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Comparison of CT based-CTV plan and CT based-ICRU38 plan in Brachytherapy Planning of Uterine Cervix Cancer (자궁경부암 강내조사 시 CT를 이용한 CTV에 근거한 치료계획과 ICRU 38에 근거한 치료계획의 비교)

  • Cho, Jung-Ken;Han, Tae-Jong
    • Journal of Radiation Protection and Research
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    • v.32 no.3
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    • pp.105-110
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    • 2007
  • Purpose : In spite of recent remarkable improvement of diagnostic imaging modalities such as CT, MRI, and PET and radiation therapy planing systems, ICR plan of uterine cervix cancer, based on recommendation of ICRU38(2D film-based) such as Point A, is still used widely. A 3-dimensional ICR plan based on CT image provides dose-volume histogram(DVH) information of the tumor and normal tissue. In this study, we compared tumor-dose, rectal-dose and bladder-dose through an analysis of DVH between CTV plan and ICRU38 plan based on CT image. Method and Material : We analyzed 11 patients with a cervix cancer who received the ICR of Ir-192 HDR. After 40Gy of external beam radiation therapy, ICR plan was established using PLATO(Nucletron) v.14.2 planing system. CT scan was done to all the patients using CT-simulator(Ultra Z, Philips). We contoured CTV, rectum and bladder on the CT image and established CTV plan which delivers the 100% dose to CTV and ICRU plan which delivers the 100% dose to the point A. Result : The volume$(average{\pm}SD)$ of CTV, rectum and bladder in all of 11 patients is $21.8{\pm}6.6cm^3,\;60.9{\pm}25.0cm^3,\;111.6{\pm}40.1cm^3$ respectively. The volume covered by 100% isodose curve is $126.7{\pm}18.9cm^3$ in ICRU plan and $98.2{\pm}74.5cm^3$ in CTV plan(p=0.0001), respectively. In (On) ICRU planning, $22.0cm^3$ of CTV volume was not covered by 100% isodose curve in one patient whose residual tumor size is greater than 4cm, while more than 100% dose was irradiated unnecessarily to the normal organ of $62.2{\pm}4.8cm^3$ other than the tumor in the remaining 10 patients with a residual tumor less than 4cm in size. Bladder dose recommended by ICRU 38 was $90.1{\pm}21.3%$ and $68.7{\pm}26.6%$ in ICRU plan and in CTV plan respectively(p=0.001) while rectal dose recommended by ICRU 38 was $86.4{\pm}18.3%$ and $76.9{\pm}15.6%$ in ICRU plan and in CTV plan, respectively(p=0.08). Bladder and rectum maximum dose was $137.2{\pm}50.1%,\;101.1{\pm}41.8%$ in ICRU plan and $107.6{\pm}47.9%,\;86.9{\pm}30.8%$ in CTV plan, respectively. Therefore, the radiation dose to normal organ was lower in CTV plan than in ICRU plan. But the normal tissue dose was remarkably higher than a recommended dose in CTV plan in one patient whose residual tumor size was greater than 4cm. The volume of rectum receiving more than 80% isodose (V80rec) was $1.8{\pm}2.4cm^3$ in ICRU plan and $0.7{\pm}1.0cm^3$ in CTV plan(p=0.02). The volume of bladder receiving more than 80% isodose(V80bla) was $12.2{\pm}8.9cm^3$ in ICRU plan and $3.5{\pm}4.1cm^3$ in CTV plan(p=0.005). According to these parameters, CTV plan could also save more normal tissue compared to ICRU38 plan. Conclusion : An unnecessary excessive radiation dose is irradiated to normal tissues within 100% isodose area in the traditional ICRU plan in case of a small size of cervix cancer, but if we use CTV plan based on CT image, the normal tissue dose could be reduced remarkably without a compromise of tumor dose. However, in a large tumor case, we need more research on an effective 3D-planing to reduce the normal tissue dose.

