The aim of this study is to compare the geometric characteristics of the lung tumor, such as tumor centroid, HU change relative to breath phase, depending on tumor location and adhesion using 4DCT and deformable image registration program (MIMVista). The Y axis change was most significant and the mean Y axis centroid fluctuation was $7.32{\pm}6.88mm$ in lower lung tumor. The mean HU variation in lower lung mass has changed more than other locations, and its mean HU variation was $7.7{\pm}4.97%$ and non-adhered mass was more changed. Correlation for the mass volume between 3DCT and MIP was very high and its coefficient was 0.998. The effect of tumor location, adhesion and diaphragm excursion to geometric uncertainties was analyzed by linear regression model, it was influenced to mass deformation and geometrical variation so much except diaphragm excursion. but intra-fractional and inter-patient's uncertainties were great, so it couldn't find any exact deformation trend.
Ha, Tae-Sung;Ahn, Cheol;Jung, Pyeong-Hwan;Cho, Jeong-Hee;Lee, Jong-Seok;Lee, Hye-Nam;Yoo, Beong-Gyu
Journal of radiological science and technology
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v.33
no.4
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pp.387-394
/
2010
In the field of healthcare, the conventional sterilization treatments have been replaced by irradiation methods which are in accordance with internationally well established quality standards. The quality control in radiation sterilization assures that the absorbed dose of the irradiated material is in agreement with its requirements and standards. The electron beam irradiation requires technical assessments of more process parameters than gamma irradiation does. Korea has witnessed wide uses of electron accelerators since early 2000 but there hasn't been research experiences relating to quality system in accordance with international standards. The new large scale e-beam irradiation system with the specification of 10 MeV, 8 kW was installed and operated in 2008 by Seoul Radiology Services Co. It consists of the electron accelerator, product handling system, safety, documentation and control subsystems into an integrated system to meet the requirement of the Good Manufacturing Practice such as process quality assurance and management of product tracking records. To implement the international standard such as EN ISO11137, it is necessary to understand the purposes aimed in the standard and carry out the tests following the procedures required. This study presented the specification of the e-beam facility and showed what its design requirements and features are. The test results on a variety of process parameters were presented and validated it they are within the required limits.
The prostate cancer is the most common malignant tumor in males. Prostate cancer is the most common malignant tumor that occurs in the male in Korea in 2007 to an annual average of 5,292 cases and 3.3% of the total cancer incidence seventh occurred. Our study compared property for tomotherapy and proton therapy in radiotherapy of prostate cancer patients. We analyzed DVH(Dose Volume Histogram) and dose distribution for prostate, bladder and rectum for radiation treatment planning of prostate cancer with 11 patients in Ilsan K cancer hospital from June to November 2011. There was no differences between tomotherapy and proton therapy in the purpose of prostate cancer therapy for PTV. The adjacent organs of bladder and rectum of average dose-volume were 2port proton therapy that it was low dose treatment comparing with tomotherapy and 5port proton therapy. $H{\cdot}I$ of proton therapy was less than $H{\cdot}I$ of tomotherapy. Also, 5port was less than 2port in $H{\cdot}I$ of proton therapy. However, 2port proton therapy has more advantage over 5port proton therapy that the bladder and rectum of average dose-volume and control time of equipment in radiotherapy of prostate cancer.
Planning dose must be delivered accurately for radiation therapy. Also, It must be needed accurately setup. However, patient positioning images were need for accuracy setup. Then patient positioning images is followed by additional exposure to radiation. For 45 points in the phantom, we measured the doses for 6 MV and 10 MV photon beams, OBI(On Board Imager) and CBCT(Conebeam Computed Tomography) using OSLD(Optically Stimulated Luminescent Dosimeter). We compared the differences in the cases where posture confirmation imaging at each point was added to the treatment dose. Also, we tried to propose a photography cycle that satisfies the 5% recommended by AAPM(The American Association of Physicists in Medicine). As a result, a maximum of 98.6 cGy was obtained at a minimum of 45.27 cGy at the 6 MV, a maximum of 99.66 cGy at a minimum of 53.34 cGy at the 10 MV, a maximum of 2.64 cGy at the minimum of 0.19 cGy for the OBI and a maximum of 17.18 cGy at the minimum of 0.54 cGy for the CBCT.The ratio of the radiation dose to the treatment dose is 3.49% in the case of 2D imaging and the maximum is 22.65% in the case of 3D imaging. Therefore, tolerance of 2D image is 1 exposure per day, and 3D image is 1 exposure per week. And it is need to calculation of separate in the parallelism at additional study.
