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Comparison between FDG Uptake and Clinicopathologic and Immunohistochemical Parameters in Pre-operative PET/CT Scan of Primary Gastric Carcinoma (원발성 위암 환자의 치료 전 PET/CT 스캔에서 FDG 섭취 정도와 임상병리학적 및 면역조직화학적 지표들과의 비교)

  • Han, Eun-Ji;Choi, Woo-Hee;Chung, Yong-An;Kim, Ki-Jun;Maeng, Lee-So;Sohn, Kyung-Myung;Jung, Hyun-Suk;Sohn, Hyung-Sun;Chung, Soo-Kyo
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.1
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    • pp.26-34
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    • 2009
  • Purpose: The purpose of this study was to find out what clinicopathologic or immunohistochemical parameter that may affect FDG uptake of primary tumor in PET/CT scan of the gastric carcinoma patient. Materials and Methods: Eighty-nine patients with stomach cancer who underwent pre-operative FDG PET/CT scans were included. In cases with perceptible FDG uptake in primary tumor, the maximum standardized uptake value (SUVmax) was calculated. The clinicopathologic results such as depth of invasion (T stage), tumor size, lymph node metastasis, tumor differentiation and Lauren's classification and immunohistochemical markers such as Ki-67 index, expression of p53, EGFR, Cathepsin D, c-erb-B2 and COX-2 were reviewed. Results: Nineteen out of 89 gastric carcinomas showed imperceptible FDG uptake on PET/CT images. In cases with perceptible FDG uptake in primary tumor, SUVmax was significantly higher in T2, T3 and T4 tumors than T1 tumors ($5.8{\pm}3.1$ vs. $3.7{\pm}2.1$, p=0.002). SUVmax of large tumors (above or equal to 3 cm) was also significantly higher than SUVmax of small ones (less than 3 cm) ($5.7{\pm}3.2$ vs. $3.7{\pm}2.0$, p=0.002). The intestinal types of gastric carcinomas according to Lauren showed higher FDG uptake compared to the non-intestinal types ($5.4{\pm}2.8$ vs. $3.7{\pm}1.3$, p=0.003). SUVmax between p53 positive group and negative group was significantly different ($6.0{\pm}2.8$ vs. $4.4{\pm}3.0$, p=0.035). No significant difference was found in presence of LN metastasis, tumor differentiation, Ki-67 index, and expression of EGFR, Cathepsin D, c-erb-B2 and COX-2. Conclusion: T stage of gastric carcinoma influenced the detectability of gastric cancer on FDG PET PET/CT scan. When gastric carcinoma was perceptible on PET/CT scan, T stage, size of primary tumor, Lauren's classification and p53 expression were related to degree of FDG uptake in primary tumor.

Assessment of the Impacts of 'Sea Prince' Oil Spill on the Rocky Intertidal Macrobenthos Community (암반조간대 대형저서동물군집에 대한 씨프린스호 유류 유출사고 영향 평가)

  • Shin, Hyun-Chool;Lee, Jung-Ho;Lim, Kyeong-Hun;Yoon, Seong-Myeoung;Koh, Chul-Hwan
    • Korean Journal of Environmental Biology
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    • v.26 no.3
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    • pp.159-169
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    • 2008
  • This study was aimed to classify the intertidal macrozoobenthic community status after 2 years of Sea Prince oil spill, and oil spill effects along oil spreading track from heavily impacted to unaffected reference site. Field sampling was initiated in late February and continued through November 1998 seasonally, after 2.5 years of oil spill. 7 rocky sampling sites were selected among coastal regions coated and/or affected by the Sea Prince spilled oil. Identified species was 158 species, 65 family, 24 order, 9 class, 5 phylum. Mollusca was the dominant faunal group comprising 100 species (63.3%), and followed by 38 species of Crustacea (24.1%), 12 species of Echinodermata (7.6%), 5 species of Porifera (3.2%), and 3 species of Cnidaria (1.9%). On Dugpo of Sori Island, the fewest species was collected from 28 species to 35 species seasonally among sampling stations. But far away Dugpo toward Gamak Bay, the number of species increased, collecting the maximum on Sohwoenggan Island. At the wreck site of Sori Island, especially the species number of attached animals such as poriferans and anthozoans was very low compared to another site. The density and biomass on the higher tidal zone increased toward the low affected sites, but biomass on middle tidal zone decreased. The invertebrate biomass of study area was dependent on the sessile animals. The major dominant species were small-sized barnacles, Chthmallus challengeri, periwinkles, Littorina brevicula, mussels, Septifer virgatus, and so on. The biomass of C. challengeri and L. brevicula on the higher tidal zone was highest in the wreck site of Sori Island and decreased further and further. However, mussels on the middle tidal zone showed the inverse trends because of the larger individual size of mussel inhabited in Sori Island than those of another sites. As a result of community analysis, the effect of oil spill was not found distinctly. Several ecological indices and cluster analysis did not show the meaningful variation with oil track despite of the conspicuous differences among tidal heights. These indicate that the macrozoobenthic community level of oil spreaded zone recovered in some degree after the Sea Prince oil spill accident, but population or individual levels of dominant sessile animals took more recovery times.

