• Journal of agricultural medicine and community health
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• v.20 no.1
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• pp.1-13
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• 1995

Based on the questionnaires sent to 270 nurses of public health centers in kyungnam during the period of March 19 to April 11 in 1992, this study was written for the of finding out the grade of satisfaction, obstacles in carrying out duties concerned with nursing services and the change of nurses role needed according to the change of the local public health administration. The first-ranking tasks carried by nurses of public health center are believed to have been family planning activities before the 1970's, nursing services during the 1970's, mother-child health activities during the 1980's, and nursing services during the period of 1990 to 1992. As far as the priority order of all the family planning activities is concerned, the counseling of the insertion of intrauterine contraceptive device, the use of oral pill or the distribution of condom was placed emphasis on before 1970, and publicity activities of family planning after that time. The first priority order of mother-child health activities has been put on the registration of pregnant women since 1970, with prenatal examination and vaccination ranking next to it. The priority order for activities against tuberculosis was laid on finding out and registration of new T.B. patients every year, with patients' control, and medication or injection ranking next to it. As for the priority order of nursing services, traveling medical examination and treatment ranked the first-stressed activity before 1970, with medication and injection ranking next to it. The first priority order management activity of communicable diseases was put on vaccination before 1970, with medication and injection. ranking next. And consultation and education ranked second to it during 1990 to 1992. As for the health services of the aged, traveling examination and treatment ranked the order, with the assistance of medical examination ranking next to it. As far as troubles and obstacles shown in case of family planning, the rate of residents' lack understanding was 28.8%, that of lacking budget 13.6%, and the imperfection of public health administration system 11.9%. In the case of tuberculosis control, residents' lacking understanding was 32.5%, the deficiency of public health administration system 18.2%, over-duty(shortage of hands) 15.6%, and the insufficiency skill and know-how 13.0%. In the case of nursing services, the deficiency of public health administration system was 18.2%, each over-duty(the shortage of hands) and the shortage of facilities and equipment 15.6% respective, and residents' lacking understanding 13.0%. The rate of dissatisfaction with the chance or possibility of promotion for his or her career or capability was shown to be 49.2%, and 65.9% of the health nurses expressed their complaints of the deficiency of the chance of the promotion to a professional or expert. when the public health nurses were asked in the questionably whether they were satisfied or not with current state of equipment and facilities needed for public health service, 49.6% of them answered in the negative. The grade of the satisfaction with the current individual position was shown to be low as much as the status of his or her position was now. 37.6% of those asked in the research answered to have the readiness to switch jobs for the reasons of dissatisfaction and so on with lacking promotion chance as well as bad working condition. Significant correlation between the grade of job satisfaction and the current status of the po as found to be in this research, which showed that the lower the status of position was, the lower the grade of job satisfaction was. But little correlation between the grade of job satisfaction and his or her schooling and career was found. In order to carry out primary health care successfully, it can be said that more education and publicity activities to make public health nurses and residents see it in a new light are requested. In addition to it, it is suggested that the improvement of promotion system for public health nurses and the enlargement of job province should also be taken in consideration of the high dissatisfaction with and complaints of the chance of promotion and the system of position. In order words, it is important that considerations for system improvement enough to make nursing services pleasant and satisfactory should be taken into.

• Journal of Gastric Cancer
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• v.6 no.1
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• pp.36-42
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• 2006

