• The Journal of Korean Society for Radiation Therapy
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• v.24 no.2
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• pp.95-106
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• 2012

Purpose: The objective of this study was to investigate the usefulness of an IMRT treatment plan according to whether there was a shell-type pseudo target during radiation therapy for patients in Stage III or IV of non-small cell lung cancer (NSCLC). Materials and Methods: After setting an IMRT (Intensity-Modulated Radiation Therapy, IMRT) plan for when there was a shell-type pseudo target (SPT) and when there was none (WSPT) with 22 patients in Stage III or IV of NSCLC, the investigator analyzed dose-volume histograms (DVHs) and made assessment with dosimetric comparisons such as homogeneity index (HI) inside the tumor target, conformity index (CI) of the tumor target, spinal cord maximum dose, Esophagus $V_{50%}$, mean lung dose (MLD), and $V_{40%}$, $V_{30%}$, $V_{20%}$, $V_{10%}$, $V_{5%}$. Results: The mean CI of WSPT and SPT was $1.22{\pm}0.04$ and $1.16{\pm}0.032$ ($.000^*$), respectively, and the mean HI of WSPT and SPT was $1.06{\pm}0.015$ and $1.07{\pm}0.014$ ($.000^*$), respectively. In SPT, the mean of each CI difference decreased by $-5.16{\pm}2.54%$, while HI increased by average $0.81{\pm}0.47%$. Esophagus $V_{50%}$ recorded $14.54{\pm}12.01%$ (WSPT) and $12.14{\pm}11.09%$ ($.000^*$, SPT) with the mean of SPT differences dropping by $-26.37{\pm}25.05%$. Mean spinal cord maximum dose was $3,898.44{\pm}1,075.0$ cGy (WSPT) and $3,810.8{\pm}1,134.9$ cGy ($.004^*$, SPT) with SPT dropping by average $-3.36{\pm}5.81%$. As for lung $V_{X%}$, the mean of $V_{5%}$ and $V_{10%}$ differences was $-1.62{\pm}2.29%$ ($.006^*$) and $-1.98{\pm}5.02%$ ($.005^*$), respectively with SPT making a decrease. The mean of V20%, V30%, and V40% differences was $-3.51{\pm}3.07%$ ($.000^*$), $-4.84{\pm}6.01%$ ($.000^*$), and $-6.16{\pm}8.46%$ ($.001^*$), respectively, with SPT making a decrease with statistical significance. In MLD assessment, SPT also dropped by average $-2.83{\pm}2.41%$ ($.000^*$). Those results show that SPT allows for mean 169 cGy (Max: 547 cGy, Min: 6.4 cGy) prescription dose. Conclusion: An IMRT treatment plan with SPT during radiation therapy for patients in Stage III or IV of NSCLC will help to reduce the risk of lung toxicity and radiation-induced pneumonia by cutting down radiation doses entering the normal lung, reduce the local control failure rate during radiation therapy due to increasing prescription doses to a certain degree, and increase treatment effects.

• Journal of Korean Medical classics
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• v.3
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• pp.218-247
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• 1989