Evaluation of Radioactivity Concentration According to Radioactivity Uptake on Image Acquisition of PET/CT 2D and 3D (PET/CT 2D와 3D 영상 획득에서 방사능 집적에 따른 방사능 농도의 평가)

  • Park, Sun-Myung;Hong, Gun-Chul;Lee, Hyuk;Kim, Ki;Choi, Choon-Ki;Seok, Jae-Dong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.1
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    • pp.111-114
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    • 2010
  • Purpose: There has been recent interest in the radioactivity uptake and image acquisition of radioactivity concentration. The degree of uptake is strongly affected by many factors containing $^{18}F$-FDG injection volume, tumor size and the density of blood glucose. Therefore, we investigated how radioactivity uptake in target influences 2D or 3D image analysis and elucidate radioactivity concentration that mediate this effect. This study will show the relationship between the radioactivity uptake and 2D,3D image acquisition on radioactivity concentration. Materials and Methods: We got image with 2D and 3D using 1994 NEMA PET phantom and GE Discovery(GE, U.S.A) STe 16 PET/CT setting the ratio of background and hot sphere's radioactivity concentration as being a standard of 1:2, 1:4, 1:8, 1:10, 1:20, and 1:30 respectively. And we set 10 minutes for CT attenuation correction and acquisition time. For the reconstruction method, we applied iteration method with twice of the iterative and twenty times subset to both 2D and 3D respectively. For analyzing the images, We set the same ROI at the center of hot sphere and the background radioactivity. We measured the radioactivity count of each part of hot sphere and background, and it was comparative analyzed. Results: The ratio of hot sphere's radioactivity density and the background radioactivity with setting ROI was 1:1.93, 1:3.86, 1:7.79, 1:8.04, 1:18.72, and 1:26.90 in 2D, and 1:1.95, 1:3.71, 1:7.10, 1:7.49, 1:15.10, and 1:23.24 in 3D. The differences of percentage were 3.50%, 3.47%, 8.12%, 8.02%, 10.58%, and 11.06% in 2D, the minimum differentiation was 3.47%, and the maximum one was 11.06%. In 3D, the difference of percentage was 3.66%, 4.80%, 8.38%, 23.92%, 23.86%, and 22.69%. Conclusion: The difference of accumulated concentrations is significantly increased following enhancement of radioactivity concentration. The change of radioactivity density in 2D image is affected by less than 3D. For those reasons, when patient is examined as follow up scan with changing the acquisition mode, scan should be conducted considering those things may affect to the quantitative analysis result and take into account these differences at reading.