Purpose: The $p21^{Waf1/Cip1}$ protein Inhibits the cell cycle by Inhibiting the phosphorylation at the $G1{\rightarrow}S$ check point, and the $p27^{kip1}$ protein similarly performs the suppressor function by controlling the p27-mediated G1 arrest. In this study, we analysed the clinical status and survival rates in correlations with p21 and p27 expression patterns in gastric cancer. Materials and Methods: Between 1993 and 1997, 192 patients who underwent surgeries in Catholic Medical Center were analysed retrospectively in this study. Immunohistochemical staining was performed and if the nuclei of the tumor cells were stained, we assumed those as positive results. Statistical analysis was based on clinicopathological findings and differences in survival rates. Results: The expression rate of p27 was 28.1% and 15.6% in p21 each. The ratio of T1-2(80.0%) was significantly high in p21 (+), but the ratio of T3-4 (50.6%) was slightly high in p21 (-). There was no statistical significance regarding other factors. The results in p27 was not much different from expression rate of p21 in T-stage. In addition, p27 expression in diffuse type (91.3%) was higher than in intestinal type (62.7%) by Lauren's classification (P<0.05). Also, there was no statistical significance in other factors. In the correlation of p21 and p27, p27 was positive when p21 was positive (53.5%). Conversely, p27 was negative when p21 was negative (76.5%, p<0.05). In the p21 and p27 combination test, there was higher rate of T1-2 (87.5%) in p21 (+)/p27 (+), and higher rate of T3-4 (58.1%) in p21 (-)/p27 (-) (P<0.05). Results showed higher rate of intestinal type (100%) in p21 (+)/p27 (+), and diffuse type (87.0%) was dominant in p21 (-)/p27 (-) (P<0.05) by Lauren's classification. Moreover, there was no statistical significance in the 5-year survival rate in the expression of p21 and p27, and the 5-year survival rate was highest in the case of p21 (+)/p27 (+) without statistical significance. Conclusion: In our study, $p21^{Waf1/Cip1}\;and\;p27^{kip1}$ expressed similar patterns. The expression of $p21^{Waf1/Cip1}\;and\;p27^{kip1}$ affected the degree of invasiveness of the tumor, and. Combined examination result revealed the correlation of $p21^{Waf1/Cip1}\;and\;p27^{kip1}$ with Lauren's classification and depth of invasion of the tumor. However, we assumed that little difference between the survival rates depending on expression of $p21^{Waf1/Cip1}\;and\;p27^{kip1}$ has limited their value as predictable prognostic indicators.

• Journal of Sasang Constitutional Medicine
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• v.11 no.2
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• pp.151-183
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• 1999

The object of this study was 200 patients who had been treated in the Oriental Medical Hospital at Dong Eui Medical Center during 9 months from Jan. 1999 to sept. 1999. We proceeded the judgment of Sasang Constitution according to 'Questionnaire of Sasang Constitution Classification (I)', and 'Questionnaire of Sasang Constitution Classification II(QSCCII)' and the diagnosis by a medical specialist. The following conclusion were made in comparison with Sasang Constitution and Questionnaire. 1. We selected the 84 subjects what had the statistical value out of the 196 subjects('Questionnaire of Sasang Constitution Classification (I)' had the 71 subjects and 'Questionnaire of Sasang Constitution Classification II(QSCCII)', had the 121 subjects). And we selected again the 73 subjects('Questionnaire of Sasang Constitution Classification (I)', had the 33 subjects and 'Questionnaire of Sasang Constitution Classification II (QSCC II)' had the 40 subjects) out of the 84 subjects, because it had a repeated subjects. 2. We made the Questionnaire what has the 85 subjects, including the subjects what was approved its statistical value by 'A CLINICAL STUDY OF THE JUDGMENT OF SASANG CONSTITUTION ACCORDING TO QUESTIONNAIRE' and 'A CLINICAL STUDY OF THE TYPE OF DISEASE AND SYMPTOM ACCORDING TO SASANG CONSTITUTION CLASSIFICATION'. The subject what ask the physique and the body form was 7, the subject what ask the external appearance and the posture was 7, the subject what ask the habit and the character was 3, the subject what ask the physiology and the pathology was 3, the subject what ask the phenomenon that he has frequency was 4, the subject what ask the eating was 3, the subject what ask the symptom that he has frequency was 14, the subject what ask the work and the qualities-defects was 6, the subject what ask the friendly intercourse was 7, the subject what ask the usual mind was 5, the subject what ask the emotional inclination was I, the subject what ask the behavioral inclination was 10, the subject what ask the character was 15. 3. In the new Questionnaire, the subject what has relevance to Soyang was 84, the subject what has relevance to Soeum was 87, the subject what has relevance to Taeeum was 70. And we made the point of subject with the statistical ratio. The total point of Soyang was 7785.04, the total point of Soeum was 7742.80, the total point of Taeeum was 7746.60. 4. As a result of judgment of Sasang Constitution between the clinical diagnosis by a medical specialist and the new Questionnaire, the diagnostic accuracy of new Questionnaire was 73.33%. The diagnostic accuracy of Soyang was low, the others was high. And the Taeyang was excepted.

