• Title/Summary/Keyword: Block Adjustment

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Evaluation of brown rice to replace corn in weanling pig diet

  • Kim, Sheena;Cho, Jin Ho;Kim, Hyeun Bum;Song, Minho
    • Journal of Animal Science and Technology
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    • v.63 no.6
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    • pp.1344-1354
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    • 2021
  • This study was conducted to evaluate the effects of brown rice (Japonica) on growth performance, nutrient digestibility, and blood parameters of weanling pigs. A total of 60 weanling pigs (28-day-old, 30 barrows and 30 gilts, 6.73 ± 0.77 kg body weight [BW]) were randomly allotted to 2 dietary treatments (6 pigs per pen; 5 replicates per treatment) in a randomized complete block design with the initial BW and sex as blocks. The dietary treatments were a typical nursery diet based on corn and soybean meal (CON) and the CON replaced 50% of corn with brown rice (BR). Pigs were fed respective dietary treatments for 5 weeks. For the last week of experiment period, pigs were fed respective dietary treatments containing 0.2% chromic oxide as an indigestible marker. Fecal samples were collected from randomly selected 1 pig in each pen daily for the last 3 d after the 4-d adjustment period. Blood was collected from randomly selected 1 pig in each pen on d 0, 3, 7, and 14 after weaning. Compared with pig fed CON diet, pigs fed the BR diet were found to have higher (p < 0.05) final BW, overall average daily gain, and apparent ileal digestibility (AID) and apparent total tract digestibility (ATTD) of dry matter and energy. However, there were no significant differences between the groups with respect to average daily feed intake, gain to feed ratio, frequency of diarrhea, and the AID and ATTD of crude protein during overall experimental period. Similarly, there were no significant differences on blood parameters between the groups. Thus, the findings of this study indicate that brown rice (Japonica) can be used to replace 50% of corn in the diet of pigs during the nursery period without negatively affecting growth performance, nutrient digestibility, or blood parameters.

Comparison of the efficacy of genicular nerve phenol neurolysis and radiofrequency ablation for pain management in patients with knee osteoarthritis

  • Gokhan Yildiz;Gevher Rabia Genc Perdecioglu;Damla Yuruk;Ezgi Can;Omer Taylan Akkaya
    • The Korean Journal of Pain
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    • v.36 no.4
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    • pp.450-457
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    • 2023
  • Background: Genicular nerve neurolysis with phenol and radiofrequency ablation (RFA) are two interventional techniques for treating chronic refractory knee osteoarthritis (KOA) pain. This study aimed to compare the efficacy and adverse effects of both techniques. Methods: Sixty-four patients responding to diagnostic blockade of the superior medial, superior lateral, and inferior medial genicular nerve under ultrasound guidance were randomly divided into two groups: Group P (2 mL phenol for each genicular nerve) and Group R (RFA 80℃ for 60 seconds for each genicular nerve). The numeric rating scale (NRS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were used to evaluate the effectiveness of the interventions. Results: RFA and phenol neurolysis of the genicular nerves provided effective analgesia within groups at 1 week, 1 month, and 3 months compared to baseline. There was no significant difference between the groups in terms of NRS and WOMAC scores at all measurement times. At the 3rd month follow-up, 50% or more pain relief was observed in 53.1% of patients in Group P and 50% of patients in Group R. The rate of transient paresthesia was 34.4% in Group P and 6.3% in Group R, and this was significantly higher in Group P. Conclusions: Neurolysis of the genicular nerves with both RFA and phenol is effective in the management of KOA pain. Phenol may be a good alternative to RFA. Further studies are needed on issues such as dose adjustment to prevent transient paresthesia response.

Feeding Unprotected CLA Methyl Esters Compared to Sunflower Seeds Increased Milk CLA Level but Inhibited Milk Fat Synthesis in Cows

