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Changes in blood pressure and determinants of blood pressure level and change in Korean adolescents (성장기 청소년의 혈압변화와 결정요인)

  • Suh, Il;Nam, Chung-Mo;Jee, Sun-Ha;Kim, Suk-Il;Kim, Young-Ok;Kim, Sung-Soon;Shim, Won-Heum;Kim, Chun-Bae;Lee, Kang-Hee;Ha, Jong-Won;Kang, Hyung-Gon;Oh, Kyung-Won
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.2 s.57
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    • pp.308-326
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    • 1997
  • Many studies have led to the notion that essential hypertension in adults is the result of a process that starts early in life: investigation of blood pressure(BP) in children and adolescents can therefore contribute to knowledge of the etiology of the condition. A unique longitudinal study on BP in Korea, known as Kangwha Children's Blood Pressure(KCBP) Study was initiated in 1986 to investigate changes in BP in children. This study is a part of the KCBP study. The purposes of this study are to show changes in BP and to determine factors affecting to BP level and change in Korean adolescents during age period 12 to 16 years. A total of 710 students(335 males, 375 females) who were in the first grade at junior high school(12 years old) in 1992 in Kangwha County, Korea have been followed to measure BP and related factors(anthropometric, serologic and dietary factors) annually up to 1996. A total of 562 students(242 males, 320 females) completed all five annual examinations. The main results are as follows: 1. For males, mean systolic and diastolic BP at age 12 and 16 years old were 108.7 mmHg and 118.1 mmHg(systolic), and 69.5 mmHg and 73.4 mmHg(diastolic), respectively. BP level was the highest when students were at 15 years old. For females, mean systolic and diastolic BP at age 12 and 16 years were 114.4 mmHg and 113.5 mmHg(systolic) and 75.2 mmHg and 72.1 mmHg(diastolic), respectively. BP level reached the highest point when they were 13-14 years old. 2. Anthropometric variables(height, weight and body mass index, etc) increased constantly during the study period for males. However, the rate of increase was decreased for females after age 15 years. Serum total cholesterol decreased and triglyceride increased according to age for males, but they did not show any significant trend fer females. Total fat intake increased at age 16 years compared with that at age 14 years. Compositions of carbohydrate, protein and fat among total energy intake were 66.2:12.0:19.4, 64.1:12.1:21.8 at age 14 and 16 years, respectively. 3. Most of anthropometric measures, especially, height, body mass index(BMI) and triceps skinfold thickness showed a significant correlation with BP level in both sexes. When BMI was adjusted, serum total cholesterol showed a significant negative correlation with systolic BP at age 12 years in males, but at age 14 years the direction of correlation changed to positive. In females serum total cholesterol was negatively correlated with diastolic BP at age 15 and 16 years. Triglyceride and creatinine showed positive correlation with systolic and diastolic BP in males, but they did not show any correlation in females. There was no consistent findings between nutrient intake and BP level. However, protein intake correlated positively with diastolic BP level in males. 4. Blood pressure change was positively associated with changes in BMI and serum total cholesterol in both sexes. Change in creatinine was associated with BP change positively in males and negatively in females. Students whose sodium intake was high showed higher systolic and diastolic BP in males, and students whose total fat intake was high maintained lower level of BP in females. The major determinants on BP change was BMI in both sexes.

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A Study of Knowledge, Attitude, and Practice Relative to Maternal and Child Health Among Women Residing in Apartments at Yonsei Community Health Area (연세지역 아파트 주민의 모자보건에 관한 실태조사)