• The Korean Journal of Nuclear Medicine Technology
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• v.17 no.2
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• pp.95-100
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• 2013

Purpose: Since 2008, hepatitis A patients was rapidly increasing. So, Most of the health checkup examinees were interested in whether hepatitis A antibody was a lot. thereby The number of tests was increasing. In recent years, Antibody test results in the range of cut-off values were increased. According to the cause analysis, most examinees had a hepatitis A vaccine. This study was conducted to classify hepatitis A antibody as natural antibody and antibody after vaccination and compared the titer for seroconversion rate based on cut-off values. Materials and Methods: For a month in August 2012, First, We surveyed 185 health examinees and classified 119 health examinees who had acquired natural antibody. Second, for employees who were inoculated against hepatitis at our hospital, We classified into 53 primary inoculators and 59 secondary inculators. when the standard of cut-off value was 1, The seroconversion rate was compared the titer divided by 0.90-1.10 (${\pm}$), 0.60-0,89 (1+), 0.30-0.59 (2+), 0.01-0.29 (3+) and we compared the titer for seroconversion rate by each manufacturer after vaccination. Results: When the standard of cut-off value was 1, the titer of 119 health examinees who had acquired natural antibody was 0.90-1.10 (${\pm}$): 0%, 0.60-0.89 (1+): 0%, 0.30-0.59 (2+): 4.2%, 0.01-0.29 (3+): 96% and the titer of <0.60 ($${\geq_-}2+$$) was 100%. The titer of 53 primary inoculators was 0.90-1.10 (${\pm}:59.1%$), 0.60-0.89 (1+): 18.1%, 0.30-0.59 (2+): 18.1%, 0.01-0.29 (3+): 4.6% and the seroconversion rate was 45.3%. The titer of $${\geq_-}0.60$$ ($${\leq_-}1+$$) was 77.3%. The titer of 59 secondary inoculators was 0.90-1.10 (${\pm}:1.9%$), 0.60-0.89 (1+): 15.4%, 0.30-0.59 (2+): 36.54%, 0.01-0.29 (3+): 46.2% and the seroconversion rate was 88.1%. The titer of <0.60 ($${\geq_-}2+$$) was 82.7%. When we compared the titer for seroconversion rate by each manufacturer after vaccination, the seroconversion rate of 53 primary inoculators was BNIBT: 20.8% (${\pm}:24.5%$), GB: 15.7% (${\pm}:7.8%$), RIAKEY: 94.3% (${\pm}:3.8%$), ROCHE: 83% (${\pm}:0%$), ABBOTT: 73.1% (${\pm}:5.8%$) and the seroconversion rate of 59 secondary inoculators was BNIBT : 86.4% (${\pm}:1.7%$), GB: 88.5% (${\pm}:1.9%$), RIAKEY: 100% (${\pm}:0%$), ROCHE: 98.3% (${\pm}:0%$), ABBOTT: 98.2% (${\pm}:0%$). Conclusion: The study show that the titer of natural immune antibodies is higher than the titer of vaccination and the titer of secondary inoculation is mainly higher than the titer of primary inoculation. Consequently, if we know the titer of hepatitis A antibodies, it will help to give resullt reports. And then, when we compared the titer and the seroconversion rate by each manufacturer, There was a very distinct difference. As the test subjects inoculate against hepatitis A (HAV), it is considered BNIBT, GB will occur false negative rate and RIAKEY, ROCHE, ABOTT will occur false positive rate.

