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A Study on IMRT (Intensity Modulated Radiation Therapy) Delivery Technique and FFF (Flattening Filter Free) Beam to Increase Skin Dose to Irregularly Shaped Skin Surface. (IMRT(Intensity Modulated Radiation Therapy)전달 기법과 FFF(Flattening Filter Free) 빔을 이용한 요철 부위 피부 선량 증가 방법에 대한 고찰)

  • Woo Heon;Son Sang Jun;Je Young Wan
    • The Journal of Korean Society for Radiation Therapy
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    • v.34
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    • pp.7-12
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    • 2022
  • Purpose: When it is difficult to secure the skin dose when treating Irregularly Shaped Skin Surface such as the nose where it is difficult to apply a bolus, increase the skin dose with a treatment plan that combines the IMRT (Intensity Modulated Radiation Therapy) delivery technique and FFF (Flattening Filter Free), It was tried to find out whether or not through the phantom experiment. Materials & Methods: Based on the 6MV-FF (Flattening Filter) and VMAT (Volumetric-Modulated Arc Therapy) treatment plans, which are the most commonly used treatment plans for head and neck cancer, A comparison group was created by combining VMAT and IMRT, FF and FFF, and the presence or absence of 5 mm bolus application. A virtual target was created on the Rando Phantom's nose, and a virtual bolus of 5 mm was applied assuming full contact on the Rando Phantom's nose. Five measurement points were determined based on the phantom's nose, and the absorbed dose was measured by irradiating each treatment plan 3 times per treatment plan according to the treatment technique and whether or not the bolus was applied. Result: The difference in skin dose in FF vs FFF increased in the case of FFF in VMAT bolus off, and there was no difference in case of IMRT bolus off. In VMAT bolus 5 mm and IMRT bolus 5 mm, it was confirmed that the skin dose was rather decreased in FFF. The difference in skin dose between VMAT and IMRT increased only in the case of FFF bolus off, and there was no statistical difference in the rest. For the difference in skin dose between bolus off vs bolus 5 mm, it was confirmed that the skin dose increased at bolus 5 mm, except for the case of using IMRT FFF. The treatment plan combining IMRT and FFF did not find any statistically significant difference as a result of analyzing the measured values of the treatment plan skin dose applied with a 5 mm bolus using the commonly used VMAT and FF. Therefore, it is thought that by using IMRT_FFF, it is possible to deliver a skin dose similar to that of applying a 5 mm bolus to VMAT_FF, which can be useful for patients who need a high skin dose but have difficulty applying a bolus. Conclusion: For patients who find it difficult to apply bolus, an increase in skin dose can be expected with a treatment plan that properly combines IMRT and FFF compared to VMAT and FF.

Evaluation of surface dose comparison by treatment equipment (치료 장비 별 표면 선량 비교평가)

  • Choi Eun Ha;Yoon Bo Reum;Park Byoung Suk;An Ye Chan;Park Myoung Hwan;Park Yong Chul
    • The Journal of Korean Society for Radiation Therapy
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    • v.34
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    • pp.31-42
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    • 2022
  • Purpose: This study measures and compares the surface dose values in the virtual target volume using Tomotherapy, Halcyon, and TrueBeam equipment using 6MV-Flattening Filter-Free(FFF) energy. Materials and Methods: CT scan was performed under three conditions of without bolus, 0.5 cm bolus, and 1 cm bolus using an IMRT phantom (IBA, Germany). The Planning Target Volume (PTV) was set at the virtual target depth, and the treatment plan was established at 200 cGy at a time. For surface dosimetry, the Gafchromic EBT3 film was placed in the same section as the treatment planning system and repeated measurements were performed 10 times and then analyzed. Result: As a result of measuring the surface dose for each equipment, without, 0.5 cm, 1 cm bolus is in this order, and the result of Tomotherapy is 115.2±2.0 cGy, 194.4±3.3 cGy, 200.7±2.9 cGy, The result in Halcyon was 104.7±3.0 cGy, 180.1±10.8 cGy, 187.0±10.1 cGy, and the result in TrueBeam was 92.4±3.2 cGy, 148.6±5.7 cGy, 155.8±6.1 cGy, In all three conditions, the same as the treatment planning system, Tomotherapy, Halcyon, TreuBeam was measured highly in that order. Conclusion: Higher surface doses were measured in Tomotherapy and Halcyon compared to TrueBeam equipment. If the characteristics of each equipment are considered according to the treatment site and treatment purpose, it is expected that the treatment efficiency of the patient will increase as well as the treatment satisfaction of the patient.

