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Risk Factor Analysis for Preventing Foodborne Illness in Restaurants and the Development of Food Safety Training Materials (레스토랑 식중독 예방을 위한 위해 요소 규명 및 위생교육 매체 개발)

  • Park, Sung-Hee;Noh, Jae-Min;Chang, Hye-Ja;Kang, Young-Jae;Kwak, Tong-Kyung
    • Korean journal of food and cookery science
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    • v.23 no.5
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    • pp.589-600
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    • 2007
  • Recently, with the rapid expansion of the franchise restaurants, ensuring food safety has become essential for restaurant growth. Consequently, the need for food safety training and related material is in increasing demand. In this study, we identified potentially hazardous risk factors for ensuring food safety in restaurants through a food safety monitoring tool, and developed training materials for restaurant employees based on the results. The surveyed restaurants, consisting of 6 Korean restaurants and 1 Japanese restaurant were located in Seoul. Their average check was 15,500 won, ranging from 9,000 to 23,000 won. The range of their total space was 297.5 to $1322.4m^2$, and the amount of kitchen space per total area ranged from 4.4 to 30 percent. The mean score for food safety management performance was 57 out of 100 points, with a range of 51 to 73 points. For risk factor analysis, the most frequently cited sanitary violations involved the handwashing methods/handwashing facilities supplies (7.5%), receiving activities (7.5%), checking and recording of frozen/refrigerated foods temperature (0%), holding foods off the floor (0%), washing of fruits and vegetables (42%), planning and supervising facility cleaning and maintaining programs of facilities (50%), pest control (13%), and toilet equipped/cleaned (13%). Base on these results, the main points that were addressed in the hygiene training of restaurant employees included 4 principles and 8 concepts. The four principles consisted of personal hygiene, prevention of food contamination, time/temperature control, and refrigerator storage. The eight concepts included: (1) personal hygiene and cleanliness with proper handwashing, (2) approved food source and receiving management (3) refrigerator and freezer control, (4) storage management, (5) labeling, (6) prevention of food contamination, (7) cooking and reheating control, and (8) cleaning, sanitation, and plumbing control. Finally, a hygiene training manual and poster leaflets were developed as a food safety training materials for restaurants employees.

Development of an Offline Based Internal Organ Motion Verification System during Treatment Using Sequential Cine EPID Images (연속촬영 전자조사 문 영상을 이용한 오프라인 기반 치료 중 내부 장기 움직임 확인 시스템의 개발)

  • Ju, Sang-Gyu;Hong, Chae-Seon;Huh, Woong;Kim, Min-Kyu;Han, Young-Yih;Shin, Eun-Hyuk;Shin, Jung-Suk;Kim, Jing-Sung;Park, Hee-Chul;Ahn, Sung-Hwan;Lim, Do-Hoon;Choi, Doo-Ho
    • Progress in Medical Physics
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    • v.23 no.2
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    • pp.91-98
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    • 2012
  • Verification of internal organ motion during treatment and its feedback is essential to accurate dose delivery to the moving target. We developed an offline based internal organ motion verification system (IMVS) using cine EPID images and evaluated its accuracy and availability through phantom study. For verification of organ motion using live cine EPID images, a pattern matching algorithm using an internal surrogate, which is very distinguishable and represents organ motion in the treatment field, like diaphragm, was employed in the self-developed analysis software. For the system performance test, we developed a linear motion phantom, which consists of a human body shaped phantom with a fake tumor in the lung, linear motion cart, and control software. The phantom was operated with a motion of 2 cm at 4 sec per cycle and cine EPID images were obtained at a rate of 3.3 and 6.6 frames per sec (2 MU/frame) with $1,024{\times}768$ pixel counts in a linear accelerator (10 MVX). Organ motion of the target was tracked using self-developed analysis software. Results were compared with planned data of the motion phantom and data from the video image based tracking system (RPM, Varian, USA) using an external surrogate in order to evaluate its accuracy. For quantitative analysis, we analyzed correlation between two data sets in terms of average cycle (peak to peak), amplitude, and pattern (RMS, root mean square) of motion. Averages for the cycle of motion from IMVS and RPM system were $3.98{\pm}0.11$ (IMVS 3.3 fps), $4.005{\pm}0.001$ (IMVS 6.6 fps), and $3.95{\pm}0.02$ (RPM), respectively, and showed good agreement on real value (4 sec/cycle). Average of the amplitude of motion tracked by our system showed $1.85{\pm}0.02$ cm (3.3 fps) and $1.94{\pm}0.02$ cm (6.6 fps) as showed a slightly different value, 0.15 (7.5% error) and 0.06 (3% error) cm, respectively, compared with the actual value (2 cm), due to time resolution for image acquisition. In analysis of pattern of motion, the value of the RMS from the cine EPID image in 3.3 fps (0.1044) grew slightly compared with data from 6.6 fps (0.0480). The organ motion verification system using sequential cine EPID images with an internal surrogate showed good representation of its motion within 3% error in a preliminary phantom study. The system can be implemented for clinical purposes, which include organ motion verification during treatment, compared with 4D treatment planning data, and its feedback for accurate dose delivery to the moving target.

