Park, Su-Gyeong;Chang, Hye-Sook;Choi, Eun-Kyong;Yi, Byong-Yong;Kim, Jae-Sung
Radiation Oncology Journal
/
v.10
no.2
/
pp.267-275
/
1992
Remote afterloading high dose rate brachytherapy (HDRB) is a new technology and needs new biological principle for time and dose schedule. Here, authors attempt to evaluate the technique and clinical outcome in 116 patients, 590 procedures peformed at Asan Medical Center for 3 years. From Sep. 1989 to Aug 1992, 471 procedures of intracavitary radiation in 58 patients of cervical cancer and 26 of nasopharyngeal cancer,79 intraluminal radiation in 12 of esophageal cancer, 11 of endobronchial cancer and 1 Klatskin tumor and 40 interstitial brachytherapy in 4 of breast cancer, 1 sarcoma and 1 urethral cancer were performed. Median follow-up was 7 months with range $1\~31$ months. All procedures except interstitial were performed under the local anesthesia and they were all well tolerated and completed the planned therapy except 6 patients. 53/58 patients with cervical cancer and 22/26 patients with nasopharynx cancer achieved CR. Among 15 patients with palliative therapy, $80{\%}$ achieved palliation. We will describe the details of the technique and results in the text. To evaluate biologic effects of HDRB and optimal time/dose/fractionation schedule, we need longer follow-up. But authors feel that HDRB with proper fractionation schedule may yield superior results compared to the low dose rate brachytherapy considering the advantages of HDRB in safety factor for operator, better control of radiation dose and volume and patients comfort over the low dose brachytherapy.
Kim, Tae-Yong;Kim, Kyoung-Ju;Kim, Ki-Hwan;Kim, Ji-Eun;Park, Sun-Won;Oh, So-Won;Jung, Young-Ho
Korean Journal of Head & Neck Oncology
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v.27
no.1
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pp.47-53
/
2011
Purpose : Concurrent chemoradiotherapy(CCRT) with 3 weekly cisplatin is the standard treatment of locally advanced head and neck cancer(HNC). The aim is to evaluate the efficacy and toxicities of low-dose weekly cisplatin-based CCRT, which was devised to reduce the toxicity of CCRT. Method : We retrospectively analyzed HNC patients who received low-dose weekly cisplatin-based CCRT between 2008 and 2010. Cisplatin 35mg/$m^2$ was weekly given to all patients during radiotherapy. The efficacy was evaluated by the degree of clinical response, treatment failure and survival. The toxicity was evaluated by hematologic toxicities and oral mucositis. Results : A total of 27 patients were analyzed and median age was 59(range 31-81). The ratio of administered dose of radiotherapy and cisplatin to planned dose were 0.98 and 0.93, respectively. Complete remission and partial remission were 73% and 23%, respectively. Treatment failure was observed in 8(30%) patients. 1-year survival rate and 1-year disease free survival rate were 82% and 59%, respectively. Overall survival and progression-free survival did not reach median time. Grade 3/4 anemia, neutropenia, thrombocytopenia and oral mucositis were observed in 11%, 19%, 7% and 32% of patients, respectively. In terms of administered cycles, however, only 1-3% of grade 3/4 hematologic toxicities occurred among total 190 cycles. Severe oral mucositis were statistically associated with old age(p=0.003). Treatment failure had no statistical relation with age, pathology, primary site and stage. Conclusion : Low-dose weekly cisplatin-based CCRT seemed to deliver enough dose of cisplatin and to show low drop-out rate and good efficacy with low hematologic toxicities.
The designed drone-based unmanned remote radiation detection module was developed according to the needs of the nuclear power plant decommissioning workshop. Using the Geiger-Mueller tube sensitive to low-level radiation measurement, It was manufactured to measure the amount of radiation leaking into and out of the containment vessel. The drone-based radiation detection module weighs less than 200g, It can be operated inside and outside the containment vessel of a nuclear power plant. To check the performance of the designed equipment, a performance evaluation test was conducted with reference to the international standard (IEC-60864). The stability of the radiation detection module designed to meet the needs of the field the statistical rate of change by repeated measurements in the rate of change experiment to evaluate the measurement accuracy was ±4.6%. The accuracy ±7.3% in the linearity experiment to evaluate the dose rate dependence, the linear The figure satisfies the international performance evaluation standard of ±3.5%. The radiation detection module developed in this study is a customized equipment for a nuclear power plant dismantling workshop. It will be helpful for accurate measurement of space dose rate and safety management of radiation worksites in sites with a lot of radiation dust.