• The Korean Journal of Nuclear Medicine Technology
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• v.18 no.2
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• pp.22-27
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• 2014

Purpose There is the recent PET/CT scan in tendency that use low dose to reduce patient's exposure along with development of equipments. We diminished $^{18}F$-FDG dose of patient to reduce patient's exposure after setting up GE Discovery 690 PET/CT scanner (GE Healthcare, Milwaukee, USA) establishment at this hospital in 2011. Accordingly, We evaluate acquisition time per proper bed by change of infusion dose to maintain quality of image of PET/CT scanner. Materials and Methods We inserted Air, Teflon, hot cylinder in NEMA NU2-1994 phantom and maintained radioactivity concentration based on the ratio 4:1 of hot cylinder and back ground activity and increased hot cylinder's concentration to 3, 4.3, 5.5, 6.7 MBq/kg, after acquisition image as increase acquisition time per bed to 30 seconds, 1 minute, 1 minute 30 seconds, 2 minute, 2 minutes 30 seconds, 3 minutes, 3 minutes 30 seconds, 4 minutes, 4 minutes 30 seconds, 5 minutes, 5 minutes 30 seconds, 10 minutes, 20 minutes, and 30 minutes, ROI was set up on hot cylinder and back radioactivity region. We computated standard deviation of Signal to Noise Ratio (SNR) and BKG (Background), compared with hot cylinder's concentration and change by acquisition time per bed, after measured Standard Uptake Value maximum ($SUV_{max}$). Also, we compared each standard deviation of $SUV_{max}$, SNR, BKG following in change of inspection waiting time (15minutes and 1 hour) by using 4.3 MBq phantom. Results The radioactive concentration per unit mass was increased to 3, 4.3, 5.5, 6.7 MBqs. And when we increased time/bed of each concentration from 1 minute 30 seconds to 30 minutes, we found that the $SUV_{max}$ of hot cylinder acquisition time per bed changed seriously according to each radioactive concentration in up to 18.3 to at least 7.3 from 30 seconds to 2 minutes. On the other side, that displayed changelessly at least 5.6 in up to 8 from 2 minutes 30 seconds to 30 minutes. SNR by radioactive change per unit mass was fixed to up to 0.49 in at least 0.41 in 3 MBqs and accroding as acquisition time per bed increased, rose to up to 0.59, 0.54 in each at least 0.23, 0.39 in 4.3 MBqs and in 5.5 MBqs. It was high to up to 0.59 from 30 seconds in radioactivity concentration 6.7 MBqs, but kept fixed from 0.43 to 0.53. Standard deviation of BKG (Background) was low from 0.38 to 0.06 in 3 MBqs and from 2 minutes 30 seconds after, low from 0.38 to 0 in 4.3 MBqs and 5.5 MBqs from 1 minute 30 seconds after, low from 0.33 to 0.05 in 6.7 MBqs at all section from 30 seconds to 30 minutes. In result that was changed the inspection waiting time to 15 minutes and 1 hour by 4.3 MBq phantoms, $SUV_{max}$ represented each other fixed values from 2 minutes 30 seconds of acquisition time per bed and SNR shown similar values from 1 minute 30 seconds. Conclusion As shown in the above, when we increased radioactive concentration per unit mass by 3, 4.3, 5.5, 6.7 MBqs, the values of $SUV_{max}$ and SNR was kept changelessly each other more than 2 minutes 30 seconds of acquisition time per bed. In the same way, in the change of inspection waiting time (15 minutes and 1 hour), we could find that the values of $SUV_{max}$ and SNR was kept changelessly each other more than 2 minutes 30 seconds of acquisition time per bed. In the result of this NEMA NU2-1994 phantom experiment, we found that the minimum acquisition time per bed was 2 minutes 30 seconds for evaluating values of fixed $SUV_{max}$ and SNR even in change of inserting radioactive concentration. However, this acquisition time can be different according to features and qualities of equipment.