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A Study on the Continuing Education of Dental Technicians (치과기공사의 보수교육에 관한 연구(I) -보수교육 실태와 인식을 중심으로 -)

  • Moon, Je-Hyuk
    • Journal of Technologic Dentistry
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    • v.22 no.1
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    • pp.179-198
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    • 2000
  • Since dental prosthesis is made possible only when dental technicians give themselves to the study of knowledge and the acquisition of updated skills, continuing education is of great importance in that it makes up for the efforts of dental technicians. Accordingly, continuing education relates to a system designed to contribute to the enhancement of the talents of dental technicians and the dental health of the nation. Specialized knowledge and information may work as the best weapon to preserve their jbs. This is true of this modern society where no one can expecth to survive without acquiring knowledge and information constantly for work is getting more classified and more divirsifide. This paper is dedicated to take a look at the current condition of the continuing education of dental technicians and to come up with measure to make general evaluation and to improve continuing education. This research resorts to 609 questionnaires among 6433 copies save unfaithfully responded 34 copos with 6.431 dental technicians as the subjects enrolled in the Dental technician Association. The collected questionnaires consist of 365 dental technicians living in Seoul and of 244 ones, Which account for 11.8 percent of dental technicians enrolled in the association. Because dental technicians live more in local areas than Seoul, the generalization of this survey leaves something to be desired. I have come up with the following findings. 1. 6,431 dental technicians, or 36.3 percent of an total of 14,956 licensed dental technicians, were admitted as numbers of the Dental Tachnician Association as of October 31, 1999. In the '98 continuing education. 4,141 dental technicians among 4,711 dental technicians got relevant training, and in the '99 continuing education, 4,075 technicians, or 75.9 percent of 5,365 technicians got relevant training while 1,290 technicians or 24.2 percent, fail to get relevant training. 2. The survey has it that 38.1 percent of dental technicians are ignorant of the laws on continuing education, and that technicians staying in local communities(146 persons, or 61.6%) take more part in education than those living in the capital of Korea(159 persons, or 146%), and that the older they are, the more money they earn, the more carrer they have, the higher position they hold, the more part they take in education 3. According to the survey, those who have the experience of getting training more than three times account for 52 persons(16.8%) in Seoul and 47 persons(22.4%) in local districts(p<0.01). In terms of sanctions in relation to continuing education, 26 dental technicians(4.6%) say that they have ever gotten sanctions, and 533 dental technicians(95.4%) say that they haven't. And those who were absent from continuing education(72 technicians : 13.51%) didn't get any sanction. 4. In terms of the degree of understanding continuing education, local technicians(46.8% : 110 persons) have a higher understanding of continuing education than their countparts staying in Seoul(36.0% : 130). Continuing education is not the ultimate goal itself. It should be changed to motivate those who get education to be willing to take part in contunuing education, and to help dental technicians in a practical and specific way. And the branch societies should be developde to engage in more specialized and classified expert fields. Of course, the curriculum should be so selected that the conceptions of dental technicians may be reflected to the maximum extent, and the ultimate effores should be made to effect diversity in the ways of educational methods and to perfect the preparation of continuing education on the part of instructors. Regulations should be established in relation to continuing education with a veiew to enhancing the participation of continuing education and its effectiveness. The supervision of the Ministry of Health and Welfare is of great importance in this context. The regulation of continuing education is not administrative regulation, but the expression of national will to guarantee the medical service of the nation at highest level. Therefore, it is necessary that the Ministry of Health and Welfare should change their understanding of the needs for the continuing education of dental experts, and that the expertise of government employees in charge of continuing education should be expanded. It goes without saying that the government should suppory continuing education in a financial way so as to supply the person in charge of public welfare and control the quality of national medicine.

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Irradiation Preservation of Korean Fish 1. Kadurization of croaker, yellow corvenia and roundnose flounder (방사선조사에 의한 한국산어류의 품질보존에 관한 연구 1. 민어, 참조기 및 물가자미의 감마선 조사 후의 보존특성)

