• The Korean Journal of Nuclear Medicine Technology
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• v.15 no.2
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• pp.26-29
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• 2011

Purpose: The general test method of the Korean Pharmacopeia specifies the test method on the clauses of quality control after manufacturing. According to KFDA Guidance for Medicines, standards of residual solvents regulates the maximum permissible dose of acetonitrile as 400 ppm, ethanol as 5,000 ppm, and acetic acid as 5,000 ppm. This study aims at identifying the type of resiual solvents in the final [F-18]FDG vial of an automatic synthesizer and measure its residual quantity. Materials and Methods: The center carried out residual solvents test of [F-18]FDG injection using Agilent Technologies 7890A with a Flame Ionization Detector. The column of Agilent Technologies 7890A used in measuring of residual solvents was CP WAX column ($30m{\times}0.53mm{\times}1.0{\mu}m$) and analysis condition was split mode 1:1 at the initial temperature $70^{\circ}C$ which was increased $20^{\circ}C/minute$ after two minutes and maintained at the final $140^{\circ}C$ for two minutes. The analysis method was as following: Firstly, ethanol-acetonitrile-acetic acid mixture was classified into four types of concentration (250-25-250 ppm, 1,000-100-1,000 ppm, 3,000-300-3,000 ppm, and 6,000-600-6,000 ppm), and $1.0{\mu}L$ of each type of concentration was injected into gas chromatography followed by an analysis of its peak domain. Then, a calibration-curve by the external standard method was drawn based on the analysis result. Results: While ethanol and acetonitrile were detected in TRACERlab MX, FASTlab had additional acetic acid. The residual quantity of the ethanol-acetonitrile-acetic acid mixture evaluated using the calibration-curve was average 72 ppm ethanol, 54 ppm acetonitrile, and 1030 ppm acetic acid for FASTlab, whereas average 439 ppm ethanol and 79 ppm acetonitrile for TRACERlab MX. This indicated that both of them were within the maximum permissible dose. Conclusion: Solvent residues in the [F-18]FDG injection were all within maximum permissible doses and proper to be used to examine a patient. The result indicated that types and quantities of solvent resides of radioactive pharmaceuticals vary depending on the automatic synthesizer.

• The Korean Journal of Nuclear Medicine Technology
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• v.15 no.2
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• pp.21-25
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• 2011

Purpose: $^{18}F$-FDG Fusion Whole Body PET scan is performed approximately 1 hour after injecting $^{18}F$-FDG. At this point in the injection procedure, as a tool of the criteria of time input, time of clocks or computers can be used and in the scan procedure, time of workstation can be used. In case that synchronized time input is not done in the injection and scan procedures for PET scan, time error from injection to scan can occur. This time error may affect Standard Uptake Value (SUV) being used as quantitative assessment. Therefore, in this study, we analyzed the change of SUV according to time input difference and necessity of time synchronization. Materials and Methods: The analysis was performed to 30 patients ($54.8{\pm}15.5$ years old) who examined $^{18}F$-FDG Fusion Whole Body PET scan in Department of nuclear medicine, Asan Medical Center from December 2009 to February 2010. To observe the change of SUV according to time input difference, the image was reconstructed and analyzed by artificially changing time difference of 1, 2, 3, 5, 10, 20 min against the same patients based on 60 minutes. Result: SUV of the image that reconstructed the images of 30 patients by giving intervals of 1, 2, 3, 5, 10, 20 min respectively and the image that entered original time was compared and analyzed through paired t-test. Based on 0 minute, mean SUV of aorta was changed by 0.3, 1.1, 1.4, 3.2, 4.7, 12.5% respectively and there was no statistically significant difference in 1, 2 minutes (p>0.05) but there was significant difference in 3, 5, 10, 20 min (p<0.05). The changes of $SUV_{avg}$ of liver were 1.6, 2.5, 3.0, 4.2, 6.6, 12.8% in 1, 2, 3, 5, 10, 20 min respectively and the changes of $SUV_{max}$ of primary lesion were 1.0, 1.5, 2.2, 3.5, 6.6, 12.8% respectively (p<0.05). Conclusion: Errors may occur in the process of measuring or recording variables affecting SUV such as height and weight of patients, $^{18}F$-FDG dose, Emission scan start time etc. and as these errors are more, the accurate assessment of SUV is interfered. Therefore, in order to assess SUV more accurately, it is thought that efforts to minimize these errors should be made. Of these efforts, time synchronization will be a cornerstone for accurate scanning.