As mentioned above, I got the next conclusion since I had considered the medical contents of the ancient period(上古時代) and the era of the old-Korea(古朝鮮時代) through several bibliographic records. 1. There were Pung-baeg(風伯), Uh-sa(雨師), Un-sa(雲師) that were the names of the governmental officials during the ancient period of Whan-ung(桓雄). Among them, Uh-sa specially managed the treatment for diseases. When we think of the significance of Pung(風)-which means the winds, Uh(雨)-which means the rain, Un(雲)-which means of clouds, we will find out that the human life will be affected by all kinds of phenomena of the nature. So I can infer that ancestries could prevent and treat diseases with adjusting them tn the changes in the weather. 2. There were five government officials(五事) in the ancient period of Whan-ung(桓雄上古時代). They are Uh-ga(牛加), Ma-ga(馬加), Ku-ga(狗加), Cheo-ga(猪加) and Yang-ga(羊加), and had charges of five important duties. Among them, Cheo-ga was set to a charge of treatment for diseases. So we can notice that there existed people who treated for diseases professionally. When we think of the meanings of Uh(牛)-which intends cows or bulls. Ma(馬)-which intends horses, Ku(狗)-which intends dogs, Cheo(猪)-which intends wild boars and Yang(羊)-which intends sheep, we can see that livestocks would be raised at that time, and they came to have more chances to digest meat. Since the digestion of meat became to be a burden on the stomach and the intestines, it might cause a lot of indigestive troubles. 3. When I compared Tan-gun Pal-ga(檀君八加) with the Oh-ga(五加) in the ancient period of Whan-ung(桓雄上古時代), I could tell that the community of Tan-gun's period is more advanced and specialized than one of Whan-ung's. When I think of the next sentence ; "The Prince Imperial, Bu-u(夫虞) become to be a Ro-ga(鷺加), who treat for diseases professionally.", I am sure that the treatment for diseases was more importment than any other things, because he was the third son of Tan-gun(檀君). 4. According to Tan-gun(檀君) mythology, Whan-ung(桓雄) came down from the heaven of the pure Yang(純陽) to the earth and then changed into a man who had had more Yang(陽) than Yin(陰). And a bear came up from the underground(or the cave) to the ground and then changed into a women who had had more Yin(陰) than Yang(陽). So both of them became to hold together. This story implicated that ancestors had taken a serious view of each of them, namely the ancestors didn't give the ascendance to the one side of them, and made much account of the mutual harmony. So I am sure that this fact coincided with the basic theories of oriental medical science. To refer to two proverbs of Tan-gun mythology that are "Ki-Sam-Chil-Il(忌三七日)" which means caring for twenty one days, and "Pul-Gyon-Il-Gwang-Baeg-Il(不見日光百日)" which means keeping indoors for one hundred days, I can tell you that "twenty-one-day" involves the principle of the birth of life, and "one-hundred-day" contains a preparatory period or the period of death to bear another life. 5. From the medical stuff, such as wormwood(艾), garlic(蒜), or wonder-working herbage(靈草), that had been written at the bibliographic papers of the ancient period(上古時代) and the era of the old-Korea(古朝鮮時代), I consider that many people might get a lot of women's diseases, indigestive troubles, and other diseases that were caused by the weakness, but with using various spices, such as the leaves of water pepper(蔘), they could prevent the occurrance of all kinds of diseases previously. So I regard this treatment as the medicine from food. 6. One of the sayings at Nae-gyong(內經) is that "The stone accupuncture(砭石) came from the orient." We can see both "wonder-wor-king wormwood(靈草)" and "dried wormwood(乾艾)" in the several bibliographic papers of the ancient history of the old-Korea(朝鮮上古史). From these records, I can be convinced that ancestors would utilize the acupuncture(針) and the moxa cautery(灸) to cure a patient of a disease. 7. Even though someone claimed that the book, "medical science and chemistry(醫學化學)" and "medical treatment(醫學大方)" had had been written during the ancient period of the old-Korea(上古朝鮮時代), such a fact can't have been ascertained historical evidence. But it has been handed down that there existed the original phonetic alphabet, such as the "Ka-Im-To alphabet(加臨土文字)" at that time. The terms about the diseases, which had been occurred at the community of the old-Korea(古朝鮮地域), were recorded fragmentarily at other records after that time. The origin of confucianism came from the race of the eastern barbarians, and Tae-Ho-Pok-Hi(太嗅伏義) and the king. Sun(舜) came from the eastern barbarians, too. The divination of tortoise shells at the country of Un(殷) is another from which was developed at the eastern barbarians' fortune-telling of animal bones. From these facts, I can infer that, by all means, they might record the medical knowledge which had been stored for thousands of years while contacting with china directly.

