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Evaluation of Image Quality for Various Electronic Portal Imaging Devices in Radiation Therapy (방사선치료의 다양한 EPID 영상 질평가)

  • Son, Soon-Yong;Choi, Kwan-Woo;Kim, Jung-Min;Jeong, Hoi-Woun;Kwon, Kyung-Tae;Cho, Jeong-Hee;Lee, Jea-Hee;Jung, Jae-Yong;Kim, Ki-Won;Lee, Young-Ah;Son, Jin-Hyun;Min, Jung-Whan
    • Journal of radiological science and technology
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    • v.38 no.4
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    • pp.451-461
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    • 2015
  • In megavoltage (MV) radiotherapy, delivering the dose to the target volume is important while protecting the surrounding normal tissue. The purpose of this study was to evaluate the modulation transfer function (MTF), the noise power spectrum (NPS), and the detective quantum efficiency (DQE) using an edge block in megavoltage X-ray imaging (MVI). We used an edge block, which consists of tungsten with dimensions of 19 (thickness) ${\times}$ 10 (length) ${\times}$ 1 (width) $cm^3$ and measured the pre-sampling MTF at 6 MV energy. Various radiation therapy (RT) devices such as TrueBeam$^{TM}$ (Varian), BEAMVIEW$^{PLUS}$ (Siemens), iViewGT (Elekta) and Clinac$^{(R)}$iX (Varian) were used. As for MTF results, TrueBeam$^{TM}$(Varian) flattening filter free(FFF) showed the highest values of $0.46mm^{-1}$ and $1.40mm^{-1}$ for MTF 0.5 and 0.1. In NPS, iViewGT (Elekta) showed the lowest noise distribution. In DQE, iViewGT (Elekta) showed the best efficiency at a peak DQE and $1mm^{-1}DQE$ of 0.0026 and 0.00014, respectively. This study could be used not only for traditional QA imaging but also for quantitative MTF, NPS, and DQE measurement for development of an electronic portal imaging device (EPID).

Effects of Heat Treatment, Sugar Addition and Fermentation on Cytotoxicity of Korean Mistletoe (가열처리, 당의 첨가 및 발효에 의한 한국산 겨우살이의 세포독성변화)

  • Park, Jong-Heum;Hyun, Chang-Kee;Shin, Heuyn-Kil;Yeo, Ick-Hyun
    • Korean Journal of Food Science and Technology
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    • v.29 no.2
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    • pp.362-368
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    • 1997
  • As a preliminary study for the development of cancer-preventing functional food using Korean mistletoe, the cytotoxic effects of Korean mistletoe on between non-tumorigenic A3l cell and tumorigenic MSV cell derived from mouse 3T3 fibroblast cell line were investigated. While the raw extract, of which $ID_{50}$, value was $3.94\;{\mu}g/mL$, showed strong cytotoxic effect, its heat-treated extract was not cytotoxic up to $30\;{\mu}g/mL$. On the other hand, the heat-treated extract with law concentration showed an accelerative effect on the proliferation of non-tumorigenic A3l cell and an inhibitory effect on that of tumorigenic MSV cell. In addition, the influences of the addition of carbohydrates, such as galactose, lactose, glucose, mannose, fructose, sucrose and starch, to mistletoe extract were studied. There were not any significant changes with raw extract plus carbohydrate treatment, but the accelerative and inhibitory effects of heat-treated extract on each A3l and MSV cell were increased further by the treatment with sugars such as lactose, galactose, glucose, fructose. In order to investigate the changes of cytotoxicity of fermented Korean mistletoe according to fermentation periods, the raw and heat-treated extract were inoculated with Lactobacillus plantarum. During 1, 3, 5 and 7 fermentation days, the fermented raw mistletoe extract showed gradual accelerative effect on A31 cell proliferation without any changes of cytotoxicity on MSV cell. In case of the fermented heat-treated extract, however, the accelerative effect of heat-treated extract on A31 cell proliferation in early stage was disappeared during the fermentation.

