• Journal of the Korea Safety Management & Science
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• v.17 no.4
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• pp.199-206
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• 2015

The purpose of this study was to investigate radiation dose sensitivity due to displacement of human extremities in the water bolus box on radiation therapy. Water bolus box and human thigh with femur bone were constructed in computerized radiation therapy planning system to verify the absorbed dose. Two 6MV X-ray beams were irradiated bilaterally into water bolus box and then radiation dose were calculated each situation at displacement of middle axis of thigh from the center in water bolus box to right and left direction. Absorbed dose of thigh and femur bone increased by the distance of displacement. The maximum dose of thigh even increased 20% over than prescribed dose. This is in contrast to conventional concept of dose distribution in water bolus box. Based on this result, displacement of body site in the water bolus box have to be averted during radiation therapy.

• The Journal of Korean Society for Radiation Therapy
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• v.11 no.1
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• pp.73-78
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• 1999

In general, the patients of the head and neck cancer are treated with 4MV photon beam up to prescribed dose, but spinal cord should be excluded in the treatment field. When its absorbed dose is limited at the tolerance dose. In case of the patients who has the positive posterior neck nodes need a boost electron beam treatment to the prescribed dose. In that case, the anatomical structure of the neck and the physical structure of the standard electron cone interrupt to allow proper access to the disease site. Therefore, we extended treatment SSD for the remove of the those hindrances. In this study, we evaluated the dosimetric variation of the standard electron cone for the extended SSD, from 100cm to 120cm, 5 cm increment, and compare to the custom-made electron cone. As a result, the $\%$ depth dose, the point of maximum dose and the range of maximum were changed within the $2\%$. The penumbra width was increased from 1.0cm to 2.0cm. However, the dosimetric characteristics of the custom-made electron cone was very similar to that of the 100cm SSD standard electron cone and due to its characteristic of physical structure, patients didn't need re-positioning after photon beam treatment, therefore accurate treatment was possible, we conclude that the custom-made electron cone was very useful for the clinical practice.

• Radiation Oncology Journal
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• v.31 no.1
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• pp.12-17
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• 2013

Purpose: Parotid gland can be considered as a risk organ in whole brain radiotherapy (WBRT). The purpose of this study is to evaluate the parotid gland sparing effect of computed tomography (CT)-based WBRT compared to 2-dimensional plan with conventional field margin. Materials and Methods: From January 2008 to April 2011, 53 patients underwent WBRT using CT-based simulation. Bilateral two-field arrangement was used and the prescribed dose was 30 Gy in 10 fractions. We compared the parotid dose between 2 radiotherapy plans using different lower field margins: conventional field to the lower level of the atlas (CF) and modified field fitted to the brain tissue (MF). Results: Averages of mean parotid dose of the 2 protocols with CF and MF were 17.4 Gy and 8.7 Gy, respectively (p < 0.001). Mean parotid dose of both glands ${\geq}20$ Gy were observed in 15 (28.3%) for CF and in 0 (0.0%) for MF. The whole brain percentage volumes receiving >98% of prescribed dose were 99.7% for CF and 99.5% for MF. Conclusion: Compared to WBRT with CF, CT-based lower field margin modification is a simple and effective technique for sparing the parotid gland, while providing similar dose coverage of the whole brain.

• Tuberculosis and Respiratory Diseases
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• v.85 no.1
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• pp.80-88
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• 2022

Background: Although it is known that inhaled corticosteroid (ICS) use may increase the risk of respiratory infection, its influence on the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection remains unknown. Thus, the aim of this study was to investigate the association between ICS use and the positivity of SARS-CoV-2 infection among patients with chronic respiratory diseases. Methods: Nationwide data of 44,968 individuals with chronic respiratory diseases tested for SARS-CoV-2 until May 15, 2021 were obtained from the Ministry of Health and Welfare and Health Insurance Review and Assessment Service in Korea. The positivity of SARS-CoV-2 infection was retrospectively analysed according to the prescription, type, and dose of ICS taken one year before SARS-CoV-2 test. Results: Among 44,968 individuals tested, 931 (2.1%) were positive for SARS-CoV-2. A total of 7,019 patients (15.6%) were prescribed ICS one year prior to being tested for SARS-CoV-2. Low, medium, and high doses of ICS were prescribed in 7.5%, 1.6%, and 6.5% of total cases, respectively. Among types of ICS, budesonide, fluticasone, beclomethasone, and ciclesonide were prescribed in 3.7%, 8.9%, 2.3%, and 0.6% of total cases, respectively. A multivariate analysis showed no significant increase in infection with ICS use (odds ratio, 0.84; 95% confidence interval, 0.66-1.03). Moreover, there were no associations between the positivity of infection and the dose or type of ICS prescribed. Conclusion: Prior ICS use did not increase the positivity for SARS-CoV-2 infection. Moreover, different doses or types of ICS did not affect this positivity.