• Journal of Animal Science and Technology
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• v.44 no.3
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• pp.327-340
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• 2002

This study was conducted to investigate the effects of domestic clay minerals on feed efficiency, meat quantity, meat quality and economic traits in 24 head of Hanwoo steers(166.1kg in body weight) for 540 days from six to 24 months in age. Feeding trial was conducted with 4 treatment(six heads/treatment) which were T1(Control), T2(Control+Kaolinite), T3(Control+Bentonite), T4(Control+Illite). The results obtained are summarized as follows; The range of average daily gains were 0.682 to 0.713, 0.669 to 0.714, 0.690 to 0.840 and 0.699 to 0.756kg in growing, fattening, finishing and over-all period, respectively, and the gains were high in T1 for growing and fattening period but in clay mineral groups for finishing and over-all period, especially it was high in Illite and Bentonite groups. Concentrates and TDN intakes per unit of kg gains were lower in clay mineral groups than in control and was lower especially in Bentonite groups. In carcass characteristics, dressed carcass and fresh meat and retailed cut percent were not apparently difference by treatments, and yield index was 69.3, 68.9, 68.8 and 68.6 in T3, T2, T4 and T1, respectively. Marbling scores were 5.1, 4.6, 4.4 and 3.3 in T3, T2, T4 and T1, respectively, and the range of shear force by treatment was from 3.51 to 6.02kg/cm2. and were improved with significant difference(P<0.05) in clay mineral groups than in control. Also in palatability traits, panel test scores of juiciness, tenderness and flavor were improved in clay mineral feeding groups, especially the flavor was improved with highly significant difference(P<0.01) in clay mineral groups than in control. In total fatty acid contents, the rate of SFA(saturated fatty acid) in longissimus muscle of beef was higher in the order of T2, T3, T1 and T4 while the rate of MUFA(monounsaturated fatty acid) was high in the order of T4, T3, T1 and T2. The content of oleic acid which is major influential factor at the flavor of beef was higher in Illite groups than in any other groups. In composition of amino acids in longissimus muscles of beef, the rate of essential amino acids was high in the order of T1, T2, T3 and T4. and the rate of amino acids in clay mineral groups was smaller than in control.In chemical component in Gom-Tang(soup of bone) made by Hanwoo steer’s leg-bone, the ranges of crude protein, ether extract, and crude ash was 0.81 to 1.24, 0.17 to 0.35 and 0.07 to 0.09%, respectively. In mineral composition, the ranges of Ca, P, Na and Mg was 14.01 to 15.77, 11.45 to 16.40, 37.92 to 49.99 and 0.26 to 0.46ppm, respectively. Chemical composition were not apparently different but mineral composition was increased in clay mineral groups than in control. Income by treatments was 967,096 to 1,524,055 Won per head for 540 days and income of clay mineral groups in comparison with control’s increased by 23.7 to 57.6 percent, and especially it was higher in bentonite and(or) Illite groups than others. According to the above results it may be concluded that clay mineral to growing-fattening Hanwoo steers can be improved the meat quantity, meat quality and income. Especially the effect of bentonite and illite is large and can be recommended for usage to improve animal performance as feed additives of growing-fattening Hanwoo steers.

• Korean Journal of Psychosomatic Medicine
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• v.12 no.2
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• pp.157-164
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• 2004

Objectives : This study was designed to investigate depression, anxiety, alexithymia, stress responses between well-controlled and poorly-controlled diabetic patients by glycated hemoglobin levels. Methods : The subjects were 55 diabetic patients(mean age : $49.9{\pm}9.9$, 27 men and 28 women) who were confirmed to have diabetes depending on the laboratory findings as well as clinical symptoms at the St. Vincent Hospital Diabetes Clinic, from Mar. 2004 to Aug. 2004. Korean version of Beck Depression Inventory(BDI), State and Trait Anxiety Inventory(STAI), Toronto Alexithymia Scale(TAS) and Stress Response Inventory(SRI) were used for assessment. Based on glycated hemoglobin levels, the patients were divided into 10 well-controlled group(below 7%) and 45 poorly-controlled group(above 7%). We compared BDI, STAI, TAS and SRI scores between two groups by independent t-test. Results 1) Well-controlled diabetics, compared with poorly controlled group, manifested decreased illness duration($12.2{\pm}55.4$months vs. $55.4{\pm}66.6 months)(p=0.000), but other demographic data showed no difference between two groups. 2) The STAI scores of poorly-controlled group were significantly higher in both state anxiety sores $(38.7{\pm}3.8 \;vs.\;43.7{\pm}6.7)(p=0.29)$ and trait anxiety scores$(36.9{\pm}5.7\;vs.\;41.5{\pm}6.4)(p=0.43)$ than well-controlled groups. 3) No significant differences were found in the score of BDI, TAS, SRI between well and poorly-controlled diabetic groups. Conclusion : The above results suggest that poorly-controlled diabetic patients are more likely to have higher anxiety level than well-controlled diabetic patients. However, there were no differences in depression, alexithymia, stress responses between two group. We suggest that physicians should consider integrated approaches for psychiatric problems in the management of diabetic patients.