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Coronary Fistulas -20 years experience - (관상동맥루)

  • Lee Jeong Ryul;Jung Yo Chun;Choi Chang Hyu;Kim Woong Han;Kim Yong Jin;Bae Eun Jung;Noh Chung Il
    • Journal of Chest Surgery
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    • v.38 no.9 s.254
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    • pp.609-615
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    • 2005
  • Background: Some controversy still exists concerning the operative indications of coronary fistulas. Nevertheless, a short-term and long-term outcomes are excellent with surgical interventions. In this study, we assessed our surgical results on this disease entity during the last 20 years. Anatomic diversity was described as well. Material and Method: From April 1986 to March 2005, 20 patients with coronary fistulas underwent surgical correction in Seoul National University Children's Hospital. Their medical records were reviewed retrospectively. Result: Twelve patients ($60\%$) were asymptomatic prior to surgery. All had electrocardiogram and echocardiogram and all but 3 had coro-nary angiogram preoperatively. Anatomically, none of them had two or more coronary fistulas. The sites of origin were left coronary system in 11 patients and right in 9. The draining sites were right ventricle in 11, right atrium in 3, left ventricle in 3, main pulmonary artery in 2, and superior vena cavae in 1. All of the involved, the coro-nary arteries were dilated or aneurismal. In 1 case, there was atherosclerotic change but no ischemic evidence in preoperative electrocardiogram. Operative techniques included external obliteration (13), internal obliteration (5), and both (2). External obliteration was done by ligation of the fistulous tract only in T patients, by fstula ligation plus plication in 3 and by plication or patch closure via fistulotomy in 3. There was no operative mortality. All of postoperative morbidities including transient sinus arrhythmia (2), complete atrioventricular block (1), decreased left ventricular function (2), ventricular tachycardia (1), pericarditis (1), and seizure (1) improved on discharge. The mean follow-up was 55.1$\pm$50.2 months (4.0 months${\~}$18.0 years) and there were no recurrences of fistula. There was 1 second operation for aortic root aneurysm, which developed after external patch closure of right coronary fistula. Conclusion: We demonstrated here that coronary fistulas can be cured with excellent clinical outcome and low operative risk under precise diagnosis. Understanding the anatomic diversity will help to construct surgical plans.

Taxonomical Classification of Namweon Series, Black Volcanic Ash Soils (흑색 화산회토인 남원통의 분류)

  • Song, Kwan-Cheol;Hyun, Byung-Geun;Sonn, Yeon-Kyu;Lim, Han-Cheol;Lee, Shin-Chan
    • Korean Journal of Soil Science and Fertilizer
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    • v.42 no.5
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    • pp.385-392
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    • 2009
  • This study was conducted to reclassify Namweon series, black volcanic ash soils, in Jeju Island based on the second edition of Soil Taxonomy : A Basic System of Soil Classification for Making and Interpreting Soil Surveys. Morphological properties of typifying pedon of Namweon series were investigated and physicochemical properties were analyzed according to Soil Survey Laboratory Methods Manual. The typifying pedon of Namweon series has black (10YR 2/1) silt loam Ap horizon (0~11 cm) and black (10YR 2/1) silt loam BA horizon (11~72 cm). Bw horizon (72~100 cm) is very dark brown (10YR 2/2) silt loam. That occurs on lava plain derived from volcanic ash materials. The typifying pedon contains 5.2~6.4% oxalate extractable (Al + 1/2 Fe), over 85% phosphate retention, and lower bulk density than $0.90Mg\;m^{-3}$. Ap, BA, and Bw horizons of the pedon have andic soil properties. That can be classified as Andisol. The typifying pedon has an udic soil moisture regime and has a 1,500 kPa water retention of 15% or more on air-dried samples throughout all horizons, and can be classified as Udand. Ap and BA horizons (0~72 cm) have a color value, moist, and chroma of 2 or less, melanic index of 1.70 or less, and 6% or more organic carbon. That meets the requirements of melanic epipedon. That keys out as Melanudand. That has more than 6.0% organic carbon and the colors of mollic epipedon throughout a layer 50 cm or more thick within 60 cm of the mineral soil surface.. Thus, that keys out as Pachic Melanudand. The pedon has a fine-earth fraction that has a water content at 1,500 kPa tension of 12% or more on air-dried samples and has less than 35% (by volume) rock fragments. Thus, the substitute for particle-size class is medial. That has a sum of 8 times the Si (percnt by weight extracted by acid oxalate) plus 2 times the Fe (percnt by weight extracted by acid oxalate) of 5 or more, and 2 times the Fe is more than 8 times the Si. Thus, the mineralogy class is ferrihydritic. Namweon series can be classified as medial, ferrihydritic, thermic family of Pachic Melanudands, not as ashy, thermic family of Typic Melanudands.