• Journal of Preventive Medicine and Public Health
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• v.3 no.1
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• pp.1-16
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• 1970

The present status of control measures for public health important helminthic infections in Korea was surveyed in 1969 and the following results were obtained. The activities of parasitic examination and Ascaris treatment for the positives which were done during 1966 to 1969 were brought in poor result and could not decrease the infection rate. It is needed to improve or strengthen the activities. The mass treatment activities for paragonimiasis and clonorchiasis in the areas which were designated by the Ministry of Health were carried out during 1965 to 1968 with no good results in decrease of estimated number of the patients. There were too many pharmaceutical companies where many kinds of anthelmintics were produced. It may be better to reduce the number of anthelmintics produced and control the quality. The human feces, the most important source of helminthic infections, was generally not treated in sanitary ways because of the poor sewerage system and no sewage treatment plant in urban areas and insanitary latrines in rural areas. The field soils of 170 specimens were collected from 34 areas out of 55 urban and tourist areas where night soil has been prohibited by a regulation to be used as a fertilizer, and examined for parasites contamination with the result of Ascaris egg detection in 44%. Some kinds of vegetables of 64 specimens each from the supply agents of parasite free vegetables and general markets were collected and examined for parasites contamination with the results of Ascaris egg detection in 25% and 36% respectively. The parasite control activities and the ability of parasitological examination techniques in the health centers of the country were not satisfactory. The budget of the Ministry of Health for the parasite control was very poor. The actual expenditure needed for cellophane thick smear technique was 8 Won per a specimen. As a principle the control of helminthic infections might be led toward breaking the chain of events in the life cycle of the prasites and eliminating environmental and host factors concerned with the infections, and the following methods nay be pointed out. 1) Mass treatment might be done to eliminate human reservoirs of an infection. 2) Animal reservoirs which are related with human infections night be eliminated. 3) The excretes of reservoirs, particularly human feces, should be treated in sanitary ways by the means of sanitary sewerage system and sewage treatment plant in urban areas and sanitary latrines such as waterborne latrine, aqua privy and pit latrine in rural areas. The increase of national economical development and prohibition of the habit of using night soils as a fertilizer might be very important factors to achieve the purpose. 4) The control of vehicles and intermediate hosts might be done by the means of prohibition of soil contamination with parasites, food sanitation, insect control and snail control. 5) The improvement of insanitary attitudes and bad habits which are related with parasitic infections night be done by the means of prohibition of habit of using night soils as a fertilizer, and improving eating habits and personal hygiene. 6) Chemoprophylactic measure and vaccination may be effective to prevent the infections or the development of a parasite to adult in the bodies when the bodies were invaded by parasites. Further studies and development of this kind of measures are needed.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.3 no.1
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• pp.30-40
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• 2000