  • Dohme-Meier, F.;Bee, G.
    • Asian-Australasian Journal of Animal Sciences
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    • v.25 no.1
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    • pp.75-85
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    • 2012
  • An experiment was conducted to compare the effect of the same amount of 18:2 offered either as 18:2n-6 or as a mixture of unprotected 18:2c9t11 and 18:2t10c12 on feed intake, milk components as well as plasma and milk fatty acid profile. Fifteen cows were blocked by milk yield and milk fat percentage and within block assigned randomly to 1 of 3 treatments (n = 5). Each cow passed a 12-d adjustment period (AP) on a basal diet. After the AP cows received 1 of 3 supplements during an 18-d experimental period (EP). The supplements contained either 1.0 kg ground sunflower seeds (S), 0.5 kg conjugated linoleic acid (CLA)-oil (C) or 0.75 kg of a mixture of ground sunflower seeds and CLA-oil (2:1; SC). All 3 supplements contained the same amount of 18:2 either as CLA (${\Sigma}18$:2c9t11+18:2t10c12, 1:1) or as 18:2c9c12. During the last 2 d of AP and the last 4 d of EP feed intake and milk yield were recorded daily and milk samples were collected at each milking. Blood samples were collected from the jugular vein on d 11 of AP and d 15 and 18 of EP. The 18:2 intake increased in all treatments from AP to EP. Regardless of the amount of supplemented CLA, the milk fat percentage decreased by 2.35 and 2.10%-units in treatment C and SC, respectively, whereas in the treatment S the decrease was with 0.99%-unit less pronounced. Thus, C and SC cows excreted daily a lower amount of milk fat than S cows. The concentration of trans 18:1 in the plasma and the milk increased from AP to EP and increased with increasing dietary CLA supply. While the concentration of 18:2c9t11 and 18:2t10c12 in the plasma and that of 18:2t10c12 in the milk paralleled dietary supply, the level of 18:2c9t11 in the milk was similar in C and CS but still lower in S. Although the dietary concentration of CLA was highest in treatment C, the partial replacement of CLA by sunflower seeds had a similar inhibitory effect on milk fat synthesis. Comparable 18:2c9t11 levels in the milk in both CLA treatments implies that this isomer is subjected to greater biohydrogenation with increasing supply than 18:2t10c12. The fact that unprotected 18:2t10c12 escaped biohydrogenation in sufficient amounts to affect milk fat synthesis reveals opportunities to develop feeding strategies where reduced milk fat production is desirable or required by the metabolic state of the cow.

Gene Expression Profile of the Responder vs. the Non-Responder to the Acupuncture Mediated Analgesic Effects (침자극에 대한 반응과 비반응군 흰쥐의 특이 유전자 발현 연구)

  • Sur Young Chan;Rho Sam Woong;Lee Gi Seog;Ko Eun Jung;Hong Moo Chang;Shin Min Kyu;Min Byung il;Bae Hyun Su
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.17 no.3
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    • pp.633-642
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    • 2003
  • A pain is the symptom which defends against noxious stimulus about a human body, it is known that if the periphery of perceptive nerve were stimulated by a physical or chemical factors, the stimulation is induced by transmission to pain center in the cerebral cortex according to pain conduction tract. The treatment of pain is to decrease a stimulus that causes a pain or block off a nerve transmitting a stimulus or puts on a way to calm down pain center, but It is for adjustment of a pain to be the most representative in acupuncture among various ways to cure a pain in Oriental medicine. However, the analgesic effect of an individual response to acupuncture stimulation shows marked individual variations, so these days genetic a few approach is attempted. On this the author determined that the responding group was appointed those whose tail flick latency (TFL) responding time delayed the minimum of 30 % comparing with basal reaction time. For those whose TFL time had shorter than 30 % was grouped as a non-responding group. And then the hypothalamus of each group was dissected and RNA was further purified. After synthesizing cDNA using oligo dT primer, products were finally applied to the PCR. The results were as follows; The ratio of responding group to non-responding group was 6:4. Ach T (acetylcholinesterase T subunit), BF-I (Brain factor-I), DBH (Dopamine β-hydroxylase) and PNM (Phosphotidylethanolamine N-Methyltransferase) were revealed significantly in the responding group. Cathepsin B and Tau were revealed significantly in the non-responding group. The PCR results show that Ach T, BF-I, DBH and PNM are expressed abundantly in the responding group, where as cathepsin B and tau are abundant in the non-responding group. These results suggest that the analgesic effect on acupuncture stimulation is related to regulation of neurotransmitter as well as neurodegeration of cerebrum.

