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Radiation Therapy in Elderly Skin Cancer (노령의 피부암에서 방사선치료)

  • Kim, Jin-Hee
    • Radiation Oncology Journal
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    • v.26 no.2
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    • pp.113-117
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    • 2008
  • Purpose: To evaluate the long term results(local control, survival, failure, and complications) after radiation therapy for skin cancer in elderly patients. Material and Methods: The study spanned from January 1990 to October 2002. Fifteen elderly patients with skin cancer were treated by radiotherapy at the Keimyung University Dongsan Medical Center. The age distribution of the patients surveyed was 72 to 95 years, with a median age of 78.8 years. The pathologic classification of the 15 patients included squamous cell carcinoma(10 patients), basal cell carcinoma(3 patients), verrucous carcinoma(1 patient) and skin adnexal origin carcinoma(1 patient). The most common tumor location was the head(13 patients). The mean tumor diameter was 4.9 cm(range 2 to 9 cm). The radiation dose was delivered via an electron beam of 6 to 15 MeV. The dose range was adjusted to the tumor diameter and depth of tumor invasion. The total radiation dose ranged from $50{\sim}80$ Gy(mean: 66 Gy) with a 2 Gy fractional dose prescribed to the 80% isodose line once a day and 5 times a week. One patient with lymph node metastasis was treated with six MV photon beams boosted with electron beams. The length of the follow-up periods ranged from 10 to 120 months with a median follow-up period of 48 months. Results: The local control rates were 100%(15/15). In addition, the five year disease free survival rate(5YDFS) was 80% and twelve patients(80%) had no recurrence and skin cancer recurrence occurred in 3 patients(20%). Three patients have lived an average of 90 months($68{\sim}120$ months) without recurrence or metastasis. A total of 9 patients who died as a result of other causes had a mean survival time of 55.8 months after radiation therapy. No severe acute or chronic complications were observed after radiation therapy. Only minor complications including radiation dermatitis was treated with supportive care. Conclusion: The results suggest that radiation therapy is an effective and safe treatment method for the treatment of skin cancer in elderly patients who achieved a good survival rate and few minor complications.

Diagnosis of Real Condition and Distribution of Protected Trees in Changwon-si, Korea (창원시 보호수의 분포현황과 실태진단)

  • You, Ju-Han;Park, Kyung-Hun;Lee, Young-Han
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.29 no.1
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    • pp.59-70
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    • 2011
  • The purpose of this study is to present raw data to systematically and rationally manage the protected trees located in Changwon-si, Korea. This study investigated about the present condition and the information of location, individual, management, health and soil. The results are as follows. The protected trees were located in 26 spots, and species of trees were 9 taxa; Zelkova serrata, Celtis sinensis, Aphananthe aspera, Ginkgo biloba, Carpinus tschonoskii, Pinus densiflora for. multicaulis, Quercus variabilis, Pinus densiflora and Salix glandulosa. In protected tree types, shade trees were the most, and the majority of theirs were 200 years or more in age. The range of altitude was 14~173m, and the number of trees located in flat fields was the most. For location types, village and field and mountain were presented in the order and, in land use, land for building was the most. The range of height was 8.0~30.0m, 0.6~5.1m in crown height, 240~700cm in diameter of breast and 210~800cm in diameter of root. In case of crown area, Zelkova serrata of No.5 was most large. The status boards were mostly installed except No.23 and No.26. The sites with fence were 9 spots, and the site with stonework were 14 spots. The sites with the support beam were 5 spots, and most sites were not covered up with soil. The materials of bottom were soil, gravel and vegetation in the order. The range of withering branch rate was 0~40%, and peeled bark rate was 0~60%. The sites made holes were 23 spots, and the hole size of Aphananthe aspera of No.12 was the largest. The sites disturbed by human trampling were 7 spots, the sites by disease and insects of 2 spots, the sites by injury of 23 spots and the sites by exposed roots of 13 spots. In the results of soil analysis, there showed that acidity was pH 4.5~8.0, organic matter content of 3.5~69.8g/kg, electrical conductivity(EC) of 0.11~2.87dS/m, available $P_2O_5$ of 3.0~490.6mg/kg, exchangeable K of 0.10~1.05cmol+/kg, exchangeable Ca of 1.41~16.45cmol+/kg, exchangeable Mg of 0.37~1.96cmol+/kg, exchangeable Na of 0.25~2.41cmol+/kg and cation exchange capacity(C.E.C) of 8.35~26.55cmol+/kg.