  • Yu, Seung-Hum;Chung, Young-Sook;Lee, Kyung-Ja;Kim, Kwang-Jong
    • Journal of Preventive Medicine and Public Health
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    • v.4 no.1
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    • pp.77-87
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    • 1971
  • A study of the knowledge, attitude and practices about the maternal and child health of 305 married women residing in apartments at the Yonsei Community Health area was conducted during the period from November to December 1970 using designed questionnaire with well trained interviewers. The results and findings obtained from the study are summarized as follows: A. Pregnancy and Birth Questions were asked about their last child. 1. 16.4% of the women were pregnant. 2. Among 281 women who had experienced delivery, 48.0% were assisted by doctor or midwisves for their last delivery, while the rest of women delivered their last baby at home without any professional's assistance. The higher the level of education or the greater exposure to mass communication, the more the deliveries were assisted by doctors or midwives. Those women who were born and raised in cities had more deliveries assisted by doctors and midwives than those who were not. 3. Kinds of delivery sheets used. Among 141 cases of home delivery 68% used cement bag paper or vinyl sheets. Three% used nothing and remained used unsterile materials. 4. Among 141 cases of home delivery, 70.2% used scissors. The rest of them used other methods. 5. 47.3% of the women had a rest for one month or more after birth. The higher the level of education, the longer the period of rest was observed. 6. 52.4% of the women fed the colostrum to their babies. This was not related to the mother's education. 7 About half(42.9%) of the women had poor knowledge about a proper diet for the pre and post natal period. B. Child Health 1. Knowledge and practice regarding to the immunization for their children: Most of the women (93.2%) could name at least one kind of immunization. 20.3% could name 6 kinds of immunization. Mothers education level did not influence their ability to name immunizations. 85.2% of children had been immunized at least once. 2. Morbidity of last born children: 48.1% of their last born children were found to have been sick during the last year. Less than half(41.5%) of the sick children were seen by doctor. 3. Counselling at well baby clinic: Most of the women(76.5%) had no counselling for their children. Registration rate at the well baby clinic at the Severance Hospital was 13.2%. 45.9% wanted to visit to the well baby clinic at the Severance Hospital. 4. Weaning Period: 44.6% said that the beginning of the weaning for their last born children was from 6 months to twelve months of age. The most important reason of weaning was the health of both mothers and children. 5. Knowledge and Practice regarding birth and death Registration: 64.6% of the women could name correctly the Ku-office as the place for the registration. Only 29.2% registered the birth of their last born children within 14 days. C. Knowledge, Attitude and Practice regarding to family planning Most: of the women accepted the idea of family planning. 97.7% could name at least one contraceptive method. 35.4% were found to be current users of contraceptive methods. The ideal number of children was 3.1 in average.

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Difference of Short Term Survival in Patients with ARDS According to Responsiveness to Alveolar Recruitment (급성호흡곤란증후군 환자에서 폐포모집술의 반응에 따른 초기 예후의 차이)

  • Kim, Ho Cheol;Cho, Dae Hyun;Kang, Gyoung Woo;Park, Dong Jun;Lee, Jong Deok;Hwang, Young Sil
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.3
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    • pp.280-288
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    • 2004
  • Background : Lung protective strategies, using low tidal volume in ARDS, improve survival rate in ARDS. However, low tidal volume ventilation may promote alveolar de-recruitment. Therefore, alveolar recruitment is necessary to maintain arterial oxygenation and to prevent repetitive opening and closure of collapsed alveoli in lung protective strategies. There has been a recent report describing improvement in arterial oxygenation with use of recruitment maneuver. However, impact of recruitment on outcome of ARDS is unknown. We evaluated whether short-term survival difference existed in patients with ARDS, who were performed alveolar recruitment maneuver(ARM) and prone position, according to response of alveolar recruitment or not. Methods : All patients who were diagnosed with ADRS and received mechanical ventilation were included. ARM were sustained inflation($35-45cmH_2O$ CPAP for 30-40 sec.) or increasing level of PEEP. If these methods were ineffective, alveolar recruitment with prone position was done for at least 10 hours. $P_aO_2/FiO_2$(P/F) ratio was determined before and at 0.5 and 2 hours after ARM. We defined a responder if the P/F ratio was increased over 50% of baseline value. We compared 10-days and 30-days survival rate between responders and non-responders. Results : 20 patients(M:F=12:8, $63{\pm}14age$) were included. Among them, 12 patients were responders and 8 patients were non-responders. In responders, P/F ratio was increased from $92{\pm}25mmHg$ to $244{\pm}85mmHg$. In non-responders, P/F ratio increased from $138{\pm}37mmHg$ to $163{\pm}60mmHg$. Among non-responders, P/F ratio was improved over 50% in 2 patients after prone position. Overall, 14 patients were responders after ARM and prone position. The 10-days and 30-days survival rate in responders was significantly higher than in non-responders(86%, 57% in responders and 33%, 0% in non-responders)(p<0.05). There was no significant difference between responders and non-responders in age($71{\pm}11$, $60{\pm}14$), lung injury score($2.8{\pm}0.2$, $2.9{\pm}0.45$), simplified acute physiology score(SAPS) II ($35{\pm}4.6$, $34{\pm}5.7$), positive end-positive pressure level($15.6{\pm}1.9cmH_2O$, $14.5{\pm}2.1cmH_2O$). Conclusion : ARM may improve arterial oxygenation in some patients with ARDS. These responders in patients with ARDS showed significant higher 10-days and 30-days survival rate than non-responders patients with alveolar recruitment.