AN ANALYSIS OF FAILURE MODE OF TEETH RESTORED WITH FIBER-REINFORCED POSTS UNDER THE CONDITION OF BONY RESORPTION (치주지지가 감소된 상태에서 섬유강화형 포스트로 수복한 치아의 실패양상 분석)

  • Lee Byung-Woo;Yi Yang-Jin;Cho Lee-Ra;Park Chan-Jin
    • The Journal of Korean Academy of Prosthodontics
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    • v.41 no.2
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    • pp.232-242
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    • 2003
  • Statement of problem : Fiber-reinforced posts have lower modulus of elasticity than titanium post or cast post-core. With this similar elasticity to that of dentin, fiber-reinforced posts have been known to have a tendency to reduce the risk of root fracture. However, there were few studies on the teeth restored with fiber-reinforced posts under the condition of reduced periodontal support. Purpose : The purpose of this study was to evaluate the fracture strength and failure mode of endodontically treated teeth restored with fiber-reinforced posts and titanium posts under the condition of reduced periodontal support. Material and method : Extracted human maxillary incisor roots were divided into 3 groups (group 1 carbon fiber post, group 2 : glass fiber post, and group 3 : titanium alloy post). After coronectomy and endodontic treatment, teeth were restored with each post systems and resin core according to the manufacturer's recommendation. Then, teeth with simulated periodontal ligament were embedded in the acrylic resin blocks at the level of 4 mm below the cemento-enamel junction. Each specimen was exposed to $10^5$ load cycles with average 30 N force in $36.5^{\circ}C$ water using a computer-controlled chewing simulator. Loads were applied at $45^{\circ}$ angle to the long axis of the teeth. After cyclic loading, teeth were subjected a compressive load until failure at a crosshead speed of 0.5 mm/min. Fracture strength (N) and failure mode were examined. The fracture strength was analyzed with one-way ANOVA and the Scheffe adjustment at the 95% significance level. Results and conclusion : The results were as follows. 1. There was no statistically significant difference in the mean fracture strength among the groups (P<.05). 2. Carbon fiber post and glass fiber post group showed less root fracture tendency than control group. 3. All specimens with root fractures showed fracture lines above the level of acrylic resin block, except for only one specimen in group 3.

Backgrounding steers on temperate grasses mixed with vetch and/or using energy supplementation

  • de Oliveira Lazzarotto, Eduardo Felipe Colerauz;de Menezes, Luis Fernando Glasenapp;Paris, Wagner;Molinete, Marcos Luis;Schmitz, Gean Rodrigo;Baraviera, Jose Henrique Ignacio;Farenzena, Roberta;de Paula, Adalberto Luiz
    • Asian-Australasian Journal of Animal Sciences
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    • v.32 no.6
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    • pp.800-807
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    • 2019
  • Objective: The aim was to evaluate backgrounding beef steers on oat + ryegrass pastures mixed with vetch and/or using energy supplementation. Methods: A randomized block design with three treatments and three replications was used. The treatments were: grass + supplement (oat + ryegrass + supplementation), legume + supplement (oat + ryegrass + vetch + supplementation) and grass + legume (oat + ryegrass + vetch). A continuous grazing system with a variable stocking rate was used. Twenty-seven intact crossbred steers (1/4 Marchigiana, 1/4 Aberdeen Angus and 2/4 Nellore) aged 7 months old and average weight of 190 kg were used. Steers were supplemented at 1% of the body weight of ground corn. The experiment lasted 84 days, between May and August 2014. Behavioral assessments were performed two times per experimental period, for 24 hours. Results: The forage mass was different between treatments, being greater for steers fed without legume. The accumulation rate, forage allowance, and stocking rate did not differ between treatments due to the adequate adjustment of forage allowance. The final weight of animals, as well as the dry matter intake (kg/d), did not differ between treatments. However, forage intake was higher for non-supplemented animals in relation to supplemented steers. Supplement intake did not alter the total digestible nutrient intake due to pasture quality. Animals fed grass + supplement had higher live weight gain per area than those fed grass + legume. Animals without supplementation spent more time in grazing. Conclusion: Feeding behavior was not altered by mixing with vetch or supplementation. Non-supplemented animals started the grazing peak earlier and spent more time in grazing than those supplemented; however, the average daily gain was similar between treatments. The live weight gain per hectare was 47% higher in pastures in which the animals received supplementation compared with those mixed with vetch, a consequence of the substitutive effect.