Accuracy of 5-axis precision milling for guided surgical template (가이드 수술용 템플릿을 위한 5축 정밀가공공정의 정확성에 관한 연구)

  • Park, Ji-Man;Yi, Tae-Kyoung;Jung, Je-Kyo;Kim, Yong;Park, Eun-Jin;Han, Chong-Hyun;Koak, Jai-Young;Kim, Seong-Kyun;Heo, Seong-Joo
    • The Journal of Korean Academy of Prosthodontics
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    • v.48 no.4
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    • pp.294-300
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    • 2010
  • Purpose: The template-guided implant surgery offers several advantages over the traditional approach. The purpose of this study was to evaluate the accuracy of coordinate synchronization procedure with 5-axis milling machine for surgical template fabrication by means of reverse engineering through universal CAD software. Materials and methods: The study was performed on ten edentulous models with imbedded gutta percha stoppings which were hidden under silicon gingival form. The platform for synchordination was formed on the bottom side of models and these casts were imaged in Cone beam CT. Vectors of stoppings were extracted and transferred to those of planned implant on virtual planning software. Depth of milling process was set to the level of one half of stoppings and the coordinate of the data was synchronized to the model image. Synchronization of milling coordinate was done by the conversion process for the platform for the synchordination located on the bottom of the model. The models were fixed on the synchordination plate of 5-axis milling machine and drilling was done as the planned vector and depth based on the synchronized data with twist drill of the same diameter as GP stopping. For the 3D rendering and image merging, the impression tray was set on the conbeam CT and pre- and post- CT acquiring was done with the model fixed on the impression body. The accuracy analysis was done with Solidworks (Dassault systems, Concord, USA) by measuring vector of stopping’s top and bottom centers of experimental model through merging and reverse engineering the planned and post-drilling CT image. Correlations among the parameters were tested by means of Pearson correlation coefficient and calculated with SPSS (release 14.0, SPSS Inc. Chicago, USA) ($\alpha$ = 0.05). Results: Due to the declination, GP remnant on upper half of stoppings was observed for every drilled bores. The deviation between planned image and drilled bore that was reverse engineered was 0.31 (0.15 - 0.42) mm at the entrance, 0.36 (0.24 - 0.51) mm at the apex, and angular deviation was 1.62 (0.54 - 2.27)$^{\circ}$. There was positive correlation between the deviation at the entrance and that at the apex (Pearson Correlation Coefficient = 0.904, P = .013). Conclusion: The coordinate synchronization 5-axis milling procedure has adequate accuracy for the production of the guided surgical template.

Skin Damage Sustained During Head-and-Neck and Shoulder Radiotherapy Due to the Curvature of Skin and the Use of Immobilization Mask (머리-목 그리고 어깨의 방사선 치료 시 피부곡면과 고정장치로 인한 피부손상연구)

  • Kim, Soo-Kil;Jeung, Tae-Sig;Lim, Sang-Wook;Park, Yeong-Mouk;Park, Dahl
    • Progress in Medical Physics
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    • v.21 no.1
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    • pp.86-92
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    • 2010
  • The purpose of this study was to measure curvature contour skin dose using radiochromic film and TLD for a conventional open field. We also attempted to quantify the degradation of skin sparing associated with use of immobilization devices for high energy photon beams and to calculate the skin dose with a help of Monte Carlo (MC) simulation. To simulate head-and-neck and shoulder treatment, a cylindrical solid water phantom 11 cm in diameter was irradiated with 6 MV x-rays using $40{\times}40\;cm^2$ field at 100 cm source axis distance (SAD) to the center of the phantom. Aquaplastic mesh mask was placed on the surface of the cylindrical phantom that mimicked relevant clinical situations. The skin dose profile was obtained by taking measurements from $0^{\circ}$ to $360^{\circ}$ around the circumference of the cylindrical phantom. The skin doses obtained from radiochromic film were found to be 47% of the maximum dose of $D_{max}$ at the $0^{\circ}$ beam entry position and 61% at the $90^{\circ}$ oblique beam position without the mask. Using the mask (1.5 mm), the skin dose received was 59% at $0^{\circ}$ incidence and 78% at $80^{\circ}$ incidence. Skin dose results were also gathered using thin thermoluminescent dosimeters (TLD). With the mask, the skin dose was 66% at $0^{\circ}$ incidence and 80% at $80^{\circ}$ incidence. This method with the mask revealed the similar pattern as film measurement. For the treatments of the head-and-neck and shoulder regions in which immobilization mask was used, skin doses at around tangential angle were nearly the same as the prescription dose. When a sloping skin contour is encountered, skin doses may be abated using thinner and more perforated immoblization devices which should still maintain immoblization.