Diagnostic Value of ADA Multiplied by Lymphocyte to Neutrophil Ratio in Tuberculous Pleurisy (결핵성 흉막염에서 ADA 활성도와 림프구/중성구 비의 곱의 진단적 유용성)

  • Jeon, Eun Ju;Kwak, Hee Won;Song, Ju Han;Lee, Young Woo;Jeong, Jae Woo;Choi, Jae Cheol;Shin, Jong Wook;Kim, Jae Yeol;Park, In Won;Choi, Byoung Whui
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.1
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    • pp.17-23
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    • 2007
  • Background: Many diagnostic approaches for defining the definitive cause of pleurisy should be included due to the large variety of diseases resulting in pleural effusion. Although ADA is a useful diagnostic tool for making a differential diagnosis of pleural effusion, particularly for tuberculous pleural effusion, a definitive diagnostic cut-off value remains problematic in Korea. It was hypothesized that ADA multiplied by the Lymphocyte/Neutrophil ratio(L/N ratio) might be more powerful for making a differential diagnosis of pleural effusion. Methods: One hundred and ninety patients, who underwent thoracentesis and treatment in Chung-Ang University Hospital from January, 2005 through to February 2006, were evaluated. The clinical characteristics, radiologic data and the examination of the pleural effusion were analyzed retrospectively. Results: 1. Among the 190 patients, 59 patients (31.1%) were diagnosed with tuberculous pleurisy, 45 patients(23.7%) with parapneumonic effusion, 42 patients(22.1%) with malignant effusions, 36 patients(18.9%) with transudate, and 8 patients(4.2%) with empyema. One hundred and twenty one patients were found to have an ADA activity of 1 to 39 IU/L(63.7%). Twenty-nine were found to have an ADA activity of 40 to 75 IU/L(15.3%) and 40 were found to have an ADA activity of 75 IU/L or greater(21.0%). 2. Among the patients with tuberculous pleurisy, 5(8%), 18(30%) and 36 patients(60%) had an ADA activity ranging from 1 to 39 IU/L, 40 to 75 IU/L, and 75 IU/L or greater, respectively. In those with an ADA activitiy 40 to 75 IU/L, 18 patients(62%) had tuberculous pleurisy, 9(31%) had parapneumonic effusion and empyema, and 1(3.4%) had a malignant effusion. 3. In those with an ADA activity of 40 to 75 IU/L, there was no significant difference between tuberculous pleurisy and non-tuberculous pleural effusion(tuberculous pleurisy : 61.3 ${\pm}$ 9.2 IU/L, non-tuberculous pleural effusion : 53.3${\pm}$10.5 IU/L). 4. The mean L/N ratio of those with tuberculous pleurisy was 39.1 ${\pm}$ 44.6, which was significantly higher than nontuberculous pleural effusion patients (p<0.05). The mean ADA x L/N ratio of the tuberculous pleurisy patients was 2,445.7 ${\pm}$ 2,818.5, which was significantly higher than the non-tuberculous pleural effusion patients (level p<0.05). 5. ROC analysis showed that the ADA x L/N ratio had a higher diagnostic value than the ADA alone in the group with an ADA between 40-75 IU/L. Conclusion: The ADA multiplied by the lymphocyte-to-neutrophil ratio might provide a more definitive diagnosis of tuberculous pleurisy.

