Park, Sun Kyung;Choi, Yun Suk;Choi, Sung Wook;Song, Sung Wook
The Korean Journal of Pain
/
v.28
no.1
/
pp.45-51
/
2015
Background: Arthroscopic shoulder operations (ASS) are often associated with severe postoperative pain. Nerve blocks have been studied for pain in shoulder surgeries. Interscalene brachial plexus blocks (ISB) and an intra-articular injection (IA) have been reported in many studies. The aim of the present study is to evaluate the effect of ISB, a continuous cervical epidural block (CCE) and IA as a means of postoperative pain control and to study the influence of these procedures on postoperative analgesic consumption and after ASS. Methods: Fifty seven patients who underwent ASS under general anesthesia were randomly assigned to one of three groups: the ISB group (n = 19), the CCE group (n = 19), and the IA group (n = 19). Patients in each group were evaluated on a postoperative numerical rating scale (NRS), their rescue opioid dosage (ROD), and side effects. Results: Postoperative NRSs were found to be higher in the IA group than in the ISB and CCE groups both at rest and on movement. The ROD were $1.6{\pm}2.3$, $3.0{\pm}4.9$ and $7.1{\pm}7.9$ mg morphine equivalent dose in groups CCE, ISB, and IA groups (P = 0.001), respectively, and statistically significant differences were noted between the CCE and IA groups (P = 0.01) but not in between the ISB and CCE groups. Conclusions: This prospective, randomized study demonstrated that ISB is as effective analgesic technique as a CCE for postoperative pain control in patients undergoing ASS.
This study was conducted for the purpose of efficient radioactive waste disposal and management. Experiment was evaluated the decontamination efficiencies of the four types decontamination materials(Water, Alcohol, Decontamination Water, Decontamination Gel) with radioactive wastes generated during radio-pharmaceutical production process at Korea Institute Radiological and Medical Sciences(KIRAMS). The radioactive waste sample used in experiment is a lead plate of the fume hood that was disposed in April, 2019. In the experimental method, radioactive waste was measured before and after decontamination using a HPGe semiconductor detector and Gamma survey meter. The measured values before and after decontamination were evaluated for decontamination efficiency as a percentage. As a result, it was confirmed that a lot of specific activity and surface dose rate was removed from the radioactive wastes. In particular, when decontamination water was used, most of the radioactivity of radioactive wastes was removed. Considering these results, if decontamination water is used in decontamination of radioactive waste, decontamination efficiency equivalent to the disposition criteria can be expected with just one decontamination treatment. In addition, in the case of water and alcohol, only on decontamination was effective in approximately 75% and 95%. Otherwise, when decontamination gel was used, it was confirmed that the largest deviation occurred among all experimental results.
Human papillomavirus (HPV) is a causative agent for a subset of oropharyngeal cancer (OPC). The current standard of care (SOC) for locally advanced OPC is 70 Gy definitive radiotherapy (RT) concurrent with cisplatin, which entails significant proportions of acute and late grade 3 or higher toxicities. Accordingly, discovery of favorable prognosis of HPV-related OPC has led to enthusiasm to attenuate subspecialties therapy in multidisciplinary treatment. Diverse deintensification strategies were investigated in multiple phase 2 trials with an assumption that attenuated treatments result in comparable oncologic outcome and less toxicities compared with SOC. Several trials on chemotherapy deintensification revealed that concomitant administration of cisplatin is not to be omitted or substituted for cetuximab without compromising progression-free survival or local control. A transoral robotic surgery (TORS) is investigated as alternative local treatment, but TORS plus SOC or mild deintensified adjuvant RT showed similar toxicities and inferior oncologic outcomes compared with SOC definitive RT or moderately deintensified RT. However, it has been reported that TORS plus deintensified 30-36 Gy adjuvant RT results in excellent outcome and less late toxicity compared with SOC adjuvant RT. Several phase 2 trials reported apparently equivalent progression-free survival and local control and similar adverse effects with moderately deintensified 60 Gy RT compared with SOC 70 Gy RT. Further dose reduction below 60 Gy has been investigated using biology-directed approaches, which use response to induction chemotherapy or metabolic images to triage HPV-positive OPC for deintensified RT. In summary, these trials provide valuable insights for future directions. Available evidence consistently showed that moderately deintensified RT is effective and safe for HPV-positive OPC in both definitive and adjuvant settings. Concurrent cisplatin remains an essential component without which progression-free survival is significantly compromised for advanced HPV-positive OPC. A simple incorporation of TORS to SOC may be detrimental for oncologic outcome without anticipated toxicity reduction. Given the lack of level 1 evidence, it is prudent to curb an unjustified deviation from the current SOC and limit any deintensified strategies to clinical trials and adhere to the current SOC.