Effects of Motion Correction for Dynamic $[^{11}C]Raclopride$ Brain PET Data on the Evaluation of Endogenous Dopamine Release in Striatum (동적 $[^{11}C]Raclopride$ 뇌 PET의 움직임 보정이 선조체 내인성 도파민 유리 정량화에 미치는 영향)

  • Lee, Jae-Sung;Kim, Yu-Kyeong;Cho, Sang-Soo;Choe, Yearn-Seong;Kang, Eun-Joo;Lee, Dong-Soo;Chung, June-Key;Lee, Myung-Chul;Kim, Sang-Eun
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.6
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    • pp.413-420
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    • 2005
  • Purpose: Neuroreceptor PET studies require 60-120 minutes to complete and head motion of the subject during the PET scan increases the uncertainty in measured activity. In this study, we investigated the effects of the data-driven head mutton correction on the evaluation of endogenous dopamine release (DAR) in the striatum during the motor task which might have caused significant head motion artifact. Materials and Methods: $[^{11}C]raclopride$ PET scans on 4 normal volunteers acquired with bolus plus constant infusion protocol were retrospectively analyzed. Following the 50 min resting period, the participants played a video game with a monetary reward for 40 min. Dynamic frames acquired during the equilibrium condition (pre-task: 30-50 min, task: 70-90 min, post-task: 110-120 min) were realigned to the first frame in pre-task condition. Intra-condition registrations between the frames were performed, and average image for each condition was created and registered to the pre-task image (inter-condition registration). Pre-task PET image was then co-registered to own MRI of each participant and transformation parameters were reapplied to the others. Volumes of interest (VOI) for dorsal putamen (PU) and caudate (CA), ventral striatum (VS), and cerebellum were defined on the MRI. Binding potential (BP) was measured and DAR was calculated as the percent change of BP during and after the task. SPM analyses on the BP parametric images were also performed to explore the regional difference in the effects of head motion on BP and DAR estimation. Results: Changes in position and orientation of the striatum during the PET scans were observed before the head motion correction. BP values at pre-task condition were not changed significantly after the intra-condition registration. However, the BP values during and after the task and DAR were significantly changed after the correction. SPM analysis also showed that the extent and significance of the BP differences were significantly changed by the head motion correction and such changes were prominent in periphery of the striatum. Conclusion: The results suggest that misalignment of MRI-based VOI and the striatum in PET images and incorrect DAR estimation due to the head motion during the PET activation study were significant, but could be remedied by the data-driven head motion correction.

The Role of Radiotherapy in Patients with Brain Metastasis (고형암의 뇌전이시 방사선치료 효과)

  • Lee Soon Nam;Choo Mi-Soon;Lee Kyung-Ja;Nam Eunmi
    • Radiation Oncology Journal
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    • v.17 no.4
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    • pp.281-286
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    • 1999
  • Purpose : Brain metastases are the most frequent metastatic neurologic complication of systemic cancer. Even if the prognosis of brain metastases is grave, with available treatments, most patients experience effective palliation of neurologic symptoms and meaningful extension of life. We evaluated the clinical features and prognostic factors of the patients who were diagnosed as solid tumors with brain metastasis and received radiotherapy for brain metastases. Materials and Methods: Between January 1987 and January 1998, 71 patients with brain metastases from solid malignancy were included. We reviewed neurologic symptoms and signs of patients and evaluated improvememt of neurologic symptoms and signs. Survival durations after brain metastasis were ana lysed according to several factors such as age, performance status, primary malignancies, the pre-sence of brain metastasis at initial diagnosis of primary tumor, multiplicity of brain metastass, the presence of metastases other than brain, and treatment method. Results: Frequent symptoms associated with brain metastasis were headache (47.9$\%$), motor weakness (40.8$\%$), nausea and vomiting (19.7$\%$) and mental change (19.7%). Palliation of these symptoms was accomplished in 64.9$\%$ of cases. The overall median survival time was 16 weeks and 1- and 2-year survival rates were 15.0$\%$ and 5.1$\%$ respectively. Patients without extracranial metastases (n=27) had longer median survival than patients with extracranial metastases (33 weeks vs 10 weeks, p=0.0018). In patients with single brain metastasis (n=37), the median survival time was longer in patients treated with surgery plus radiotherapy than in patients treated with radiotherapy alone (40 weeks vs 16 weeks, p=0.0438). Conclusion: Patients who has brain metastases only constitute a prognostically favorable group and they may be benefited from radiotherapy and surgery if indicated.