The Comparison Study of Early and Midterm Clinical Outcome of Off-Pump versus On-Pump Coronary Artery Bypass Grafting in Patients with Severe Left Ventricular Dysfunction (LVEF${\le}35{\%}$) (심한 좌심실 부전을 갖는 환자에서 시행한 Off-Pump CABG와 On-Pump CABG의 중단기 성적비교)

  • Youn Young Nam;Lee Kyo Joon;Bae Mi Kyung;Shim Yeon Hee;Yoo Kyung-Jong
    • Journal of Chest Surgery
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    • v.39 no.3 s.260
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    • pp.184-193
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    • 2006
  • Background: Off-pump coronary artery bypass grafting (OPCAB) has been proven to result in less morbidity. The patients who have left ventricular dysfunction may have benefits by avoiding the adverse effects of the cardiopulmonary bypass. The present study compared early and midterm outcomes of off-pump versus on-pump coronary artery bypass grafting (On pump CABG) in patients with severe left ventricular dysfunction. Material and Method: Ninety hundred forth six patients underwent isolated coronary artery bypass grafting by one surgeon between January 2001 and Febrary 2005.. Data were collected in 100 patients who had left ventricular ejection fraction (L VEF) less than $35\%$ (68 OPCAB; 32 On pump CABG). Mean age of patients were 62.9$\pm$9.0 years in OPCAS group and 63.8$\pm$8.0 years in On pump CABG group. We compared the preoperative risk factors and evaluated early and midterm outcomes. Result: In OPCAB and On pump CABG group, mean number of used grafts per patient were 2.75$\pm$0.72, 2.78$\pm$0.55 and mean number of distal anastomoses were 3.00$\pm$0.79, 3.16$\pm$0.72 respectively. There was one perioperative death in OPCAB group ($1.5\%$). The operation time, ventilation time, ICU stay time, CK-MB on the first postoperative day, and occurrence rate of complications were significantly low in OPCAB group. Mean follow-up time was 26.6$\pm$12.8 months (4${\~}$54 months). Mean LVEF of OPCAB and On pump CABG group improved significantly from $27.1\pm4.5\%$ to $40.7\pm13.0\%$ and $26.9\pm5.4\%$ to $33.3\pm13.7\%$. The 4-year actuarial survival rate of OPCAB and On pump CABG group were $92.2\%,\;88.3\%$ and the 4-year freedom rates from cardiac death were $97.7\%,\;96.4\%$ respectively. There were no significant differences between two groups in 4 year freedom rate from cardiac event and angina. Conclusion: OPCAS improves myocardial function and favors early and mid-term outcomes in patients with severe left ventricular dysfunction compared to On pump CABG group. Therefore, OPCAB is a preferable operative strategy even in patients with severe left ventricular dysfunction.

Prevalence of Enteyobius vermiculuris infection and preventive effects of masts treatment among children in rural and urban areas, and children in orphanages (농촌, 도시 및 집단생활 아동의 요충 감염과 집단 구충에 의한 예방 효과)