The Science-Related Attitudes from Adults' Experiences during Science Cultural Activities: Focusing on the Case of Science Fiction Discussions (성인들의 과학문화 활동 경험에서 나타난 과학 관련 태도 -과학소설 독서토론 활동 사례를 중심으로-)

  • Eunji Kang;Chaeyeon Shin;Jinwoong Song
    • Journal of The Korean Association For Science Education
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    • v.43 no.2
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    • pp.139-150
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    • 2023
  • This study started with the awareness of the need to explore various aspects of science education and was conducted according to the necessity of practical research on science cultural activities targeting adults. Accordingly, adults' book discussions of science fiction were selected as research cases, and science-related attitudes in science cultural activities were explored. There are four participants in the study, all of whom have engaged in a book club and have not majored or are working in science disciplines. Three science fictions were selected after establishing specific standards for the selection discussed with participants. For four months, a total of three unstructured book discussions of science fiction, post-interviews for each discussion, and in-depth individual interviews after the end of the entire activity were conducted. Various data such as recorded and transcribed reading discussion discourse, post- and in-depth individual interviews, researchers' observation records, and participants' book journals were collected and analyzed using a continuous comparison method. As a result of the study, as scientific thinking is illustrated in SF, the participants also demonstrated scientific attitudes during their discussions. In addition, the textual feature(storytelling) of science fiction was found to lessen cognitive overload and the burden of understanding science by providing scientific knowledge with context. Finally they demonstrated a shift in attitude toward science, valuing science cultural activities in themselves, rather than simply viewing science as a subject of understanding and learning. The conclusions and meanings of this study based on the above results are presented to enhance a positive attitude toward science for adults even after school education.

Treatment Effect with Weekly Teriparatide in the Vertebral Compression Fractures in Patients with Severe Osteoporosis (심한 골다공증 환자에서 발생한 척추체 압박골절에 대한 주 단위 테리파라타이드(Teriparatide)의 투여 효과)

  • Hwang, Seok-Ha;Woo, Young-Kyun;Jeon, Ho-Seung;Suh, Seung-Pyo;Kim, Joo-Young;Kim, Jae-Nam
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.6
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    • pp.528-536
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    • 2019
  • Purpose: This study examined the effects of a weekly teriparatide on the change in vertebral compression ratio, back pain, and vertebral fracture healing in osteoporosis patients with vertebral compression fractured induced by low energy trauma. Materials and Methods: From January 2016 to December 2017, 57 patients with severe osteoporotic vertebral fractures with a T score of -3.5 or less were included in this study. The changes in the vertebral compression ratio, visual analogue scale (VAS), Oswestry disability index (ODI) for at least 6 months were examined. The morphology of bone marrow edema and the presence of intervertebral cleft, osteocalcin, and N-terminal telopeptide (NTx) were also investigated. Results: The mean compression ratio was 20% in the experimental group (teripratide group) at 3 months, and 38% in the control group. A significant difference in the compression ratio of the vertebral body over time was observed (p<0.05; t-test). A comparison of the compression ratio of the vertebral body with the follow-up duration in each group showed no significant increase in the, compression (p=0.063) in the experimental group and a significant increase in the control group (p<0.05). The mean time to reach the plateau of the compression rate was one month in the experimental group and three months in the control group. The VAS score in the experimental and control group was 0.39 and 1.07 points, respectively. The ODI score in the experimental and control group was 33.72 and 39.52, respectively. At the last follow-up radiographs, there were no cases with an intervertebral cleft (0%) in the experimental group and 1 case (2.2%) in the control group. A significant difference in the osteocalcin level was observed between the injury and 6 months after the injury (p=0.003). In addition, there was no significant difference in the NTx level between the injury and 6 months after injury (p=0.960). Conclusion: In vertebral compression fractures patients with severe osteoporosis, a weekly teriparatide can promote the union of fractures, prevent further collapse of the vertebral body, and reduce the back pain faster.