Effects of Palm Kernel Expellers on Growth Performance, Nutrient Digestibility, and Blood Profiles of Weaned Pigs

  • Seo, J.;Kim, W.;Kim, J.;Kim, J.K.;Kim, S.C.;Jang, Y.;Jang, K.;Kim, K.;Kim, B.;Park, S.;Park, I.;Kim, M.K.;Seo, K.S.;Kim, H.B.;Kim, I.H.;Seo, S.;Song, M.
    • Asian-Australasian Journal of Animal Sciences
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    • v.28 no.7
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    • pp.987-992
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    • 2015
  • This experiment was conducted to investigate the effects of palm kernel expellers on growth performance, nutrient digestibility, and blood profiles of weaned pigs. A total of 88 weaned pigs ($6.94{\pm}0.76kg$ body weight [BW]; 28 d old) were randomly allotted to 2 dietary treatments (4 pigs/pen; 11 replicates/treatment) in a randomized complete block design (sex as a block). The dietary treatments were a typical nursery diet based on corn and soybean meal (CON) and CON added with 20% of palm kernel expellers (PKE). Pigs were fed for 6 wk using a 3-phase feeding program with declining diet complexity and with phases of 1, 2, and 3 wk, respectively. Blood was collected from randomly selected 2 pigs in each pen before weaning and on d 7 after weaning. Pigs were fed respective dietary treatments containing 0.2% chromic oxide from d 29 to 35 after weaning. Fecal samples were collected from randomly selected 2 pigs in each pen daily for the last 3 days after the 4-d adjustment period. Measurements were growth performances, digestibility of dry matter, nitrogen and energy, white and red blood cell counts, packed cell volume, and incidence of diarrhea. The PKE increased average daily gain (ADG) (246 vs 215 g/d; p = 0.06) and average daily feed intake (ADFI) (470 vs 343 g/d; p<0.05) and decreased gain-to-feed ratio (G:F) (0.522 vs 0.628 g/g; p<0.05) during phase 2 compared with CON, but did not affect growth performance during phase 1 and 3. During overall experimental period, PKE increased ADG (383 vs 362 g/d; p = 0.05) and ADFI (549 vs 496 g/d; p<0.05) compared with CON, but did not affect G:F. However, no differences were found on digestibility of dry matter, nitrogen, and energy between CON and PKE. The PKE reduced frequency of diarrhea (15% vs 25%; p = 0.08) for the first 2 wk after weaning compared with CON. Similarly, PKE decreased white blood cells (8.19 vs $9.56{\times}10^3/{\mu}L$; p = 0.07), red blood cells (2.92 vs $3.25{\times}10^6/{\mu}L$; p = 0.09), and packed cell volume (11.1% vs 12.6%; p = 0.06) on d 7 after weaning compared with CON. In conclusion, addition of 20% palm kernel expellers to nursery diet based on corn and soybean meal had no negative effects on growth performance, nutrient digestibility, and blood profiles of weaned pigs.

Design of DVB-T/H SiP using IC-embedded PCB Process (IC-임베디드 PCB 공정을 사용한 DVB-T/H SiP 설계)

  • Lee, Tae-Heon;Lee, Jang-Hoon;Yoon, Young-Min;Choi, Seog-Moon;Kim, Chang-Gyun;Song, In-Chae;Kim, Boo-Gyoun;Wee, Jae-Kyung
    • Journal of the Institute of Electronics Engineers of Korea SD
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    • v.47 no.9
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    • pp.14-23
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    • 2010
  • This paper reports the fabrication of a DVB-T/H System in Package (SiP) that is able to receive and process the DVB-T/H signal. The DVB-T/H is the European telecommunication standard for Digital Video Broadcasting (DVB). An IC-embedded Printed Circuit Board (PCB) process, interpose a chip between PCB layers, has applied to the DVB-T/H SiP. The chip inserted in DVB-T/H SiP is the System on Chip (SoC) for mobile TV. It is comprised of a RF block for DVB-T/H RF signal and a digital block to convert received signal to digital signal for an application processor. To operate the DVB-T/H IC, a 3MHz DC-DC converter and LDO are on the DVB-T/H SiP. And a 38.4MHz crystal is used as a clock source. The fabricated DVB-T/H SiP form 4 layers which size is $8mm{\times}8mm$. The DVB-T/H IC is located between 2nd and 3rd layer. According to the result of simulation, the RF signal sensitivity is improved since the layout modification of the ground plane and via. And we confirmed the adjustment of LC value on power transmission is necessary to turn down the noise level in a SiP. Although the size of a DVB-T/H SiP is decreased over 70% than reference module, the power consumption and efficiency is on a par with reference module. The average power consumption is 297mW and the efficiency is 87%. But, the RF signal sensitivity is declined by average 3.8dB. This is caused by the decrease of the RF signal sensitivity which is 2.8dB, because of the noise from the DC-DC converter.