Background: Dosimetric comparison of two dimensional (2D) radiography and three-dimensional computed tomography (3D-CT) based dose distributions with high-dose-rate (HDR) intracavitry radiotherapy (ICRT) for carcinoma cervix, in terms of target coverage and doses to bladder and rectum. Materials and Methods: Sixty four sessions of HDR ICRT were performed in 22 patients. External beam radiotherapy to pelvis at a dose of 50 Gray in 27 fractions followed by HDR ICRT, 21 Grays to point A in 3 sessions, one week apart was planned. All patients underwent 2D-orthogonal and 3D-CT simulation for each session. Treatment plans were generated using 2D-orthogonal images and dose prescription was made at point A. 3D plans were generated using 3D-CT images after delineating target volume and organs at risk. Comparative evaluation of 2D and 3D treatment planning was made for each session in terms of target coverage (dose received by 90%, 95% and 100% of the target volume: D90, D95 and D100 respectively) and doses to bladder and rectum: ICRU-38 bladder and rectum point dose in 2D planning and dose to 0.1cc, 1cc, 2cc, 5cc, and 10cc of bladder and rectum in 3D planning. Results: Mean doses received by 100% and 90% of the target volume were $4.24{\pm}0.63$ and $4.9{\pm}0.56$ Gy respectively. Doses received by 0.1cc, 1cc and 2cc volume of bladder were $2.88{\pm}0.72$, $2.5{\pm}0.65$ and $2.2{\pm}0.57$ times more than the ICRU bladder reference point. Similarly, doses received by 0.1cc, 1cc and 2cc of rectum were $1.80{\pm}0.5$, $1.48{\pm}0.41$ and $1.35{\pm}0.37$ times higher than ICRU rectal reference point. Conclusions: Dosimetric comparative evaluation of 2D and 3D CT based treatment planning for the same brachytherapy session demonstrates underestimation of OAR doses and overestimation of target coverage in 2D treatment planning.
Journal of the Korea Academia-Industrial cooperation Society
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v.11
no.6
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pp.2118-2123
/
2010
Korean individual occupational exposure control is focused on the retrospective service to the over-exposed person by the reading of personal dosimeter. Since the radiophamaceuticals using in the nuclear medicine department are uncontained radiation sources, the potential exposure at working environment is very high. Moreover, a patient remains radioactive for hours or even days after the administration of a radiopharmaceutical for diagnosis or treatment. Thus, the proper working environmental exposure control must be established and executed to protect not only the affiliated employees, but also guardians accompanying patients and temporarily visiting public from the exposure by the patients. Japanese radiation protection law regulates working environmental radiation exposure by regularly measuring and filing the environmental dose for years. This study was aimed at measuring working environmental radiation dose in the nuclear medicine department of an university hospital located in Daejeon, Korea. We measured the accumulation radiation dose in air at 8 locations in the nuclear medicine department by using the same method as in Japan with glass dosimeters. The highest dose rate, 0.23 mSv per month, was measured at the waiting room, and the second one is at reception desk. Even though the doses were lower than the Korean constraint dose rate (0.3 mSv/week) at the boundary of the radiation controlled area, it was over the dose limit of public (1 mSv/y) and environment (0.25 mSv/y). Conclusionally, it was found that the new or additional procedure was necessary to less the exposure dose to the receptionist and guardians by the environmental radiation dose in the nuclear medicine department.
Clinical estimation of bladder and rectal doses from high dose rate intracavitary irradiation in carcinoma of the cervix uteri has been initiated on a routine basis in an effort to obtain the optimum radiotherapeutic dose. Simulation films with contrast media are used to image the bladder and rectum, and dose rates are estimated at various interesting points with the aid of treatment planning computer, NEC Therac-2300. Fifty-three patients have been reviewed in order to ascertain the correlation between radiation dose at interesting points in the bladder and rectum and the dose at Point A and B. The dose ratio between doses at Point A 'and interesting points is an important clinical factor in evaluating the treatment planning. This also serves as documentation of the dose to normal structures within the treatment volume. Authors conclude that obtained data are within acceptable ranges and routine simulation films of the bladder and rectum after administration of contrast media with dose calculations at interesting points provide important information for optimizing radiotherapy planning in the treatment of cervical carcinoma without increased time and effort or patient's discomfort.
In nuclear medicine, radioactive isotope tracers are administered to the human body to obtain and evaluate disease morphological information and biological function information. Dose calibrator is a device used to measure the radioactivity of a single nuclide in medical institutions. Administration of the correct dose to the human body acts as an important factor in diagnosis and treatment, and measurement through a dose calibrator before administration is the most important factor. Dose calibrator performs daily quality control after installation in each medical institution. Quality control is a means of guaranteeing quality control after installation, and is essential for improving the quality of treatment and promoting patient safety. Therefore, accurate and standardized performance evaluation methods should be established. In this study, 3D printing was used for quantitative evaluation of quality control by increasing the accuracy and standardization of quality control. When the 3D printer was installed and reproducibility was tested, the error range of the expected value and reading value decreased by 0.302% in the F-18 nuclide and 0.09% in the 99mTc-pertechnate nuclide than when the 3D printer was installed. The error rate for other nuclides was also found to have a low error rate for reproducibility tests when 3D printing was installed.
