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GafChromic Film Dosimetry for Stereotactic Radiosurgery with a Linear Accelerator (선형가속기를 이용한 정위방사선 치료 시 GafChromic Film을 이용한 선량측정)

  • Han Seung Hee;Cho Byung Chul;Park Suk Won;Oh Do Hoon;Park Hee Chul;Bae Hoon Sik
    • Radiation Oncology Journal
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    • v.21 no.2
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    • pp.167-173
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    • 2003
  • Purpose: The purpose of this study was to evaluate whether a GafChromic film applied to stereotactic radiosurgery with a linear accelerator could provide information on the value for acceptance testing and quality control on the absolute dose and relative dose measurements and/or calculation of treatment planning system. Materials and methods: A spherical acrylic phantom, simulating a patient's head, was constructed from three points. The absolute and relative dose distributions could be measured by inserting a GafChromic film into the phantom. We tested the use of a calibrated GafChromic film (MD-55-2, Nuclear Associate, USA) for measuring the optical density. These measurements were achieved by irradiating the films with a dose of 0-112 Gy employing 6 MV photon. To verify the accuracy of the prescribed dose delivery to a target isocenter using a five arc beams (irradiated in 3 Gy per one beam) setup, calculated by the Linapel planning system the absolute dose and relative dose distribution using a GafChromic film were measured. All the irradiated films were digitized with a Lumiscan 75 laser digitizer and processed with the RIT113 film dosimetry system. Results: We verified the linearity of the Optical Density of a MD-55-2 GafChromic film, and measured the depth dose profile of the beam. The absolute dose delivered to the target was close to the prescribed dose of Linapel within an accuracy for the GafChromic film dosimetry (of $\pm$3$\%$), with a measurement uncertainty of $\pm$1 mm for the 50$\~$90$\%$ isodose lines. Conclusion: Our results have shown that the absolute dose and relative dose distribution curves obtained from a GafChromic film can provide information on the value for acceptance. To conclude the GafChromic flim is a convenient and useful dosimetry tool for linac based radiosurgery.

Comparison of Outcomes According to the Hospitals of Antenatal Care in Very Low Birth Weight Infants (극소 저체중 출생아에서 산전 관리 기관에 따른 임상 경과 및 예후 비교)

  • Lee, Byoung-Kook;Lee, Heun-Ji;Min, Sung-Joo;Kim, Do-Hyun;Kim, Hee-Sup
    • Neonatal Medicine
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    • v.16 no.2
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    • pp.205-212
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    • 2009
  • Purpose: The purpose of this study was to evaluate the differences according to the hospitals of antenatal care in premature infants. Methods: We retrospectively reviewed the medical records of premature infants with gestational ages <37 weeks and very low birth weights who were admitted immediately after birth to the neonatal intensive care unit (NICU) at the Dongguk University Ilsan Hospital between March 2007 and February 2009. The hospitals of antenatal care were divided into two levels (primary antenatal care hospital: hospitals with less than a level 2 NICU, secondary antenatal care hospital: hospitals with a level 3 NICU) based on the level of NICU in hospitals. In addition, total infants were divided into two groups (Immediate group: infants born within 24 hours of maternal admission, Delayed group: infants born after 24 hours of maternal admission). The differences between maternal and neonatal variables in each groups were studied. Results: Neonates in secondary antenatal care hospitals comprised 11.0% of the study neonates (10 of 91). We compared with two groups (primary antenatal care hospital and secondary antenatal care hospital), but there were no differences in all subjects. However, the 1 minute Apgar score ($\leq3$) was lower in the immediate group than the delayed group. Conclusion: Shorter duration of maternal admission to delivery was associated with a lower 1 minute Apgar score of neonates. These findings suggest that if maintenance of pregnancy is difficult when high-risk gravidas are transferred, clinicians must prepare for emergencies of neonates.