A study for the assessment of dose given by outdoor radon to respiratory system has been carried out by making use of radon-cups containing CR-39 plastic track detectors. Detection efficiencies were determined by irradiation of the radon-cups in a standard radon chamber of known concentration. Thus determined detection factors of CR-39 plastic track detector in bare, open cup and filtered cup geometry are found to be 0.273, 0.0813 and 0.0371 $trmm^{-2}$/(37$Bqm^{-3}{\cdot}d$), respectively, which are chemically etched in 30% NaOH solution of $70^{\circ}C$ for 220 minutes. The outdoor radon concentrations measured at Taejeon(Chungnam National University) from May 1988 to March 1989 are in the range of 27.4 - 135.8 Bq/$m^3$(0.74 - 3.67pCi/l)by open cup and 16.7 - 143.9 Bq/$m^3$(0.45 - 3.89 pCi/l) by filtered cup, which yield overall annual average value of outdoor radon concentration of $70.8Bq/m^3$(1.91 pCi/l). Corresponding effective dose equivalent rate to respiratory system of ICRP standard man is assessed to be 520 nSv /h.
Youn, Sang Hee;Cho, Kwan Ho;Kim, Joo-Young;Ha, Boram;Lim, Young Kyung;Jeong, Jong Hwi;Lee, Sang Hyun;Yoo, Heon;Gwak, Ho-Shin;Shin, Sang Hoon;Hong, Eun Kyung;Kim, Han Kyu;Hong, Je Beom
Radiation Oncology Journal
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v.36
no.3
/
pp.182-191
/
2018
Purpose: To investigate the clinical outcome of proton therapy (PT) in patients with chordoma. Materials and Methods: Fifty-eight patients with chordoma treated with PT between June 2007 and December 2015 at the National Cancer Center, Korea, were retrospectively analyzed. The median total dose was 69.6 cobalt gray equivalent (CGE; range, 64.8 to 79.2 CGE). Local progression-free survival (LPFS), distant metastasis-free survival (DMFS), overall survival (OS), and disease-specific survival (DSS) rates were calculated by the Kaplan-Meier method. Results: With the median follow-up of 42.8 months (range, 4 to 174 months), the 5-year LPFS, DMFS, OS, and DSS rates were 87.9%, 86.7%, 88.3%, and 92.9%, respectively. The tumor location was associated with the patterns of failure: the LPFS rates were lower for cervical tumors (57.1%) than for non-cervical tumors (93.1%) (p = 0.02), and the DMFS rates were lower for sacral tumors (53.5%) than for non-sacral tumors (100%) (p = 0.001). The total dose was associated with both the LPFS rate and DMFS rate. The initial tumor size was associated with the DMFS rate, but was not associated with the LPFS rate. Three patients had grade 3 late toxicity with none ≥grade 4. Conclusion: PT is an effective and safe treatment in patients with chordomas. The tumor location was associated with the patterns of failure: local failure was common in cervical tumors, and distant failure was common in sacral tumors. Further refinement of PT, such as the utilization of intensity modulated PT for cervical tumors, is warranted to improve the outcome.
Radiation exposure to humans can be caused by the gamma rays emitted from natural radioactive elements(such as uranium, thorium and potassium and any of their decay products) of Naturally Occurring Radioactive Materials(NORM) or Technologically Enhanced Naturally Occurring Radioactive Materials(TENORM) added consumer products. In this study, assume that activity of radioactive elements is $^{238}U$, $^{235}U$, $^{232}Th$$1Bq{\cdot}g^{-1}$, $^{40}K$$10Bq{\cdot}g^{-1}$ and the gamma rays emitted from these natural radioactive elements radioactive equilibrium state. In this study, reflected End-User circumstances and evaluated annual exposure dose for products based on ICRP reference voxel phantoms and ICRP Recommendation 103 using the Monte Carlo Method. The consumer products classified according to the adhere to the skin(bracelet, necklace, belt-wrist, belt-ankle, belt-knee, moxa stone) or not(gypsum board, anion wallpaper, anion paint), and Geometric Modeling was reflected in Republic of Korea "Residential Living Trend-distributions and Design Guidelines For Common Types of Household.", was designed the Room model($3m{\times}4m{\times}2.8m$, a closed room, conservatively) and the ICRP reference phantom's 3D segmentation and modeling. The end-user's usage time assume that "Development and Application of Korean Exposure Factors." or conservatively 24 hours; in case of unknown. In this study, the results of the effective dose were 0.00003 ~ 0.47636 mSv per year and were confirmed the meaning of necessary for geometric modeling to ICRP reference phantoms through the equivalent dose rate of belt products.
