• The Journal of Korean Society for Radiation Therapy
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• v.32
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• pp.85-92
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• 2020

Purpose: To find out the advantages of thermoplastic bolus compared to conventional bolus, which is mainly used in clinical practice, We evaluated Two cases in terms of dose and location reproducibility to assess Usability of thermoplastic Bolus for skin VMAT radiotherapy. Materials and Methods: Two patient's treated with left breast skin lesion were simulated using thermoplastic Bolus and planned with 2arc VMAT. the prescription dose was irradiated to 95% or more of the target volume. We evaluated The reproducibility of the bolus position by measuring the length of the air gap in the CBCT (Cone Beam CT) image. to evaluate dose reproducibility, we compared The dose distribution in the plan and CBCT and measured in vivo for patient 2. Results: The difference between the air gap in patient 1's simulation CT and the mean air gap (M1) during 10 treatments in the CBCT image was -0.42±1.24mm. In patient 2, the difference between the average air gap between the skin and the bolus (M2) during 14 treatments was -1.08±1.3mm, and the air gap between the bolus (M3) was 0.49±1.16. The difference in the dose distribution between Plan CT and CBCT was -1.38% for PTV1 D95 and 0.39% for SKIN (max) in patient 1. In patient 2, PTV1 D95 showed a difference of 0.63% and SKIN (max) -0.53%. The in vivo measurement showed a difference of -1.47% from the planned dose. Conclusion: thermoplastic Bolus is simpler and takes less time to manufacture compared to those produced by 3D printer. Also compared to conventional bolus, it has high reproducibility in the set-up side and stable results in terms of dose delivery.

• Journal of Nutrition and Health
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• v.56 no.5
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• pp.537-553
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• 2023

Purpose: The purpose of this study was to evaluate the nutritional quality of complementary baby food products sold in Korea according to the baby food stages and food composition. Methods: A total of 1,587 complementary food products sold online and offline between March and December 2021 were investigated. They ranged from liquid meals to solid rice for babies aged 5 to 36 months. Results: The number of intakes per packaged volume was 2.8 in Stage 1, 1.9 in Stage 2, 1.4 in Stage 3, and 1.1 in Stage 4 (p < 0.0001). The dietary variety scores (DVS) of the complementary baby food products were 3.4 in Stage 1, 5.5 in Stage 2, 7.1 in Stage 3, and 9.7 in Stage 4 (p < 0.0001) and showed a significant increase in the later stages. The Korean dietary diversity score (KDDS) significantly increased from 2.3 in Stage 1, to 2.8 in Stage 2, 3.0 in Stage 3, and 3.4 in Stage 4 (p < 0.0001). The higher the baby food stage, the higher the proportion of grains/meat/vegetable ingredients. The ratio of protein intake to Adequate Intake (AI) or Recommended Nutrition Intake (RNI) was higher in products with a KDDS of 3 points or more, or in products with 2 points or fewer in Stages 1 and 2 (p < 0.0001, respectively). The ratio of protein intake to RNI increased as the KDDS score increased in Stages 3 and 4 (p < 0.0001, respectively). For all stages of baby foods, the ratio of protein intake to AI or RNI was high in products that included the meat group (beans, nuts, meat, eggs, fish, and shellfish) (p < 0.0001, respectively). Conclusion: Continuous research and nutritional evaluation are required for establishing nutrient content standards for commercially available baby foods, considering breast milk intake.

• Radiation Oncology Journal
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• v.21 no.1
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• pp.82-93
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• 2003

Purpose : To reduce the Irradiation dose to the lungs and heart in the case of chest wail irradiation using an oppositional electron beam, we used an Individualized custom bolus, which was precisely designed to compensate for the differences In chest wall thickness. The benefits were evaluated by comparing the normal tissue complication probablilties (NTCPS) and dose statistics both with and without boluses. Materials and Methods : Boluses were made, and their effects evaluated in ten patients treated using the reverse hockey-stick technique. The electron beam energy was determined so as to administer 80% of the irradiation prescription dose to the deepest lung-chest wall border, which was usually located at the internal mammary lymph node chain. An individualized custom bolus was prepared to compensate for a chest wall thinner than the prescription depth by meticulously measuring the chest wall thickness at 1 emf intervals on the planning CT Images. A second planning CT was obtained overlying the individuailzed custom bolus for each patient's chest wall. 3-D treatment planning was peformed using ADAC-Pinnacle$^{3}$ for all patients with and without bolus. NTCPS based on 'the Lyman-Kutcher' model were analyzed and the mean, maximum, minimum doses, V$_{50}$ and V$_{95}$ for 4he heari and lungs were computed. Results .The average NTCPS in the ipsliateral lung showed a statistically significant reduction (p<0.01), from 80.2${\pm}$3.43% to 47.7${\pm}$4.61%, with the use of the individualized custom boluses. The mean lung irradiation dose to the ipsilateral iung was also significantly reduced by about 430 cGy, Trom 2757 cGy to 2,327 cGy (p<0.01). The V$_{50}$ and V$_{95}$ in the ipsilateral lung markedly decreased from the averages of 54.5 and 17.4% to 45.3 and 11.0%, respectively. The V$_{50}$ and V$_{95}$ In the heart also decreased from the averages of 16.8 and 6.1% to 9.8% and 2.2%, respectively. The NTCP In the contralateral lung and the heart were 0%, even for the cases with no bolus because of the small effective mean radiation volume values of 4.4 and 7.1%, respectively Conclusion : The use of an Individualized custom bolus in the radiotherapy of postrnastectorny chest wall reduced the NTCP of the ipsilateral lung by about 24.5 to 40.5%, which can improve the complication free cure probability of breast cancer patients.