Usefulness assessment of secondary shield for the lens exposure dose reduction during radiation treatment of peripheral orbit (안와 주변 방사선 치료 시 수정체 피폭선량 감소를 위한 2차 차폐의 유용성 평가)

  • Kwak, Yong Kuk;Hong, Sun Gi;Ha, Min Yong;Park, Jang Pil;Yoo, Sook Hyun;Cho, Woong
    • The Journal of Korean Society for Radiation Therapy
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    • v.27 no.1
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    • pp.87-95
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    • 2015
  • Purpose : This study presents the usefulness assessment of secondary shield for the lens exposure dose reduction during radiation treatment of peripheral orbit. Materials and Methods : We accomplished IMRT treatment plan similar with a real one through the computed treatment planning system after CT simulation using human phantom. For the secondary shield, we used Pb plate (thickness 3mm, diameter 25mm) and 3 mm tungsten eye-shield block. And we compared lens dose using OSLD between on TPS and on simulation. Also, we irradiated 200 MU(6 MV, SPD(Source to Phantom Distance)=100 cm, $F{\cdot}S\;5{\times}5cm$) on a 5cm acrylic phantom using the secondary shielding material of same condition, 3mm Pb and tungsten eye-shield block. And we carried out the same experiment using 8cm Pb block to limit effect of leakage & transmitted radiation out of irradiation field. We attached OSLD with a 1cm away from the field at the side of phantom and applied a 3mm bolus equivalent to the thickness of eyelid. Results : Using human phantom, the Lens dose on IMRT treatment plan is 315.9cGy and the real measurement value is 216.7cGy. And after secondary shield using 3mm Pb plate and tungsten eye-shield block, each lens dose is 234.3, 224.1 cGy. The result of a experiment using acrylic phantom, each value is 5.24, 5.42 and 5.39 cGy in case of no block, 3mm Pb plate and tungsten eye-shield block. Applying O.S.B out of the field, each value is 1.79, 2.00 and 2.02 cGy in case of no block, 3mm Pb plate and tungsten eye-shield block. Conclusion : When secondary shielding material is used to protect critical organ while irradiating photon, high atomic number material (like metal) that is near by critical organ can be cause of dose increase according to treatment region and beam direction because head leakage and collimator & MLC transmitted radiation are exist even if it's out of the field. The attempt of secondary shield for the decrease of exposure dose was meaningful, but untested attempt can have a reverse effect. So, a preliminary inspection through Q.A must be necessary.

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INHIBITORY EFFECT OF Er:YAG LASER ON THE GROWTH OF STREPTOCOCCUS MUTANS (Er:YAG 레이저 조사가 Streptococcus mutans의 증식억제에 미치는 효과)

  • Song, Gwang-Chul;Lee, Chang-Seop;Lee, Sang-Ho;Lee, Nan-Young
    • Journal of the korean academy of Pediatric Dentistry
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    • v.30 no.1
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    • pp.15-24
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    • 2003
  • The purpose of this study is to investigate the sterilization effect of Er:YAG laser against the intraoral acid producing bacterium, S. mutans, by irradiating the culture solution containing S. mutans KCTC 3065 with Er:YAG laser having a $650{\mu}m$ diameter beam through the non-contact method. We obtained the following results after examining the temperature changes of the culture solution, numbers of bacterial colonies, and acid-producing ability and attaching ability on teeth by measuring the amount of extracellular polysaccharide produced by S. mutans. The number of bacterial colony was decreased in $10{\mu}l$ culture solution irradiated with laser in overall compared to the control solution. The number decreased as the irradiation intensity and pulse repetition rate were larger and as the exposure time was increased. However, it did not change significantly in $100{\mu}l$ culture solution compared to the control solution. Although the acid-producing ability of S. mutans was inhibited for a certain duration after laser irradiation in 10r1 bacterial culture solution, it did not change in $100{\mu}m$ solution compared with the control solution. The amount of extracellular polysaccharide synthesized by S. mutans was partially decreased through laser irradiation in $10{\mu}m$ culture solution but did not change in $100{\mu}m$ culture solution. Based on these findings, we concluded that Er:YAG laser has an sterilization effect on S. mutans in which we presume that the mechanism is through the heat effect rather than the mechanical effect from development of ultrasound.

