• The Journal of Korean Society for Radiation Therapy
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• v.24 no.2
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• pp.61-66
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• 2012

Purpose: The purpose of this study is to compare plans prescribed to point A with these prescribed to point H recommended by ABS (American Brachytherapy Society) in high dose rate intracavitary brachytherapy for cervical carcinoma. Materials and Methods: This study selected 103 patients who received HDR (High Dose Rate) brachytherapy using tandem and ovoids from March 2010 to January 2012. Point A, bladder point, and rectal point conform with Manchester System. Point H conforms with ABS recommendation. Also Sigmoid colon point, and vagina point were established arbitrarily. We examined distance between point A and point H. The percent dose at point A was calculated when 100% dose was prescribed to point H. Additionally, the percent dose at each reference points when dose is prescribed to point H and point A were calculated. Results: The relative dose at point A was lower when point H was located inferior to point A. The relative doses at bladder, rectal, sigmoid colon, and vagina points were higher when point H was located superior to point A, and lower when point H was located inferior to point A. Conclusion: This study found out that as point H got located much superior to point A, the absorbed dose of surrounding normal organs became higher, and as point H got located much inferior to point A, the absorbed dose of surrounding normal organs became lower. This differences dose not seem to affect the treatment. However, we suggest this new point is worth being considered for the treatment of HDR if dose distribution and absorbed dose at normal organs have large differences between prescribed to point A and H.

• Radiation Oncology Journal
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• v.21 no.4
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• pp.276-282
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• 2003

Purpose: Although high-dose-rate intracavitary radiotherapy (HDR ICR) has been used in the treatment of cervical cancer, the potential for increased risk of late complication, most commonly in the rectum, is a major concern. We have previously reported on 136 patients treated with HDR brachytherapy between 1995 and 1999. The purpose of this study is to upgrade the previous data and confirm the correlation between late rectal complication and rectal dose in cervix cancer patients treated with HDR ICR. Materials and Methods: A retrospective analysis was peformed for 222 patients with cevix cancer who were treated for curative intent with external beam radiotherapy (EBRT) and HDR ICR from July 1995 to December 2001. The median dose of EBRT was 50.4 (30.6$\~$56.4) Gy with a daily fraction size 1.8 Gy. A total of six fractions of HDR ICR were given twice weekly with fraction size of 4 (3$\~$5.5) Gy to A point by Iridium-192 source. The rectal dose was calculated at the rectal reference point using the barium contrast criteria. in vivo measurement of the rectal dose was peformed with thermoluminescent dosimeter (TLD) during HDR ICR. The median follow-up period was 39 months, ranging from 6 to 90 months. Results: Twenty-one patients (9.5$\%$) experienced late rectal bleeding, from 3 to 44 months (median, 13 months) after the completion of RT. The calculated rectal doses were not different between the patients with rectal bleeding and those without, but the measured rectal doses were higher in the complicated patients. The differences of the measured ICR rectal fractional dose, ICR total rectal dose, and total rectal biologically equivalent dose (BED) were statistically significant. When the measured ICR total rectal dose was beyond 16 Gy, when the ratio of the measured rectal dose to A point dose was beyond 70$\%$, or when the measured rectal BED was over 110 Gy$_{3}$, a high possibility of late rectal complication was found. Conclusion: Late rectal complication was closely correlated with measured rectal dose by in vivo dosimetry using TLD during HDR ICR. If data from in vivo dosimetry shows any possibility of rectal bleeding, efforts should be made to reduce the rectal dose.

• Radiation Oncology Journal
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• v.14 no.3
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• pp.201-209
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• 1996

Purpose : To assess the efficacy of high dose rate - intracavitary radio-therapy (HDR-ICR) in the radiotherapy of FIGO stage IB squamous cell carcinoma of uterine cervix and to determine the optimum dose combination scheme of external radiotherapy and ICR to achieve acceptable local control without severe complication. Materials and Methods : One hundred and sixty two patients with FIGO stage Ib squamous cell carcinoma of uterine cervix who received definitive radiotherapy between May 1979 and December 1990 were retrospectively analyzed. All the patients received external radiotherapy combined with HDR-ICR. External dose of 40-46 Gy in 4.5-5 weeks was given to whole pelvis(median 45 Gy) and ICR dose of 30-39 Gy in 10-13 times was given to the point A. Midline shielding was done after 20-45 Gy of external radiotherapy(median 40 Gy) Summation of external dose Plus ICR dose to the point A range were 64.20-95.00 Gy. and mean was 83.94 Gy. We analyzed the local control rate, survival rate, and late complication rate. Rusults : Initial complete response rate was $99.4\%$ for all patients. Overall 5-year survival rate was $91.1\%$ and 5-year disease free survival rate was $90.9\%$. Local failure rate was $4.9\%$ and distant failure rate was $4.3\%$. Tumor size was the only significant prognostic factor. When tumor size greater than 3cm, 5-rear survival rate was $92.6\%$ and less than 3cm, that was $79.6\%$. Late complication rate was $23.5\%$ with $18.5\%$ of rectal complication and $4.9\%$ of bladder complication. Mean rectal dose summation of external midline dose plus ICR rectal point dose was lower in the patients without rectal complication(74.88 Gr) than those with rectal complication (78.87 Gy). Complication rate was increased with low rate of improvement of survival rate when summation of external midline dose plus point A or point R dose by ICR was greater than 70-75 Gy. Conclusion : The definitive radiation therapy using high dose rate ICR in FIGO stage IB uterine cervical cancer is effective treatment modality with good local control and survival rate without severe complication.