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A Study on Differences of Opinions on Home Health Care Program among Physicians, Nurses, Non-medical personnel, and Patients. (가정간호 사업에 대한 의사, 간호사, 진료관련부서 직원 및 환자의 인식 비교)

  • Kim, Y.S.;Lim, Y.S.;Chun, C.Y.;Lee, J.J.;Park, J.W.
    • The Korean Nurse
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    • v.29 no.2
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    • pp.48-65
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    • 1990
  • The government has adopted a policy to introduce Home Health Care Program, and has established a three stage plan to implement it. The three stage plan is : First, to amend Article 54 (Nurses for Different Types of Services) of the Regulations for Implementing the Law of Medical Services; Second, to tryout the new system through pilot projects established in public hospitals and clinics; and third, to implement at all hospitals and equivalent medical institutions. In accordance with the plan, the Regulation has been amend and it was promulgated on January 9,1990, thus establishing a legal ground for implementing the policy. Subsequently, however, the Medical Association raised its objection to the policy, causing a delay in moving into the second stage of the plan. Under these circumstances, a study was conducted by collecting and evaluating the opinions of physicians, nurses, non-medical personnel and patients on the need and expected result from the home health care for the purpose of help facilitating the implementation of the new system. As a result of this study, it was revealed that: 1. Except the physicians, absolute majority of all other three groups - nurses, non-medical personnel and patients -gave positive answers to all 11 items related to the need for establishing a program for Home Health Care. Among the physicians, the opinions on the need for the new services were different depending on their field of specialty, and those who have been treating long term patients were more positive in supporting the new system. 2. The respondents in all four groups held very positive view for the effectiveness and the expected result of the program. The composite total of scores for all of 17 items, however, re-veals that the physicians were least positive for the- effectiveness of the new system. The people in all four groups held high expectation on the system on the ground that: it will help continued medical care after the discharge from hospitals; that it will alleviate physical and economic burden of patient's family; that it will offer nursing services at home for the patients who are suffering from chronic disease, for those early discharge from hospital, or those who are without family members to look after the patients at home. 3. Opinions were different between patients( who will receive services) and nurses (who will provide services) on the types of services home visiting nurses should offer. The patients wanted "education on how to take care patients at home", "making arrangement to be admitted into hospital when need arises", "IV injection", "checking blood pressure", and "administering medications." On the other hand, nurses believed that they can offer all 16 types of services except "Controlling pain of patients", 4. For the question of "what types of patients are suitable for Home Health Care Program; " the physicians, the nurses and non-medical personnel all gave high score on the cases of "patients of chronic disease", "patients of old age", "terminal cases", and the "patients who require long-term stay in hospital". 5. On the question of who should control Home Health Care Program, only physicians proposed that it should be done through hospitals, while remaining three groups recommended that it should be done through public institutions such as public health center. 6. On the question of home health care fee, the respondents in all four groups believed that the most desireable way is to charge a fixed amount of visiting fee plus treatment service fee and cost of material. 7. In the case when the Home Health Care Program is to be operated through hospitals, it is recommended that a new section be created in the out-patient department for an exclusive handling of the services, instead of assigning it to an existing section. 8. For the qualification of the nurses for-home visiting, the majority of respondents recommended that they should be "registered nurses who have had clinical experiences and who have attended training courses for home health care". 9. On the question of if the program should be implemented; 74.0% of physicians, 87.5% of non-medical personnel, and 93.0% of nurses surveyed expressed positive support. 10. Among the respondents, 74.5% of -physicians, 81.3% of non-medical personnel and 90.9% of nurses said that they would refer patients' to home health care. 11. To the question addressed to patients if they would take advantage of home health care; 82.7% said they would if the fee is applicable to the Health Insurance, and 86.9% said they would follow advises of physicians in case they were decided for early discharge from hospitals. 12. While 93.5% of nurses surveyed had heard about the Home Health Care Program, only 38.6% of physicians surveyed, 50.9% of non-medical personnel, and 35.7% of patients surveyed had heard about the program. In view of above findings, the following measures are deemed prerequisite for an effective implementation of Home Health Care Program. 1. The fee for home health care to be included in the public health insurance. 2. Clearly define the types and scope of services to be offered in the Home Health Care Program. 3. Develop special programs for training nurses who will be assigned to the Home Health Care Program. 4. Train those nurses by consigning them at hospitals and educational institutions. 5. Government conducts publicity campaign toward the public and the hospitals so that the hospitals support the program and patients take advantage of them. 6. Systematic and effective publicity and educational programs for home heath care must be developed and exercises for the people of medical professions in hospitals as well as patients and their families. 7. Establish and operate pilot projects for home health care, to evaluate and refine their programs.

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