Spatial Composition and Landscape Characteristics of Shimwon-Pavilion Garden in Chilgok - Focusing on 'Shimwon-pavilion Poem of 25 Sceneries' and 「Shimwon-pavilion Soosukgi(心遠亭水石記)」 - (칠곡 심원정원림의 공간구성과 경관특성 - '심원정 25영(心遠亭 二十五詠)'과 「심원정수석기(心遠亭水石記)」를 중심으로 -)

  • Kim, Hwa-Ok;Park, Yool-Jin;Rho, Jae-Hyun;Shin, Sang-Seop;Cho, Ho-Hyeon
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.34 no.2
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    • pp.27-34
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    • 2016
  • The results of investigation on the spatial composition and landscape characteristics of Shimwon-pavilion garden built and enjoyed by Jo Byeong-sun in 1937 during the period of Japanese colonialism based on 'Shimwon-pavilion Soosukgii(水石記)' and 'Shimwon-pavilion Poem of 25 Sceneries(二十五詠)' contained in 'Anthology of Giheon(寄軒)' are as follows. 1. Shimwon-pavilion garden is assumed as Byeol-Seo garden based on the planning background and contents of Gimun and the observations on spot. By its location, it is classified as 'Planted forest' with a pine forest in the north and 'Byeol-Seo of mooring type' with Guyacheon flowing in the garden. It is about 400m away from the main house in the straight-line distance. 2. The meaning and attributes of reclusiveness are well represented in the 'screening structures' all around Shimwon-pavilion garden with Hakrimsan, a Gasan(假山) in the north, vines on Chwibyeong(翠屛) in the east and west, Eunbyeong(隱屛) of stone walls along with Guyacheon in the south, which shows the spirit of Giheon who adored the Taoistic life. 3. Shimwon-pavilion garden, located in the Songrimsa, a temple of thousand years, is a place of consilience where Buddhism was accepted, Taoistic life was pursued with Tao Yuan-ming's philosophy regarding rural areas and romantic sensibilities of Li Po, called poem master(詩仙), the confucian values of Zhu Xi were realized. Giheon intended to build and enjoy this place as a microcosm and shelther where he unfolded his own view of learning and cultivated his mind. 4. 25 sceneries on Shimwon-pavilion consist of 5 sceneries in the space of pavilion(architecture) and 20 sceneries in the outer garden. First, 5 sceneries consist of ancillary rooms for various uses, including Jeongunru, Amsushil, Wiryujae, Iyeoldang, and Jeong-Gak Shimwon-pavilion embracing them, which shows that Shimwon-pavilion is a place to foster younger students. And 20 scenary is divided into 9 sceneries on the natural spaces and 11 artificially created facilities. 9 sceneries are engraved on the rocks as described in 'Seokgyeonggi'. 5. 4 sceneries of the indoor scenery lexemes(亭閣 心遠亭 怡悅堂 停雲樓 闇修室) were intended to be recognized by the framed pictures, 5 places among the scenery lexemes in garden(龜巖 醒石 隱屛 兩忘臺 東槃) by letters carved on the rocks, and 8 places(君子沼 杞泉 天光雲影橋 芳園 槐岡 柳堤 石扉 東翠屛) by sign stones, but signs of 8 sceneries are not currently identified because they have been be swept away and demolished. 6. A variety of plant landscapes with various meanings and water landscape with various types are contained in 25 sceneries - Sophora symbolizing a tree for scholar in Gehgang(槐岡), Willow symbolizing Tao Yuanming and continued vitality in Yooje(柳堤), Boxthorn symbolizing family togetherness in spring(杞泉), vines and herbal plants and waterfalls(隱瀑), shallow pond(君子沼), pond(湯池), water hole(杞泉), water flowing in the middle of rock(盤陀石), water flowing between the rocks(水口巖). 7. While Shimwon-pavilion garden is a garden near the water, the active involvements with 11 sceneries directly built is distinguished. The other pavilion gardens are faithful in engraving the names by setting the scenery lexemes of the nature-oriented Gyeong(景) and Gok(曲) near and far, but Shimwon-pavilion garden is a garden for active learning(修景) with the spaces built to match with the beautiful nature and to show the depths of space off.