This study peformed to confirm the corrected dose In different electron density materials using the superposition/FFT convolution method in radiotherapy Planning system. The experiments of the $K_2HPO_4$ diluted solution for bone substitute, Cork for lung and n-Glucose for soft tissue are very close to effective atomic number of tissue materials. The image data acquisited from the 110 KVp and 130 KVp CT scanner (Siemes, Singo emotions). The electron density was derived from the CT number (H) and adapted to planning system (Xio, CMS) for heterogeneity correction. The heterogeneity tissue phantom used for measurement dose comparison to that of delivered computer planning system. In the results, this investigations showed the CT number is highly affected in photoelectric effect in high Z materials. The electron density in a given energy spectrum showed the relation of first order as a function of H in soft tissue and bone materials, respectively. In our experiments, the ratio of electron density as a function of H was obtained the 0.001026H+1.00 in soft tissue and 0.000304H+1.07 for bone at 130 KVp spectrum and showed 0.000274H+1.10 for bone tissue in low 110 KVp. This experiments of electron density calibrations from CT number used to decide depth and length of photon transportation. The Computed superposition and FFT convolution dose showed very close to measurements within 1.0% discrepancy in homogeneous phantom for 6 and 15 MV X rays, but it showed -5.0% large discrepancy in FFT convolution for bone tissue correction of 6 MV X rays. In this experiments, the evaluated doses showed acceptable discrepancy within -1.2% of average for lung and -2.9% for bone equivalent materials with superposition method in 6 MV X rays. However the FFT convolution method showed more a large discrepancy than superposition in the low electron density medium in 6 and 15 MV X rays. As the CT number depends on energy spectrum of X rays, it should be confirm gradient of function of CT number-electron density regularly.
Kim, Jeong-Ho;Cho, Hyun-Dong;Won, Yeong-Seon;Park, Wool-Lim;Lee, Kwan-Woo;Kim, Hyuk-Joo;Seo, Kwon-Il
Journal of Life Science
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v.28
no.11
/
pp.1369-1378
/
2018
Prunus mume Siebold & Zucc., a member of the Rosaceae family (called Maesil in Korea), has been widely distributed in East Asia, e.g. Korea, Japan and China, and its fruit has been used as a traditional drug and health food. In this study, we evaluated physicochemical properties and physiological activities of condensed Prunus mume juice treated with pectinase (PJ). The values of total acidity, pH, sugar contents, turbidity moisture content of the PJ were 35.81%, 2.73, $54.36^{\circ}Brix$, 2.75 and 51.32%, respectively. The PJ had effective DPPH radical scavenging activity, reducing power effect, $H_2O_2$ scavenging activity and ${\beta}$-carotene bleaching effect. DPPH radical scavenging activities of PJ was 46.31%; their reducing power ($OD_{700}$) was 1.80; $H_2O_2$ scavenging activity of PJ was 91.62%; and ${\beta}$-carotene bleaching effect of PJ was 73.02%. Also, PJ showed effective levels of ${\alpha}$-glucosidase inhibition activity. The cell viability was measured by SRB assay. The PJ significantly decreased the cell viability of mouse melanoma cells (B16) and human melanoma cells (SK-MEL-2 and SK-MEL-28) in a dose-dependent manner, however, there was no effect on human keratinocyte HaCaT. In morphological study, PJ-treated SK-MEL-2 cells showed distorted and shrunken cell masses. Total polyphenol contents and total flavonoid contents of PJ were 588.31 mg% (gallic acid equivalent) and 860.45 mg% (rutin equivalent). The antiproliferative effect of PJ seems to be associated with the antioxidant activity of its flavonoid and polyphenol contents. In conclusion, PJ may be beneficial in development of a functional food material.
