiratory period.

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The evaluation of the feasibility about prostate SBRT by analyzing interfraction errors of internal organs (분할치료간(Interfraction) 내부 장기 움직임 오류 분석을 통한 전립선암의 전신정위적방사선치료(SBRT) 가능성 평가)

  • Hong, soon gi;Son, sang joon;Moon, joon gi;Kim, bo kyum;Lee, je hee
    • The Journal of Korean Society for Radiation Therapy
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    • v.28 no.2
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    • pp.179-186
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    • 2016
  • Purpose : To figure out if the treatment plan for rectum, bladder and prostate that have a lot of interfraction errors satisfies dosimetric limits without adaptive plan by analyzing MR image. Materials and Methods : This study was based on 5 prostate cancer patients who had IMRT(total dose: 70Gy) Using ViewRay MRIdian System(ViewRay, ViewRay Inc., Cleveland, OH, USA) The treatment plans were made on the same CT images to compare with the plan quality according to adaptive plan, and the Eclipse(Ver 10.0.42, Varian, USA) was used. After registrate the 5 treatment MR images to the CT images for treatment plan to analyze the interfraction changes of organ, we measured the dose volume histogram and the changes of the absolute volume for each organ by appling the first treatment plan to each image. Over 5 fractions, the total dose for PTV was $V_{36.25}$ Gy $${\geq_-}$$ 95%. To confirm that the prescription dose satisfies the SBRT dose limit for prostate, we measured $V_{100%}$, $V_{95%}$, $V_{90%}$ for CTV and $V_{100%}$, $V_{90%}$, $V_{80%}$ $V_{50%}$ of rectum and bladder. Results : All dose average value of CTV, rectum and bladder satisfied dose limit, but there was a case that exceeded dose limit more than one after analyzing the each image of treatment. After measuring the changes of absolute volume comparing the MR image of the first treatment plan with the one of the interfraction treatment, the difference values were maximum 1.72 times at rectum and maximum 2.0 times at bladder. In case of rectum, the expected values were planned under the dose limit, on average, $V_{100%}=0.32%$, $V_{90%}=3.33%$, $V_{80%}=7.71%$, $V_{50%}=23.55%$ in the first treatment plan. In case of rectum, the average of absolute volume in first plan was 117.9 cc. However, the average of really treated volume was 79.2 cc. In case of CTV, the 100% prescription dose area didn't satisfy even though the margin for PTV was 5 mm because of the variation of rectal and bladder volume. Conclusion : There was no case that the value from average of five fractions is over the dosimetric limits. However, dosimetric errors of rectum and bladder in each fraction was significant. Therefore, the precise delivery is needed in case of prostate SBRT. The real-time tracking and adaptive plan is necessary to meet the precision delivery.

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