• Radiation Oncology Journal
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• 제20권4호
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• pp.343-352
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• 2002

Purpose : Radiotherapy is the main treatment modality for uterine cervix cancer. Since the rectum is in the radiation target volume, rectal bleeding is a common late side effect. This study evaluates the risk factors of radiation induced rectal bleeding and discusses its optimal management. Materials and Methods : total of 213 patients who completed external beam radiation therapy (EBRT) and intracavitary radiation (ICR) between September 1994 and December 1999 were included in this study. No patient had undergone concurrent chemo-radiotherapy. Ninety patients received radiotherapy according to a modified hyperfractionated schedule. A midline block was placed at a pelvic dose of between 30.6 Gy to 39.6 Gy. The total parametrial dose from the EBRT was 51 to 59 Gy depending on the extent of their disease. The Point A dose from the HDR brachytherapy was 28 Gy to 30 Gy $(4\;Gy\times7,\;or\;5\;Gy\times6)$. The rectal point dose was calculated either by the ICRU 38 guideline, or by anterior rectal wall point seen on radiographs, with barium contrast. Rectal bleeding was scored by the LENT/SOMA criteria. For the management of rectal bleeding, we opted for observation, sucralfate enema or coagulation based on the frequency or amount of bleeding. The median follow-up period was 39 months $(12\~86\;months)$. Results : The incidence of rectal bleeding was $12.7\%$ (27/213); graded as 1 in 9 patients, grade 2 in 16 and grade 3 in 2. The overall moderate and severe rectal complication rate was $8.5\%$. Most complications $(92.6\%)$ developed within 2 years following completion of radiotherapy (median 16 months). No patient progressed to rectal fistula or obstruction during the follow-up period. In the univariate analysis, three factors correlated with a high incidence of bleeding an icruCRBED greater than 100 Gy $(19.7\%\;vs.\;4.2\%)$, an EBRT dose to the parametrium over 55 Gy $(22.1\%\;vs.\;5.1\%)$ and higher stages of III and IV $(31.8\%\;vs.\;10.5\%)$. In the multivariate analysis, the icruCRBED was the only significant factor (p>0.0432). The total parametrial dose from the EBRT had borderline significance (p=0.0546). Grade 1 bleeding was controlled without further management (3 patients), or with sucralfate enema 1 to 2 months after treatment. For grade 2 bleeding, sucralfate enema for 1 to 2 months reduced the frequency or amount of bleeding but for residual bleeding, additional coagulation was peformed, where immediate cessation of bleeding was achieved (symptom duration of 3 to 10 months). Grade 3 bleeding lasted for 1 year even with multiple transfusions and coagulations. Conclusion : Moderate and several rectal bleeding occurred in $8.5\%$ of patients, which is comparable with other reports. The most significant risk factor for rectal bleeding was the accumulated dose to the rectum (icruCRBED), which corrected with consideration to biological equivalence. Prompt management of rectal bleeding, with a combination of sucralfate enema and coagulation, reduced the duration of the symptom, and minimized the anxiety/discomfort of patients.

• Radiation Oncology Journal
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• 제23권4호
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• pp.223-229
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• 2005

Purpose: In this work we designed and made MPBP(Multi Purpose Brachytherapy Phantom). The MPBP enables one to reproduce the same patient set-up in MPBP as the treatment of the patient and we tried to get an exact analysis of rectal doses in the phantom without need of in-vivo dosimetry. Materials and Methods: Dose measurements were tried at a point of rectum 1, the reference point of rectum, with a diode detector for 4 patients treated with tandem and ovoid for a brachytherapy of a cervix cancer. Total 20 times of rectal dose measurements were made with 5 times a patient. The set-up variation of the diode detector was analyzed. The same patient set-ups were reproduced in self-made MPBP and then rectal doses were measured with TLD. Results: The measurement results of the diode detector showed that the set-up variation of the diode detector was the maximum $11.25{\pm}0.95mm$ in the y-direction for Patient 1 and the maximum $9.90{\pm}4.50mm,\;20.85{\pm}4.50mm,\;and\;19.15{\pm}3.33mm$ in the z-direction for Patient 2, 3, and 4, respectively. Un analyzing the degree of variation in 3 directions the more variation was showed in the z-direction than x- and y-direction except Patient 1. The results of TLD measurements in MPBP showed the relative maximum error of 8.6% and 7.7% at a point of rectum 1 for Patient 1 and 4, respectively and 1.7% and 1.2% for Patient 2 and 3, respectively. The doses measured at R1 and R2 were higher than those calculated except R point of Patient 2. this can be thought to related to the algorithm of dose calculation, whcih corrects for air and water but is guessed not to consider the correction for the scattered rays, but by considering the self-error (${\pm}5%$) TLD has the relative error of values measured and calculated was analyzed to be in a good agreement within 15%. Conclusion: The reproducibility of dose measurements under the same condition as the treatment could be achieved owing to the self-made MPMP and the dose at the point of interest could be analyzed accurately. If a treatment is peformed after achieving dose optimization using the data obtained in the phantom, dose will be able to be minimized to important organs.