Comparison of the Clinical Outcomes of a Single Injection Adductor Canal Block with the Concomitant Use of Transdermal Buprenorphine and Continuous Adductor Canal Block after Total Knee Arthroplasty (슬관절 인공관절 전치환술 후 일회 주사 내전근관 차단술 및 경피성 Buprenorphine 병합 요법과 도관 삽입 지속적 내전근관 차단술의 임상결과 비교)

  • Huh, Jung-Wook;Park, Man-Jun;Ko, Young-Chul;Ha, Dong-Jun;Park, Joon-Hyung;Lee, Woo-Myung
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.5
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    • pp.411-417
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    • 2019
  • Purpose: To compare the clinical outcomes of single injection adductor canal block (SACB), continuous adductor canal block (CACB), and the concomitant use of transdermal buprenorphine after total knee arthroplasty (TKA). Materials and Methods: A total of 125 patients who underwent TKA were divided into three groups and the clinical results were retrospecitively compared. Group I was comprised of patients with pain controlled by SACB (n=41). Group II consisted of patients with pain controlled by both SACB and transdermal buprenorphine (10 ㎍/h) (n=44). Group III contained patients with pain controlled by CACB (n=40). The visual analogue scale (VAS) was used as the pain control indicator and the patients were measured on a VAS for resting on the bed (VAS-Rest) at 12 hours, 24 hours, and 48 hours after surgery. The VAS while doing continuous passive motion (VAS-CPM) on the first and second postoperative day was also measured. In addition, the total amount of medications used (Butopahn, Tridol, and Ketorac) for the intravenous patient controlled analgesia (PCA) was counted for 48 hours after surgery. As the indicator of the functional recovery outcome, the incidence of nausea and vomiting was observed for 48 hours after surgery. The maximum knee joint flexion range and maximum walking distance on the first and second postoperative day, and the total length of stay at the hospital were compared. Results: The VAS-Rest was similar in the three groups at 12 hours after surgery, but at 24 hours and 48 hours after surgery, group II and III a lower VAS-CPM and total amount of medications used for PCA than group I (p<0.05). The three groups showed a low incidence of nausea and vomiting, maximum knee joint flexion range, and similar walking distance and total length of stay at the hospital. Conclusion: The combination of SACB and transdermal buprenorphine has great pain control effect initially. On the other hand, it is not associated with catheter complications and it is convenient to use and safety toward the renal function. Therefore, the concomitant use of SACB and transdermal buprenorphine can be an effective pain control method after TKA.

Correction of Single Thoracic Adolescent Idiopathic Scoliosis Using Pedicle Screw Instrumentation: Comparison of Stainless Steel to Titanium Alloy Instruments (척추경 나사못 고정술을 이용한 단일 흉추 청소년기 특발성 척추 측만증의 치료: 스테인리스강과 티타늄 합금 기기의 비교)

  • Kim, Sung-Soo;Lim, Dong-Ju;Kim, Jung-Hoon;Choi, Byung-Wan;Kim, Hwi-Young;Lee, Jun-Seok
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.2
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    • pp.141-149
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    • 2019
  • Purpose: To compare the results of two different instruments made of stainless steel and titanium alloy for correction of single thoracic adolescent idiopathic scoliosis (AIS) using pedicle screw instrumentation. Materials and Methods: A total of 141 patients with single thoracic AIS treated with pedicle screw instrumentation and selective thoracic fusion were retrospectively reviewed after a follow-up of 2 years. The patients had a main thoracic curve of 40° to 75° and were divided into two groups based on instrument materials; S group (stainless steel, n=90) and T group (titanium alloy, n=51). The diameter of the stainless steel rod used was 7.0 mm while that of the titanium alloy rod was 6.35 mm or 6.0 mm. Standing long-cassette radiographic measurements including various coronal and sagittal parameters for the preoperative, early postoperative and 2-year postoperative followup were analyzed. There were no significant differences in the preoperative curve characteristics between the two groups. Results: In the S group, the preoperative main thoracic curve of 51.3°±8.4° was improved to 19.0°±7.6° (63.1% correction) and the lumbar curve of 32.3°±8.4° spontaneously decreased to 12.7°±8.2° (62.9% correction) at 2 years postoperatively. In the T group, the preoperative main thoracic curve of 49.5°±8.4° and the lumbar curve of 30.3°±8.9° was improved to 18.8°±7.4° (62.2% correction) and 11.3°±5.4° (63.3% correction), respectively. The corrections of coronal curves were not statistically different between the two groups (p>0.05). The thoracic kyphosis was changed from 16.8°±8.5° to 24.3°±6.1° in the S group and from 19.6°±11.2° to 26.6°±8.5° in the T group. There were no significant differences in the changes of sagittal curves, coronal and sagittal balances at the 2-year follow-up and the number of fused segments and used screws between the two groups (p>0.05). Conclusion: When conducting surgery for single thoracic AIS using pedicles screw instrumentation, two different instruments made of stainless steel and titanium alloy showed similar corrections for coronal and sagittal curves.