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Chemical Age Dating of Zircon and Monazite by E1ectron Microprobe (전자현미분석기를 이용한 저어콘 및 모나자이트의 화학적 연대 측정법)

  • 이석훈
    • The Journal of the Petrological Society of Korea
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    • v.10 no.3
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    • pp.179-189
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    • 2001
  • The determination of trace concentration of U, Th and Pb was carried out for chemical dating of zircon and monazite by electron microprobe. Detection limit and error range should be considered to measure characteristic X-rays of M-line from those minerals, which are low in the ionization of atom and low peak intensity in the spectrum. The element of U, Th and Pb were simultaneously measured with 3 spectrometers equipped with PET crystal to reduce a total counting time and error due to drift of instrumental operating condition. Detection limit could be improved from increase of the peak/background ratio through adjusting pulse height analyzer about 1000 mv baseline. Under permissible maximum analytical conditions, theoretical detection limit of U, Th and Pb is down to 30 ppm (99% confidence level). The analytical result was maintained at a relative error $\pm$10% ($2{\sigma}$) in 800 ppm Pb, $\pm$5% ($2{\sigma}$) in 2330 ppm U and $\pm$10% ($2{\sigma}$) in dating from a single measurement of zircon at 15 keV and 100 nA. However, for the precise dating of zircon and monazite, if it is considered a 3 $\mu\textrm{m}$ spatial resolution, <100 ppm ($3{\sigma}$) detection limit and <$\pm$10% ($2{\sigma}$) relative error, optimum analytical conditions are given as 15~20 keV accelerating voltage, 100~200 nA beam current and 300~1200 sec total counting time. To reduce material damage by high current, there is need to be up to 3~5 $\mu\textrm{m}$ of electron beam diameter, or to use arithmetic average of multiple measuring at a shorter counting time. A younger or relatively low concentration rocks can be dated chemically by lower detection limit and improved precision resulted from increase of current and measuring time.

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Design and Dose Distribution of Docking Applicator for an Intraoperative Radiation Therapy (수술중 방사선치료를 위한 조립형 조사기구의 제작과 선량 분포)

  • Chu, Sung-Sil;Kim, Gwi-Eon;Loh, John-Kyu
    • Radiation Oncology Journal
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    • v.9 no.1
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    • pp.123-130
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    • 1991
  • A docking intraoperative electron beam applicator system, which is easily docking in the collimator for a linear accelerator after setting a sterilized transparent cone on the tumor bearing area in the operation room, has been designed to optimize dose distribution and to improve the efficiency of radiation treatment method with linear accelerator. This applicator system consisted of collimator holder with shielded metals and docking cone with transparent acrylic cylinder, A number of technical innovations have been used in the design of this system, this dooking cone gives a improving latral dose coverage at therapeutic volume. The position of $90\%$ isodose curve under suface of 8 cm diameter cone was extended $4\sim7$ mm at 12 MeV electron and the isodose measurements beneath the cone wall showed hot spots as great as $106\%$ for acrylic cone. The leakage radiation dose to tissues outside the cone wall was reduced as $3\sim5\%$ of output dose. A comprehensive set of dosimetric characteristics of the intraoperative radiation therapy applicator system is presented.

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Study on the Improvement of Stow Net Fishing Technique and the Enlargement of Fishing Ground to the Distant Waters - 1 . Model Experiment of the Net - (안강망어법의 개량과 어장의 원해로의 확대를 위한 연구 - 1 . 어구의 모형실험 -)