• Radiation Oncology Journal
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• 제22권3호
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• pp.165-176
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• 2004

Purpose: Firstly, to analyze facto in terms of radiation treatment that might potentially cause subfrontal relapse in two patients who had been treated by craniospinal irradiation (CSI) for medulloblastoma, Secondly, to explore an effective salvage treatment for these relapses. Materials and Methods: Two patients who had high-risk disease (T3bMl, T3bM3) were treated with combined chemoradiotherapy CT-simulation based radiation-treatment planning (RTP) was peformed. One patient who experienced relapse at 16 months after CSI was treated with salvage surgery followed by a 30.6 Gy IMRT (intensity modulated radiotherapy). The other patient whose tumor relapsed at 12 months after CSI was treated by surgery alone for the recurrence. To investigate factors that might potentially cause subfrontal relapse, we evaluated thoroughly the charts and treatment planning process including portal films, and tried to find out a method to give help for placing blocks appropriately between subfrotal-cribrifrom plate region and both eyes. To salvage subfrontal relapse in a patient, re-irradiation was planned after subtotal tumor removal. We have decided to treat this patient with IMRT because of the proximity of critical normal tissues and large burden of re-irradiation. With seven beam directions, the prescribed mean dose to PTV was 30.6 Gy (1.8 Gy fraction) and the doses to the optic nerves and eyes were limited to 25 Gy and 10 Gy, respectively. Results: Review of radiotherapy Portals clearly indicated that the subfrontal-cribriform plate region was excluded from the therapy beam by eye blocks in both cases, resulting in cold spot within the target volume, When the whole brain was rendered in 3-D after organ drawing in each slice, it was easier to judge appropriateness of the blocks in port film. IMRT planning showed excellent dose distributions (Mean doses to PTV, right and left optic nerves, right and left eyes: 31.1 Gy, 14.7 Gy, 13.9 Gy, 6.9 Gy, and 5.5 Gy, respectively. Maximum dose to PTV: 36 Gy). The patient who received IMRT is still alive with no evidence of recurrence and any neurologic complications for 1 year. Conclusion: To prevent recurrence of medulloblastoma in subfrontal-cribriform plate region, we need to pay close attention to the placement of eye blocks during the treatment. Once subfrontal recurrence has happened, IMRT may be a good choice for re-irradiation as a salvage treatment to maximize the differences of dose distributions between the normal tissues and target volume.

• Radiation Oncology Journal
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• 제22권3호
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• pp.200-207
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• 2004