• Korean Journal of Psychosomatic Medicine
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• v.12 no.2
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• pp.165-173
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• 2004

Objectives: Diabetes mellitus is a heterogeneous, chronic, progressive disease characterized by hyperglycemia and abnormality in protein, carbohydrate, fat metabolism. Recent studies have reorted two times prevalence of depression in individuals with diabetes compared to individuals without diabetics. This study was designed to investigate glycemic controls, anxiety, alexithymia, stress responses between depressed diabetic patients and non-depressed diabetic patients. Methods The subjects were 60 diabetic patients(mean age : $50.3{\pm}9.7$ years, 31 men and 29 women) who were confirmed to have diabetes depending on the laboratory findings as welt as clinical symptoms at the St. Vincent Hospital Diabetes Clinic, from Mar. 2004 to Sep. 2004. Laboratory test including, blood chemistry. glycated hemoglobin, urinalysis for proteinuria and Korean version of Beck Depression Inventory(BDI), State and Trait Anxiety Inventory(STAI), Toronto Alexithymia Scale(TAS) and Stress Response Inventory(SRI) were used for assessment. Based on BDI scores, all diabetics were divided into 13 depressed-diabetics group(above 20 point) and 47 non-depressed group(below 20 point). We compared demographic data. glycemic controls, STAI, TAS and SRI scores between two groups by independent t-test. Results : 1) Depressed diabetic groups were 13(mean age : $55.4{\pm}7.2$ years, 7 men and 6 women) and non depressed groups were 47(mean age $48.9{\pm}9.8$ years, 24 men and 23 women). In depressed diabetics, compared with non-depressed group, manifested aged(p=0.031), but other demographic data showed no difference between two groups. 2) No significant differences were noted in FBS, PP2h, Hb A1C, total cholesterol, HDL-cholesterol, SGOT/SGPT, BUN levels between depressed and non-depressed groups. But, blood creatine levels of depressed group were significantly increased than non-depressed group(p=0.026). 3) No significant differences were found in the score of STAI, STAI-S, STAI-T, TAS between depressed and non-depressed groups. 4) The SRI scores of depressed groups were significantly higher than non-depressed groups$(59.7{\pm}24.9\;vs.\;31.5{\pm}22.0)(p=0.000)$. Conclusion : The above results suggest that depressed diabetic patients are have more stress responses and higher blood creatine levels. However, there were no differences in laboratory data related to glycemic controls, and anxiety. alexithymia levels between two groups. We suggest that physicians should consider integrated approaches for psychiatric problems in the management of diabetes.

• Journal of Korean Physical Therapy Science
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• v.9 no.2
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• pp.67-75
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• 2002