Treatment Results of CyberKnife Radiosurgery for Patients with Primary or Recurrent Non-Small Cell Lung Cancer (원발 혹은 재발성 비소세포 폐암 환자에서 사이버나이프률 이용한 체부 방사선 수술의 치료 결과)

  • Kim, Woo-Chul;Kim, Hun-Jung;Park, Jeong-Hoon;Huh, Hyun-Do;Choi, Sang-Huoun
    • Radiation Oncology Journal
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    • v.29 no.1
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    • pp.28-35
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    • 2011
  • Purpose: Recently, the use of radiosurgery as a local therapy in patients with early stage non-small cell lung cancer has become favored over surgical resection. To evaluate the efficacy of radiosurgery, we analyzed the results of stereotactic body radiosurgery in patients with primary or recurrent non-small cell lung cancer. Materials and Methods: We reviewed medical records retrospectively of total 24 patients (28 lesions) with non-small cell lung cancer (NSCLC) who received stereotactic body radiosurgery (SBRT) at Inha University Hospital. Among the 24 patients, 19 had primary NSCLC and five exhibited recurrent disease, with three at previously treated areas. Four patients with primary NSCLC received SBRT after conventional radiation therapy as a boost treatment. The initial stages were IA in 7, IB in 3, IIA in 2, IIB in 2, IIIA in 3, IIIB in 1, and IV in 6. The T stages at SBRT were T1 lesion in 13, T2 lesion in 12, and T3 lesion in 3. 6MV X-ray treatment was used for SBRT, and the prescribed dose was 15~60 Gy (median: 50 Gy) for PTV1 in 3~5 fractions. Median follow up time was 469 days. Results: The median GTV was 22.9 mL (range, 0.7 to 108.7 mL) and median PTV1 was 65.4 mL (range, 5.3 to 184.8 mL). The response rate at 3 months was complete response (CR) in 14 lesions, partial response (PR) in 11 lesions, and stable disease (SD) in 3 lesions, whereas the response rate at the time of the last follow up was CR in 13 lesions, PR in 9 lesions, SD in 2 lesions, and progressive disease (PD) in 4 lesions. Of the 10 patients in stage 1, one patient died due to pneumonia, and local failure was identified in one patient. Of the 10 patients in stages III-IV, three patients died, local and loco-regional failure was identified in one patient, and regional failure in 2 patients. Total local control rate was 85.8% (4/28). Local recurrence was recorded in three out of the eight lesions that received below biologically equivalent dose 100 $Gy_{10}$. Among 20 lesions that received above 100 $Gy_{10}$, only one lesion failed locally. There was a higher recurrence rate in patients with centrally located tumors and T2 or above staged tumors. Conclusion: SBRT using a CyberKnife was proven to be an effective treatment modality for early stage patients with NSCLC based on high local control rate without severe complications. SBRT above total 100 $Gy_{10}$ for peripheral T1 stage patients with NSCLC is recommended.