A Comparison between Minimally Invasive Percutaneous Plate Osteosynthesis and Plate Fixation in the Treatment of Clavicle Midshaft Fracture (쇄골 간부 골절의 최소 침습적 경피적 금속판 고정술과 관혈적 수술 비교)

  • Yoo, Seong-Ho;Kang, Suk-Woong;Kim, Bu-Hwan;Song, Moo-Ho;Kim, Yeong-Joon;Park, Gyu-Taek;Kwack, Chang-Hun
    • Journal of the Korean Orthopaedic Association
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    • v.52 no.1
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    • pp.1-6
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    • 2017
  • Purpose: To retrospectively compare minimally invasive percutaneous plate osteosynthesis (MIPPO) with open plate fixation for the treatment of clavicle midshaft fracture. Materials and Methods: Between November 2011 to May 2014, 40 cases that were followed for more than 1 year-among all cases of MIPPO and open plate fixation-were analyzed. The study population was divided into two groups: group A included 20 cases of MIPPO and group B included 20 open plate fixation cases. The comparative analysis between the two groups was based on the operative time, bone union, functional evaluation (American Shoulder and Elbow Society score), incision length, pain relief (visual analogue scale, VAS), and complication. Results: The bone union was successful for all the cases, and the functional evaluation scores of the shoulder joint were satisfactory for both groups (p>0.05). The operative time was 47.5 minutes and 58.7 minutes for group A and B, respectively (p<0.05). The incision length for group A was 6.2 cm and that for group B was 10.7 cm with statistical significance (p<0.05). Pain relief (VAS) after surgery for group A showed a quick recuperation in the early stages. For complications, there were 2 cases of dysesthesia and 1 case of malunion due to metal fixation failure in group A. There were 6 cases of dysesthesia and 2 cases of cosmetic problem due to hypertrophic scar in group B. Conclusion: Surgical results of clavicle shaft fracture were satisfactory for both groups, but group A had advantages of shorter operative time, minimal incision length, and better pain relief in the early stages compared with group B. However, we need further evaluations with long-term follow-up results and complications, such as malunion and exposure on radiation.

Clinical Characteristics and Comparison of the Various Methods Used for the Diagnosis of the New Influenza A Pandemic in Korea (한국에서의 2009 신종 인플루엔자 A의 임상양상과 다양한 진단 방법들의 비교)

  • Kwon, Min Jung;Lee, Chang Kyu;Roh, Kyoung Ho;Nam, Myung Hyun;Yoon, Soo Young;Lim, Chae Seung;Cho, Yun Jung;Kim, Young Kee;Lee, Kap No
    • Laboratory Medicine Online
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    • v.1 no.1
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    • pp.26-34
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    • 2011
  • Background: Laboratory diagnosis of new influenza A (H1N1) is crucial for managing patients and establishing control and prevention measures. We compared the diagnostic accuracies of the real time RT-PCR (rRT-PCR) test recommended for the confirmation of the new flu and the viral culture method used conventionally for viral disease with that of the rapid antigen test (RAT). Methods: We performed RAT, R-mix culture, and real-time PCR by using 861 respiratory samples collected from December 2009 to January 2010 and evaluated the abilities of these methods to detect new influenza A. The relationship among the positive rates of RAT, grades of culture, and the cycle threshold (Ct) values of rRT-PCR was also evaluated. Results: Of the 861 patients, 308 (35.8%) were diagnosed with new influenza A. The sensitivities, specificities, positive predictive values, and negative predictive values of the tests were respectively as follows: 59.7%, 99.5%, 98.4%, and 81.6% for RAT; 93.2%, 100%, 100%, and 96.3% for R-mix culture; and 95.8%, 100%, 100%, and 97.7% for rRT-PCR. Samples with weak positive grade in culture and those with Ct values of 30-37 in rRT-PCR showed positivities as low as 25.3% and 2.3% in RAT, respectively. The hospitalization rate and death rate of the confirmed patients were 3.2% and 0.3%, respectively, and gastrointestinal symptoms were observed in 7.2% of the patients. Conclusions: R-mix culture and rRT-PCR tests showed excellent reliability in the diagnosis of new influenza A and could be very useful, especially for samples with low viral load.