Study on 6 MV Photon beam Dosimetry by Asymmetric Collimator Variation of Linear Accelerator (6MV 선형가속기의 비대칭 조사야의 변화에 따른 선량분포)

  • Yoon, Joo-Ho;Lee, Chul-Soo;Yum, Ha-Yong
    • The Journal of Korean Society for Radiation Therapy
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    • v.12 no.1
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    • pp.91-104
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    • 2000
  • Recently linear accelerator in radiation therapy in asymmetric field has been easily used since the improvement and capability of asymmetrical field adjustment attached to the machine. It has been thought there have been some significant errors in dose calculation when asymmetrical radiation fields have been utilized in practice of radiation treatments if the fundamental data for dose calculation have been measured in symmetrical standard fields. This study investigated how much the measured data of dose distributions and their isodose curves are different between in asymmetrical and symmetrical standard fields, and how much there difference affect the error in dose calculation in conventional method measured in symmetrical standard field. The distributions of radiation dose were measured by photon diode detector in the water phantom (RFA-300P, Scanditronix, Sweden) as tissue equivalent material on utilization of 6 MV linear accelerator with source surface distance (SSD) 1000 mm. The photon diode detector has the velocity of 1 mm per second from water surface to 250 mm depth in the field size of $40mm{\times}40mm\;to\;250mm{\times}250mm\;symmetric\;field\;and\;40mm{\times}20mm\;to\;250mm{\times}125mm$ asymmetrical fields. The measurements of percent depth dose (PDD) and subsequent plotting of their isodose curves were performed from water surface to 250mm dmm from Y-center axis in $100mm{\times}50mm$ field in order to absence the variability of depth dose according to increasing field sizes and their affects to plotted isodose curves. The difference of PDD between symmetric and asymmetric field was maximum $4.1\%\;decrease\;in\;40mm{\times}20mm\;field,\;maximum\;6.6\%\;decrease\;in\;100mm{\times}50mm\;and\;maximum\;10.2\%\;decrease\;200mm{\times}100mm$, the larger decrease difference of PDD as the greater field size and as greater the depth, The difference of PDD between asymmetrical field and equivalent square field showed maximum $2.4\%\;decrease\;in\;60mm{\times}30mm\;field,\;maximum\;4.8\%\;decrease\;in\;150mm{\times}75mm\;and\;maximum\;6.1\%\;decrease\;in\;250mm{\times}125mm$, and the larger decreased differenced PDD as the greater field size and as greater the depth, these differences of PDD were out of $5\%$ of dose calculation as defined by international Commission on radiation unit and Measurements(ICRU). In the dose distribution of asymmetrical field (half beam) the plotted isodose curves were observed to have deviations by decreased PDD as greater as the blocking of the beam moved closer to the central axis, and as the asymmetrical field increased by moving the block 10 mm keeping away from the central axis, the PDD increased and plotted isodose curves were gradually more flattened, due to reduced amount of the primary beam and the fraction of low energy soft radiations by passing thougepth in asymmetrical field by moving independent jaw each 10 h beam flattening filter. As asymmetrical radiation field as half beam radiation technique is used, the radiation dosimetry calculated in utilizing the fundamental data which measured in standard symmetrical field should be converted on bases of nearly measured data in asymmetrical field, measured beam data flies of various asymmetrical field in various energy and be necessary in each institution.