A Study of the Reactive Movement Synchronization for Analysis of Group Flow (그룹 몰입도 판단을 위한 움직임 동기화 연구)

  • Ryu, Joon Mo;Park, Seung-Bo;Kim, Jae Kyeong
    • Journal of Intelligence and Information Systems
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    • v.19 no.1
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    • pp.79-94
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    • 2013
  • Recently, the high value added business is steadily growing in the culture and art area. To generated high value from a performance, the satisfaction of audience is necessary. The flow in a critical factor for satisfaction, and it should be induced from audience and measures. To evaluate interest and emotion of audience on contents, producers or investors need a kind of index for the measurement of the flow. But it is neither easy to define the flow quantitatively, nor to collect audience's reaction immediately. The previous studies of the group flow were evaluated by the sum of the average value of each person's reaction. The flow or "good feeling" from each audience was extracted from his face, especially, the change of his (or her) expression and body movement. But it was not easy to handle the large amount of real-time data from each sensor signals. And also it was difficult to set experimental devices, in terms of economic and environmental problems. Because, all participants should have their own personal sensor to check their physical signal. Also each camera should be located in front of their head to catch their looks. Therefore we need more simple system to analyze group flow. This study provides the method for measurement of audiences flow with group synchronization at same time and place. To measure the synchronization, we made real-time processing system using the Differential Image and Group Emotion Analysis (GEA) system. Differential Image was obtained from camera and by the previous frame was subtracted from present frame. So the movement variation on audience's reaction was obtained. And then we developed a program, GEX(Group Emotion Analysis), for flow judgment model. After the measurement of the audience's reaction, the synchronization is divided as Dynamic State Synchronization and Static State Synchronization. The Dynamic State Synchronization accompanies audience's active reaction, while the Static State Synchronization means to movement of audience. The Dynamic State Synchronization can be caused by the audience's surprise action such as scary, creepy or reversal scene. And the Static State Synchronization was triggered by impressed or sad scene. Therefore we showed them several short movies containing various scenes mentioned previously. And these kind of scenes made them sad, clap, and creepy, etc. To check the movement of audience, we defined the critical point, ${\alpha}$and ${\beta}$. Dynamic State Synchronization was meaningful when the movement value was over critical point ${\beta}$, while Static State Synchronization was effective under critical point ${\alpha}$. ${\beta}$ is made by audience' clapping movement of 10 teams in stead of using average number of movement. After checking the reactive movement of audience, the percentage(%) ratio was calculated from the division of "people having reaction" by "total people". Total 37 teams were made in "2012 Seoul DMC Culture Open" and they involved the experiments. First, they followed induction to clap by staff. Second, basic scene for neutralize emotion of audience. Third, flow scene was displayed to audience. Forth, the reversal scene was introduced. And then 24 teams of them were provided with amuse and creepy scenes. And the other 10 teams were exposed with the sad scene. There were clapping and laughing action of audience on the amuse scene with shaking their head or hid with closing eyes. And also the sad or touching scene made them silent. If the results were over about 80%, the group could be judged as the synchronization and the flow were achieved. As a result, the audience showed similar reactions about similar stimulation at same time and place. Once we get an additional normalization and experiment, we can obtain find the flow factor through the synchronization on a much bigger group and this should be useful for planning contents.