• The Korean Journal of Nuclear Medicine Technology
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• v.15 no.2
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• pp.47-52
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• 2011

Purpose: Facilities use own sever or mini PACS system for storage and analysis of the PET/CT data. Mini PACS can storage scan data as well as measuring SUV. Therefore, the study was performed to confirm whether or not measured SUV on mini PACS is measured equally on PET/CT workstation. Materials and Methods: In February 2011, 30 patients who were performed $^{18}F$-FDG wholebody PET/CT scan in Biograph 16, Biograph 40 and Discovery Ste 8 were enrolled. First, using each workstation, SUV in liver and aorta of mediastinum level was measured. Second, using mini PACS, SUV was measured by same method. Result: The correlation coefficient of SUV in liver between PET/CT scanner and min PACS in Biograph 16, Biograph 40, Discovery Ste 8 was 0.99, 0.98, 0.64 respectably, the correlation coefficient of SUV in aorta was 0.98, 0.98, 0.66, and these were showed positive correlation coefficient. Difference of SUV between Biograph workstation and mini PACS was not showed statistical significant difference at 5% level of significance. Difference of SUV between Discovery Ste 8 workstation and mini PACS was showed statistical significant difference at 5% level of significance. Conclusion: In case that patient was scanned by the other scanner, if the correction of SUV formula in mini PACS for each scanners is performed, mini PACS will be usefully used to provide consistently quantitative assessment.

• The Journal of Korean Society for Radiation Therapy
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• v.26 no.2
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• pp.297-303
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• 2014

Purpose : The purpose of this study is reproducibility evaluation of deep inspiration breath-hold(DIBH) technique by respiration data and heart position analysis in radiation therapy for Left Breast cancer patients. Materials and Methods : Free breathing(FB) Computed Tomography(CT) images and DIBH CT images of three left breast cancer patients were used to evaluate the heart volume and dose during treatment planing system( Eclipse version 10.0, Varian, USA ). The signal of RPM (Real-time Position Management) Respiratory Gating System (version 1.7.5, Varian, USA) was used to evaluate respiration stability of DIBH during breast radiation therapy. The images for measurement of heart position were acquired by the Electronic portal imaging device(EPID) cine acquisition mode. The distance of heart at the three measuring points(A, B, C) on each image was measured by Offline Review (ARIA 10, Varian, USA). Results : Significant differences were found between the FB and DIBH plans for mean heart dose (6.82 vs. 1.91 Gy), heart $V_{30}$ (68.57 vs. $8.26cm^3$), $V_{20}$ (76.43 vs. $11.34cm^3$). The standard deviation of DIBH signal of each patient was ${\pm}0.07cm$, ${\pm}0.04cm$, ${\pm}0.13cm$, respectively. The Maximum and Minimum heart distance on EPID images were measured as 0.32 cm and 0.00 cm. Conclusion : Consequently, using the DIBH technique with radiation therapy for left breast cancer patients is very useful to establish the treatment plan and to reduce the heart dose. In addition, it is beneficial to using the Cine acquisition mode of EPID for the reproducibility evaluation of DIBH.

• The Journal of Korean Society for Radiation Therapy
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• v.26 no.2
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• pp.355-362
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• 2014

Purpose : When head&neck cancer radiation therapy, thermoplastic mask is applied for patients with fixed. The purpose of this study is to evaluate usefulness of thermoplastic mask for SRS in tomotherapy by conparison with the conventional mask. Materials and Methods : Typical mask(conventional mask, C-mask) and mask for SRS are used to fix body phantom(rando phantom) on the same iso centerline, then simulation is performed. Tomotherapy plan for orbit and salivary glands is made by treatment planning system(TPS). A thick portion and a thin portion located near the treatment target relative to the mask S-mask are defined as region of interest for surface dose dosimetry. Surface dose variation depending on the type of mask was analyzed by measuring the TPS and EBT film. Results : Surface dose variation due to the type of mask from the TPS is showed in orbit and salivary glands 0.65~2.53 Gy, 0.85~1.84 Gy, respectively. In case of EBT film, -0.2~3.46 Gy, 1.04~3.02 Gy. When applied to the S-mask, in TPS and Gafchromic EBT3 film, substrantially 4.26%, 5.82% showed maximum changing trend, respectively. Conclusion : To apply S-mask for tomotherapy, surface dose is changed, but the amount is insignificant and be useful when treatment target is close critical organs because decrease inter and intra fractional variation.