Purpose: An analysis was to compare the results of radiation alone with those of radiation with dally low dose cisplatin as a radiation sensitizer in locally advanced cervical cancer. Materials and Methods: A retrospective analysis of 59 patients diagnosed with locally advanced uterine cervix cancer between December 1996 and March 2001 was peformed. Thirty one patients received radiation alone and 28 patients received dally low dose cisplatin, as a radiation sensitizer, and radiation therapy. The median follow-up period was 34 months, ranging from 2.5 to 73 months. The radiation therapy consisted of 4500 cGy external beam irradiation to the whole pelvis (midline block after 3060 cGy), a 900$\~$l,000 cGy boost to the involved parametrium and high dose-rate intracavitary brachytherapy (a total dose of 3,000$\~$3,500 cGy/500 cGy per fraction to point A, twice per week). In the chemoradiation group, 10 mg of daily intravenous cisplatin was given daily from the 1st day of radiation therapy to the 20th day of radiation therapy. According to the FIGO classification, the patients were subdivided into 51 (86.4$\%$) and 8 (13.6$\%$) stages IIB and stage IIIB, respectively. Results: The overall 5 year survival rate was 65.65$\%$ and according to treatment modality were 56.75$\%$ and 73.42$\%$ in the radiation alone and chemoradiation groups, respectively (p=0.180). The 5 year disease-free survival rates were 49.39$\%$ and 63.34$\%$ in the radiation alone and chemoradiatoin groups, respectively (p=0.053), The 5 year locoregional control rates were 52.34$\%$ and 73.58$\%$ in the radiation alone and chemoradiation groups, respectively (p=0.013). The 5 year distant disease-free survival rates were 59.29$\%$ and 81.46$\%$ in the radiation alone and chemoradiation groups, respectively (p=0.477), Treatment related hematologic toxicity were prominent in the chemoradiation group. Leukopenia $\geq$grade) occurred in 3.2$\%$and 28.5$\%$ of the radiation alone and chemoradiation groups, respectively (p=0.02). There were no statistical differences in the incidences of vesical, rectal and small bowel complications between two groups. Conclusion: Radiation therapy with low dose cisplatin did not improve the rates of survival and response rates, but did improve the rate of disease free survival and locoregional control rates In locally advanced cervical cancer. The incidence of bone marrow suppression was higher in the chemoradiation group.

• Radiation Oncology Journal
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• 제22권3호
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• pp.225-233
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• 2004

Purpose: The Ideal breast irradiation method should provide an optimal dose distribution In the treated breast volume and a minimum scatter dose to the nearby normal tissue. Physical wedges have been used to Improve the dose distribution In the treated breast, but unfortunately Introduce an Increased scatter dose outside the treatment yield, pavllculariy to the contralateral breast. The typical physical wedge (FW) was compared with 4he virtual wedge (VW) to do)ermine the difference In the dose distribution affecting on the treated breast and the contralateral breast, lung, heart and surrounding perlpheral soft tissue. Methods and Materials: The data collected consisted of a measurement taken with solid water, a Humanoid Alderson Rando phantom and patients. The radiation doses at the ipsllateral breast and skin, contralateral breast and skin, surrounding peripheral soft tissue, and Ipsllateral lung and heart were compared using the physical wedge and virtual wedge and the radiation dose distribution and DVH of the treated breast were compared. The beam-on time of each treatment technique was also compared Furthermore, the doses at treated breast skin, contralateral breast skin and skin 1.5 cm away from 4he field margin were also measured using TLD in 7 patients of tangential breast Irradiation and compared the results with phantom measurements. Results: The virtual wedge showed a decreased peripheral dose than those of a typical physical wedge at 15$^{\circ}$, 30$^{\circ}$, 45$^{\circ}$, and 60$^{\circ}$. According to the TLD measurements with 15$^{\circ}$ and 30$^{\circ}$ virtual wedge, the Irradiation dose decreased by 1.35$\%$ and 2.55$\%$ In the contralateral breast and by 0.87$\%$ and 1.9$\%$ In the skin of the contralateral breast respectively. Furthermore, the Irradiation dose decreased by 2.7$\%$ and 6.0$\%$ in the Ipsllateral lung and by 0.96$\%$ and 2.5$\%$ in the heart. The VW fields had lower peripheral doses than those of the PW fields by 1.8$\%$ and 2.33$\%$. However the skin dose Increased by 2.4$\%$ and 4.58$\%$ In the Ipsliateral breast. VW fields, In general, use less monitor units than PW fields and shoriened beam-on time about half of PW. The DVH analysis showed that each delivery technique results In comparable dose distribution in treated breast. Conclusion: A modest dose reduction to the surrounding normal tissue and uniform target homogeneity were observed using the VW technique compare to the PW beam in tangential breast Irradiation The VW field is dosmetrically superlor to the PW beam and can be an efficient method for minimizing acute, late radiation morbidity and reduce 4he linear accelerator loading bV decreasing the radiation delivery time.