Implementation Strategy for the Elderly Care Solution Based on Usage Log Analysis: Focusing on the Case of Hyodol Product (사용자 로그 분석에 기반한 노인 돌봄 솔루션 구축 전략: 효돌 제품의 사례를 중심으로)

  • Lee, Junsik;Yoo, In-Jin;Park, Do-Hyung
    • Journal of Intelligence and Information Systems
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    • v.25 no.3
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    • pp.117-140
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    • 2019
  • As the aging phenomenon accelerates and various social problems related to the elderly of the vulnerable are raised, the need for effective elderly care solutions to protect the health and safety of the elderly generation is growing. Recently, more and more people are using Smart Toys equipped with ICT technology for care for elderly. In particular, log data collected through smart toys is highly valuable to be used as a quantitative and objective indicator in areas such as policy-making and service planning. However, research related to smart toys is limited, such as the development of smart toys and the validation of smart toy effectiveness. In other words, there is a dearth of research to derive insights based on log data collected through smart toys and to use them for decision making. This study will analyze log data collected from smart toy and derive effective insights to improve the quality of life for elderly users. Specifically, the user profiling-based analysis and elicitation of a change in quality of life mechanism based on behavior were performed. First, in the user profiling analysis, two important dimensions of classifying the type of elderly group from five factors of elderly user's living management were derived: 'Routine Activities' and 'Work-out Activities'. Based on the dimensions derived, a hierarchical cluster analysis and K-Means clustering were performed to classify the entire elderly user into three groups. Through a profiling analysis, the demographic characteristics of each group of elderlies and the behavior of using smart toy were identified. Second, stepwise regression was performed in eliciting the mechanism of change in quality of life. The effects of interaction, content usage, and indoor activity have been identified on the improvement of depression and lifestyle for the elderly. In addition, it identified the role of user performance evaluation and satisfaction with smart toy as a parameter that mediated the relationship between usage behavior and quality of life change. Specific mechanisms are as follows. First, the interaction between smart toy and elderly was found to have an effect of improving the depression by mediating attitudes to smart toy. The 'Satisfaction toward Smart Toy,' a variable that affects the improvement of the elderly's depression, changes how users evaluate smart toy performance. At this time, it has been identified that it is the interaction with smart toy that has a positive effect on smart toy These results can be interpreted as an elderly with a desire to meet emotional stability interact actively with smart toy, and a positive assessment of smart toy, greatly appreciating the effectiveness of smart toy. Second, the content usage has been confirmed to have a direct effect on improving lifestyle without going through other variables. Elderly who use a lot of the content provided by smart toy have improved their lifestyle. However, this effect has occurred regardless of the attitude the user has toward smart toy. Third, log data show that a high degree of indoor activity improves both the lifestyle and depression of the elderly. The more indoor activity, the better the lifestyle of the elderly, and these effects occur regardless of the user's attitude toward smart toy. In addition, elderly with a high degree of indoor activity are satisfied with smart toys, which cause improvement in the elderly's depression. However, it can be interpreted that elderly who prefer outdoor activities than indoor activities, or those who are less active due to health problems, are hard to satisfied with smart toys, and are not able to get the effects of improving depression. In summary, based on the activities of the elderly, three groups of elderly were identified and the important characteristics of each type were identified. In addition, this study sought to identify the mechanism by which the behavior of the elderly on smart toy affects the lives of the actual elderly, and to derive user needs and insights.

The Evaluation of Non-Coplanar Volumetric Modulated Arc Therapy for Brain stereotactic radiosurgery (뇌 정위적 방사선수술 시 Non-Coplanar Volumetric Modulated Arc Therapy의 유용성 평가)