• Clinical and Experimental Pediatrics
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• v.52 no.8
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• pp.930-937
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• 2009

Purpose : We evaluated the effectiveness of treatment and cardiac complications of replacing a high dose of aspirin with a high dose of ibuprofen for children in acute phase of Kawasaki disease. We also analyzed the possibility of replacing a high dose of aspirin with a high dose of ibuprofen to prevent complications such as Reye󰡑s syndrome caused by aspirin. Methods : One hundred eight children with Kawasaki disease were admitted in the pediatrics department from January 1, 2004 to December 31, 2008. Echocardiography and laboratory tests were performed during diagnosis, and the children were followed-up at 6-8 weeks after the diagnosis. We retrospectively analyzed their characteristics and clinical results. Results : The children were assigned to receive either a high dose of aspirin with intravenous immunoglobulin (IVIG) (aspirin group) or a high dose of ibuprofen with IVIG (ibuprofen group). A total of 55 and 53 children were included in the aspirin and ibuprofen groups, respectively. The mean defervescence period was 6.5${\pm}$2.1 days in the aspirin group, and $6.9{\pm}1.9$ days in the ibuprofen group (P=0.309). The number of failed treatments, during and after treatment, was 8 in the aspirin group and 10 in the ibuprofen group (P=0.547). There were 11 initial cardiac complications in the aspirin group, and 14 in the ibuprofen group, but children who showed improvement at follow-up was 7 and 13 in the aspirin and ibuprofen groups, respectively (P=0.133). Laboratory findings were also improved in both groups. Conclusion : We can be considered whether we will replace high dose of aspirin by high dose of ibuprofen in acute phase of Kawasaki disease. Therefore, we can prevent the severe complications of aspirin use, such as Reye's syndrome.

• Progress in Medical Physics
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• v.9 no.4
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• pp.259-266
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• 1998

To achieve the 2D dose distribution around the designed high dose rate Ir-192 source substitution for Co-60 brachytherapy source, we determined the exposure rate constant and tissue attenuation factors as a large depth as a 20 cm from source center. The exposure rate constant is used for apparent activity in designed source with self-absorption and encapsulation steel wall. The tissue dose delivered from the 4401 segments of 2.5 mm in a diameter and 2.5 mm height of disk-type source layer. In the experiments, the tissue attenuation factors include the tissue attenuation and multiple scattering in a medium surrounding the source. The fitted the polynomial regression with 4th order for the tissue attenuation factors are very closed to the experimental measurement data within ${\pm}$1% discrepancy. The Meisberger's constant showed the large uncertainty in large distance from source. The exposure rate constant 4.69 Rcm$^2$/mCi-hr was currently used for determination of apparent activity of source and air kerma strength was obtained 0.973 for tissue absorbed dose from the energy spectrum of Ir-192 source. In our experiments with designed high dose rate brachytherapy source, the apparent activity of Ir-192 source was delivered from the 54.6 % of actual physical source activity through the self-absorption and encapsulation wall attenuations. This paper provides the 2-dimensional dose tabulation from unit apparent activity in a water medium for dose planning includes the multiple scattering, source anisotropy effect and geometric factors.

• Journal of the Korean Society of Radiology
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• v.13 no.7
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• pp.925-932
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• 2019

In this paper, we developed optical dosimetry system with a plastic scintillator, a commercial 50 mm, f1.8 lens, and a commercial high-sensitivity CMOS (complementary metal-oxide semiconductor) camera. And, the correction processors of vignetting, geometrical distortion and scaling were established. Using the developed system, we can measured a percent depth dose, a beam profile and a dose linearity for 6 MV medical LINAC (Linear Accelerator). As results, the optically measured percent depth dose was well matched with the measured percent depth dose by ion-chamber within 2% tolerance. And the determined flatness was 2.8%. We concluded that the optical dosimetry system was sufficient for application of absorbed dose monitoring during radiation therapy.