• The Korean Journal of Nuclear Medicine Technology
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• 제18권1호
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• pp.76-81
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• 2014

Purpose: Diversity and the lachrymal duct deformities and the passage inside the nasal cavity except for anterior image such as epiphora happens during the test were able to express more precisely during the dacryoscintigraphy. Also, we thought about the necessity of a method to classify the passage into the naso-lachrymal duct from epiphora. Therefore, we are to find the validity of the method to obtain both oblique views except for anterior views. Materials and Methods: The targets of this research are 78 patients with epiphora due to the blockage at the lachrymal duct from January 2013 to August 2013. Average age was $56.96{\pm}13.36$. By using a micropipette, we dropped 1-2 drops of $^{99m}TcO4^-$ of 3.7 MBq (0.1 mCi) with $10{\mu}L$ of each drop into the inferior conjunctival fold, then we performed dynamic check for 20 minutes with 20 frames of each minute. In case of we checked the passage from both eyes to nasal cavity immediately after the dynamic check, we obtained oblique view immediately. If we didn't see the passage in either side of the orbit, we obtained oblique views of the orbit after checking the frontal film in 40 minutes. The instrument we used was Pin-hole Collimator with Gamma Camera(Siemens Orbiter, Hoffman Estates, IL, USA). Results: Among the 78 patients with dacryoscintigraphy, 35 patients were confirmed with passage into the nasal cavity from the anterior view. Among those 35 patients, 15 patients were confirmed with passage into the nasal cavity on both eyes, and it was able to observe better passage patterns through oblique view with a result of 8 on both eyes, 2 on left eye, and 1 on right eye. 20 patients had passage in left eye or right eye, among those patients 10 patients showed clear passage compared to the anterior view. 13 patients had possible passage, and 30 patients had no proof of motion of the tracer. To sum up, 21 patients (60%) among 35 patients showed clear pattern of passage with additional oblique views compared to anterior view. People responded obtaining oblique views though 5 points scale about the utility of passage identification helps make diagnoses the passage, passage delayed, and blockage of naso-lachrymal duct by showing the well-seen portions from anterior view. Also, when classifying passage to naso-lachrymal duct and flow to the skin, oblique views has higher chance of classification in case of epiphora (anterior:$4.14{\pm}0.3$, oblique:$4.55{\pm}0.4$). Conclusion: It is considered that if you obtain oblique views of the bilateral orbits in addition to anterior view during the dacryoscintigraphy, the ability of diagnose for reading will become higher because you will be able to see the areas that you could not observe from the anterior view so that you can see if it emitted after the naso-lachrymal duct and the flow of epiphora on the skin.

• The Korean Journal of Nuclear Medicine Technology
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• 제12권3호
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• pp.222-228
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• 2008

Purpose: The objectives of this study were to compare the left ventricle ejection fraction (LVEF) from gated cardiac blood pool scan (GCBP) for analysis auto-drawing region of interest mode (AROI) and manual-drawing region of interest mode (MROI), respectively. To evaluation the relationships between values produced by both ROI modes. Materials and Methods: Gated cardiac blood pool scan using in vivo method Tc-99m Red Blood Cell were performed for 33 patients (mean age: $53.2{\pm}13.2\;y$) with objective of chemotherapy using single head gamma camera (ADAC Laboratories, Milpitas, CA). Left ventricular ejection fraction was automatically and manually measured, respectively. Results: There was significant difference statistically between AROI and MROI ($LVEF^{AROI}$: $71.4{\pm}12.4%$ vs. $LVEF^{MROI}$: $65.8{\pm}5.9%$, p=0.003). Intra-observer agreements in AROI was higher than MROI ($\gamma^{AROI}=0.964$, Cronbach's $\alpha^{AROI}=0.986$ vs. $\gamma^{MROI}=0.793$, Cronbach's $\alpha^{MROI}=0.911$), either. Additionally, there was no significant difference statistically at best septal view (${\Delta}LVEF^{BSV}=0.7{\pm}2.3%$, p=0.233), however statistically significant difference was found at badly separated septal view (${\Delta}LVEF=10.9{\pm}11.4%$, p=0.001). Moreover, Intra-observer agreements in best septal view was higher than badly separated septal view ($\gamma^{BSV}=0.939$, Cronbach's $\alpha^{BSV}=0.978$; $\gamma=0.948$, Cronbach's $\alpha=0.981$ at AROI, $\gamma^{BSV}=0.836$, Cronbach's $\alpha^{BSV}=0.936$; $\gamma=0.748$, Cronbach's $\alpha=0.888$ at MROI). Conclusion: When best septal view was acquired, LVEF by AROI and MROI indicated not different. Comparing Intra-observer agreements with AROI and MROI, the AROI tended to show higher. Therefore, it is considered that the AROI than MROI is valuable in reproducibility and objective when ROI analysis by acquire left ventricular of best septal view.

