• The Journal of Korean Society for Radiation Therapy
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• v.33
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• pp.137-144
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• 2021

Purpose : The usability of X-Jaw split VMAT was evaluated by comparative analysis of the dose distribution between the treatment plan divided by X-Jaw and Full field VMAT treatment plan in left breast cancer treatment including supraclavicular lymph nodes. Materials and Methods : 10 patients with left breast cancer, including supraclavicular lymph nodes, were simulated using vacuum cushion, and 2 Full field Arc VMAT and 4 X-Jaw split Arc VMAT were planned The treatment plan was designed to include more than 95% of the Planning Target Volume (PTV) and to be minimally irradiated in the surrounding Organ at risk (OAR). Dose analysis of PTV and OAR was performed through dose volume histogram (DVH). Results : The Full field VMAT treatment plan and the X-Jaw split VMAT treatment plan of 10 patients were expressed as average values and compared. The difference between the two treatment plans was not large, with a Conformity index (CI) of 1.05±0.04, 1.04±0.03, and a Homogeneity index (HI) of 1.07±0.008, 1.07±0.009. For OAR, V5 in the left lung is 56.1±6.50%, 50.4±6.30%, and V20 is 20.0±4.15%, 13.52±3.61%. Compared to Full field VMAT, V5 decreased by 10.0% V20 by 32.6% in X-Jaw split VMAT. The V30 of the heart is 3.68±1.85%, 2.23±1.52%, and the Mean dose is 8.93±1.65 Gy, 7.67±1.52 Gy. In the X-Jaw split VMAT, V30 decreased by 39.3% and the Mean dose decreased by 14.1%. The left lung and heart, which are normal tissues, were found to have a statistical significance of that p-value is less than 0.05. Conclusion : In the case of left breast cancer treatment, which includes Supraclavicular lymph nodes with a large PTV volume and a length of X Jaw of 15 cm or more, the X-Jaw split VMAT shows improved dose distribution, which can reduce radiation dose of OAR such as lungs and heart, while maintaining similar PTV coverage with HI and CI equivalent to Full field VMAT. It is thought to be effective in reducing radiation complications.

• Radiation Oncology Journal
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• v.10 no.2
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• pp.213-217
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• 1992

Locally advanced cervical carcinoma has shown high rate of local failure and poor survival rate despite the advances in modern radiation therapy techniques. Combination of chemotherapy and radiation therapy demonstrated benefit in improving local control and possibly the overall survival. Twelve patients with advanced stages (Figo stage III, IV) or 11b with bulky tumors (>5 cm in diameter) were treated with combination of radiation therapy and concurrent weekly cisplatin between May of 1988 and September of 1991 at Inje University Paik Hospital. Cisplatin was administered in bolus injections of 50 mg at weekly intervals during the courses of radiation therapy. Median follow-up period was 34 months with ranges from 3 to 53 months. Eleven patients were evaluable for the estimation of response. Response was noted in all the 11 patients: complete response (CR) in 7 ($64\%$), partial response (PR) in 4 ($36\%$). Of the 7 patients with CR, all maintained local control, whereas only 1 of 4 with PR showed local control. Six of 7 with CR are alive disease free on the completion of follow-up. Eight of 11 patients ($73\%$) maintained local control in the pelvis. The median survival for CR patient is 27 months and 9 months for the PR patients. Analysis of survival by stage shows 11 b 4/5, III 2/3 and IV 1/3. Overall survival rate was $61\%$. Three patients recurred: 1 at local, 1 in distant site and 1 with local and distant site. Toxicity for the combination therapy was not excessive. These results are preliminary, but definitely encouraging in view of markedly improved response rate compared with the results of historical control group.