Obstetric and Neonatal Outcomes of the Teenage Pregnancy (청소년 임신에 따른 임산부와 신생아의 주산기 문제점)

  • Shin, Jeong-Hee;Bauer, Siegfried;Yoon, Young-Sun;Jeong, Hyun-Chul;Rhie, Young-Jun;Lee, Jang-Hoon;Woo, Chan-Wook;Choi, Byung-Min;Kim, Hai-Joong;Park, Sang-Hee;Song, Ji-Won
    • Neonatal Medicine
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    • v.17 no.1
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    • pp.94-101
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    • 2010
  • Purpose:In recent years, Korea has showed a steady increase in the frequency of teenage birth, while the overall birth rate has declined. As the teenage birth is known as a high risk pregnancy itself, we examined perinatal complications of teenage mothers and whose neonates in aspects of medical problem, and social status and support. Methods:We examined the perinatal characteristics of teenage mothers and whose babies, who were hospitalized at Korea University Ansan Hospital from January 2004 to July 2009 using medical records retrospectively. Twenty-seven teenage mothers and their 28 babies were enrolled in this study. Results:Teenage mothers were all unmarried and showed high rates of preterm labor, maternal anemia, and unexpected delivery. Among them, 11 (40.7%) were from families that were separated. Eleven mothers (40.7%) did not have any antenatal care. There were high rates of prematurity and low birth weight (60.7% and 64.3%, respectively). The complication included: respiratory distress syndrome, patent ductus arteriosus and necrotizing enterocolitis. Fourteen babies (51.9%) were not going to be brought up by their biological parents. Conclusion:Teenage pregnancy had high rates of preterm labor and associated complications, often caused by the lack of proper antenatal care. Babies from unmarried mothers were likely to be adopted and this could be a social burden. Therefore, to reduce unplanned teenage pregnancy and births, sex education and social supports should be provided to all teenagers.

The Current Status of Utilization of Palliative Care Units in Korea: 6 Month Results of 2009 Korean Terminal Cancer Patient Information System (말기암환자 정보시스템을 이용한 우리나라 암환자 완화의료기관의 이용현황)

  • Shin, Dong-Wook;Choi, Jin-Young;Nam, Byung-Ho;Seo, Won-Seok;Kim, Hyo-Young;Hwang, Eun-Joo;Kang, Jina;Kim, So-Hee;Kim, Yang-Hyuck;Park, Eun-Cheol
    • Journal of Hospice and Palliative Care
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    • v.13 no.3
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    • pp.181-189
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    • 2010
  • Purpose: Recently, health policy making is increasingly based on evidence. Therefore, Korean Terminal Cancer Patient Information System (KTCPIS) was developed to meet such need. We aimed to report its developmental process and statistics from 6 months data. Methods: Items for KTCPIS were developed through the consultation with practitioners. E-Velos web-based clinical trial management system was used as a technical platform. Data were collected for patients who were registered to 34 inpatient palliative care services, designated by Ministry of Health, Welfare, and Family Affairs, from $1^{st}$ of January to $30^{th}$ of June in 2009. Descriptive statistics were used for the analysis. Results: From the nationally representative set of 2,940 patients, we obtained the following results. Mean age was $64.8{\pm}12.9$ years, and 56.6% were male. Lung cancer (18.0%) was most common diagnosis. Only 50.3% of patients received the confirmation of terminal diagnosis by two or more physicians, and 69.7% had an insight of terminal diagnosis at the time of admission. About half of patients were admitted to the units on their own without any formal referral. Average and worst pain scores were significantly reduced after 1 week when compared to those at the time of admission. 73.4% faced death in the units, and home-discharge comprised only 13.3%. Mean length of stay per admission was $20.2{\pm}21.2$ days, with median value of 13. Conclusion: Nationally representative data on the characteristics of patients and their caregiver, and current practice of service delivery in palliative care units were obtained through the operation of KTCPIS.