• Food Science of Animal Resources
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• 제30권6호
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• pp.997-1006
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• 2010

The objective of this study was to investigate the proximate composition, pH, meat color, water holding capacity (WHC), cooking loss (CL), cholesterol content, and trans-fatty acid content of Hanwoo beef according to quality grade and cut. Five cuts [Cheggt (strip loin), Dngsim (loin), Moksim (chuck roll), Udoon (top round), Yanggi (brisket)] were obtained from 15 Hanwoo animals [3 bulls and 12 steers, 24-30 months old]. Three animals were selected from each quality grade of $1^{++}$, $1^+$, 1, 2, and 3. The protein and moisture contents (%) were significantly higher, and the fat contents (%) were significantly lower in 3 quality grade compared to the other grades (p<0.05). pH values of chuck roll and strip loin were significantly lower in $1^+$ quality grade (5.61 and 5.51) than those in 3 quality grade (5.88 and 5.92) (p<0.05). CIE L* values were significantly higher in the $1^{++}$ quality grade group (38.52-42.69%) than in 3 quality grade (33.02-36.08) (p<0.05). In the $1^{++}$ and 2 quality grade groups, CIE $L^*$ values of loin were significantly higher than those of other cuts (p<0.05). CIE $a^*$ values of loin (28.11) in 1 quality grade were the highest, whereas those of strip loin (15.36) in 3 quality grade were the lowest (p<0.05). WHC was not significantly different among the five cuts or quality grades. In CL, loin and strip loin were significantly lower in $1^{++}$ quality grade than in 3 quality grade (p<0.05), and they were also significantly lower (22.21-24.81%) than the other cuts in the same quality grade (p<0.05). The loin in $1^{++}$ (41.26 mg/100 g), $1^+$ (43.23), and 1 quality grades (48.63) had higher cholesterol contents (%) than in 2 (36.02) and 3 quality grades (29.84) (p<0.05). Cholesterol contents of the five cuts in $1^{++}$ quality grade (39.44-43.31%) were significantly higher than those in 3 quality grade (28.09-32.39%). The trans-fatty acid contents of the five cuts were 1.08-2.72%. The loin, strip loin, brisket, and top round in 3 quality grade had significantly higher trans-fatty acid contents than those of the other grades (p<0.05).

• Economic and Environmental Geology
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• 제44권5호
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• pp.413-431
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• 2011