• Journal of the Korean Arthroscopy Society
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• v.15 no.2
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• pp.92-98
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• 2011

Purpose: We describe a all-arthroscopic technique for decompression of spinoglenoid ganglion cyst and present our clinical results for this procedure. Materials and Methods: From March 2006 to June 2009, eight patients (7 males, 1 female; mean age 40.6 years; range: 21~61) were included who underwent arthroscopic decompression of spinoglenoid ganglion cyst. The most common symptoms were vague shoulder pain and external rotation weakness, which lasted 6.4 months (range: 3~8) on average. Five of eight patients were noted abnormalities on electromyographic (EMG) examination to have suprascapular nerve neuropathy and magnetic resonance imaging (MRI) showed spinoglenoid ganglion cysts in all eight patients and the cyst size was 2.6 cm (range: 1.8~3.6). Labral pathology was identified intraoperatively in all patients and the cysts were decompressed by the posterosuperior capsulotomy under arthroscopic control and labral repair with suture anchors was performed in six patients. Results: The average clinical outcome scores including Constant and Murley, Simple shoulder test (SST) all improved significantly at the time of the final follow-up and there were no complications resulting from the procedures. All patients including the patients with abnormal EMG study recovered strength on isokinetic strength testing. Follow-up MRI scans were performed on all patients at a mean of 5.2 months postoperatively (range: 3~12) revealed complete resolution of the cysts and no evidence of recurrences were seen at an average of 18 months (range: 12~26) of follow-up. Conclusion: Arthroscopic decompression of spinoglenoid ganglion cyst effectively restores patient function and all patients in this study showed improvement in their postoperative MRI findings. Arthroscopic decompression is also useful in the appropriate treatment for labral pathology and may contribute to decreased risk of cyst recurrence.

• The Journal of Korean Society for Radiation Therapy
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• v.26 no.2
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• pp.313-320
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• 2014

Purpose : The purpose of the study is to evaluate the efficiency of Coaxial MLC VMAT plan (Using $273^{\circ}$ and $350^{\circ}$ collimator angle) That the leaf motion direction aligned with axis of OAR (Organ at risk, It means spinal cord or cauda equine in this study.) compare to Universal MLC VMAT plan (using $30^{\circ}$ and $330^{\circ}$ collimator angle) for spine SBRT. Materials and Methods : The 10 cases of spine SBRT that treated with VMAT planned by Coaxial MLC and Varian TBX were enrolled. Those cases were planned by Eclipse (Ver. 10.0.42, Varian, USA), PRO3 (Progressive Resolution Optimizer 10.0.28) and AAA (Anisotropic Analytic Algorithm Ver. 10.0.28) with coplanar $360^{\circ}$ arcs and 10MV FFF (Flattening filter free). Each arc has $273^{\circ}$ and $350^{\circ}$ collimator angle, respectively. The Universal MLC VMAT plans are based on existing treatment plans. Those plans have the same parameters of existing treatment plans but collimator angle. To minimize the dose difference that shows up randomly on optimizing, all plans were optimized and calculated twice respectively. The calculation grid is 0.2 cm and all plans were normalized to the target V100%=90%. The indexes of evaluation are V10Gy, D0.03cc, Dmean of OAR (Organ at risk, It means spinal cord or cauda equine in this study.), H.I (Homogeneity index) of the target and total MU. All Coaxial VMAT plans were verified by gamma test with Mapcheck2 (Sun Nuclear Co., USA), Mapphan (Sun Nuclear Co., USA) and SNC patient (Sun Nuclear Co., USA Ver 6.1.2.18513). Results : The difference between the coaxial and the universal VMAT plans are follow. The coaxial VMAT plan is better in the V10Gy of OAR, Up to 4.1%, at least 0.4%, the average difference was 1.9% and In the D0.03cc of OAR, Up to 83.6 cGy, at least 2.2 cGy, the average difference was 33.3 cGy. In Dmean, Up to 34.8 cGy, at least -13.0 cGy, the average difference was 9.6 cGy that say the coaxial VMAT plans are better except few cases. H.I difference Up to 0.04, at least 0.01, the average difference was 0.02 and the difference of average total MU is 74.1 MU. The coaxial MLC VMAT plan is average 74.1 MU lesser then another. All IMRT verification gamma test results for the coaxial MLC VMAT plan passed over 90.0% at 1mm / 2%. Conclusion : Coaxial MLC VMAT treatment plan appeared to be favorable in most cases than the Universal MLC VMAT treatment planning. It is efficient in lowering the dose of the OAR V10Gy especially. As a result, the Coaxial MLC VMAT plan could be better than the Universal MLC VMAT plan in same MU.