Dose Verification Study of Brachytherapy Plans Using Monte Carlo Methods and CT Images (CT 영상 및 몬테칼로 계산에 기반한 근접 방사선치료계획의 선량분포 평가 방법 연구)

  • Cheong, Kwang-Ho;Lee, Me-Yeon;Kang, Sei-Kwon;Bae, Hoon-Sik;Park, So-Ah;Kim, Kyoung-Joo;Hwang, Tae-Jin;Oh, Do-Hoon
    • Progress in Medical Physics
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    • v.21 no.3
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    • pp.253-260
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    • 2010
  • Most brachytherapy treatment planning systems employ a dosimetry formalism based on the AAPM TG-43 report which does not appropriately consider tissue heterogeneity. In this study we aimed to set up a simple Monte Carlo-based intracavitary high-dose-rate brachytherapy (IC-HDRB) plan verification platform, focusing particularly on the robustness of the direct Monte Carlo dose calculation using material and density information derived from CT images. CT images of slab phantoms and a uterine cervical cancer patient were used for brachytherapy plans based on the Plato (Nucletron, Netherlands) brachytherapy planning system. Monte Carlo simulations were implemented using the parameters from the Plato system and compared with the EBT film dosimetry and conventional dose computations. EGSnrc based DOSXYZnrc code was used for Monte Carlo simulations. Each $^{192}Ir$ source of the afterloader was approximately modeled as a parallel-piped shape inside the converted CT data set whose voxel size was $2{\times}2{\times}2\;mm^3$. Bracytherapy dose calculations based on the TG-43 showed good agreement with the Monte Carlo results in a homogeneous media whose density was close to water, but there were significant errors in high-density materials. For a patient case, A and B point dose differences were less than 3%, while the mean dose discrepancy was as much as 5%. Conventional dose computation methods might underdose the targets by not accounting for the effects of high-density materials. The proposed platform was shown to be feasible and to have good dose calculation accuracy. One should be careful when confirming the plan using a conventional brachytherapy dose computation method, and moreover, an independent dose verification system as developed in this study might be helpful.

Environmental Impact Assessment of Rapeseed Cultivation by Life Cycle Assessment (전과정평가를 이용한 유채재배의 환경영향 평가)

  • Hong, Seung-Gil;Nam, Jae-Jak;Shin, Joung-Du;Ok, Yong-Sik;Choi, Bong-Su;Yang, Jae-E.;Kim, Jeong-Gyu;Lee, Sung-Eun
    • Korean Journal of Environmental Agriculture
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    • v.30 no.1
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    • pp.24-30
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    • 2011
  • BACKGROUND: High input to the arable land is contributed to increasing productivity with causing the global environmental problems at the same time. Rapeseed cultivation has been forced to reassess its positive point for utilization of winter fallow field. The Objective of this study was performed to assess the environmental impact of rapeseed cultivation with double-cropping system in paddy rice on Yeonggwang district using life cycle assessment technique. METHODS AND RESULTS: For assessing each stage of rapeseed cultivation, it was collected raw data for input materials as fertilizer and pesticide and energy consumption rate by analyzing the type of agricultural machinery and working hours by 1 ton rapeseed as functional unit. Environmental impacts were evaluated by using Eco-indicator 95 method for 8 impact categories. It was estimated that 216 kg $CO_2$-eq. for greenhouse gas, 3.98E-05 kg CFC-11-eq. for ozone lazer depletion, 1.78 kg SO2-eq. for acidification, 0.28 kg $PO_4$-eq. for eutrophication, 5.23E-03 kg Pb-eq. for heavy metals, 2.51E-05 kg B(a)p-eq. for carcinogens, 1.24 kg SPM-eq. for smog and 6,460 MJ LHV for energy resource are potentially emitted to produce 1 ton rapeseed during its whole cultivation period, respectively. It was considered that 90% of these potential came from chemical fertilizer. For the sensitivity analysis, by increasing the productivity of rapeseed by 1 ton per ha, potential environmental loading was reduced at 22%. CONCLUSION(s): Fertilization affected most dominantly to the environmental burden, originated from the preuse stage, i.e. fertilizer manufacturing and transporting. It should be included and assessed an indirect emission, which is not directly emitted from agricultural activities. Recycling resource in agriculture with reducing chemical fertilizer and breeding the high productive variety might be contribute to reduce the environmental loading for the rapeseed cultivation.