• Journal of Chest Surgery
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• v.24 no.3
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• pp.253-260
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• 1991

The adequacy of anticoagulation with heparin during cardiopulmonary bypass, and precise neutralization with protamine at the conclusion of cardiopulmonary bypass, were important. In sixty children undergoing cardiopulmonary bypass, ACT and heparin dose-response curve were studied. Total dose of heparin before bypass were 2.80$\pm$0.74 mg/kg and the amount of protamine administered after bypass were 3.0$\pm$1.23 mg/kg. So protamine: heparin ratio was 1.07: l.c After administration of protamine which dose is calculated with heparin dose-response curve, ACTs were returned to normal range[mean 114.8 $\pm$13 second]. The heparin sensitivity and its half-life do not have relationship with age, weight, height, surface area and urine amount during operation. And there are too much individual variations in heparin sensitivity and its half-life. So conventional heparin protocols can overestimate or underestimate the amount of heparin and protamine. Heparin dose-response curve makes it possible to maintain anticoagulation in a safe range during bypass with adequate amount of heparin individually. At the conclusion of bypass, this curve can be used to predict the precise amount of protamine amount of protamine needed for neutralization of the heparin. But heparin dose-response curve to be used clinically, further studies will be needed about relationship between ACT and heparin level in the high range, influence of hemodilution and hypothermia to ACT and discrepancy between true adequate amount of protamine and calculated amount by heparin dose-response curve.

• Journal of Radiation Protection and Research
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• v.41 no.2
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• pp.133-140
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• 2016

Backgrounds: The accident at Fukushima Daiichi Nuclear Power Plant (NPP), March 2011, caused serious radioactive contamination over wide area in east Japan. Therefore, it is important to know the effect of the accident and the status of NPP. Materials and Methods: This paper provides a review on the status of radiation dose and radioactive contamination caused by the accident on the basis of publicized information. Results and Discussion: Monitoring of radiation dose and exposure dose of residents has been conducted extensively by the governments and various organizations. The effective dose of general residents due to the accident proved to be less than a mSv both for external and internal dose. The equivalent committed dose of thyroid was evaluated to be a few mSv in mean value and less than 50 mSv even for children. Monitoring of radioactivity concentration has been carried out on food ingredients, milk and tap water, and actual meal. These studies indicated the percentage of foods above the regulation standard was over 10% in 2011 but decreasing steadily with time. The internal dose due to foods proved to be tens of ${\mu}Sv$ and much less than that due to natural $^{40}K$ even in the Fukushima area and decreasing steadily, although high level concentration is still observed in wild plants, wild mushrooms, animals and some kind of fishes. Conclusion: According to extensive studies, not only the effect of the accident but also the pathway and countermeasures against radioactive contamination have been revealed, and they are applied very effectively for restoration of environment and reconstruction of the area.

• International Journal of Contents
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• v.13 no.4
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• pp.12-15
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• 2017

Among the possible stereotactic body radiation therapy (SBRT) modalities used to treat patients with metastatic spinal tumors, this study compared Cyberknife, tomotherapy, and volumetric modulated arc radiotherapy (VMAT). We established treatment plans for each of them modality and quantitatively analyzed the dose evaluation factors of the dose-volume histogram (DVH) for all spinal bones, focusing on the tumor and spinal cord, in order to examine the usefulness of VMAT. For the treatment planning dose, the mean dose ($D_{max}$) and $D_{5%}$ showed statistical differences in the target dose, but no difference was shown in the spinal cord dose. For the DVH indices, tomotherapy showed the best performance was the best in terms of uniformity index, while VMAT showed better performance was better than the other two modalities in terms of the conformity index and the dose gradient index. VMAT had a much shorter treatment time than Cyberknife and tomotherapy. These findings suggest that VMAT FFF is the most effective therapy for SBRT of patients with metastatic spinal tumors for whom a high dose of radiation is prescribed.

• Journal of Radiation Protection and Research
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• v.46 no.4
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• pp.213-217
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• 2021

Background: Radiation exposure can occur as a result of occupational activities utilizing sources of radiation. The average level of occupational exposure is generally similar to the global average, but some workers receive more than this. In this study, the occupational exposure data for workers in Korea to check the recent trend of radiation exposure. Materials and Methods: The data collection and analysis are carried out by two separate periods based on the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) survey. One is the year 2003 to 2014 for a recent survey, and the other is 2015 to 2019. All available data were collected by annual reports from radiation dose registry organizations. Results and Discussion: The annual dose over the record level to the total workers did not change much compared with the total increasing number of workers in this period. The dose to the nuclear fuel cycle field has a tendency to decrease. It resulted from the efforts of radiation dose reduction with high technology introduced to this area. Also, it is important result that the radiation dose to the workers in radiography is remarkably reduced. Conclusion: The number of radiation workers and average doses were analyzed for occupational categories in Korea. It still needs cooperative efforts between the dose registry organizations for the efficient dose management of Korean radiation workers.