Kim, Woo-Chul;Kim, Hun-Jung;Park, Jeong-Hoon;Huh, Hyun-Do;Choi, Sang-Huoun
Radiation Oncology Journal
/
v.29
no.1
/
pp.28-35
/
2011
Purpose: Recently, the use of radiosurgery as a local therapy in patients with early stage non-small cell lung cancer has become favored over surgical resection. To evaluate the efficacy of radiosurgery, we analyzed the results of stereotactic body radiosurgery in patients with primary or recurrent non-small cell lung cancer. Materials and Methods: We reviewed medical records retrospectively of total 24 patients (28 lesions) with non-small cell lung cancer (NSCLC) who received stereotactic body radiosurgery (SBRT) at Inha University Hospital. Among the 24 patients, 19 had primary NSCLC and five exhibited recurrent disease, with three at previously treated areas. Four patients with primary NSCLC received SBRT after conventional radiation therapy as a boost treatment. The initial stages were IA in 7, IB in 3, IIA in 2, IIB in 2, IIIA in 3, IIIB in 1, and IV in 6. The T stages at SBRT were T1 lesion in 13, T2 lesion in 12, and T3 lesion in 3. 6MV X-ray treatment was used for SBRT, and the prescribed dose was 15~60 Gy (median: 50 Gy) for PTV1 in 3~5 fractions. Median follow up time was 469 days. Results: The median GTV was 22.9 mL (range, 0.7 to 108.7 mL) and median PTV1 was 65.4 mL (range, 5.3 to 184.8 mL). The response rate at 3 months was complete response (CR) in 14 lesions, partial response (PR) in 11 lesions, and stable disease (SD) in 3 lesions, whereas the response rate at the time of the last follow up was CR in 13 lesions, PR in 9 lesions, SD in 2 lesions, and progressive disease (PD) in 4 lesions. Of the 10 patients in stage 1, one patient died due to pneumonia, and local failure was identified in one patient. Of the 10 patients in stages III-IV, three patients died, local and loco-regional failure was identified in one patient, and regional failure in 2 patients. Total local control rate was 85.8% (4/28). Local recurrence was recorded in three out of the eight lesions that received below biologically equivalent dose 100 $Gy_{10}$. Among 20 lesions that received above 100 $Gy_{10}$, only one lesion failed locally. There was a higher recurrence rate in patients with centrally located tumors and T2 or above staged tumors. Conclusion: SBRT using a CyberKnife was proven to be an effective treatment modality for early stage patients with NSCLC based on high local control rate without severe complications. SBRT above total 100 $Gy_{10}$ for peripheral T1 stage patients with NSCLC is recommended.
Aim of this study is to investigate the feasibility of 2D ion chamber array as a substitute of the water phantom system in a periodic Linac QA. For the feasibility study, a commercial ion chamber matrix was used as a substitute of the water phantom in the measurement for a routine QA beam properties. The device used in this study was the I'm RT MatriXX (Wellhofer Dosimetrie, Germany). The MatriXX consists of a 1,020 vented ion chamber array, arranged in $24{\times}24\;cm^2$ matrix. Each ion chamber has a volume of $0.08\;cm^3$, spacing of 0.762 cm. We investigated dosimetric parameters such as dose symmetry, energy ($TPR_{20,10}$), and absolute dose for comparing with the water phantom data with a Farmer-type ionization chamber (FC65G, Wellhofer Dosimetrie, Germany). For the MatriXX measurements, we used the white polystyrene phantom (${\rho}:\;1.18\;g/cm^3$) and also considered the intrinsic layer (${\rho}:\;1.06\;g/cm^3$, t: 0.36 cm) of MatriXX to be equivalent to water depth. In the preliminary study of geometrical QA using MatriXX, the rotation axis of collimator and half beam junction test were included and compared with film measurements. Regarding the dosimetrical QA, the MatriXX has shown good agreements within ${\pm}1%$ compared to the water phantom measurements. In the geometrical test, the data from MatriXX were comparable with those from the films. In conclusion, the MatriXX is a good substitute for water phantom system and film measurements. In addition, the results indicate that the MatriXX as a cost-effective novel QA tool to reduce time and personnel power.
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