Toxin Produced by Pathogenic Vibrios Isolated from Sea Food (수산물에서 분리된 병원성 비브리오균의 용혈성독소)

  • CHANG Dong-Suck;SHINODA Sumio
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.27 no.2
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    • pp.107-113
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    • 1994
  • Among the currently recognized pathogenic vibrios, V. vulnificus and V. cholerae non O1 are the most serious bacteria from the point of view of sea food hygiene in Korea. In this paper, the authors compared the hemolytic activities of the crude hemolysin produced by V. vulnificus and V. cholerae non O1 isolated from shellfish collected in Chungmoo, Korea. The authors also attempted to improve the purification method of V. vulnificus hemolysin(VVH) and tried to make antiserum with the purified hemolysin. VVH was produced in abundance in heart infusion broth containing $2\%$ NaCl in a shaking cultivation process(140rpm) at $37^{\circ}C$ for 15 hours. While hemolysin production patterns of V. cholerae non O1 were quite different by the strain during the culture times compared with the V. vulnificus. Hemolytic activity of the VVH on sheep erythrocytes was stronger than those of rabbit, but hemolytic activities of the hemolysin produced by V. cholerae non O1 on rabbit erythrocytes were as much as twice as strong as on those of sheep and horse. VVH was purified by two steps of hydrophobic column chromatography on Phenyl-Sepharose HP with Fast Protein Liquid Chromatography(FPLC). Purification fold and yield of VVH was much improved by changing the elution buffer's pH from 6.0 to 9.8 and adding $1\%$ CHAPS(a zwitter ionic detergent) and $50\%$ ethylene glycol to the 10mM glycine buffer during the repeated hydrophobic column chromatography. Homogeneity of the purified hemolysin was shown by polyacrylamide gel electrophoresis. According to the five times repeated purification results, the specific activity was increased 27500 times and the yield was improved by $23.4\%$ on average. About $250{\mu}g$ of purified hemolysin was harvested from the 2400ml of culture supernatant of V. vulnificus. Molecular weight of VVH was estimated to be 50KDa by the SDS-PAGE and the neutralization scores of the obtained antiserum acting against VVH were $2000{\sim}8500$.

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An Experimental Study on the Early Feeding of Infants (신생아의 조기수유에 관한 실험적 연구)

  • 하영수
    • Journal of Korean Academy of Nursing
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    • v.5 no.1
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    • pp.1-16
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    • 1975
  • The newborn human is the only mammalian whose mother does not have a food supply ready for it's offspring at birth. From two to four days usually elapse before the mother's supply If milk appears, and during this period, some kind of artificial feeding should be supplied to the infants. Because of this factor, there has been continued debate fog the past hundreds of years as to when the first feeding should be started Accordingly, many experiments were carried out by scholars and because of these, Pre-lateral feedings were believed to be necessary. Many types of pre-lateral feedings were tried and the conclusion was reached that glucose water was the best food for the first infants'feedings. Traditionally, This has been started 12 hours after birth. The causes for the 12 hours delay were thought to (1) provide rest for the infants: (2) prevent regurgitation ana vomiting which tended to be prevalent during this tine: (3) in cases of low weight infants, prevention of aspiration pneumonia. From recent studies of newborn physiology and as pediatric medicine has been rapidly advancing, many studies hare been carried out concerning the improvement of infant nutrition and the early feeding of infants has been emphasized. This author believes it would be very beneficial to try two different kinds of feedings for the infant. (1) experimental feedings ana (2) comparative feeding, and during this period to investigate and compare the infants blood sugar level, hematocrit, gamma globulin level weight changes and to observe the infant reaction ill order to search for a more desirable feeding program. This study was conducted from January to March 1974 with data related to 40 healthy newborn infants (male 21, female 19: weight, 2.79∼4.20㎏ : gestation, 39∼40 weeks) born at Ewha Womens University Hospital and the results obtained were as follows : 1. At time of birth the blood sugar level from the cord sample averaged 88.99㎎/100㎖, but the blood sugar level rapidly dropped after 2 to 3 hours and reached the lowest point after 10 to 11 hours (54.48㎎/100㎖) and rose again by the 24 hour time period (76.80㎎/100㎖). Changes in the blood sugar level of the experiments: groups and the compare-five group was not significantly different until the 6 to 7 hour period, but by the 10 to 11 hour period the blood sugar levels of the experimental group (49,10㎎/100㎖) and the comparative group (49.70㎎/100㎖) were lower than the remainder of the experimental groups. 9. There ware no significant weight changes between the two groups. Average weight at birth was 3.35㎏, but at the 24 hours period birth weight averaged 3.29㎏. (1.8% reduction of birth weight). It continually lowered until at 48 hours, average weight was 3.26㎏ (2.7% reduction from birth weight.) 3. Hematocrit readings showed no significant difference between the groups. Hematocrit, the average value at birth, was 28.07% and abruptly elevated to average 64.35% at the 2 to 3 hour period, then slowly lowered to an average of 59.67% at the 6 to 7 hour period, 55.10% at the 10 to 11 hour period, ana 53.70% at the 24 hour period. 4. At birth, average gamma globulin value averaged 1,39㎎/100㎖. and at the 24 hour period averaged 1,52㎎/100㎖ revealing no significant difference between the two feeding groups. 5. Such factors as voiding, passing of meconium, regurgitation and vomiting showed no significance between the two feeding groups. However, the number of infants voiding and passing meconium in the experimental groups during the first 12 hours was slightly greater. In general there was an increased tendency for regurgitation and. vomiting among a small group of the infants during the first 24 hours which thereafter decreased. 6. Fluid intake averaged 24.38cc at the first feeding and increased to average 30.48cc at the third feeding and further increased to 73. 00cc at the fifteenth feeding. Finally it was suggested that the most reasonable method of early feeding is to give less than 25cc of 5% glucose water and/or 8% powdered milk at 8 to 9 flours after birth in order to prevent hypoglycemia and dehydration.