• Nuclear Engineering and Technology
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• v.52 no.3
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• pp.469-476
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• 2020

Research reactors in-core experimental facilities are designed to provide the highest steady state flux for user's irradiation requirements. However, fuel conversion from highly enriched uranium (HEU) to low enriched uranium (LEU) driven by the ongoing effort to diminish proliferation risk, will impact reactor physics parameters. Preserving the reactor capability to produce the needed flux to perform its intended research functions, determines the conversion feasibility. This study investigates the neutron flux in the central experimental facility of two material test reactors (MTR), the IAEA generic10 MW benchmark reactor and the 22 MW s Egyptian Test and Research Reactor (ETRR-2). A 3D full core model with three uranium enrichment of 93%, 45%, and 20% was constructed utilizing the OpenMC particle transport Monte Carlo code. Neutronics calculations were performed for fresh fuel, the beginning of life cycle (BOL) and end of life cycle (EOL) for each of the three enrichments for both the IAEA 10 MW generic reactor and core 1/98 of the ETRR-2 reactor. Criticality calculations of the effective multiplication factor (K_eff) were executed for each of the twelve cases; results show a reasonable agreement with published benchmark values for both reactors. The thermal, epithermal and fast neutron fluxes were tallied across the core, utilizing the mesh tally capability of the code and are presented here. The axial flux in the central experimental facility was tallied at 1 cm intervals, for each of the cases; results for IAEA 10 MW show a maximum reduction of 14.32% in the thermal flux of LEU to that of the HEU, at EOL. The reduction of the thermal flux for fresh fuel was between 5.81% and 9.62%, with an average drop of 8.1%. At the BOL the thermal flux showed a larger reduction range of 6.92%-13.58% with an average drop of 10.73%. Furthermore, the fission reaction rate was calculated, results showed an increase in the peak fission rate of the LEU case compared to the HEU case. Results for the ETRR-2 reactor show an average increase of 62.31% in the thermal flux of LEU to that of the HEU due to the effect of spectrum hardening. The fission rate density increased with enrichment, resulting in 34% maximum increase in the HEU case compared to the LEU case at the assemblies surrounding the flux trap.

• Proceedings of the Korean Powder Metallurgy Institute Conference
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• 2003.04a
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• pp.35-35
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• 2003