  • Lee, Doo Sang;Kang, Hyo Seok;Choi, Byoung Joon;Park, Sang Jun;Jung, Da Ee;Lee, Geon Ho;Ahn, Min Woo;Jeon, Myeong Soo
    • The Journal of Korean Society for Radiation Therapy
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    • v.30 no.1_2
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    • pp.9-16
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    • 2018
  • Purpose : Brain Stereotactic Radiosurgery can treat non-invasive diseases with high rates of complications due to surgical operations. However, brain stereotactic radiosurgery may be accompanied by radiation induced side effects such as fractionation radiation therapy because it uses radiation. The effects of Coplanar Volumetric Modulated Arc Therapy(C-VMAT) and Non-Coplanar Volumetric Modulated Arc Therapy(NC-VMAT) on surrounding normal tissues were analyzed in order to reduce the side effects caused fractionation radiation therapy such as head and neck. But, brain stereotactic radiosurgery these contents were not analyzed. In this study, we evaluated the usefulness of NC-VMAT by comparing and analyzing C-VMAT and NC-VMAT in patients who underwent brain stereotactic radiosurgery. Methods and materials : With C-VMAT and NC-VMAT, 13 treatment plans for brain stereotactic radiosurgery were established. The Planning Target Volume ranged from a minimum of 0.78 cc to a maximum of 12.26 cc, Prescription doses were prescribed between 15 and 24 Gy. Treatment machine was TrueBeam STx (Varian Medical Systems, USA). The energy used in the treatment plan was 6 MV Flattening Filter Free (6FFF) X-ray. The C-VMAT treatment plan used a half 2 arc or full 2 arc treatment plan, and the NC-VMAT treatment plan used 3 to 7 Arc 40 to 190 degrees. The angle of the couch was planned to be 3-7 angles. Results : The mean value of the maximum dose was $105.1{\pm}1.37%$ in C-VMAT and $105.8{\pm}1.71%$ in NC-VMAT. Conformity index of C-VMAT was $1.08{\pm}0.08$ and homogeneity index was $1.03{\pm}0.01$. Conformity index of NC-VMAT was $1.17{\pm}0.1$ and homogeneity index was $1.04{\pm}0.01$. $V_2$, $V_8$, $V_{12}$, $V_{18}$, $V_{24}$ of the brain were $176{\pm}149.36cc$, $31.50{\pm}25.03cc$, $16.53{\pm}12.63cc$, $8.60{\pm}6.87cc$ and $4.03{\pm}3.43cc$ in the C-VMAT and $135.55{\pm}115.93cc$, $24.34{\pm}17.68cc$, $14.74{\pm}10.97cc$, $8.55{\pm}6.79cc$, $4.23{\pm}3.48cc$. Conclusions : The maximum dose, conformity index, and homogeneity index showed no significant difference between C-VMAT and NC-VMAT. $V_2$ to $V_{18}$ of the brain showed a difference of at least 0.5 % to 48 %. $V_{19}$ to $V_{24}$ of the brain showed a difference of at least 0.4 % to 4.8 %. When we compare the mean value of $V_{12}$ that Radione-crosis begins to generate, NC-VMAT has about 12.2 % less amount than C-VMAT. These results suggest that if NC-VMAT is used, the volume of $V_2$ to $V_{18}$ can be reduced, which can reduce Radionecrosis.

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The Application of 3D Bolus with Neck in the Treatment of Hypopharynx Cancer in VMAT (Hypopharynx Cancer의 VMAT 치료 시 Neck 3D Bolus 적용에 대한 유용성 평가)

  • An, Ye Chan;Kim, Jin Man;Kim, Chan Yang;Kim, Jong Sik;Park, Yong Chul
    • The Journal of Korean Society for Radiation Therapy
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    • v.32
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    • pp.41-52
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    • 2020
  • Purpose: To find out the dosimetric usefulness, setup reproducibility and efficiency of applying 3D Bolus by comparing two treatment plans in which Commercial Bolus and 3D Bolus produced by 3D Printing Technology were applied to the neck during VMAT treatment of Hypopahrynx Cancer to evaluate the clinical applicability. Materials and Methods: Based on the CT image of the RANDO phantom to which CB was applied, 3D Bolus were fabricated in the same form. 3D Bolus was printed with a polyurethane acrylate resin with a density of 1.2g/㎤ through the SLA technique using OMG SLA 660 Printer and MaterializeMagics software. Based on two CT images using CB and 3D Bolus, a treatment plan was established assuming VMAT treatment of Hypopharynx Cancer. CBCT images were obtained for each of the two established treatment plans 18 times, and the treatment efficiency was evaluated by measuring the setup time each time. Based on the obtained CBCT image, the adaptive plan was performed through Pinnacle, a computerized treatment planning system, to evaluate target, normal organ dose evaluation, and changes in bolus volume. Results: The setup time for each treatment plan was reduced by an average of 28 sec in the 3D Bolus treatment plan compared to the CB treatment plan. The Bolus Volume change during the pretreatment period was 86.1±2.70㎤ in 83.9㎤ of CB Initial Plan and 99.8±0.46㎤ in 92.2㎤ of 3D Bolus Initial Plan. The change in CTV Min Value was 167.4±19.38cGy in CB Initial Plan 191.6cGy and 149.5±18.27cGy in 3D Bolus Initial Plan 167.3cGy. The change in CTV Mean Value was 228.3±0.38cGy in CB Initial Plan 227.1cGy and 227.7±0.30cGy in 3D Bolus Initial Plan 225.9cGy. The change in PTV Min Value was 74.9±19.47cGy in CB Initial Plan 128.5cGy and 83.2±12.92cGy in 3D Bolus Initial Plan 139.9cGy. The change in PTV Mean Value was 226.2±0.83cGy in CB Initial Plan 225.4cGy and 225.8±0.33cGy in 3D Bolus Initial Plan 224.1cGy. The maximum value for the normal organ spinal cord was the same as 135.6cGy on average each time. Conclusion: From the experimental results of this paper, it was found that the application of 3D Bolus to the irregular body surface is more dosimetrically useful than the application of Commercial Bolus, and the setup reproducibility and efficiency are excellent. If further case studies along with research on the diversity of 3D printing materials are conducted in the future, the application of 3D Bolus in the field of radiation therapy is expected to proceed more actively.