In vivo Radiosensitization Effect of H DAC Inhibitor, SK-7041 on RIF-1 Cell Line (히스톤 탈아세틸효소 억제제 SK-7041의 RIF-1 세포주에 대한 생체내 방사선 감수성 증진 효과)

  • Chie, Eui-Kyu;Shin, Jin-Hee;Kim, In-Ah;Kim, Il-Han
    • Radiation Oncology Journal
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    • v.28 no.4
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    • pp.219-223
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    • 2010
  • Purpose: To test the radiosensitizing effect of the newly synthesized novel histone deacetylase inhibitor, SK-7041 in vivo. Materials and Method: The RIF-l cell line was implanted into the back of a 6-week-old female C3H mouse, intradermally, The mice were grouped into control, drug, radiation (RT), and RT+drug group. SK-7041, 4 mg/kg was administered intraperitoneally for six cycles every 12 hours for mice in the drug and RT+drug group, An identical volume of phosphate buffered saline (PBS) was administered at the same frequency to mice in the control and RT groups. A single 5 Gy fraction was delivered to mice in RT and RT+drug group 6 hours after the fourth delivery. The volume of the implanted tumor was measured every 2~3 days to formulate the growth delay curve. Results: For the control, drug, RT, and RT +drug groups, the average duration for implanted tumor to reach a volume of $1,500mm^3$ was 10 days, 10 days, 9 days, and 12 days, respectively. Moreover, the tumor volume on D14 was $276.7mm^3$, $279.9mm^3$, $292.5mm^3$, and $185.5mm^3$, respectively (p=0.0004). The difference for the change in slope for the control and drug versus the RT and RT+drug groups were borderline significant (p=0.0650). Conclusion: The results of this study indicate that SK-7041 has a radiosensitizing effect for the RIF-1 cell line in vivo at a low concentration and this effect may be synergistic. Implementing this result to clinical trial is warranted.

Comparison of neonatal outcomes between the spontaneous and in vitro fertilization twin pregnancies (인공수정 및 자연수정으로 태어난 쌍생아간 임상 양상 비교)

  • Kim, Hee Moon;Lee, Jeong Won;Shin, Seon Hee;Kim, Sung Koo;Sung, Tae Jung
    • Clinical and Experimental Pediatrics
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    • v.50 no.8
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    • pp.740-745
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    • 2007
  • Purpose : There is a dominant opinion that in vitro fertilization (IVF) leads to an increased incidence of twins, low birth weight (LBW) infants, prematurity and mortality. On the other hand, technical development of IVF and improvement of neonatal intensive care have increased the survival rate of neonates. The purpose of this study was to verify the tendency by comparing the clinical aspects of IVF and spontaneously conceived twins, and to establish methods to increase the survival rate of neonates after IVF. Methods : Retrospective reviews were performed on all twin infants who were admitted to the nursery and NICU at Kangnam Sacred Heart Hospital, Hallym University from January 1, 2000 to December 31, 2006. Medical records of IVF twins (study group, n=92) and spontaneously conceived twins (control group, n=265) were analyzed and compared. Neonatal outcomes and complications, as well as obstetric outcomes, were analyzed and compared. Results : Mean gestational age and birth weight of the study group ($34.6{\pm}3.5$ weeks, $2,203.9{\pm}617.2g$) were considerably lower than those of the control group ($36.3{\pm}2.4$ weeks, $2,367.0{\pm}517.9g$). The frequency of prematurity less than 37 weeks (68.5% vs 51.3%) and extremely LBW (15.2% vs 6.4%) were also significantly higher in the study group. Other neonatal outcomes were all insignificant. The obstetric characteristics, maternal age ($32.6{\pm}3.3$ years vs $30.3{\pm}3.9$ years) and the frequency of cesarean delivery(95.7% vs 79.9%) were significantly higher in the study group. Other obstetric outcomes were insignificant except for the frequency of incompetent internal os of cervix (36.2% vs 3.6%) and cerclage operation (38.3% vs 4.3%). Conclusion : Based on the above results, clinical outcomes of twin infants will be further improved by careful attention and thorough antenatal care of the IVF twins.