The purpose of this study is to know the average of hip joint range of motion and difference according to the aging for the elderly. This study consisted of elder male(n=75) and elder female(n=109). The result of assessment and analysis in hip pint range of motion are as follows : 1) The average hip flexion(knee flexed) joint range of motion in 60-69(from sixty to sixty-nine)years old are $104.26^{\circ}$(Left-Male), $101.00^{\circ}$(Right-Male), $107.05^{\circ}$(Left-Female), $107.05^{\circ}$(Right-Female). 70-79years old are $104.59^{\circ}$(L-M), $102.05^{\circ}$(R-M), $105.73^{\circ}$(L-F), $108.75^{\circ}$(R-F). 80-89years old are $101.53^{\circ}$(L-M), $101.13^{\circ}$(R-M), $96.83^{\circ}$(L-F), $97.67^{\circ}$(R-F). There was significant difference in hip flexion(knee flexed) among female group(p<.01). The average hip flexion(knee extended) joint range of motion in 60-69(from sixty to sixty-nine)years old are $73.13^{\circ}$(Left-Male), $72.04^{\circ}$(Right-Male), $77.29^{\circ}$(Left-Female), $75.97^{\circ}$(Right-Female). 70-79years old are $74.95^{\circ}$(L-M), $72.19^{\circ}$(R-M), $76.73^{\circ}$(L-F), $76.65^{\circ}$(R-F). 80-89years old are $70.83^{\circ}$(L-M), $70.37^{\circ}$(R-M), $69.00^{\circ}$(L-F), $69.00^{\circ}$(R-F). There was significant difference in left hip flexion(knee extended) among female group(p<.05). 2) The average hip extension joint range of motion in 60-69years old are $13.09^{\circ}$(L-M), $12.78^{\circ}$(R-M), $10.97^{\circ}$(L-F), $10.68^{\circ}$(R-F). 70-79years old are $8.95^{\circ}$(L-M), $8.48^{\circ}$(R-M), $11.24^{\circ}$(L-F), $10.90^{\circ}$(R-F). 80-89 years old are $8.40^{\circ}$(L-M), $8.23^{\circ}$(R-M), $7.33^{\circ}$(L-F), $7.33^{\circ}$(R-F). There was significant difference in left(p<.01) and right(p<.05) hip extension among male group(p<.05). 3) The average hip abduction joint range of motion in 60-69 years old are $33.04^{\circ}$(L-M), $33.17^{\circ}$(R-M), $33.16^{\circ}$(L-F), $33.37^{\circ}$(R-F). 70-79 years old are $31.00^{\circ}$(L-M), $30.05^{\circ}$(R-M), $32.44^{\circ}$(L-F), $32.68^{\circ}$(R-F). 80-89 years old are $29.07^{\circ}$(L-M), $27.90^{\circ}$(R-M), $28.17^{\circ}$(L-F), $28.67^{\circ}$(R-F). There was no significant difference among group. 4) The average hip adduction pint range, of motion in 60-69years old are $29.57^{\circ}$(L-M), $29.35^{\circ}$(R-M), $31.87^{\circ}$(L-F), $31.89^{\circ}$(R-F). 70-79, years old are $27.41^{\circ}$(L-M), 27.00(R-M) $30.85^{\circ}$(L-F), $31.28^{\circ}$(R-F). 80-89 years old are $26.87^{\circ}$(L-M), $26.63^{\circ}$(R-M), $24.67^{\circ}$(L-F), $24.83^{\circ}$(R-F). There was significant difference in hip abduction among female group(p<01). 5) The average hip external rotation pint range of motion in 60-69years old are $32.26^{\circ}$(L-M), $31.17^{\circ}$(R-M), $33.53^{\circ}$(L-F), $34.42^{\circ}$(R-F). 70-79 years old are $31.64^{\circ}$(L-M), $28.62^{\circ}$(R-M) $31.29^{\circ}$(L-F), $31.45^{\circ}$(R-F). 80-89 years old are $26.40^{\circ}$(L-M), $26.07^{\circ}$(R-M), $24.77^{\circ}$(L-F), $24.27^{\circ}$(R-F). There was significant difference in left(male, female p<.01) and right(female p<.0l) hip external rotation among group. 6) The average hip internal rotation joint range of motion in 60-69years old are $30.30^{\circ}$(L-M), $28.13^{\circ}$(R-M), $34.27^{\circ}$(L-F), $36.03^{\circ}$(R-F). 70-79years old are $31.24^{\circ}$(L-M), $29.57^{\circ}$(R-M), $28.51^{\circ}$(L-F), $29.10^{\circ}$(R-F). 80-89 years old are $24.63^{\circ}$(L-M), $24.40^{\circ}$(R-M), $24.27^{\circ}$(L-F), $24.27^{\circ}$(R-F). There was significant difference in left(male p<.05, female p<.01) and right(female p<.01) hip internal rotation among group.