)를 금속와이어에 인가하면 저항발열에 의해 와이어가 미세한 입자나 금속증기상태로 폭발하는 현상을 이용한 것으로 기상합성법에 속한다고 할 수 있다. 선폭법은 다른 제조법에 비해 공정이 간단하여 생산비용이 저렴하며, 원재료의 조성을 갖는 분말의 합성과 금속간화합물, 융점차이가 나는 재료의 합금화 등이 가능하다. 인가에너지의 크기와 폭발 시 분위기를 제어함으로써 분말의 평균크기와 분포 제어 또한 가능하다. 본 연구는 러시아의 우수한 기초기술을 바탕으로 Pb-Sn계 합금은 전기폭발법으로 극미세분말을 제조하였으며, 분말의 형상, 상 화학조성의 변화를 조사하였다. 본 실험에 사용된 Sn-Pb계(All-Union State Standard 1499-70, 0.53mm)합금와이어는 자동시스템(1-0.6Hz)에 의해 챔버안으로 공급되었다. 이 때 임계폭발 와이어 길이는 50-80nm으로 실험을 행하였다. 챔버 압력은 1.4~2.0atm으로 유지하였다. 제조된 분말의 특성은 XRD, XRPES, SEM등을 이용하여 분말의 형상과 상, 화학조성, 표면분석을 행하였으며 DSC, TGA, BET분석을 통하여 온도변화에 따른 금속분말의 열량변화, 질량변화, 비표면적을 측정하였다. 제조된 Sn-Pb계 분말은 모두 평균 입도 117nm~220nm의 구형형상이었다. 이때 합금분말의 조성은 51.17~63.21 at%Sn, 35.47~46.37 at%Pb로 나타났다. 와이어에 인가되는 비에너지(W/Wc)가 감소된에 EK라 표면층의 Pb함량이 증가함을 보였다. 이는 와이어 내부 저항의 감소로 인한 공정시간의 지연과 Sn, Pb의 확산계수 차이에 의한 것으로 사료된다. 열분석 결과, Sn~Pb계 화합물의 융점은 167~$169^{\circ}C$로 관찰되었으며, $10^{\circ}C$/min로 $920^{\circ}C$까지 승은 하였을 때 17.1~18 wt%의 질량증가를 보였다.TEX>계 나노복합분말이 얻어짐을 알 수 있었다. 이 때 X션 회절피크의 line broadening으로부터 복합분말의 Fe 명균 결정립 크기는 24nm로 초미세 결정럽의 분말합금이었다. 포화자화값은 볼밀처리에 따라 점점 증가하여 MA 30시간에는 20.3emu/g로 포화됨을 알 수 있었다. 또한 보자력 Hc는 MA초기단계에 350e로 매우 낮으나 30시간 후에는 Hc값이 2600e로 매우 큰 값을 나타내었다. 이것은 환원반응결과 초기에 생성된 Fe의 결정립이 비교적 크고 결정결함이 적으나 볼밀처리를 30시간까지 행하면 Fe 결정렵의 미세화 빛 strain 증가로 magnetic hardening이 일어나기 때문인 것으로 사료된다.길이가 50, 30cm인 압출재를 제조하였다. 열간압출한 후의 미세조직을 광학현미경으로 압출방향에 평행한 방향과 수직방향으로 관찰하였고, 열간 압출재 이방성을 검토하기 위하여 X선 회절분석을 실실하여 결정방위를 확인하였다. 전기 비저항 및 Seebeck 계수 측정을 위하여 각각 2$\times$2$\times$10$mm^3$ 그리고 5$\times$5$\times$10TEX>$mm^3$ 크기의 시편을 준비하였다.준비하였다.전류를 구성하는 주요 입자의 에너지 영역(75~l13keV)에서 가장 높은(0.80) 상관계수를 기록했다. 넷째, 회복기 중에 일어나는 입자들의 유입은 자기폭풍의 지속시간을 연장시키는 경향을 보이며 큰 자기폭풍일수록 현저했다. 주상에서 관측된 이러한 특성은 서브스톰 확장기 활동이 자기폭풍의 발달과 밀접한 관계가 있음을 시사한다.se that were all low in two aspects, named "the Nonsignificant group". And the issues were high risk perception in general setting and lo

• Korean journal of food and cookery science
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• v.26 no.5
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• pp.603-616
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• 2010

Based on recent dramatic increases in foodborne outbreaks in restaurants, self-managed sanitation systems are now recommended to control contributing risk factors. This study aimed to improve sanitation management practices in restaurants and had two objectives. First, we tried to develop a self-managed sanitation check-list, including risk factors contributing to foodborne illness and Korean food hygiene regulation articles. We also tried to evaluate current sanitation management practices in restaurants according to operation and restaurant type. Thirty restaurants were evaluated by on-the-spot inspectors using an auditing tool consisting of four dimensions, seventeen categories, and forty-one items. Total compliance rate categorized by operation type significantly differed between chain restaurants and self-managed restaurants, with values of 85.5% and 51.6%, respectively. Therefore, self-managed restaurants, which showed the lowest compliance rate of below 30.0%, need more strict control to improve current unsanitary management practices, specifically relating to 'sterilization of knives, chopping boards, and wiping cloths', 'sanitation training', 'not allowing access into the kitchen to outsiders', 'handling of food or utensils on shelves at a 15 cm distance away from floor', 'prevention of cross-contamination of cooked foods or vegetables', and 'records of kitchen access or inspection'. Thus, an effective food sanitation system is essential and should be implemented to improve the existing sanitary conditions in restaurants. However, the most important factor to achieving food sanitation management objectives is food handlers' self-motivation.