  • CHUNG Jong Rak;KIM Su Ill;LEE Min Chul
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.9 no.2
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    • pp.129-142
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    • 1976
  • Optimum doses The optimum dose that may be defined as the dose below the maximum permissible dose, yet would bring about a significant storage life extension at refrigerated temperatures, varied with species of fish as well as with the postirradiation storage temperatures. Thus the dose of 0. 1 Mrad was considered to be optimum for the croaker and yellow corvenia at $0^{\circ}C$, while at $5^{\circ}C$ the dose of 0.2 Mrad would be suitable for both species. The roundnose flounder was more radiosensitive and even at the dose of 0.1 Mrad a slight irradiation odor was detected immediately after the radiation treatment. Such degree of irradiation odor disappeared upon storage, therefore, the dose of 0.1 Mrad was considered to be optimum for the roundnose flounder at both $0^{\circ}\;and\;5^{\circ}C$. Storage life extension The croaker meats irradiated at 0.1 Mrad could be held at $0^{\circ}C$ as long as 5 weeks in good acceptable conditions, while the unirradiated control became unacceptable within 2 weeks-3-4 for extension of storage life at $0^{\circ}C$. At the storage temperature of $5^{\circ}C$, the storage life of 0.2 Mrad irradiated samples was extended from less than one week to 4 weeks--4-5 fold extension. The storage life extension of 0.1 Mrad irradiated yellow corvenia at $0^{\circ}C$ was from less than 2 weeks for the unirradiated to 4 weeks-approximately a-s folds and that of 0.2 Mrad irradiated samples stored at $5^{\circ}C$ was from 5 days to 3 weeks 4-5 folds. The roundnose flounder meats irradiated at 0.1 Mrad could held at $0^{\circ}C$ for 3-4 weeks as compared to less than 1 week for the unirradiated and at $5^{\circ}C$ the storage life could be extended from less than 3 days to up to 3 weeks. Thus the storage life extension by 4-5 folds and by 6-7 folds was possible at $0^{\circ}C\;and\;5^{\circ}C$ storage, respectively. Postirradiation storage microbiology and biochemistry In general 10 fold reduction of initial microflora was realized as a result of irradiating fish samples at 0.1 Mrad. The extent of microflora reduction increased with increasing doses applied, but not proportionately dependent. The microbial growth in the irradiated was severely retarded during the subsequent storage period, lagging far behind that of the irradiated control samples except in the late storage phase, when the levels of microflora of the irradiated either approached to or rose above the levels of the unirradiated. The microbiological changes caused by irradiation was reflected in the pronounced suppression of TVB and TMA accumulation during the storage period. This suggests that irradiation treatment brought about both quantitative and qualitative changes in microflora initially present and it is reasonable to suggest that the microflora removed by irradiation in fact represent most of the flora capable of producing TVB and TMA in normal fish spoilage process.

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Heating Performance of Hot Water Supplying System in Greenhouse (온수배관을 이용한 온실의 난방성능)

  • Yoon, Yong-Cheol;Shin, Yik-Soo;Kim, Hyeon-Tae;Bae, Seoung-Beom;Choi, Jin-Sik;Suh, Won-Myung
    • Journal of Bio-Environment Control
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    • v.21 no.2
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    • pp.79-87
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    • 2012
  • This research was conducted to obtain basic data with regard to the heating performance that would be produced by installing an aluminum hot water pipe inside the greenhouse with the goal of reducing the heating energy in greenhouse. The research results are summarized as follows. The degree of difference in relation to the temperature by height within the greenhouse during the entire experiment was significant - within the range of 4.0~$7.0^{\circ}C$. The temperature difference between incoming and outgoing water was about $3.3^{\circ}C$ greater when FCU was activated compared to when it was not activated. Meanwhile, the amount of energy consumed increased about 36.2~40.1%. The amount of pyrexia per hour also increased by 44.6~52.0%. During the experiment period, circulated flux was within the range of 0.48~$0.49L{\cdot}s^{-1}$ while average fluid speed was 1.53~$1.56m{\cdot}s^{-1}$. The average temperature difference between incoming and outgoing water was 6.24~$11.50^{\circ}C$. The amount of heating value by each set temperature within the minimum outdoor temperature range of -14.0~$-0.6^{\circ}C$ was 135,930~307,150 kcal, and the range was within the 9,610~$19,630kcal{\cdot}h^{-1}$ per hour. This demonstrated that about 23~53% heating energy of the maximum heating load could be supplied. Total radiating value and amount of energy consumed were 2,548,306 kcal and 3,075.7 kWh, respectively. When heating takes place using oil, which is a fossil fuel, the total amount of light oil consumed was 281.6 L while the cost was 321,000 won. When the electricity cost for farms is applied, the total cost was about 110,730 won, which is about 33.5% of the cost required compared to oil consumption. The temperature at in the experiment area was about 8.3~$14.6^{\circ}C$ higher compared to that of the control area.