• Clinical and Experimental Pediatrics
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• v.45 no.3
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• pp.346-353
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• 2002

Purpose : Penicillin- and multidrug-resistant S. pneumoniae poses a serious threat to clinicians because the rate of resistance of S. pneumoniae to penicillin in Korea has surged up to the world's highest level. This study was performed to assess the carriage rate, serogroups and antimicrobial susceptibility of S. pneumoniae isolated from oropharynx in children. Methods : From March to July 1998, 209 children under 5 years of age were recruited from five day care centers. The carriage rate for pneumococci was obtained. Antimicrobial susceptibilities were determined with the E-test and agar dilution methods. Serogrouping was performed on 48 of the pneumococcal isolates by the Quellung reaction. Results : The carriage rate of S. pneumoniae was 30.1%. Antimicrobial susceptibility profiles were available for 59 of the isolates. Sixty-six percent of isolates were not susceptible to penicillin, and multidrug-resistance was observed in 76.3% of the isolates. A high proportion of the penicillin-resistant strains showed associated resistance to trimethoprim-sulfamethoxazole, tetracycline, erythromycin, and oxacillin. The most prevalent oropharyngeal serogroups were 19, 6, 3, 23, and 29. Resistance of the pneumococcal isolates to penicillin was different according to the serogroups. All of the strains of serogroup 19, 23, and 29 was resistant to penicillin but 87.5% of serogroup 3 strains were susceptible to penicillin. Conclusion : The resistance rate of S. pneumoniae isolated from oropharynx in children was very high to penicillin and other antimicrobial agents. For the reduction of the drug-resistant rate of S. pneumoniae, clinicians should be required to be more judicious in their use of antimicrobial agents.

• Clinical and Experimental Pediatrics
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• v.45 no.2
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• pp.174-182
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• 2002

Purpose : The purpose of this study was to investigate the prevalence of obese and underweight adolescents in Incheon area and to examine the relationship between serum cholesterol level and obesity, then to assess the nutritional condition of adolescents. Methods : With a questionnaire regarding their demographic characteristics, blood samples were obtained from apparently healthy students aged 12 to 24 years by venipuncture at April and May, 2000. We measured the obesity index using standard body weight and the body mass index(BMI) according to the criteria established by the Korean Pediatric Society in 1998. Obesity was defined as BMI more than 95 percentile, and underweight less than 15 percentile by age and sex. Results : A total of 1,456 students(M : F=685 : 771) aged 12 to 24 years were included in this study. The prevalence of obesity by standard body weight in adolescents in Incheon were 11.7% : mild obesity 6.5%, moderate 4.6%, and severe 0.5%. By BMI, the prevalence of obesity was 6.4% in males and 6.2% in females. In males, the prevalence of obesity in rural areas was 8.5%, lower than in urban areas(14.3%). The prevalence of underweight by obesity index was 34.1% in rural areas and 22.9% in urban areas. In females, the prevalence of obesity was 12.5% in rural areas and 19.6% in urban areas. There were no significant differences between the two regions(P=0.529). The prevalence of obesity increased with age till 16.3% of peak prevalence in 16 years of age, and then decreased. In males, the prevalence of obesity in academic and vocational school were 13.7% and 9.7%, respectively(P=0.116). In females of the academic and vocational school, the prevalence of obesity was 6.8% and 18.0%, respectively(P=0.001). In obese adolescents, serum total cholesterol was over 200 mg/dL in 6.2%. Conclusion : This study revealed that the prevalence of obesity in adolescents was about 12% and that the prevalence of underweight adolescents was considerably high. We think nutritional assessment and intervention are warranted for adolescent students.

• Clinical and Experimental Pediatrics
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• v.52 no.10
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• pp.1090-1102
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• 2009

Purpose:To evaluate current feeding practices and maternal nutritional knowledge on complementary feeding. Methods:Mothers of babies aged 9-15 months who visited pediatric clinics of 14 general hospitals between September and December 2008 were asked to fill questionnaires. Data from 1,078 questionnaires were analyzed. Results:Complementary food was introduced at 4-7 months in 89% of babies. Home-made rice gruel was the first complementary food in 93% cases. Spoons were used for initial feeding in 97% cases. At 6-7 months, <50% of babies were fed meat (beef, 43%). Less than 12-month-old babies were fed salty foods such as salted laver (35%) or bean-paste soup (51%) and cow's milk (11%). The following were the maternal sources of information on complementary feeding: books/magazines (58%), friends (30%), internet web sites (29%), relatives (14%), and hospitals (4%). Compared to the 1993 survey, the incidence of complementary food introduction before 4 months (0.4% vs. 21%) and initial use of commercial food (7% vs. 39%) had decreased. Moreover, spoons were increasingly used for initial feeding (97% vs. 57%). The average maternal nutritional knowledge score was 7.5/10. Less percentage of mothers agreed with the following suggestions: bottle formula weaning before 15-18 months (68%), no commercial baby drinks as complementary food (67%), considering formula (or cow's milk) better than soy milk (65%), and feeding minced meat from 6-7 months (57%). Conclusion:Complementary feeding practices have considerably improved since the last decade. Pediatricians should advise timely introduction of appropriate complementary foods and monitor diverse information sources on complementary feeding.