Oh, Deuk Young;Kim, Jee Hoon;Lee, Paik Kwon;Ahn, Sang Tae;Rhie, Jong Won
Archives of Plastic Surgery
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v.34
no.4
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pp.466-470
/
2007
Purpose: Active prevention is an essential component in reducing the development of pressure sores. For the high-risk patient group, following the certified pressure sore screening scale as well as educating the patient and the nurses who care for them can lead to optimal management of these patients. Applying a risk assessment scale along with a prevention strategy can reduce medical costs and length of stays at the hospital. The purpose of this study is to evaluate the efficacy of a new pressure sore risk assessment scale based on the universally recommended Braden scale and our prevention program. Methods: From June to August, 2003, our pressure ulcer risk assessment scale was applied to a total of 1882 patients admitted to the experimental group (intensive care unit, neurosurgery, general surgery, and oncology units). It was based on Braden scale. We analysed sensitivity, specificity, positive and negative predictive value and ROC curve to evaluate its efficacy. Pressure ulcer prevention program was composed of patient's education using protocol and specific nursing care. The incidence of pressure ulcers was also measured during the 3 months period, and those were compared to the control group of 1789 patients from March to May, 2002. Results: 118(6.27%) of the experimental group were high-risk with an incidence of pressure ulcers measuring 4 (0.21%). Sensitivity, specificity, positive and negative predictive value of our scale were 100%, 94%, 4%, 100%, respectively, and AUC(area under the curve) was 0.992. In the control group, the incidence of pressure ulcers was 11(0.61%). Statistical analyses using chisquared tests with a significance level of 5%, the results were such that ${\chi }^2=3.6482$(p=0.0561). The results proved to be statistically significant in borderline. Conclusion: The results from this study proved that pressure sore risk assessment scale based on Braden scale has an excellent efficacy, and shows that our pressure ulcer prevention program is partially effective in reducing pressure ulcer incidence.
We examined total body irradiation (TBI)-induced effects by complete blood count (CBC) and fluorescence-activated cell sorter analysis (FACS) in the piglet following radiation irritation. A CBC included red blood cell count, white blood cell count, and platelet cell count. Four piglets were examined in this study and each piglet was divided by irradiation dose, two piglets with 4 Gy, two with 6 Gy, one with 8 Gy. All piglets showed leukopenia, thrombocytopenia after irradiation. In 6 and 8 Gy group, three piglets showed severe hemostatic disorder and gastrointestinal disorder suchas diarrhea and anorexia, and they died between 10 and 15 days after radiation irritation. In 4 Gy, two piglets showed no clinical sign after radiation injury, but persistent leukopenia was shown in blood examination. We suggest that a single TBI dose less than 6 Gy is adequate for conditioning piglet for bone marrow transplantation.
Kae, Young Ae;Lee, Mi Yeon;Park, Jin Sook;Kim, Hyo Joo;Jung, Tae Youn;Jang, Bo Young;Kim, Yoon Jeong;Koo, Dong-Hoe
Journal of Hospice and Palliative Care
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v.18
no.3
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pp.208-218
/
2015
Purpose: Although a Do-Not-Resuscitate (DNR) order is widely in use, it is one of the challenging issues in end-of-life care. This study was conducted to investigate attitudes toward DNR according to education and clinical experience. Methods: Data were collected using a structured questionnaire comprising 30 items in a tertiary hospital in Seoul, Korea. Results: Participants were 238 nurses and 72 physicians. Most participants (99%) agreed to the necessity of DNR for reasons such as dignified death (52%), irreversible medical condition (23%) and patients' autonomy in decision making (19%). Among all, 33% participants had received education about DNR and 87% had DNR experience. According to participants' clinical DNR experience, their attitudes toward DNR significantly differed in terms of the necessity of DNR, timing of the DNR consent and post-DNR treatments including antibiotics. However, when participants were grouped by the level of DNR education, no significant difference was observed except in the timing of the DNR consent. Conclusion: This study suggests that the attitudes toward DNR were more affected by clinical experience of DNR rather than education. Therefore, DNR education programs should involve clinical settings.