A Study of the Japanese Colonial Era Rock-Carved Seated Avalokiteśvara Statue at Ganghwa Bomunsa Temple (일제강점기 강화 보문사 마애관음보살좌상 연구)

  • Lee, Jumin
    • Korean Journal of Heritage: History & Science
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    • v.53 no.3
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    • pp.62-79
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    • 2020
  • The rock-carved seated Avalokiteśvara statue at Ganghwa Bomunsa Temple is a giant rock-carved Buddhist statue that was built in 1928 during the Japanese colonial era. Although it is a year-recorded Buddhist statue that occupies a prominent place in modern Korean Buddhist sculpture history, it has not been the subject of in-depth discussion due to weak research on modern Buddhist sculptures. In this study, to examine the various significant aspects of the rock-carved Seated Avalokiteśvara statue at Bomunsa Temple as a modern Buddhist sculpture, I have managed to determine its construction year, artificers, and patrons by deciphering the inscription around the rock-carved statue; in addition I have researched the effects of the rock shapes and landforms on the formation of the Buddhist statue by comparing and analyzing the points of view of both artificers and worshipers. I have also identified the specific circumstances of the time of construction from interviews with the descendants of artificers. A monk from Geumgangsan Mountain, Lee Hwaeung, took the role of sponsor and chief painter to construct the rock-carved seated Avalokiteśvara statue at Bomunsa temple. In the beginning of its construction in 1928, more than 100 donators jointly sponsored the construction of the statue. Gansong Jeon Hyoungphil sponsored alone at the time of the place of worship's expansion in 1938. Bomunsa Temple has been regarded as one of the top-three sacred places of Avalokiteśvara Bodhisattva together with Naksansa Temple in Yang Yang and Boriam in Nam Hae, due to the construction of the rock-carved statue. It took about three months to construct the statue. Lee Hwaeung drew a rough sketch and then Un Songhag and five masons from Ganghwa Island took part in the carving process. We can observe the line drawing technique around the rock-carved statue because the statue was carved based on the rough sketch of the monk painter. The aspect of Lee Hwaeung as a painter is revealed; therefore, we can identify the clue of painting pattern leading to Seogongchulyou- Hwaunghyoungjin- Ilonghyegag. The rock-carved seated Avalokiteśvara statue at Bomunsa Temple is a typical Avalokiteśvara that wears a jeweled crown and holds Kundica. It makes a strong impression as it has a big square-shaped face and a short neck and is unsophisticated in general. The artificers solved the issue of visual distortion of the rock-carved statue caused by carving on a 10-meter high and 40-degree sloping rock by controlling motion to its maximum, omitting detailed expression by emphasizing symmetry, and adjusting the head-to-body proportion to be almost one-to-one. In this study, especially, I presume the unified form of sacred sculptures and Buddhist altars, without making a Buddhist altar like the rock-carved seated Avalokiteśvara statue at Bomunsa Temple, to be a key characteristic of modern Buddhist sculptures. Furthermore, I make newly clear that the six letters of Sanskrit carved on nimbus, which had been interpreted as a Six-Syllable Mantra, are a combination with Jeongbeopgye and Sabang Mantras. In addition, three iron rings driven on eaves rock were used as a reference point, and after construction they were used as a decoration for the Bodhisattva with hanging wind chimes.