Purpose: During the first year of life, cow's milk protein is the major offender causing food allergy. Cow's milk allergy (CMA) affects 2~7% of infants, of which approximately one-half show predominantly gastrointestinal symptoms. We studied the clinical types of cow's milk allergy with predominantly gastrointestinal symptoms (CMA-GI) of childhood. Methods: The retrospective study was performed on 30 (male 22, female 8) patients who had diagnosed as CMA-GI during 2 years and 3 months from March 1995 to June 1997. Results: 1) Children with CMA-GI presented in the three types of clinical manifestation on the basis of time to reaction to milk ingestion: Quick (Q) onset (5 cases), Slow (S) onset (20 cases), Quick & Slow (Q&S) (5 cases). 2) Age on admission of the three groups was significantly different (p<0.05): (Q onset: $81.4{\pm}67.1$ days, S onset: $31.9{\pm}12.7$ days, Q&S: $366.0{\pm}65.0$ days). Although the body weight at birth was 10~95 percentile in all patients, body weight on admission was different: (Q onset: 10~50 percentile, S onset: below 10 percentile, Q&S: 10~25 percentile). S onset group was significantly different compared with other groups (p<0.05) and 90% of this one was failure to thrive below 3 percentile. 3) Peripheral leukocyte counts were as followings: (Q onset: $5,700{\sim}12,300/mm^3$, S onset: $10,000{\sim}33,400/mm^3$, Q&S: $5,200{\sim}14,900/mm^3$). Slow onset group was significantly different compared with other groups (p<0.05). Serum albumin levels on admission were as followings: (Q onset: $4.2{\pm}0.4\;g/dl$, S onset: $3.0{\pm}0.3\;g/dl$, Q&S: $4.0{\pm}0.3\;g/dl$). S onset group was significantly different compared with other groups (p<0.05) and 85% of this one was below 3.5 g/dl. 4) Although morphometrical analysis on small intestinal mucosa did not show enteropathy in Q onset and Q&S groups, all cases of S onset revealed enteropathy: 45% of this one showed subtotal villous atrophy, 55 % showed partial villous atrophy. 5) Allergic reaction test to other foods was not performed in S onset group because of ethical problem and high risk in general condition. In Q onset group, allergic reaction to one or two other foods: soy formula, weaning formula and eggs. Q&S goup revealed allergic reactions to several foods or to most of all foods except protein hydrolysate formula: eggs, potatos, some kinds of sea food, apples, carrots, beef and chicken. 6) Serum IgE level, peripheral eosinophil counts, milk RAST, soy RAST, skin test were not significantly different among groups. Conclusion: CMA-GI may present in three clinical ways on the basis of time to reaction to milk ingestion, typical clinical findings and morphologic changes in the small bowel mucosal biopsy specimens. This clinical subdivision might be helpful in diagnostic and therapeutic approaches in CMA-GI. Early suspicion is mandatory especially in S onset type because of high risks with malnutrition and enteropathy.

• Radiation Oncology Journal
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• v.19 no.2
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• pp.171-180
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• 2001

Purpose : Expression of TIMP, intrinsic inhibitor of MMP, is regulated by signal transduction in response to genotoxins and is likely to be an important step in metastasis, angiogenesis and wound healing after ionizing radiation. Therefore, we studied radiation mediated TIMP expression and its mechanism in head and neck cancer cell lines. Materials and Methods : Human head and neck cancer cell lines established at Asan Medical Center were used and radiosensitivity $(D_0)$, radiation cytotoxicity and metastatic potential were measured by clonogenic assay, n assay and invasion assay, respectively. The conditioned medium was prepared at 24 hours and 48 hours after 2 Gy and 10 Gy irradiation and expression of TIMP protein was measured by Elisa assay with specific antibodies against human TIMP. hTIMP1 promoter region was cloned and TIMP1 luciferase reporter vector was constructed. The reporter vector was transfected to AMC-HN-1 and -HN-9 cells with or without expression vector Ras, then the cells were exposed to radiation or PMA, PKC activator. EMSA was peformed with oligonucleotide (-59/-53 element and SP1) of TIMP1 promoter. Results : $D_0$ of HN-1, -2, -3, -5 and -9 cell lines were 1.55 Gy, 1.8 Gy, 1.5 Gt, 1.55 Gy and 2.45 Gy respectively. n assay confirmed cell viability, over $94\%$ at 24hrs, 48hrs after 2 Gy irradiation and over 73% after 10 Gy irradiation. Elisa assay confirmed that cells secreted TIMP1, 2 proteins continuously. After 2 Gy irradiation, TIMP2 secretion was decreased at 24hrs in HN-1 and HN-9 cell lines but after 10 Gy irradiation, it was increased in all cell lines. At 48hrs after irradiation, it was increased in HN-1 but decreased in HN-9 cells. But the change in TIMP secretion by RT was mild. The transcription of TIMP1 gene in HN-1 was induced by PMA but in HN-9 cell lines, it was suppressed. Wild type Ras induced the TIMP-1 transcription by 20 fold and 4 fold in HN-1 and HN-9 respectively. The binding activity to -59/-53, AP1 motif was increased by RT, but not to SP1 motif in both cell lines. Conclusions : We observed the difference of expression and activity of TIMPs between radiosensitive and radioresistant cell line and the different signal transduction pathway between in these cell lines may contribute the different radiosensitivity. Further research to investigate the radiation response and its signal pathway of TIMPs is needed.