For patients who are near the end of life, an inevitable step is discussion of a do-not-resuscitate (DNR) order, which involves patients, their family members and physicians. To discuss DNR orders, patients and family members should know the meaning of the order and cardiopulmonary resuscitation (CPR) which includes chest compression, defibrillation, medication to restart the heart, artificial ventilation, and tube insertion in the respiratory tract. And the following issues should be considered as well: patients' and their families' autonomy, futility of treatment, and the right for death with dignity. Terminal cancer patients should be informed of what futility of treatment is, such as a low survival rate of CPR, unacceptable quality of life after CPR, and an irremediable disease status. In Korea, two different law suits related to life supporting treatments had been filed, which in turn raised public interest in death with dignity. Since the 1980s, knowledge of and attitude toward DNR among physicians and the public have been improved. However, most patients are still alienated from the decision making process, and the decision is often made less than a week before death. Thus, the DNR discussion process should be improved. Early palliative care should be adopted more widely.
Kim, Mi-Young;Kruger, Annie J.;Jeong, Ju-Yeon;Kim, Jaehee;Shin, Phil kyung;Kim, Sun Young;Cho, Joo Young;Hahm, Ki Baik;Hong, Sung Pyo
Molecules and Cells
/
v.42
no.6
/
pp.448-459
/
2019
The phosphoinositide 3-kinase/protein kinase B/mammalian target of rapamycin (PI3K/AKT/mTOR) signaling pathway is a promising target for gastric cancer (GC) treatment; however the efficacy of PI3K/mTOR dual inhibitors in GC has not yet been maximized. Additionally, the effect of autophagy regulation by PI3K/mTOR dual inhibitors has not been clearly elucidated in GC treatment. We aimed to show that our newly developed PI3K/mTOR dual inhibitor, CMG002, when combined with an autophagy inhibitor, chloroquine (CQ), potently induces effective cancer cell death in Epstein-Barr virus (EBV)-associated gastric cancer (EBVaGC) cells, where both the PI3K/AKT/mTOR and autophagy pathways play important roles in disease pathogenesis. EBV- and mock-infected AGS and NUGC3 GC cell lines were treated with CMG002 +/- CQ. PI3K/AKT/mTOR signaling pathway mediators, cellular apoptosis and autophagy markers were confirmed by Western blot assay. Cell viability was assessed using the Cell Counting Kit-8 (CCK-8) assay. CMG002 effectively blocked the PI3K/AKT/mTOR pathway by markedly decreasing phosphorylation of AKT and its downstream mediator S6. CMG002 induced G0/G1 cell cycle arrest and enhanced apoptotic cell death in AGS and NUGC3 cells, particularly EBV-infected cells compared with mock-infected cells, as confirmed by flow cytometric analyses and TUNEL (terminal deoxynucleotidyl transferase dUTP nick end labeling) assays. The combination of CMG002 plus CQ synergistically increased apoptotic cell death in EBV-infected GC cell lines when compared with CMG002 alone (P < 0.05). Our results suggest that the new PI3K/mTOR dual inhibitor, CMG002, when used in combination with the autophagy inhibitor, CQ, provides enhanced therapeutic efficacy against EBVaGC.
A heavy particle accelerator is a device that accelerates particles using high energy and is used in various fields such as medical and industrial fields as well as research. However, secondary neutrons and particle fragments are generated by the high-energy particle beam, and among them, the neutrons do not have an electric charge and directly interact with the nucleus to cause radiation of the material. Quantitative evaluation of the radioactive material produced in this way is necessary, but there are many difficulties in actual measurement during or after operation. Therefore, this study compared and evaluated the generated radioactive material in the concrete shield for protons and carbon ions of specific energy by using the simulation code FLUKA. For the evaluation of each energy of proton beam and carbon ion, the reliability of the source term was secured within 2% of the relative error with the data of the NASA Space Radiation Laboratory(NSRL), which is an internationally standardized data. In the evaluation, carbon ions exhibited higher neutron flux than protons. Afterwards, in the evaluation of radioactive materials under actual operating conditions for disposal, a large amount of short-lived beta-decay nuclides occurred immediately after the operation was terminated, and in the case of protons with a high beam speed, more radioactive products were generated than carbon ions. At this time, radionuclides of 44Sc, 3H and 22Na were observed at a high rate. In addition, as the cooling time elapsed, the ratio of long-lived nuclides increased. For nonparticulate radionuclides, 3H, 22Na, and for particulate radionuclides, 44Ti, 55Fe, 60Co, 152Eu, and 154Eu nuclides showed a high ratio. In this study, it is judged that it is possible to use the particle accelerator as basic data for facility maintenance, repair and dismantling through the prediction of radioactive materials in concrete according to the cooling time after operation and termination of operation.
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