• Radiation Oncology Journal
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• v.25 no.4
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• pp.201-205
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• 2007

Purpose: This retrospective study was conducted to assess outcome and to determine the prognostic factors in patients with a desmoid tumor treated with postoperative radiotherapy. Materials and Methods: Twenty-seven patients with a desmoid tumor who were treated with postoperative radiotherapy between June 1984 and October 2005 were analyzed. There were 13 male and 14 female patients. The age of the patients ranged from 3 to 79 years (median age, 28 years). Tumors were located in an extra-abdominal area (21 cases), and in the abdominal walls (6 cases). The tumor size ranged from 2.5 to 25 cm (median size, 7.5 cm) in the largest linear dimension. Thirteen cases received radiotherapy after initial surgery, and 14 recurrent cases received radiotherapy after additional surgery. The total radiation dose given was $45{\sim}66$ Gy (median dose, 59.4 Gy), and the fraction size was $1.8{\sim}2.0$ Gy. Results: The median follow-up period was 61 months (range, $12{\sim}203$ months). Two patients developed local progression and six patients experienced local recurrence. The 5-year disease-free survival rate and the 5-year progression-free survival rate were 61 % and 70%, respectively. Wide local excision was associated with better disease free survival with statistical significance (p=0.028). Radiotherapy after initial surgery (p=0.046) and a higher radiation dose of more than 60 Gy (p=0.049) were associated with better progression free survival with statistical significance. At the time of the last follow-up, the number of additional surgeries was higher in patients that received radiotherapy after reoperation (p<0.001). Conclusion: Radiotherapy after the initial operation improved local control and decreased the number of subsequent operations. Thus, postoperative radiotherapy after an initial operation is recommended in patients with a high risk of recurrence for a desmoid tumor.

• Journal of Gastric Cancer
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• v.8 no.4
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• pp.256-261
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• 2008

Purpose: Intra-abdominal fluid collection is one of the risk factors associated with postoperative morbidity or mortality for patients who undergo gastric cancer surgery. The aim of this study was to analyze the clinicopathological characteristics of the patients with postoperative intra-abdominal fluid collection and to identify the indications for inserting a percutaneous drain (PCD) in patients with intra-abdominal fluid collection. Materials and Methods: Among the 1,277 patients who underwent operations for gastric cancer at Seoul National University Hospital between April 2005 and July 2006, the data of 117 patients with an intra-abdominal fluid collection were reviewed. Results: The number of patients' with pathologic stage I, II, III and IV disease was 42 (36.8%), 23 (20.2%), 16 (14%) and 33 (28.9%), respectively. Forty-three patients (36.3%) underwent PCD insertion and the other 43 patients received conservative management. A univariate analysis of multiple clinical variables revealed that age, gender, diabetes, liver disease, lymph node dissection, the pathologic stage and the body mass index (BMI, $kg/m^2$) were not significantly associated with PCD insertion (P>0.05). However, the univariate analysis showed that two characteristics were associated with a significantly high incidence of PCD insertion: a diameter of an intra-abdominal fluid collection greater than 4 cm and infectious signs such as leukocytosis, fever and bacteremia. Conclusion: About two thirds of the intra-abdominal fluid collections after surgery for gastric cancer were managed with only conservative method without other morbidities of mortality. Surgeons should consider performing PCD insertion if the largest diameter of an intra-abdominal fluid collection is over 4 cm or if infectious signs are seen.

• Child Health Nursing Research
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• v.4 no.1
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• pp.60-75
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• 1998