An Epithemal Au-Ag mineralized zone is developed in the Moisan area of Hwangsan-myeon, Haenam-gun, Jeol-lanam-do, Korea, which is located in the southwestern part of the Ogcheon metamorphic zone. It is hosted in the Hwangsan volcaniclastics of the Haenam Formation of the Late Cretaceous Yucheon Group. This research investigated the characteristics of bedding arrangement, fold, fault, fracture system, quartz vein and the time-relationship of the fracture system to understand the geological structure related to the formation of the mineralized zone. On the basis of this result, the tectonic environment at the time of the mineralization was considered. Beds mainly trend east-northeast and gently dip into north-northwest or south-southeast. Their poles have been rearranged by subhorizontal-upright open fold of (east)-northeast trend as well as dip-slip fault. Fracture system was formed through at least 6~7 different deformation events. D1 event; formation phase of the main fracture set of EW (D1-1) and NS (D1-2) trends with a good extensity, D2 event; that of the extension fracture of NW trend, and conjugate shear fracturing of the EW (dextral) and NS (sinistral) trends, D3 event; that of the extension fracture of NE trend, and conjugate shear refracturing of the EW (sinistral) and NS (dextral) trends, D4 event; that of the extension fracture of NS trend showing a poor extensity, D5 event; that of the extension fracture of NW trend, and conjugate shear refracturing of the EW (dextral) and NS (sinistral) trends, D6 event; that of the extension fracture of EW trend showing a poor extensity. Frequency distribution of fracture sets of each deformation event is D1-1 (19.73 %)> D1-2 (16.44 %)> D3=D5 (14.79 %)> D2 (13.70 %)> D4 (12.33 %)> D6 (8.22 %) in descending order. The average number of fracture sets within 1 meter at each deformation event is D6 (5.00)> D5 = D4 (4.67)> D2 (4.60)> D3 (4.13)> D1-1 (3.33)> D1-2 (2.83) in descending order. The average density of all fractures shows 4.20 fractures/1 m, that is, the average spacing of all fractures is more than 23.8 cm. The frequency distribution of quartz veins at each orientation is as follows: EW (52 %)> NW (28 %)> NS (12 %)> NE (8 %) trends in descending order. The average density of all quartz veins shows 4.14 veins/1 m, that is, the average spacing of all quartz veins is more than 24.2 cm. Microstructural data on the quartz veins indicate that the epithermal Au-Ag mineralization (ca. 77.9~73.1 Ma) in the Moisan area seems to occur mainly along the existing D1 fracture sets of EW and NS trends with a good extensity not under tectonic stress but non-deformational environment directly after epithermal rupture fracturing. The D1 fracturing is considered to occur under the unstable tectonic environment which alternates compression and tension of NS trend due to the oblique northward subduction of the Izanagi plate resulting in the igneous activity and deformation of the Yucheon Group and the Bulguksa igneous rocks during Late Cretaceous time.

• Journal of The Korean Society of Grassland and Forage Science
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• 제33권2호
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• pp.123-130
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• 2013

This study was conducted to investigate the effects of climate change on the growth characteristics and dry matter yields of silage corn hybrids in fields of forage crops of Hanwoo Experiment Station, National Institute of Animal Science, RDA, from Apr. 2009 to Sep. 2011. Corn hybrids were cultivated in Daegwallyeong of Gangwon Province, at an altitude of 760 m. Corn varieties used in this study consisted of 5 domestic varieties and 5 foreign varieties. Differences of silk days according to years occurred at an average of 5.5 days. The silk periods of domestic varieties occurred from Aug. 8 to 12, while that of overseas varieties was from Aug. 5 to 11. Silk days of domestic varieties occurred approximately 3 to 4 days earlier than those of oversea varieties. Silk days of Kwangpyeongok and P3156 belonging to the early varieties were Aug. 8 and 5, respectively. Kwangpyeongok and P3156 were Aug. 8 and 5, respectively. Pyeonganok and DK729 belonged to late varieties. The mean plant height of corn was approximately 231 cm, while those of Kwangpyeongok and Pyeonganok were 236 cm and 237 cm, respectively. The mean stem diameter and ear height of corn were approximately 23.2 mm and 94 cm, respectively. In the case of stem diameters, those of Cheonganok and 33J56 were 86 cm and 80 cm, respectively, while Gangdaok grew to a greater height (enter height) than other varieties. Dry matter yields of Kwangpyeongok and Pyeonganok were higher than those of other varieties. The mean leaf ratio of corn was 39.3%, while that of domestic varieties increased as compared to foreign varieties. The average DM yield of corn was 16,653 kg/ha, while those of 32P75, P3156, Pyeonganok, P3394 and Kwangpyeongok were 18,901, 17,997, 17,675, 17,194, 17,188 kg/ha, respectively. Total digestible nutrient (TDN) yields of 32P75, P3156, P3394, Pyeonganok and Kwangpyeongok were 13,381, 12,590, 12,532, 12,140 and 12,036 kg/ha, respectively. Corn crude protein (CP), in vitro dry matter digestibility (IVDMD), neutral detergent fiber (NDF), acid detergent fiber (ADF) and TDN were 7.8%, 74.2%, 42.4%, 23.5% and 70.3%, respectively. In the case of nutritive values of corn, there was no significant difference between of corn varieties of domestic and foreign origin.