• The Journal of Korean Society for Radiation Therapy
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• v.27 no.2
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• pp.145-156
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• 2015

Purpose : The purpose of this study is to evaluate the efficiency of Split VMAT planning(Contouring rectum divided into an upper and a lower for reduce rectum dose) compare to Conventional VMAT planning(Contouring whole rectum) for prostate cancer radiotherapy involving pelvic lymph nodes. Materials and Methods : A total of 9 cases were enrolled. Each case received radiotherapy with Split VMAT planning to the prostate involving pelvic lymph nodes. Treatment was delivered using TrueBeam STX(Varian Medical Systems, USA) and planned on Eclipse(Ver. 10.0.42, Varian, USA), PRO3(Progressive Resolution Optimizer 10.0.28), AAA(Anisotropic Analytic Algorithm Ver. 10.0.28). Lower rectum contour was defined as starting 1cm superior and ending 1cm inferior to the prostate PTV, upper rectum is a part, except lower rectum from the whole rectum. Split VMAT plan parameters consisted of 10MV coplanar $360^{\circ}$ arcs. Each arc had $30^{\circ}$ and $30^{\circ}$ collimator angle, respectively. An SIB(Simultaneous Integrated Boost) treatment prescription was employed delivering 50.4Gy to pelvic lymph nodes and 63~70Gy to the prostate in 28 fractions. $D_{mean}$ of whole rectum on Split VMAT plan was applied for DVC(Dose Volume Constraint) of the whole rectum for Conventional VMAT plan. In addition, all parameters were set to be the same of existing treatment plans. To minimize the dose difference that shows up randomly on optimizing, all plans were optimized and calculated twice respectively using a 0.2cm grid. All plans were normalized to the prostate $PTV_{100%}$ = 90% or 95%. A comparison of $D_{mean}$ of whole rectum, upperr ectum, lower rectum, and bladder, $V_{50%}$ of upper rectum, total MU and H.I.(Homogeneity Index) and C.I.(Conformity Index) of the PTV was used for technique evaluation. All Split VMAT plans were verified by gamma test with portal dosimetry using EPID. Results : Using DVH analysis, a difference between the Conventional and the Split VMAT plans was demonstrated. The Split VMAT plan demonstrated better in the $D_{mean}$ of whole rectum, Up to 134.4 cGy, at least 43.5 cGy, the average difference was 75.6 cGy and in the $D_{mean}$ of upper rectum, Up to 1113.5 cGy, at least 87.2 cGy, the average difference was 550.5 cGy and in the $D_{mean}$ of lower rectum, Up to 100.5 cGy, at least -34.6 cGy, the average difference was 34.3 cGy and in the $D_{mean}$ of bladder, Up to 271 cGy, at least -55.5 cGy, the average difference was 117.8 cGy and in $V_{50%}$ of upper rectum, Up to 63.4%, at least 3.2%, the average difference was 23.2%. There was no significant difference on H.I., and C.I. of the PTV among two plans. The Split VMAT plan is average 77 MU more than another. All IMRT verification gamma test results for the Split VMAT plan passed over 90.0% at 2 mm / 2%. Conclusion : As a result, the Split VMAT plan appeared to be more favorable in most cases than the Conventional VMAT plan for prostate cancer radiotherapy involving pelvic lymph nodes. By using the split VMAT planning technique it was possible to reduce the upper rectum dose, thus reducing whole rectal dose when compared to conventional VMAT planning. Also using the split VMAT planning technique increase the treatment efficiency.