Journal of The Korean Dental Society of Anesthesiology
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v.2
no.2
s.3
/
pp.97-100
/
2002
Background: Patient-controlled sedation (PCS) has been blown for a safe and effective sedative method on the same pharmacological concepts of patient-controlled analgesia. Many different kinds of infusion devices have been used but they often have too long nominal infusion rate and lockout time. $Perfuser^{\circledR}$ fm (B. Braun, Germany) is a new PCA device with 999.9 ml/hr nominal infusion rate and minimum 1 min lockout time. In this study, the feasibility of propofol PCS using $Perfuser^{\circledR}$ fm was examined in order to provide a safe satisfactory sedation for dental patients. Methods: Eleven healthy patients presenting for oral surgery were studied. Propofol PCS was performed using $Perfuser^{\circledR}$ fm, which was set to deliver a bolus dose of 5 mg with 999.9 ml/hr nominal infusion rate and 1 min lockout time. Propofol loading dose was randomly assigned to a bolus dose ${\times}$ 0, 2, and 3 (initial bolus). Patients were told to press the bolus button as often as they needed to relieve discomfort. Results: Total infused dose of propofol was mean 1.8 mg/kg/hr and D (Delivery)/A (Attempt) ratio was mean 72.8%. All patients was awake and there were no clinically significant intraoperative side effects during the sedation. Almost all patients were very satisfied with this type of PCS. Conclusion: Propofol PCS using $Perfuser^{\circledR}$ fm infusion pump provided good conscious sedation for dental procedures.
In order to evaluate the cytotoxicity of lead in cultures of Balb/c mouse 3T3 cell line, various cytotoxic assays were carried out after expose cells to various concentrations of lead nitrate. Cytotoxic assays using this study were included NR assay, MTT assay, measurement of LDH and protein, synthetic rate of DNA and UDS. Intrace!!ular Ca$^{2+}$ level was also measured. Light and electron microscopic studies were done for morphological changes of lead-treated cell cultures. The results were as follows; 1. The absorbances of NR and MTT were decreased dose-dependently, and NR, and MTT, values of lead nitrate were 3.4 mM and 1.5 mM, respectively. 2. Amount of LDH released into the medium was increased in dose-dependently and LDH activity at 5 mM concentration of lead nitrate was increased to 335 % of control. 3. Amount of total protein was decreased dose-dependently, and which was half of control at 2 mM concentration of lead nitrate. 4. The synthetic rate of DNA was decreased dose-dependently, and also which was remarkably decreased at 3 mM and 5 mM concentrations of lead nitrate. 5. The synthetic rate of UDS was increased at 1 mM concentration of lead nitrate, but which was remarkably decreased at 3 mM and 5 mM concentrations of lead nitrate. 6. Intrace!lular Ca$^{2+}$ level was remarkably increased at 1 mM concentration of lead nitrate, compared with control. 7. In light microscopy, number of cells and processes were decreased according to the increase of dosage of lead nitrate. Electron microscopic findings showed that many vacuoles and cisternal dilatation of rough endoplasmic reticulum were seen in the cytoplasm at 1 mM concentration of lead nittale. From the above results, high dosage treatment of lead nitrate (>3 mM) damaged genetic malerials and it also showed cytotoxicity in mouse 3T3 cell line cultures by injury of cell organelles and Ca$^{2+}$ channel.
An experiment was performed using 20 calves of about one-month old to investigate the effect of chelation therapy with calcium disodium ethylenediaminetetraacetate ($CaNa_2$EDTA) alone or along with antioxidant $\alpha$-tocopherol in lead loaded calves on blood trace minerals, erythrocytic sulfahydryl groups and some haematobiochemical parameters. Fifteen calves were given lead orally at a daily dose of 7.5 mg of 99% pure lead acetate/kg body weight for 28 days. Then the lead was withdrawn on day 28 and the calves were randomly divided into three groups. Each group of five animals was either treated with $CaNa_2$EDTA alone at the dose rate of 110 mg/kg body weight in two divided doses for 4 days or along with $\alpha$-tocopherol at the dose rate of 100 mg/kg body weight orally daily for 7 days, keeping the remaining five calves as lead-exposed untreated controls. Blood samples were collected at the end of the lead exposure (day 0) and thereafter on day 2, 4, 7 and 10 from the start of the chelation treatment. The treatment with EDTA alone led to slow but non-significant improvement in blood copper level, but incorporation of antioxidant $\alpha$-tocopherol in chelation therapy resulted in its significant decline, as recorded on day 7-post treatment. Withdrawal of lead or treatment with $CaNa_2$EDTA alone or along with $\alpha$-tocopherol enhanced the erythrocytic thiol contents and the levels of T-SH and P-SH became statistically (p<0.05) comparable to those of lead-exposed controls by day 7 and 4, respectively. There was no significant (p>0.05) change in serum urea, creatinine, total protein and albumin levels between the treatment groups. It is concluded from the present investigation that treatment with $CaNa_2$EDTA at the present dose rate is safe to be used for chelation in lead loaded calves.
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