• Journal of Korean Ophthalmic Optics Society
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• v.16 no.4
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• pp.417-423
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• 2011

Purpose: This study was to investigate that near gradient AC/A ratio could be used to prescribe a patient with distance exophoria, we compared the difference between distance gradient AC/A ratio and near gradient AC/A ratio. Also, this thesis was to understand the relationship between calculated AC/A ratio and gradient AC/A ratio. Methods: Objective and subjective refractive error were corrected and we used Howell (3 m) chart for distance phoria tests and Howell-Kim (40 cm) chart for near phoria tests. The near gradient AC/A ratio and calculated AC/A ratio were used by Howell-Kim (40 cm) combined with +1.00 D, -1.00 D, +2.00 D and -2.00 D. Results: The average value of distance exophoria was 1.17${\pm}$1.17 $\Delta$, and the average value of near exophoria was 3.71${\pm}$2.80 $\Delta$ (t-test. p<0.001). The correlation of distance phoria with near phoria was little higher (r = 0.59, p < 0.001). Gradient AC/A ratios depending on measuring distance and stimulus were higher (r = 0.11~0.53. P < 0.001), when distance was shorter and stimulus to accommodation was more. Also, stimulus to accommodation by plus lens was higher than stimulus to accommodation by minus lens (paired t-test. p < 0.001). There was negative correlation between calculated AC/A ratio and gradient AC/A ratio. As the calculated AC/A ratio was higher, gradient AC/A ratio was lesser. Near gradient AC/A ratio was slightly higher than distance gradient AC/A ratio. Distance and near gradient AC/A ratio taken through the subjective -1.00 D were 1.30 $\Delta$/D and 1.68 $\Delta$/D(t-test. t=1.67, p < 0.001). Conclusions: There is negative correlation between calculated AC/A ratio and gradient AC/A ratio. Also, there is subtle difference between near gradient AC/A ratio and distance gradient AC/A ratio. Therefore, we need to measure distance gradient AC/A ratio when a practitioner prescribe glasses for a patient with distance exophoria.

• The Journal of Korean Society for Radiation Therapy
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• v.25 no.2
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• pp.107-113
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• 2013

Purpose: To verify accuracy of respiratory gated proton therapy by measuring and analyzing proton beam delivered when respiratory gated proton therapy is being performed in our institute. Materials and Methods: The plan data of 3 patients who took respiratory gated proton therapy were used to deliver proton beam from proton therapy system. The manufactured moving phantom was used to apply respiratory gating system to reproduce proton beam which was partially irradiated. The key characteristics of proton beam, range, spreat-out Bragg peak (SOBP) and output factor were measured 5 times and the same categories were measured in the continuous proton beam which was not performed with respiratory gating system. Multi-layer ionization chamber was used to measure range and SOBP, and Scanditronix Wellhofer and farmer chamber was used to measure output factor. Results: The average ranges of 3 patients (A, B, C), who had taken respiratory gated proton therapy or not, were (A) 7.226, 7.230, (B) 12.216, 12.220 and (C) 19.918, 19.920 $g/cm^2$ and average SOBP were (A) 4.950, 4.940, (B) 6.496, 6.512 and (C) 8.486, 8.490 $g/cm^2$. And average output factor were (A) 0.985, 0.984 (B) 1.026, 1.027 and (C) 1.138, 1.136 cGy/MU. The differences of average range were -0.004, -0.004, -0.002 $g/cm^2$, that of SOBP were 0.010, -0.016, -0.004 $g/cm^2$ and that of output factor were 0.001, -0.001, 0.002 cGy/MU. Conclusion: It is observed that the range, SOBP and output factor of proton beam delivered when respiratory gated proton therapy is being performed have the same beam quality with no significant difference compared to the proton beam which was continuously irradiated. Therefore, this study verified the quality of proton beam delivered when respiratory gated proton therapy and confirmed the accuracy of proton therapy using this.

• The Journal of Korean Academy of Prosthodontics
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• v.51 no.4
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• pp.307-314
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• 2013