  • Kim, Jong-Su;Lee, Hae-Yong;An, Yeong-Gyeom
    • Parasites, Hosts and Diseases
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    • v.29 no.3
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    • pp.235-244
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    • 1991
  • An epidemiological study and mass treatments of Enterobius vermicularis infection among children near Wonju area of Kangwon province were carried out. The children were divided into 4 groups according to their residing localities; children in the mountainous area, rural area, urban area and in orphanage. They were examined by adhesive cellotape anal swab technique, and egg positive rates were obtained. The rates of egg reduction and re-infection rates after repeated mass treatments were also observed. The results obtained were as follows: 1. The overall egg Positive rate of E. vermicularis in the first screening was 19.9% (251 out of 1, 262 examinees; 19.7% in males and 20.1% in females). The positive rates were 13.0% in the mountainous area, 11 9% in the rural area, 15.1% in the urban (medium-sized) area and 61.9% in orphanages. 2. The highest positive rates were observed in the kindergarten children, and 1st and 2nd grade children of primary schools (26.2~32.2%), and the lowest rate (13.6%) in 6-year grade children of primary schools. 3. Cumulative detection rates from 3 repeated anal swabs at 4~5 days interval were higher (70.8%) than those from single anal swabs (50.0~59.2%). 4. Out of the examinees who showed the highest cumulative positive rate (70.8%), about 39.2% were consecutively positive in 3 anal swabs. Among different groups of children, the higher the total egg detection rates (87.5%), the higher the consecutive positive rates (71.9%) . 5. A total of 2, 609 (male : female=1 : 12.4) worms were collected from 17 egg-positive cases treated with anthelinintics. The mean number of worms per child was 153 (range: 4-824) . 6. The egg-positive cases in several studied groups (180 children) were treated with anthelmintics 6 times at 3-week intervals. In this case, the overall positive rate was decreased from 54.8% to 2.2% at 15 weeks after the treatments, but no complete negative conversion was experienced. However, in a group of children (154 children) including egg Positive and negative cases who were both treated with anthelmintics at 3-week interval, a complete egg-negative conversion was observed in the 9th week after treatments. 7. The egg-detection rate in the brothers or sisters of egg Positive children was 70.0% (28 out of 40 examined), and the egg-positive rate according to the family unit was 69.7%. In summarizing the above results, it is concluded that Enterobius vermicularis infection is still highly prevalent among children in Korea, and that repeated mass treatments of more than 3 times will be effective for control of this infection.

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Effects of Rye Silage on Growth Performance, Blood Characteristics, and Carcass Quality in Finishing Pigs (호맥 사일리지의 급여기간이 비육돈의 생산성, 혈액 성상 및 도체특성에 미치는 영향)

  • Shin, Seung-Oh;Han, Young-Keun;Cho, Jin-Ho;Kim, Hae-Jin;Chen, Ying-Jie;Yoo, Jong-Sang;Whang, Kwang-Youn;Kim, Jung-Woo;Kim, In-Ho
    • Food Science of Animal Resources
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    • v.27 no.4
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    • pp.392-400
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    • 2007
  • This experiment was conducted to evaluate effects of various periods of rye silage feeding on the growth performance, blood characteristics, and carcass quality of finishing pigs. A total of sixteen [($Landrace{\times}Yorkshire{\times}Duroc$)] pigs (90.26 kg in average initial body weight) were tested in individual cages for a 30 day period. Dietary treatments included 1) CON (basal diet), 2) S10 (basal diet for 20 days and 3% rye silage for 10 days) 3) S20 (basal diet for 10 days and 3% rye silage for 20 days) and 4) S30 (3% rye silage for 30 days). There were no significant differences in the ADG and gain/feed ratio among the treatments(p>0.05), however the ADFI was higher in pigs fed the CON diet than with pigs fed diets with rye silage (p<0.05). The DM digestibility was higher with the S20 diet than with the S30 diet (p<0.05). With regard to blood characteristics, pigs fed rye silage had a significantly reduced cortisol concentration compared to pigs fed the CON diet (p<0.05). The backfat thickness was higher with the CON diet than with the S20 or S30 diets (p<0.05). Regarding the fatty acid contents of the leans, the C18:0 and total SFA were significantly higher with the CON diet than with the other diets (p<0.05). However, the C18:1n9, total MUFA and UFA/SFA levels were significantly lower with the CON diet than the other diets (p<0.05). Regarding the fatty acid contents of fat, the levels of C18:1n9 and MUFA were similar with the S20 and S30 diets, however, these levels were higher than with the CON or S10 diets (p<0.05). In conclusion, feed intake and DM digestibility were affected by rye silage, and the cortisol concentration, backfat thickness and fatty acid composition of pork were positively affected by feeding pigs rye silage.