Phase Transitions of $LiMn_2O_4$ on $CO_2$ Decomposition (($CO_2$ 분해시 $LiMn_2O_4$의 상변화)

  • Kwoen, Tae-Hwan;Yang, Chun-Mo;Park, Young-Goo;Cho, Young-Koo;Rim, Byung-O
    • Journal of the Korean Applied Science and Technology
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    • v.20 no.1
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    • pp.33-43
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    • 2003
  • $LiMn_2O_4$ catalyst for $CO_2$ decomposition was synthesized by oxidation method for 30 min at 600$^{\circ}C$ in an electric furnace under air condition using manganese(II) nitrate $(Mn(NO_3)_2{\cdot}6H_2O)$, Lithium nitrate ($LiNO_3$) and Urea $(CO(NH_2)_2)$. The synthesized catalyst was reduced by $H_2$ at various temperatures for 3 hr. The reduction degree of the reduced catalysts were measured using the TGA. And then $CO_2$ decomposition rate was measured using the reduced catalysts. Phase-transitions of the catalysts were observed after $CO_2$ decomposition reaction at an optimal decomposition temperature. As the result of X-ray powder diffraction analysis, the synthesized catalyst was confirmed that the catalyst has the spinel structure, and also confirmed that when it was reduced by $H_2$, the phase of $LiMn_2O_4$ catalyst was transformed into $Li_2MnO_3$ and $Li_{1-2{\delta}}Mn_{2-{\delta}}O_{4-3{\delta}-{\delta}'}$ of tetragonal spinel phase. After $CO_2$ decomposition reaction, it was confirmed that the peak of $LiMn_2O_4$ of spinel phase. The optimal reduction temperature of the catalyst with $H_2$ was confirmed to be 450$^{\circ}C$(maximum weight-increasing ratio 9.47%) in the case of $LiMn_2O_4$ through the TGA analysis. Decomposition rate(%) using the $LiMn_2O_4$ catalyst showed the 67%. The crystal structure of the synthesized $LiMn_2O_4$ observed with a scanning electron microscope(SEM) shows cubic form. After reduction, $LiMn_2O_4$ catalyst became condensed each other to form interface. It was confirmed that after $CO_2$ decomposition, crystal structure of $LiMn_2O_4$ catalyst showed that its particle grew up more than that of reduction. Phase-transition by reduction and $CO_2$ decomposition ; $Li_2MnO_3$ and $Li_{1-2{\delta}}Mn_{2-{\delta}}O_{4-3{\delta}-{\delta}'}$ of tetragonal spinel phase at the first time of $CO_2$ decomposition appear like the same as the above contents. Phase-transition at $2{\sim}5$ time ; $Li_2MnO_3$ and $Li_{1-2{\delta}}Mn_{2-{\delta}}O_{4-3{\delta}-{\delta}'}$ of tetragonal spinel phase by reduction and $LiMn_2O_4$ of spinel phase after $CO_2$ decomposition appear like the same as the first time case. The result of the TGA analysis by catalyst reduction ; The first time, weight of reduced catalyst increased by 9.47%, for 2${\sim}$5 times, weight of reduced catalyst increased by average 2.3% But, in any time, there is little difference in the decomposition ratio of $CO_2$. That is to say, at the first time, it showed 67% in $CO_2$ decomposition rate and after 5 times reaction of $CO_2$ decomposition, it showed 67% nearly the same as the first time.

Beam Shaping by Independent Jaw Closure in Steveotactic Radiotherapy (정위방사선치료 시 독립턱 부분폐쇄를 이용하는 선량분포개선 방법)