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Optimum Radiotherapy Schedule for Uterine Cervical Cancer based-on the Detailed Information of Dose Fractionation and Radiotherapy Technique (처방선량 및 치료기법별 치료성적 분석 결과에 기반한 자궁경부암 환자의 최적 방사선치료 스케줄)

  • Cho, Jae-Ho;Kim, Hyun-Chang;Suh, Chang-Ok;Lee, Chang-Geol;Keum, Ki-Chang;Cho, Nam-Hoon;Lee, Ik-Jae;Shim, Su-Jung;Suh, Yang-Kwon;Seong, Jinsil;Kim, Gwi-Eon
    • Radiation Oncology Journal
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    • v.23 no.3
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    • pp.143-156
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    • 2005
  • Background: The best dose-fractionation regimen of the definitive radiotherapy for cervix cancer remains to be clearly determined. It seems to be partially attributed to the complexity of the affecting factors and the lack of detailed information on external and intra-cavitary fractionation. To find optimal practice guidelines, our experiences of the combination of external beam radiotherapy (EBRT) and high-dose-rate intracavitary brachytherapy (HDR-ICBT) were reviewed with detailed information of the various treatment parameters obtained from a large cohort of women treated homogeneously at a single institute. Materials and Methods: The subjects were 743 cervical cancer patients (Stage IB 198, IIA 77, IIB 364, IIIA 7, IIIB 89 and IVA 8) treated by radiotherapy alone, between 1990 and 1996. A total external beam radiotherapy (EBRT) dose of $23.4\~59.4$ Gy (Median 45.0) was delivered to the whole pelvis. High-dose-rate intracavitary brachytherapy (HDR-IBT) was also peformed using various fractionation schemes. A Midline block (MLB) was initiated after the delivery of $14.4\~43.2$ Gy (Median 36.0) of EBRT in 495 patients, while In the other 248 patients EBRT could not be used due to slow tumor regression or the huge initial bulk of tumor. The point A, actual bladder & rectal doses were individually assessed in all patients. The biologically effective dose (BED) to the tumor ($\alpha/\beta$=10) and late-responding tissues ($\alpha/\beta$=3) for both EBRT and HDR-ICBT were calculated. The total BED values to point A, the actual bladder and rectal reference points were the summation of the EBRT and HDR-ICBT. In addition to all the details on dose-fractionation, the other factors (i.e. the overall treatment time, physicians preference) that can affect the schedule of the definitive radiotherapy were also thoroughly analyzed. The association between MD-BED $Gy_3$ and the risk of complication was assessed using serial multiple logistic regression models. The associations between R-BED $Gy_3$ and rectal complications and between V-BED $Gy_3$ and bladder complications were assessed using multiple logistic regression models after adjustment for age, stage, tumor size and treatment duration. Serial Coxs proportional hazard regression models were used to estimate the relative risks of recurrence due to MD-BED $Gy_{10}$, and the treatment duration. Results: The overall complication rate for RTOG Grades $1\~4$ toxicities was $33.1\%$. The 5-year actuarial pelvic control rate for ail 743 patients was $83\%$. The midline cumulative BED dose, which is the sum of external midline BED and HDR-ICBT point A BED, ranged from 62.0 to 121.9 $Gy_{10}$ (median 93.0) for tumors and from 93.6 to 187.3 $Gy_3$ (median 137.6) for late responding tissues. The median cumulative values of actual rectal (R-BED $Gy_3$) and bladder Point BED (V-BED $Gy_3$) were 118.7 $Gy_3$ (range $48.8\~265.2$) and 126.1 $Gy_3$ (range: $54.9\~267.5$), respectively. MD-BED $Gy_3$ showed a good correlation with rectal (p=0.003), but not with bladder complications (p=0.095). R-BED $Gy_3$ had a very strong association (p=<0.0001), and was more predictive of rectal complications than A-BED $Gy_3$. B-BED $Gy_3$ also showed significance in the prediction of bladder complications in a trend test (p=0.0298). No statistically significant dose-response relationship for pelvic control was observed. The Sandwich and Continuous techniques, which differ according to when the ICR was inserted during the EBRT and due to the physicians preference, showed no differences in the local control and complication rates; there were also no differences in the 3 vs. 5 Gy fraction size of HDR-ICBT. Conclusion: The main reasons optimal dose-fractionation guidelines are not easily established is due to the absence of a dose-response relationship for tumor control as a result of the high-dose gradient of HDR-ICBT, individual differences In tumor responses to radiation therapy and the complexity of affecting factors. Therefore, in our opinion, there is a necessity for individualized tailored therapy, along with general guidelines, in the definitive radiation treatment for cervix cancer. This study also demonstrated the strong predictive value of actual rectal and bladder reference dosing therefore, vaginal gauze packing might be very Important. To maintain the BED dose to less than the threshold resulting in complication, early midline shielding, the HDR-ICBT total dose and fractional dose reduction should be considered.