A New Medium Maturing and High Quality Rice Variety with Lodging and Disease Resistance, 'Jinbo' (중생 고품질 내도복 내병성 벼 품종 '진보')

  • Kim, Jeong-Il;Park, No-Bong;Lee, Ji-Yoon;Park, Dong-Soo;Yeo, Un-Sang;Chang, Jae-Ki;Kang, Jung-Hun;Oh, Byeong-Geun;Kwon, Oh-Deog;Kwak, Do-Yeon;Lee, Jong-Hee;Yi, Gi-Hwan;Kim, Chun-Song;Song, You-Cheon;Cho, Jun-Hyun;Nam, Min-Hee;Choung, Jin-Il;Shin, Mun-Sik;Jeon, Myeong-Gi;Yang, Sae-Jun;Kang, Hang-Weon;Ahn, Jin-Gon;Kim, Jae-Kyu
    • Korean Journal of Breeding Science
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    • v.43 no.3
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    • pp.165-171
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    • 2011
  • A new rice variety 'Jinbo' is a japonica rice (Oryza sativa L.) with good eating quality, lodging tolerance, and resistance to rice stripe virus (RSV) and bacterial blight disease (BB). It was developed by the rice breeding team of Yeongdeog Substation, National Institute of Crop Science (NICS), RDA in 2009. This variety was derived from a cross between 'Yeongdeog26' with good grain quality and wind tolerance and 'Koshihikari' with good eating quality in 1998 summer season. A promising line, YR21324-56-1-1, selected by pedigree breeding method, was designated as the name of 'Yeongdeog45' in 2005. After the local adaptability test was carried out at nine locations from 2006 to 2008, 'Yeongdeog45' was released as the name of 'Jinbo' in 2009. 'Jinbo' has short culm length as 74 cm and medium maturating growth duration. This variety is resistant to $K_1$, $K_2$, and $K_3$ races of bacterial blight and stripe virus and moderately resistant to leaf blast disease with durable resistance, and also it has tolerance to unfavorable environments such as cold and dried wind. 'Jinbo' has translucent and clear milled rice kernel without white core and white belly rice, and good eating quality as a result of panel test. The yield potential of 'Jinbo' in milled rice is about 5.65 MT/ha at ordinary fertilizer level in local adaptability test. This cultivar would be adaptable to middle plain, mid-west costal area, east-south coastal area, and south mid-mountainous area.

Variation of Leaf Characters in Cultivating and Wild Soybean [Glycine max (L.) Merr.] Germplasm (콩 재배종과 야생종 유전자원의 엽 형질 변이)

  • Jong, Seung-Keun;Kim, Hong-Sig
    • Korean Journal of Breeding Science
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    • v.41 no.1
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    • pp.16-24
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    • 2009
  • Although leaf characters are important in soybean [Glycin max (L.) Merr.] breeding and development of cultural methods, very little information has been reported. The objectives of this study were to evaluate and analyze the relationships among leaf characters and suggest possible classification criteria for cultivating and wild (Glycin soja Sieb. & Zucc.) soybeans. Total of 94 cultivating and 91 wild soybean accessions from the Soybean Germplasm Laboratory of Chungbuk National University were used for this study. Central leaflet of the second leaf from the top of the plant was selected to measure leaf characters. Average leaf length, leaf width, leaf area, leaf shape index (LSI) of cultivating and wild soybeans were 12.3$\pm$1.25 cm and 6.6$\pm$1.35 cm, 6.8$\pm$1.241 cm and 2.9$\pm$0.92 cm, 55.6$\pm$15.75 $cm^2$ and 14.3$\pm$7.83 $cm^2$, and 1.9$\pm$0.38 and 2.4$\pm$0.53, respectively. Based on LSI, three categories of leaf shape, i.e., oval, ovate and lanceolate, were defined as LIS$\leq$2.0, LSI 2.1~3.0 and 3.1$\leq$LSI, respectively. Percentage of oval, ovate and lanceolate leaf types among cultivating and wild soybean accessions were 78.7%, 17.0% and 4.3 %, and 40%, 15.4% and 4.4%, respectively. Based on leaf length, three categories for cultivating, i.e. short leaf ($\leq$11.0 cm), intermediate (11.1~13.0 cm), and long (13.1 cm$\leq$), and four categories, i.e. short ($\leq$5.0 cm), intermediate (5.1~7.0 cm), long (7.0~9.0 cm), and very long (9.1 cm$\leq$) for wild soybeans were defined. Short, intermediate and long leaf types were about 1/3, 1/2 and 1/6, respectively, in cultivating soybeans, and 15.4%, 40.7% and 39.5%, plus 4.4% of very long leaf type in wild soybean. Cultivating and wild soybeans had leaf thickness, leaf area ratio (LAR), angle and petiol length of 0.25$\pm$0.054 mm and 0.14$\pm$0.032 mm, 40.1$\pm$8.22 and 53.7$\pm$12.02, $37.6{\pm}5.89^{\circ}$ and $54.6{\pm}10.77^{\circ}$, and 23.9$\pm$5.89 cm and 5.9$\pm$2.33 cm, respectively. There were highly significant positive correlations between leaf length and leaf width, and negative correlation between LSI and leaf width both in cultivating and wild soybeans. Although leaf area showed significant correlations with leaf length, leaf width and LIS in cultivating soybeans, wild soybeans showed no significant relationships among these characters. In general, soybeans with oval, ovate and lanceolate leaves were significantly different in leaf width and thickness. Cultivating soybean with oval leaf had greater leaf area, while wild soybeans with oval or ovate leaf had longer petiol than with lanceolate leaf.