The Consideration of Bolus Effects of Games Attached on Lesion area (환부 부착용 거즈의 Bolus Effect에 관할 고찰)

  • Park JuYoung;Ju SangKyu;Park YoungChul;Han YoungYi;Shin EunHyuk;Park YongHwan
    • The Journal of Korean Society for Radiation Therapy
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    • v.16 no.1
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    • pp.51-56
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    • 2004
  • The aim of this study is to evaluate the effect of skin dose and PDD by using wounds protecting gauzes or Vaselinespread gauzes. And it was studied that the possibility to substitute custom bolus into gauzes. 4MV photon (CL600C, varian, US), Polystyrene Phantom (30(W) X30(L) X 30(H)) with Markus chamber(PTW, US) were used for dose measurement. This study was distinguished natural gauzes and spread over Vaseline gauzes. We gave variety to the gauze thickness at 5, 10 and 15 sheets respectively. For comparison between using bolus and not that, we had used 1.0 cm thickness bolus so that analyzed surface dose and PDD at the same conditions above mentioned. When maximum point was defined as reference point, surface dose was measured as $35\%$ in open beam. When the gauzes were attached to surface as 5, 10 and 15 sheets, surface dose were increased as 69, 80 and $91\%$ respectively according to thickness of gauzes. When spread over Vaseline gauzes were attached to surface as 5, 10 and 15 sheets, surface dose were increased respectively as 98, 100 and $98\%$ according to thickness of gauzes. Also when 0.5 cm bolus and 5 sheets gauzes were composed, surface dose was measured as $98\%$. The gauzes that were attached to skin surface in radiation therapy had been scattering material and contributed increasing surface dose without variation of percentage depth dose. However, if we want to delivery much dose to skin surface then we have to apply many sheets of gauzes to skin surface. Although we get easy that result by bolus or spread over Vaseline gauzes, we have to revise percentage depth dose at calculation. Therefore, if we find pertinent conditions based on measured data that are considered skin dose and patient setup efficiency, to replace custom bolus with gauzes will be helpful to efficient treatment.

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Effects of Social Support, Sleep Quality, and Oral Health Impact Profile on Depression among Pregnant Women (일부 임신부의 사회적 지지, 수면의 질 및 구강건강영향지수가 우울수준에 미치는 영향)

  • Han, Se-Young;Han, Yang-Keum
    • Journal of dental hygiene science
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    • v.17 no.2
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    • pp.134-141
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    • 2017
  • This study examined 191 pregnant women before delivery in an obstetrics and gynecology clinic in North Gyeongsang Province from May to September 2016 by using a questionnaire after obtaining informed consent for voluntary participation in the study. The study was performed to investigate the association of depression with sociodemographic characteristics, pregnancy-related characteristics, social support, sleep quality and Oral Health Impact Profile (OHIP) in pregnant women. The prevalence of depression among the pregnant women was 25.1% in the healthy group and 74.9% in the depression group. The depression level was significantly higher in women in the depression group who were unsatisfied with their marriage life, had no occupation, had lower social support, had poor sleep quality and had higher OHIP scores. The results of the logistic regression analysis indicated that, the risk ratio for more severe depression was significantly higher in the group with no experience of miscarriage and induced childbirth than in the group with childbirth experience. Conversely, the risk ratio for more severe depression was significantly lower in the group with high social support than in the group with low social support. Depression in the respondents significantly positively correlated with sleep quality and OHIP score but significantly negatively correlated with social support. The multiple regression analysis revealed that the depression level was significantly higher by 22.3% among pregnant women with lower marital satisfaction, no childbirth experience, lower social support and higher OHIP scores. In summary, depression was related to marital satisfaction, childbirth experience, social support, and OHIP score, among others, in pregnant women in this study. Therefore, further investigation is warranted to construct programs and measures that will help build positive thinking by designing and verifying a three-dimensional study model by taking into consideration various variables to reduce the incidence of depression in pregnant women.