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Processing of Functional Porridge with Optimal Mixture Ratio of Mulberry Leaf Powder and Mulberry Fruit Powder (뽕잎분말과 오디분말의 최적 혼합비율을 이용한 기능성 죽 제조)

  • Kim, You-Jin;Kim, Min-Ju;Kim, Hyun-Bok;Lim, Jung-Dae;Kim, Ae-Jung
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.46 no.9
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    • pp.1081-1090
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    • 2017
  • The purpose of this study was to develop a functional porridge prepared with mulberry leaf and mulberry fruit powder, which can ameliorate hypertension. The experiment was designed according to the central composite design. For optimization of the mixture ratio of mulberry leaf powder (MLP) and mulberry fruit powder (MFP), the independent variables were defined as MLP (X1) and MFP (X2) and the dependent variables were defined as K (Y1), Na (Y2), ${\gamma}$-aminobutyric acid (GABA) (Y3), cyanidin-3-glycoside (C3G) (Y4), rutin (Y5), and flavonoid (Y6). The optimal MLP to MFP mixture ratio according to the response surface method were 5.41 g of MLP and 2.65 g of MFP. The amounts of K, Na, GABA, C3G, rutin, and flavonoid in the optimal MLP and MFP mixture were 1,844.22 mg/100 g, 52.74 mg/100 g, 139.98 mg/100 g, 1,134.89 mg/100 g, 101.56 mg/100 g, and 201.28 mg/100 g, respectively. The amounts of Ca, K, Mg, and Na in the functional porridge at this optimal point were 27.66 mg/100 g, 131.32 mg/100 g, 19.57 mg/100 g, and 3.59 mg/100 g, respectively. Overall, this functional porridge can help reduce hypertension.

Needs on Management Development Program for Head Nurse (간호 관리 능력 개발을 위한 교육 연구)