The parents have much expectation upon the pregnancy and child birth, and in most cases, they expect the healthy parturient child. However, we can be placed on the high-risk conditions which have the physical, social and immature infant, due to the unexpected results, among the new-born. Accordingly, these high-risk newborn and premature infants will be mostly in NICU, which the concentrated medical treatment can be given, upon their conditions. After their birth and during these periods, they will be divided from the parents, and the nurse will accomplish the bringing-up activities which they can take care of the infant, expected by the parents after their birth. The hospitalization of high-risk newborn including these premature infants is the shocking experience to the parents of family, and thus they can feel the fear and uneasiness, and these reactions of parents are troubled in the behavior at the usual days, and cause the disorder and spiritless status, and these results break the supporting ability of parents, and cause the obstruction. Also, the unavoidable division between the parents and the children as like hospitalization of children can make the parents to feel the alienation emotionally, and this causes the results which the pride on the bringing-up ability of baby gets to be lost. These problems can cause the difficulties on the bonding or the parenting in the further days, and can be related to the neglect and abuse of children. Also, it is gradually increased to study and report which the emotional division by the physical division between the mother and the baby obstructs the normal affection course between the parent and the infant. The stress caused by the birth and the hospitalization of high-risk newborn, as like this, is important in the points which it can uncertainly affect the potential energy for the relationship of parent-child who are finally healthy. Accordingly, the significance and purpose of this study are to understand the contents and degree of stress which the parents of high-risk newborn including the immature child can be experienced from the hospitalization of ICU for their new borns, and thus to offer the basic program to the nursing intervention program for these. The subject of this study is the mother of newborn in NICU of 10 General Hospitals located at the 3one of Pusan, Korea from September 1997 to October 1997, and thus makes the subject of 95 person of parents who agreed to take part in the study and it is descriptive study related to the stress of mother having the newborn in NICU. The method is based on the preceding study related to the stress of mother having the experience of child hospitalization and chronic disease child, and then acquires the advice of specialists group as like 5 nursing professors, and then is amended and supplemented. Total number of questions is 43 items and consists of 5 factors as like medical treatment &nursing procedures, disease status & prognosis, role of parents, communication & inter-personal relationships, hospital environment, and is 5 point Likert Scale. The reliability of this study method is very highly shown to be Cronbach α=0.95. The collected data is analysed as Average, Frequency, Standard Deviation, T-test, ANOVA, Pearson Correlation Coefficient, Duncan multifulrange test by use of SPSS /PC (V7.5). The results of this study is summarized as under. 1. Every characteristics of subject is which the party of mother is 28.70age(±7.48) in the average ages, 51% in the high-school graduate, 38.5% in the christianity, total monthly income is 212.55 thousand won(±1.971), 74.5% in the housewife, 72.9% in the parents and children together living and the number of children to be 1.48person(± 0.6) in average, the recognition on the prognosis of baby is 74.0% in 'Don't know', the relationship with the husband after the hospitalization of babyis 37.3% in 'More Intimate', the relationship with the family of husband to be 48% in 'No-change', and the degree which is consulted with the husband about the baby is 55% in 'very frequently' and the visiting number per week is 4.59(±1.63) in average and the accompanying person in the time of visiting is which the number of husband is 56.3% and thus is the highest. The characteristics of baby is which the age is 21.88days(±16.47) after the birth in average, the sex to be 50 person in the female 52.1% and the order of birth to be 54.2% in the first chid, and the weight in the birth to be 2770gm(±610) and the height in the birth to be 46.26cm(±7.62) in aver age. The medical diagnosis is 37.5% in the premature infant, the career of hospitalization is 96.9% in 'None', and the operation plan is 90.6% in 'None' and the execution of operation is 88% in 'None' and the nursing of incubator is 55.2% in 'Yes', and the method of feeding is 50.5% in 'Oral' and the contents of feeding is 46.9% in the 'Milk'. 2. The total stress degree of subject is almost highly shown to be as 3.36(±0.86). If it is compared upon each cause, 'stress on disease status & prognosis' is highest 3.79(±1.28), and it is in the order of 'stress on medical treatment & nursing procedures' 3.70(±0.93), 'stress on hospital environment' 3.14(±0.86), 'stress on role of parents' 3.18(±0.92) and 'stress on communication & inter personal relationship' 2.62(± 0.77) 3. As the results of checking the notworthiness of stress degree upon each variable of subject, the variable showing the noted difference was the birth weight(γ=-0.16, P=0.04), birth height(γ=-0.23, P=0.03), nursing in the incubator(F=8.93, P=0.04), feed method(F=2.94, P=0.04). That is to say, it is shown which the smaller the birth weight is, the higher the stress degree of mother is noteworthily. Also, the smaller the birth height baby is, the higher the stress of mother is. In the incubator, it os shown which the mother whose baby is nursing in the incubator is higher in the stress degree than other mothers. Upon the feeding method of baby, that is to say, TPNis the highest, and it is shown in the order of NPO, Tube feeding, and P.O. feeding. When we review the above-mentioned results, as the status is serious, it is thought which we include the supporting nursing for coping with the stress of parents in the setting-up od nursing plan for the baby in the NICU.