Experimental investigation of the photoneutron production out of the high-energy photon fields at linear accelerator (고에너지 방사선치료 시 치료변수에 따른 광중성자 선량 변화 연구)

  • Kim, Yeon Su;Yoon, In Ha;Bae, Sun Myeong;Kang, Tae Young;Baek, Geum Mun;Kim, Sung Hwan;Nam, Uk Won;Lee, Jae Jin;Park, Yeong Sik
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.2
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    • pp.257-264
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    • 2014
  • Purpose : Photoneutron dose in high-energy photon radiotherapy at linear accelerator increase the risk for secondary cancer. The purpose of this investigation is to evaluate the dose variation of photoneutron with different treatment method, flattening filter, dose rate and gantry angle in radiation therapy with high-energy photon beam ($E{\geq}8MeV$). Materials and Methods : TrueBeam $ST{\time}TM$(Ver1.5, Varian, USA) and Korea Tissue Equivalent Proportional Counter (KTEPC) were used to detect the photoneutron dose out of the high-energy photon field. Complex Patient plans using Eclipse planning system (Version 10.0, Varian, USA) was used to experiment with different treatment technique(IMRT, VMAT), condition of flattening filter and three different dose rate. Scattered photoneutron dose was measured at eight different gantry angles with open field (Field size : $5{\time}5cm$). Results : The mean values of the detected photoneutron dose from IMRT and VMAT were $449.7{\mu}Sv$, $2940.7{\mu}Sv$. The mean values of the detected photoneutron dose with Flattening Filter(FF) and Flattening Filter Free(FFF) were measured as $2940.7{\mu}Sv$, $232.0{\mu}Sv$. The mean values of the photoneutron dose for each test plan (case 1, case 2 and case 3) with FFF at the three different dose rate (400, 1200, 2400 MU/min) were $3242.5{\mu}Sv$, $3189.4{\mu}Sv$, $3191.2{\mu}Sv$ with case 1, $3493.2{\mu}Sv$, $3482.6{\mu}Sv$, $3477.2{\mu}Sv$ with case 2 and $4592.2{\mu}Sv$, $4580.0{\mu}Sv$, $4542.3{\mu}Sv$ with case 3, respectively. The mean values of the photoneutron dose at eight different gantry angles ($0^{\circ}$, $45^{\circ}$, $90^{\circ}$, $135^{\circ}$, $180^{\circ}$, $225^{\circ}$, $270^{\circ}$, $315^{\circ}$) were measured as $3.2{\mu}Sv$, $4.3{\mu}Sv$, $5.3{\mu}Sv$, $11.3{\mu}Sv$, $14.7{\mu}Sv$, $11.2{\mu}Sv$, $3.7{\mu}Sv$, $3.0{\mu}Sv$ at 10MV and as $373.7{\mu}Sv$, $369.6{\mu}Sv$, $384.4{\mu}Sv$, $423.6{\mu}Sv$, $447.1{\mu}Sv$, $448.0{\mu}Sv$, $384.5{\mu}Sv$, $377.3{\mu}Sv$ at 15MV. Conclusion : As a result, it is possible to reduce photoneutron dose using FFF mode and VMAT method with TrueBeam $ST{\time}TM$. The risk for secondary cancer of the patients will be decreased with continuous evaluation of the photoneutron dose.