  • Park, Jeong-Sun
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.5
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    • pp.84-99
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    • 1998
  • The objectives of this study are to identify the actual educational contents of management for head nurse and to propose the educational subjects according to identity the needs of head, charge, and staff nurses. The subjects were investigated the actual Management Development Programs and educational needs of head nurses and prospective nurse manager(charge nurse, staff nurse with a lot of clinical experiences) in general hospitals. The tools were composed of two questionnaires: One was developed from the literature review for making items to measure actual situation. The other was revised Katz's model for measurement of educational needs. The first respondents of actual situation were 27 general hospitals with over 400 beds in Seoul and the second respondents were 89 head nurses, 67 charge nurses and 136 nurses at 3 hospitals by convenient sampling out of 27 general hospitals. Data were collected by telephone interview, mail questionnaire and visiting from 7th of October through 30th of November in 1997. In data analysis, general characteristics of the respondents and actual status of Management Development Programs were analyzed by frequency and percentage. Educational needs according to general characteristics were analyzed by ANOVA The results were as follows: 1. Actual situation of Management Development Program 1) Seven hospitals(26%) had Management Development Program for prospective managers and 14 hospitals (52%) for head nurses. 2) Education Department existed in 14 hospitals (52%). 3) One hospital(4%) had top level managers took part in the Management Development. 4) Two hospitals selected head nurse, who had finished courses of Management Development. Eight hospitals(30%) assessed educational needs. The assessment tools consisted of making a question via questionnaire(75%), determining at department meeting(12%) and interview(13%). 5) Educational programs had 3 types: 10 lecture type, 7 discussion type and 4 role play type programs. 6) One hospital evaluated the change of learner's attitude. 7) Four hospitals scored educational point, but that was measured only by attending. 8) Actual Management Development Programs were as follows. parenthesis indicates the number of hospitals. (1) Management Development Programs for Prospective manager. Role perception of Middle level Manager (1) . Role reconstruction of Nurse Manager (1). Workshop for Charge Nurse (1). Nursing Delivery System and Nursing Process (1). Communication (1). Motivation (1) (2) Management Development Programs for Head nurse.. Head nurse's Role (5). Administrative Work (7). Service Education (4). Prevention and Countermeasure of Nursing Incidence (3). Appraisal (3) 2. The results of needs on Management Development subject 1) The educational needs of all respondents on 3 skill domains showed positive agreement to strongly positive agreement. 2) High priority(more than 4.5) items were 12 of 24 Human skill items(50%), 1 of 6 Technical skill items(16%), and 2 of 13 Conceptual skill items (15%). 3) Out of high priority items, 8 items were instituted. 4) All respondents showed high needs on 3 skill domains regardless of 3 positions (head nurse, charge nurse, and nurse). Educational needs of Human skill domain, according to position were 108. S, 108.7, 106.8 (mean score = 72) , needs of Technical skill domain were 26.5, 26.6, 26.I(mean score=18), and needs of Conceptual skill domains were 56.9,56.7, 55.1(mean score=39). 5) Needs of 3 skill domains according to clinical career showed significant difference. Out of respondents, nurses with career of over 16years showed lowest degree of needs in Human skill domains(F=4.47, P=.004) and Conceptual skill domain(F=2.93, P=.034). 6) Educational needs according to educational background were not significant difference. But out of respondents, nurses educated at 3-year junior college relatively showed lowest needs in all of the 3 skill domains. With the above-mentioned findings, further study is necessary for generalization of this study at hospitals with different bed size and location. Also it is needed to study about management skill of nurse and charge nurse, and effective educational method.

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Development and Application of Practical Problem focused Teaching.Learning Process Plan for Housing for the Later life - in High School Technology.Home Economics - (실천적 문제 중심 노인주거 교수.학습 과정안 개발 및 적용 - 고등학교 기술.가정을 중심으로 -)

  • Kim, Yu-Ni;Cho, Jae-Soon
    • Journal of Korean Home Economics Education Association
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    • v.22 no.1
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    • pp.1-19
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    • 2010
  • The purpose of this study was to develop practical problem focused teaching learning process plan for housing for the later life in order to apply it to the older stage of family planning section of Technology Home Economics in a highschool. Practical problem focused method was used for the teaching learning process plans of 3-session lessons according to the ADDIE model. The global practical problem was "What should I do to plan a safe and comfortable housing for the later life?" In the development stage, 53 teaching learning materials (44 students activity materials, 2 students' and 5 teacher' reading texts, and 2 moving pictures) were developed for 3-session lessons. The planes applied to the 5 classes, 150 students, in the freshmen of B highschool during April 20th-24th, 2009. The 5 point likert questionnaire were used to evaluate the 3-session lessons about 4 contents related aspects as well as the methods and effects of the lessons besides 2 open ended questions. The overall evaluation was very positive in all 6 aspects of the lessons. Some students wanted to learn more about universal design and aging related jobs. Those results showed that the practical problem focused teaching learning process plan for housing for the later life which this study developed would be appropriate to teach the older stage of family planning section related to housing and could be adjusted to the condition of each school and regions.