  • Lee, Byoung-Gee;Kim, Jin-Kun;Lee, Ju-Hee
    • Journal of the Korean Society of Fisheries and Ocean Technology
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    • v.24 no.2
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    • pp.55-64
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    • 1988
  • Stow nets have widely been used in the western sea of Korea from the olden age. The original structure of a stow net is a large square-sectional bag net made of 4 netting panels, and the front fringes of top and bottom panels are connected to the top and bottom beams respectively. Wire ropes, which is originated from the holding anchor are gradually forked and biforked, and finally 4 pieces of wire rope (biforked pendants) are jointed to each beam. Much convenience caused by long and heavy beams were problemed, then some studies have been carried out to improve the net since 1930's. The most effective improvement were achieved in 1980 by Mr. Han and his colleagues. The key point of improvement was that the beams were removed and the belt shaped shearing device made by canvas was attached to the side panels, the head rope and ground rope to the front fringe of top and bottom panel, and biforked pendants are joined to the shearing device. Even though this is the epoch-making improvement of a stow net, the further study should be required to find out more effective method. The authors carried out a model experiment on the stow net to determine the vertical and horizontal opening of a net mouth, and also examine the front, top and side-view configuration of the net. The model net was constructed depending on the Similarity Law of Fishing Gear in 1/10 and 1/20 scale and set against to the current at shallow and speedy flowing channel. The vertical and horizontal openings were determined by using scaled bamboo poles, and the configuration was observed by using specially prepared observation platform and underwater observation glass, and also photographed by using specially prepared underwater photographic equipment. The results obtained can be summarized as follows: 1. The opening height and width of the shearing device varied in accordance with the relative length of the biforked pendants. Considering the height and width of shearing device in 6 cases of the arrangement system of biforked pendants, the best result was obtained in the case that the 2nd, 3rd and 4th pendents from the bottom-most was 5%, 9% and 4% longer than that. 2. On the top-view configuration the excessive deformation of head rope and ground rope were observed. In the actual net, 54m long head rope and ground rope were attached to the front fringe of top and bottom panels so that the head rope may be lifted to make the net mouth open highly. But actually the head rope and the ground rope are streamed backward without any lift, and also the netting followed the ropes were deformed until the 2/5 in the whole length of the net. This deformation may be guessed to disturb the entrance of fish school into the net and also caused the net to get caught by obstacles in the sea bed and to be broken largely. 3. Hydrodynamic resistance R of the actual net may be deduced as R(kg)=29.2$\times$103 v1.65. It is also expressed as R(kg)=5.9$\times$d/l$\times$ab v1.65. depending on the formula deduced by Koyama to estimate the resistance of trawl nets, where d/l denote the ratio between diameter of netting twine and length of mesh leg in every part of side panel, a and b, the stretched circumference of the mouth and the stretched length of the net, respectively.

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Studies on Estimation of Fish Abundance Using an Echo Sounder ( 2 ) - The Relationship between Acoustic Backscattering Strength and Distribution Density of Fish in a Net Cage- (어군탐지기에 의한 어군량 추정에 관한 기초적 연구 ( 2 ) - 어군의 분포밀도와 초음파산란강도의 관계 -)

  • 이대재
    • Journal of the Korean Society of Fisheries and Ocean Technology
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    • v.27 no.1
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    • pp.13-20
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    • 1991
  • This paper describes the fish-density dependence of the mean backscattering strength with aggregations of encaged, free-swimming fish of known density in relation to the experimental verification of echo-integration technique for estimating the density of fish shoals. In this experiment, various numbers of gold crussian, Carassius burgeri burgeri, with a mean length of 18.5cm and a mean weight of 205.9g, were introduced into a net cage of approximately 0.76m super(3). During the backscattering measurements. the cage was suspended on the sound axis of the 50kHz transducer having a beam width of 33 degrees at -3dB downpoints. The volume backscattering strengths from fish aggregations were measured as a function of fish density. Data acquisition, processing and analysis were performed by means of the microcomputer-based sonar-echo processor including a FFT analyzer. The calibration of echo-sounder system was carried out at field with a steel ball bearing of 38mm in diameter having the target strength of -40.8dB. The dorsal-aspect target strengths on anesthetized specimens of gold crussian used in the cage experiment were measured and compared with the target strength predicted by the fish density-echo energy relationship for aggregations of free-swimming gold crussian in the cage. The results obtained can be summarized as follows: 1. The target strengths in the dorsal aspect on anesthetized specimens of gold crussian, with the mean length of 19.1cm and the mean weight of 210.5g, varied from -40.9dB to -44.8dB with a mean of -42.6dB. This mean target strength did not differ significantly from that predicted by the regression of echo energy on fish density of free-swimming gold crussian in the cage. It suggests that the target-strength measurements on anesthetized fish was valid and can be representative for live, free-swimming fish. 2. The relationship between mean backscattering strength(, dB) and distribution density of gold $crussian(\rho, $ fish/m super(3)) was expressed by the following equation; =-41.9+11 $Log(\rho)$ with a correlation coefficient of 0.97. This result support the existence of a linear relationship between fish density and echo energy, but suggest that this line has steeper slope than the regression by the theory of estimating the density of fish schools.

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