Optimized Production through Enlargement Comparison Grown in Various Mixed Soils using Tubers of In vitro Pinellia triparita(Blume) Schott (기내증식 대반하의 상토 조성별 괴경 비대 조건 비교를 통한 최적 배양묘 생산 조건 확립)

  • Lee, Ka Youn;Min, Ji Yun;Kim, Mi Sun;Moon, Byeong Cheol;Kang, Young Min
    • Journal of agriculture & life science
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    • v.50 no.2
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    • pp.33-43
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    • 2016
  • Pinellia tripartita(Blume) Schott is a herbaceous perennial plant belonging to the Araceae and distributed on Asia including of Korea, Japan, and China. P. tripartita is often used for gardening but has not been developed mass-breeding methods. In this study, we compared the tuber growth in different combinations of mixed soils used six compositions. Tubers used to study was cultured in vitro and divided into two groups. Type I was diameter more than 1cm and the group of Type II was diameter below than 1cm. Enlargement of tubers and growth of aerial parts were measuring the plant height, number of fresh leaves and dead leaves, number of bullets, tuber size, and fresh / dry weight. The size/weight and numbers of tubers from the mixed soil B (coir 68.0%, peat moss 14.7%, perlite 3.0%, vermiculite 7.0% and zeolite 7.0%) were the best grown up for eight weeks. In case of Type I, GI (Growth index) of tuber size and weight were 45% and 101%, respectively. The difference of growth was doubled compared to the bad growth treatment as the mixed soil E(Coir 14.3%, peat moss 14.3%, perlite 42.9%, vermiculite 14.3%, and zeolite 14.3%). These results could be used as the basic information for the similar experimental design for the P. ternata.

Selection Indices to Identify Drought-tolerance and Growth Characteristics of the Selected Korean Native Plants (자생식물로부터 내건성 식물의 최적인자 선발과 생육특성)

  • Im, Hyeon Jeong;Song, Hyeon Jin;Jeong, Mi Jin;Seo, Yeong Rong;Kim, Hak Gon;Park, Dong Jin;Yang, Woo Hyung;Kim, Yong Duck;Choi, Myung Suk
    • Journal of agriculture & life science
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    • v.50 no.2
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    • pp.73-82
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    • 2016
  • Best drought tolerance index was determined through statistics analysis and growth appearance of drought tolerant plants was determined by cultivation in pot and sloping land. For determination of best drought tolerant indicators, RD(Resistant dry days), LD(Leaf area), UTR(Unit transpiration), RWC(Relative water content), RWL(Relative water loss), LA(Leaf area), SN(Stoma unmber) and SA(Stoma area) were carried out by correlation and PCA analysis. RWL and UTR were affected on plant drought tolerance according to comparison among six indices for resistant dry days. The PCs axes separated SA, LA, RD and RWC and SN. UTR was negatively correlated with SA, RWL were also negatively correlated with RWC and SN. RWL and UTR were proved best selection indicator for the selection of drought tolerant species. Ulmus parvifolia, Bidens bipinnata, Patrinia villosa, Kummerowia striata, Arundinella hirta, Artemisia gmelini etc. were selected drought tolerant plants. Shoot growth appearance of drought resistant plants was differed pot and sloping land. Shoot growth and leaf number was no significant differences between the pot and sloping land. However, root growth of drought tolerant plants was all the difference between two cultivation. T/R ratio of drought tolerant plants was also found a big difference. T/R ratio of drought tolerant plants in sloping land was lower than that of pot. These results will be served efficiently plant breeding.