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Analysis of Optimal Pathways for Terrestrial LiDAR Scanning for the Establishment of Digital Inventory of Forest Resources (디지털 산림자원정보 구축을 위한 최적의 지상LiDAR 스캔 경로 분석)

  • Ko, Chi-Ung;Yim, Jong-Su;Kim, Dong-Geun;Kang, Jin-Taek
    • Korean Journal of Remote Sensing
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    • v.37 no.2
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    • pp.245-256
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    • 2021
  • This study was conducted to identify the applicability of a LiDAR sensor to forest resources inventories by comparing data on a tree's position, height, and DBH obtained by the sensor with those by existing forest inventory methods, for the tree species of Criptomeria japonica in Jeolmul forest in Jeju, South Korea. To this end, a backpack personal LiDAR (Greenvalley International, Model D50) was employed. To facilitate the process of the data collection, patterns of collecting the data by the sensor were divided into seven ones, considering the density of sample plots and the work efficiency. Then, the accuracy of estimating the variables of each tree was assessed. The amount of time spent on acquiring and processing the data by each method was compared to evaluate the efficiency. The findings showed that the rate of detecting standing trees by the LiDAR was 100%. Also, the high statistical accuracy was observed in both Pattern 5 (DBH: RMSE 1.07 cm, Bias -0.79 cm, Height: RMSE 0.95 m, Bias -3.2 m), and Pattern 7 (DBH: RMSE 1.18 cm, Bias -0.82 cm, Height: RMSE 1.13 m, Bias -2.62 m), compared to the results drawn in the typical inventory manner. Concerning the time issue, 115 to 135 minutes per 1ha were taken to process the data by utilizing the LiDAR, while 375 to 1,115 spent in the existing way, proving the higher efficiency of the device. It can thus be concluded that using a backpack personal LiDAR helps increase efficiency in conducting a forest resources inventory in an planted coniferous forest with understory vegetation, implying a need for further research in a variety of forests.

Evaluating of the Effectiveness of RTK Surveying Performance Based on Low-cost Multi-Channel GNSS Positioning Modules (다채널 저가 GNSS 측위 모듈기반 RTK 측량의 효용성 평가)

  • Kim, Chi-Hun;Oh, Seong-Jong;Lee, Yong-Chang
    • Journal of Cadastre & Land InformatiX
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    • v.52 no.2
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    • pp.53-65
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    • 2022
  • According to the advancement of the GNSS satellite positioning system, the module of hardware and operation software reflecting accuracy and economical efficiency is implemented in the user sector including the multi-channel GNSS receiver, the multi-frequency external antenna and the mobile app (App) base public positioning analysis software etc., and the multichannel GNSS RTK positioning of the active configuration method (DIY, Do it yourself) is possible according to the purpose of user. Especially, as the infrastructure of multi-GNSS satellite is expanded and the potential of expansion of utilization according to various modules is highlighted, interest in the utilization of multi-channel low-cost GNSS receiver module is gradually increasing. The purpose of this study is to review the multi-channel low-cost GNSS receivers that are appearing in the mass market in various forms and to analyze the utilization plan of the "address information facility investigation project" of the Ministry of Public Administration and Security by constructing the multi-channel low-cost GNSS positioning module based RTK survey system (hereinafter referred to as "multi-channel GNSS RTK module positioning system"). For this purpose, we constructed a low-cost "multi-channel GNSS RTK module positioning system" by combining related modules such as U-blox's F9P chipset, antenna, Ntrip transmission of GNSS observation data and RTK positioning analysis app through smartphone. Kinematic positioning was performed for circular trajectories, and static positioning was performed for address information facilities. The results of comparative analysis with the Static positioning performance of the geodetic receivers were obtained with 5 fixed points in the experimental site, and the good static surveying performance was obtained with the standard deviation of average ±1.2cm. In addition, the results of the test point for the outline of the circular structure in the orthogonal image composed of the drone image analysis and the Kinematic positioning trajectory of the low cost RTK GNSS receiver showed that the trajectory was very close to the standard deviation of average ±2.5cm. Especially, as a result of applying it to address information facilities, it was possible to verify the utility of spatial information construction at low cost compared to expensive commercial geodetic receivers, so it is expected that various utilization of "multi-channel GNSS RTK module positioning system"