  • Ahn Yong Chan;Cho Byung Chul;Choi Dong Rock;Kim Dae Yong;Huh Seung Jae;Oh Do Hoon;Bae Hoonsik;Yeo In Hwan;Ko Young Eun
    • Radiation Oncology Journal
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    • v.18 no.2
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    • pp.150-156
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    • 2000
  • Purpose : Stereotactic radiation therapy (SRT) can deliver highly focused radiation to a small and spherical target lesion with very high degree of mechanical accuracy. For non-spherical and large lesions, however, inclusion of the neighboring normal structures within the high dose radiation volume is inevitable in SRT This is to report the beam shaping using the partial closure of the independent jaw in SRT and the verification of dose calculation and the dose display using a home-made soft ware. Materials and Methods : Authors adopted the idea to partially close one or more independent collimator jaw(5) in addition to the circular collimator cones to shield the neighboring normal structures while keeping the target lesion within the radiation beam field at all angles along the arc trajectory. The output factors (OF's) and the tissue-maximum ratios (TMR's) were measured using the micro ion chamber in the water phantom dosimetry system, and were compared with the theoretical calculations. A film dosimetry procedure was peformed to obtain the depth dose profiles at 5 cm, and they were also compared with the theoretical calculations, where the radiation dose would depend on the actual area of irradiation. Authors incorporated this algorithm into the home-made SRT software for the isodose calculation and display, and was tried on an example case with single brain metastasis. The dose-volume histograms (DVH's) of the planning target volume (PTV) and the normal brain derived by the control plan were reciprocally compared with those derived by the plan using the same arc arrangement plus the independent collimator jaw closure. Results : When using 5.0 cm diameter collimator, the measurements of the OF's and the TMR's with one independent jaw set at 30 mm (unblocked), 15.5 mm, 8.6 mm, and 0 mm from th central beam axis showed good correlation to the theoretical calculation within 0.5% and 0.3% error range. The dose profiles at 5 cm depth obtained by the film dosimetry also showed very good correlation to the theoretical calculations. The isodose profiles obtained on the home-made software demonstrated a slightly more conformal dose distribution around the target lesion by using the independent jaw closure, where the DVH's of the PTV were almost equivalent on the two plans, while the DVH's for the normal brain showed that less volume of the normal brain receiving high radiation dose by using this modification than the control plan employing the circular collimator cone only. Conclusions : With the beam shaping modification using the independent jaw closure, authors have realized wider clinical application of SRT with more conformal dose planning. Authors believe that SRT, with beam shaping ideas and efforts, should no longer be limited to the small spherical lesions, but be more widely applied to rather irregularly shaped tumors in the intracranial and the head and neck regions.

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Outcome and Prognosis in Critically III Children Receiving Continuous Renal Replacement Therapy (소아 중환자에서 지속적 신대체요법의 치료 결과와 예후)

  • Park, Kwang-Sik;Son, Ki-Young;Hwang, You-Sik;Kim, Joung-A;Cheung, Il-Chun;Shin, Jae-Il;Park, Ji-Min;Ahn, Sun-Young;Lyu, Chuhl-Joo;Lee, Jae-Seung
    • Childhood Kidney Diseases
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    • v.11 no.2
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    • pp.247-254
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    • 2007
  • Purpose : Continuous renal replacement therapy(CRRT) has been the first choice for the treatment of acute renal failure in critically ill children not only in western countries but also in Korea. However, there are very few studies that have analyzed the outcome and prognosis of this modality in Korean children. We performed this study to evaluate the factors associated with the outcome and prognosis of patients treated with CRRT. Methods : We retrospectively reviewed the medical records of 32 children who had received CRRT at Severance hospital from 2003 to 2006. The mean age was 7.5 years(range 4 days-16 years) and the mean body weight was 25.8 kg (range 3.2-63 kg). Results : Eleven(34.4%) of the 32 patients survived. Bone marrow transplantation and malignancy were the most common causes of death and underlying disease leading to the need for CRRT Mean patient weight, age, duration of CRRT, number of organ failures, urine output, estimated glomerular filtration rate(eGFR), C-reactive protein, and blood urea level did not differ significantly between survivors and nonsurvivors. (1) Pediatric risk of mortality(PRISM) III score at CRRT initiation($9.8{\pm}5.3$ vs. $26.7{\pm}7.6$, P<0.0001), (2) maximum pressor number ($2.1{\pm}1.2$ vs. $3.0{\pm}1.0$, P=0.038), and (3) the degree of fluid overload($5.2{\pm}6.0$ vs. $15.0{\pm}8.9$, P=0.002) were significantly lower in survivers than in nonsurvivors. Multivariate analysis revealed that fluid overload was the only independent factor reducing survival rate. Conclusion : CRRT was successfully applied to the treatment of acute renal failure in a wide range of critically ill children. To improve survival, we suggest the early initiation of CRRT to prevent the systemic worsening and progression of fluid overload in critically ill children with acute renal failure. (J Korean Soc Pediatr Nephrol 2007;11:247-254)

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