A Survey of Purchasing Management for School Foodservice Foods in Daegu and Gyeongbuk Province (대구.경북지역 학교급식 식재료 구매 관리 실태 조사)

  • Kim, Yun-Hwa;Lee, Yeon-Kyung
    • Food Science and Preservation
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    • v.19 no.3
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    • pp.376-384
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    • 2012
  • This study was conducted to investigate the food purchasing management of school food services. The subjects consisted of 271 school dietitians in the Daegu and Gyeongbuk area. The percentages of ready-to-use vegetables actually being used were as follows: root of balloon flowers, 88.4%; garlic, 87.8%; blanched bracken, 80.1%; raw lotus root, 65.7%; burdock, 63.5%; small green onion, 63.5%; stem of taro, 57.6%; ginger, 35.1%; radish root, 30.6%; blanched asterscaber, 29.2%; large type welsh onion, 25.8%; carrot, 25.5%; onion, 21.4%; and potato, 8.9%. The percentages of HACCP-certified products being used were as follows: meat, 75.9%; eggs, 66.7%; soybean curds, 65.5%; ready-to-use seafood, 55.1%; starch jellies, 49.9%; spice, 44.9%; kimchi, 30.9%; ready-to-use vegetables, 22.7%; and fruits, 6.9%. The percentages of environment-friendly food items being used were as follows: eggs, 31.0%; meat, 28.7%; soybean curds, 22.1%; and fruits, 17.7%. Of these food items, meat and ready-to-use seafood were being used the most in the elementary schools. The percentages of imported food items being used were as follows: starch jelly, 29.2%; ready-to-use seafood, 24.7%; soybean curds, 20.5%; spice, 15.9%; and fruits, 10.1%. The food items requiring HACCP certification were as follows: beef and pork, 81.5%; chicken, 80.1%; ready-to-use seafood, 78.6%; frozen dumplings, 73.8%; soybean curds, 71.6%; peeled eggs, 70.8%; fish paste, 69.4%; starch jelly, 65.7%; milk, 63.1%; kimchi, 54.6%; spice, 50.6%; frozen noodle, 45.4%; ready-to-use vegetables, 44.3%; and bean sprouts, 29.5%. It was confirmed that 8.1% of the sanitation monitoring results were intentionally misreported. Therefore, to supply good and safe foods to schools, active management is needed in schools and food manufacturing and delivery companies.

Genetic Polymorphism in Corticotropin-releasing Hormone Receptor Type-1 in Preeclamptic Korean Women

  • Lim, Ji-Hyae;Kim, Shin-Young;Park, So-Yeon;Kim, Do-Jin;Kim, Mi-Jin;Ahn, Hyun-Kyong;Han, Jung-Yeol;Kim, Moon-Young;Park, Hyun-Young;Lee, Kwang-Soo;Kim, Young-Ju;Ryu, Hyun-Mee
    • Journal of Genetic Medicine
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    • v.8 no.2
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    • pp.113-118
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    • 2011
  • Purpose: Placental corticotropin-releasing hormone receptor type 1 (CRHR1) expression is reduced in pregnancies with abnormal placental function such as preeclampsia (PE), and the levels and/or function of CRHR1 are genetically influenced. The aim of this study was to investigate the association between the c.33+8199C>T polymorphism in the CRHR1 gene and PE in a Korean population. Materials and Methods: Using a case-control design, the association between the CRHR1 polymorphism and the risk of PE was investigated in 203 individuals with PE and 211 normotensive controls. Genotypes were determined using a SNapShot kit and an ABI Prism 3100 Genetic analyzer. Results: Genotypes and allele frequencies for the CRHR1 polymorphism did not differ between PE and normotensive pregnancies. The variant T allele was more frequent than the ancestral C allele in both of the groups and was more frequent in the controls than in the cases. In risk analysis for PE, there was not an increased risk of preeclampsia in subjects who were concomitant homozygous rare allele genotypes (CC) (OR, 0.3; P=0.15) or heterozygous rare allele genotypes (TC) (OR, 0.8; P=0.29). There were no differences in the complications of PE such as severity or preterm delivery in patients with the CRHR1 polymorphism. Conclusion: Our findings indicate that the CRHR1 polymorphism was not associated with PE in the present Korean study group.