• The Korean Journal of Nuclear Medicine Technology
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• v.13 no.3
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• pp.56-60
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• 2009

Purpose: The various studies and efforts to develop program are in progress in the field of nuclear medicine for the purpose of reducing scan time. The Oncoflash is one of the programs used in whole body bone scan which allows to maintain the image quality while to reduce scan time. When Those applications are used in clinical setting, both the image quality and reduction of scan time should be considered, therefore, the purpose of this study was to determine the criteria for proper scan speed. Materials and Methods: The subjects of this study were the patients who underwent whole body bone scan at the departments of nuclear medicine in the Asan Medical Center located in Seoul from 1st to 10th, July, 2008. The whole body bone images obtained in the scan speed of 30cm/min were classified by the total counts into under 800 K, and over 800 K, 900 K, 1,000 K, 1,500 K, and 2,000 K. The image quality were assessed qualitatively and the percentages of those of 1,000K and under of total counts were calculated. The FWHM before and after applying the Oncoflash were analyzed using images obtained in $^{99m}Tc$ Flood and 4-Quadrant bar phantom in order to compare the resolution according to the amount of total counts by the application of the Oncoflash. Considering the counts of the whole body bone scan, the dosed 2~5 mCi were used. 152 patients underwent the measurement in which the counts of Patient Postioning Monitor (PPM) were measured with including head and the parts of chest which the starting point of whole body bone scan from 7th to 26th, August, 2008. The correlations with total counts obtained in the scan speed of 30cm/min among them were analyzed (The exclusion criteria were after over six hours of applying isotopes or low amount of doses). Results: The percentage of the whole body bone image which has the geometric average of total counts of under 1,000K among them obtained in the scan speed of 30cm/min were 17.6%(n=58) of 329 patients. The qualitative analysis of the image groups according to the whole body counts showed that the images of under 1,000K were assessed to have coarse particles and increased noises. The analysis on the FWHM of the images before and after applying the Oncoflash showed that, in the case of PPM counts of under 3.6 K, FWHM values after applying the Oncoflash were higher than that before applying the Oncoflash, whereas, in the case of that of over 3.6 K, the FWHM after applying the Oncoflash were not higher than that before applying the Oncoflash. The average of total counts at 2.5~3.0 K, 3.1~3.5 K, 3.6~4.0 k, 4.1~4.5 K, 4.6~5.0 K, 5.1~6.0 K, 6.1~7.0 K, and 7.1 K over (in PPM) were $965{\pm}173\;K$, $1084{\pm}154\;K$, $1242{\pm}186\;K$, $1359{\pm}170\;K$, $1405{\pm}184\;K$, $1640{\pm}376\;K$, $1,771{\pm}324\;K$, and $1,972{\pm}385\;K$, respectively and the correlations between the counts in PPM and the total counts of image obtained in the scan speed of 30 cm/min demonstrated strong correlation (r=.775, p<.01). Conclusions: In the case of PPM coefficient over 3.6 K, the image quality obtained in the scan speed of 30cm/min and after applying the Oncoflash was similar to that obtained in the scan speed of 15 cm/min. In the case of total counts over 1,000 K, it is expected to reduce scan time without any damage on the image quality. In the case of total counts under 1,000 K, however, the image quality were decreased even though the Oncoflash is applied, so it is recommended to perform the re-image in the scan speed of 15 cm/min.

• 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.