Evaluation of the Modified Hybrid-VMAT for multiple bone metastatic cancer (다중표적 뼈 전이암의 하이브리드 세기변조(modified hybrid-VMAT) 방사선치료계획 유용성 평가)

  • Jung, Il Hun;Cho, Yoon Jin;Chang, Won Suk;Kim, Sei Joon;Ha, Jin Sook;Jeon, Mi Jin;Jung, In Ho;Kim, Jong Dea;Shin, Dong Bong;Lee, Ik Jae
    • The Journal of Korean Society for Radiation Therapy
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    • v.30 no.1_2
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    • pp.161-167
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    • 2018
  • Purpose : This study evaluates the usefulness of the Modified Hybrid-VMAT scheme with consideration of background radiation when establishing a treatment plan for multiple bone metastatic cancer including multiple tumors on the same axis. Materials and Methods : The subjects of this study consisted of five patients with multiple bone metastatic cancer on the same axis. The planning target volume(PTV) prescription dose was 30 Gy, and the treatment plan was established using Ray Station(Ray station, 5.0.2.35, Sweden). In the treatment plan for each patient, two or more tumors were set as one isocenter. A volumetric modulated arc therapy(VMAT) plan, a hybrid VMAT(h) plan with no consideration of background radiation, and a modified hybrid VMAT(mh) with consideration of background radiation were established. Then, using each dose volume histogram(DVH), the PTV maximum dose($D_{max}$), mean dose($D_{mean}$), conformity index(CI), and homogeneity index(HI) were compared among the plans. In addition, the organ at risk(OAR) of each treatment site was evaluated, and the total MU(Monitor Unit) and treatment time were also analyzed. Results : The PTV $D_{max}$ values of VMAT, VMAT(h) and VMAT(mh) were 3188.33 cGy, 3526 cGy, and 3285.67 cGy, the $D_{mean}$ values were 3081 cGy, 3252 cGy, and 3094 cGy; the CI values were $1.35{\pm}0.19$, $1.43{\pm}0.12$, and $1.30{\pm}0.06$; the HI values were $1.06{\pm}0.01$, $1.14{\pm}0.06$, and $1.09{\pm}0.02$; and the VMAT(h) OAR value was increased 3 %, and VMAT(mh) OAR value was decreased 18 %, respectively. Furthermore, the mean MU values were 904.90, 911.73, and 1202.13, and the mean beam on times were $128.67{\pm}10.97$, $167.33{\pm}7.57$, and $190.33{\pm}4.51$ respectively. Conclusions : Applying Modified Hybrid-VMAT when treating multiple targets can prevent overdose by correcting the overlapping of doses. Furthermore, it is possible to establish a treatment plan that can protect surrounding normal organs more effectively while satisfying the inclusion of PTV dose. Long-term follow-up of many patients is necessary to confirm the clinical efficacy of Modified Hybrid-VMAT.

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