The 1998, 1999 Patterns of Care Study for Breast Irradiation After Breast-Conserving Surgery in Korea (1998, 1999년도 우리나라에서 시행된 유방보존수술 후 방사선치료 현황 조사)

  • Suh Chang-Ok;Shin Hyun Soo;Cho Jae Ho;Park Won;Ahn Seung Do;Shin Kyung Hwan;Chung Eun Ji;Keum Ki Chang;Ha Sung Whan;Ahn Sung Ja;Kim Woo Cheol;Lee Myung Za;Ahn Ki Jung
    • Radiation Oncology Journal
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    • v.22 no.3
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    • pp.192-199
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    • 2004
  • Purpose: To determine the patterns on evaluation and treatment in the patient with early breast cancer treated with conservative surgery and radiotherapy and to improve the radiotherapy techiniques, nationwide survey was peformed. Materials and Methods: A web-based database system for korean Patterns of Care Study (PCS) for 6 common cancers was developed. Two hundreds sixty-one randomly selected records of eligible patients treated between 1998$\~$1999 from 15 hospitals were reviewed. Results: The patients ages ranged from 24 to 85 years(median 45 years). Infiltrating ductal carcinoma was most common histologic type (88.9$\%$) followed by medullary carcinoma (4.2$\%$) and infiltrating lobular carcinoma (1.5$\%$). Pathologic T stage by AJCC was T1 in 59.7$\%$ of the casses, T2 in 29.5$\%$ of the cases, Tis in 8.8$\%$ of the cases. Axillary lymph node dissection was peformed I\in 91.2$\%$ of the cases and 69.7$\%$ were node negative. AJCC stage was 0 in 8.8$\%$ of the cases, stage I in 44.9$\%$ of the cases, stage IIa in 33.3$\%$ of the cases, and stage IIb in 8.4$\%$ of the cases. Estrogen and progesteron receptors were evaluated in 71.6$\%$, and 70.9$\%$ of the patients, respectively. Surgical methods of breast-conserving surgery was excision/lumpectomy in 37.2$\%$, wide excision in 11.5$\%$, quadrantectomy in 23$\%$ and partial mastectomy in 27.5$\%$ of the cases. A pathologically confirmed negative margin was obtained in 90.8$\%$ of the cases. Pathological margin was involved with tumor in 10 patients and margin was close (less than 2 mm) in 10 patients. All the patients except one recieved more than 90$\%$ of the planned radiotherapy dose. Radiotherapy volume was breast only In 88$\%$ of the cases, breast+supraclavicular fossa (SCL) in 5$\%$ of the cases, and breast+ SCL+ posterior axillary boost in 4.2%$\%$of the cases. Only one patient received isolated internal mammary lymph node irradiation. Used radiation beam was Co-60 in 8 cases, 4 MV X-ray in 115 cases, 6 MV X-ray in 125 cases, and 10 MV X-ray in 11 cases. The radiation dose to the whole breast was 45$\~$59.4 Gy (median 50.4) and boost dose was 8$\~$20 Gy (median 10 Gy). The total radiation dose delivered was 50.4$\~$70.4 Gy (median 60.4 Gy). Conclusion: There was no major deviation from current standard in the patterns of evaluation and treatment for the patients with early breast cancer treated with breast conservation method. Some varieties were identified in boost irradiation dose. Separate analysis for the datails of radiotherapy planning will be followed and the outcome of treatment is needed to evaluate the process.