Purpose: The aim of this study was to evaluate the effect of immobilization of the recombinant human bone morphogenetic protein 2 (rhBMP-2) on anodized titaum implants coated with heparin to enhance the vertical alveolar ridge augmentation in the supraalveolar peri-implant defect region. Materials and methods: 18 pure titanium implants (7.0 mm in length, 3.5 mm in diameter) were manufactured for this study. All implants were anodized and designed insertion reference line marked with laser at the apical 2.5 mm from the fixture platform. Implantation of 6 noncoated anodized implants (Control group), 6 anodized implants physically adsorbed with rhBMP-2 by dip and dry method (BMP group) and 6 anodized implants chemically immobilized 3,4-dihydroxyphenylalanine (DOPA)-heparin/ rhBMP-2 (Hep-BMP group) was performed in the both mandibular of three male adult beagle dogs using split-mouth design. Radiologic examinations were performed immediately after implant placement and 4 and 8 weeks after implant placement. The amount of mesio-distal bone augmentation was evaluated by measuring the vertical distance from the platform to the marginal bone. Statistical analysis was performed using one-way analysis of variance (SPSS version 18.0) and multiple comparison analysis of The Kruskal-Wallis test and the Mann-Whitney U test. Statistical significance was established at the 5% significant level. Results: At the 4 weeks vertical alveolar ridge augmentation of Control group, BMP group and Hep-BMP group is $0.09{\pm}0.22mm$, $1.02{\pm}0.72mm$, and $1.29{\pm}0.51mm$, At the 8 weeks $0.11{\pm}1.26mm$, $1.11{\pm}0.58mm$, $1.59{\pm}0.79mm$ according to radiographic observations. The two experimental groups showed a significantly increasing in vertical bone height compared with the control group (P<.05). However, there is no significant difference between the BMP group and Hep-BMP group (P>.05). Conclusion: The rhBMP-2 coated implants were enhanced the vertical bone growth in the supraalveolar peri-implant defect area. However, there is no significant difference between chemically and physically coating method.

• Investigative Magnetic Resonance Imaging
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• v.17 no.2
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• pp.83-90
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• 2013

Purpose : To report our clinical experience with cardiac 3.0 T MRI in patients compared with 1.5 T using individually optimized imaging protocols. Materials and Methods: We retrospectively reviewed 30 consecutive patients and 20 consecutive patients who underwent 1.5 T and 3 T cardiac MRI within 10 months. A comparison study was performed by measuring the signal-to-noise ratio (SNR), the contrast-to-noise ratio (CNR) and the image quality (by grading each sequence on a 5-point scale, regarding the presence of artifacts). Results: In morphologic and viability studies, the use of 3.0 T provided increase of the baseline SNRs and CNRs, respectively (T1: SNR 29%, p < 0.001, CNR 37%, p < 0.001; T2-SPAIR: SNR 13%, p = 0.068, CNR 18%, p = 0.059; viability imaging: SNR 45%, p = 0.017, CNR 37%, p = 0.135) without significant impairment of the image quality (T1: $3.8{\pm}0.9$ vs. $3.9{\pm}0.7$, p = 0.438; T2-SPAIR: $3.8{\pm}0.9$ vs. $3.9{\pm}0.5$, p = 0.744; viability imaging: $4.5{\pm}0.8$ vs. $4.7{\pm}0.6$, p = 0.254). Although the image qualities of 3.0 T functional cine images were slightly lower than those of 1.5 T images ($3.6{\pm}0.7$ vs. $4.2{\pm}0.6$, p < 0.001), the mean SNR and CNR at 3.0 T were significantly improved (SNR 143% increase, CNR 108% increase, p < 0.001). With our imaging protocol for 3.0 T perfusion imaging, there was an insignificant decrease in the SNR (11% decrease, p = 0.172) and CNR (7% decrease, p = 0.638). However, the overall image quality was significantly improved ($4.6{\pm}0.5$ vs. $4.0{\pm}0.8$, p = 0.006). Conclusion: With our experience, 3.0 T MRI was shown to be feasible for the routine assessment of cardiac imaging.

• Journal of agricultural medicine and community health
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• v.37 no.1
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• pp.12-22
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• 2012

Objectives: This study aimed to compare the nutritional risk, health status and depression levels of young-old (65-74 years) and old-old (75-84 years) women on low-income. Methods: A total of 624 elderly women, each over 65 years of age, participated in this study under the auspices of a community social center. Data were collected from June to August 2011 by means of personal interviews which employed questionnaires. The research tools used in this study were the nutritional risk measuring Mini Nutritional Assesment (MNA) by Kim (2000), perceived health status developed by Lawton et al. (1982), Elderly Depression Criterion developed by Sheikh & Yesavage (1985). The collected data were analyzed using the SPSS WIN 12.0 Program. Results: Nutritional risk, perceived health status and depression levels showed a significant difference between young-old and old-old. There was a positive correlation between nutritional risk and depression and a negative correlation between nutritional risk and perceived health status. A 38.2% variance in depression levels of young-old and a 29.7% variance in depression levels of old-old were explained by perceived health status, nutritional risk and the number of people living together. Conclusion: The findings demonstrate variances in depression levels among low - income women differing in age. As a result, the outcomes of this study ought to be employed in the development of future programs aimed at promoting the health of elderly women.