• Korean Journal of Clinical Pharmacy
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• v.30 no.2
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• pp.81-86
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• 2020

Background: The number of patients with dementia continues to increase as the age of aging continues to grow. Psychiatric symptoms caused by senile dementia are controlled using antipsychotics. However, these antipsychotics can lead to Parkinson's disease, and abuse of dopamine derivatives such as levodopa among Parkinsonian drugs can lead to psychosis. Therefore, we evaluated the patterns of prescribed antipsychotics and antiparkinsonian drugs in patients with senile dementia. Methods: We used data from the sample of elderly patients from the Health Insurance Review and Assessment Service (HIRA-APS-2016). We analyzed the patterns of prescribing antipsychotics and antiparkinsonian drugs including prescribed daily dosage, period of prescription, and number of patients with both antipsychotics and antiparkinsonian drugs for senile dementia. Results: Among the 159,391 patients with dementia included in this analysis, 4,963 patients (3.1%) and 16,499 patients (10.4%) were prescribed typical and atypical antipsychotic drugs, respectively. The most frequently prescribed typical antipsychotic was haloperidol (4,351 patients with dementia), whereas the atypical agent was quetiapine (12,719 patients). The most frequently prescribed antiparkinsonian drugs were in the order of levodopa/carbidopa, benztropine, and ropinirole. In addition, 1,103 and 3,508 patients prescribed typical and atypical antipsychotics, respectively, were co-prescribed antiparkinsonian drugs. Conclusions: Atypical antipsychotics were the preferred prescription in patients with senile dementia. The prescription dose was relatively low; however, the average treatment duration was mostly long-term. Selection of antipsychotics and/or antiparkinsonian drugs should be made carefully in senile dementia and the causal relationship of adverse drug reactions needs further study.

• Journal of Nuclear Fuel Cycle and Waste Technology(JNFCWT)
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• v.19 no.2
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• pp.243-253
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• 2021

In the dismantling process of a reactor coolant system (RCS) piping, a radiation protection plan should be established to minimize the radiation exposure doses of dismantling workers. Hence, it is necessary to estimate the individual effective dose in the RCS piping dismantling process when decommissioning a nuclear power plant. In this study, the radiation exposure doses of the dismantling workers at different positions was estimated using the MicroShield dose assessment program based on the NUREG/CR-1595 report. The individual effective dose, which is the sum of the effective dose to each tissue considering the working time, was used to estimate the radiation exposure dose. The estimations of the simulation results for all RCS piping dismantling tasks satisfied the dose limits prescribed by the ICRP-60 report. In dismantling the RCS piping of the Kori-1 or Wolsong-1 units in South Korea, the estimation and reduction method for the radiation exposure dose, and the simulated results of this study can be used to implement the radiation safety for optimal dismantling by providing information on the radiation exposure doses of the dismantling workers.

• Korean Journal of Clinical Pharmacy
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• v.32 no.1
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• pp.13-19
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• 2022

Background: The use of combination therapy and fixed-dose combination therapy is increasing for the treatment of type 2 diabetes. Sodium glucose cotransporter-2 inhibitor (SGLT2i) is a drug class used in combination with metformin. Methods: Type 2 diabetes patients on SGLT2i/metformin combination therapy were extracted from the 2019 Health Insurance Review & Assessment Service-National Patients Sample. On July 1, 2019, SGLT2i and metformin fixed-dose combination (SGLT2i/metformin FDC) and two-pill combination (TPC) groups were identified, and a chi-square test and multiple logistic regression were performed. Results: Of total 2,992 patients, 1,077 (36%) were prescribed SGLT2i/metformin FDC and 1,915 (64%) were prescribed TPC. We found that the most common comorbidities were in the order of dyslipidemia, gastrointestinal disease, and hypertension. Multiple logistic regression analysis showed that the use of SGLT2i/metformin FDC was lower than TPC in patients with diabetic neuropathy (OR=0.76, p=0.008). Clinic (OR=2.09, p<0.001) and general hospital (OR=1.40, p=0.019) showed higher tendency to prescribe SGLT2i/metformin FDC compared to tertiary hospital. The tendency of prescribing SGLT2i/metformin FDC was lower in Kyeonggi (OR=0.79, p=0.037), Gyeongsang (OR=0.77, p=0.025) and Chungcheong (OR=0.68, p=0.007) than Seoul. Conclusion: Factors related to the use of SGLT2i/metformin FDC in patients with type 2 diabetes were complication, medical institution and region. The tendency to prescribe SGLT2i/metformin FDC was relatively higher in clinics than in tertiary general hospitals and in Seoul than in other regions.

• International Journal of Contents
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• v.13 no.4
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• pp.12-15
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• 2017

Among the possible stereotactic body radiation therapy (SBRT) modalities used to treat patients with metastatic spinal tumors, this study compared Cyberknife, tomotherapy, and volumetric modulated arc radiotherapy (VMAT). We established treatment plans for each of them modality and quantitatively analyzed the dose evaluation factors of the dose-volume histogram (DVH) for all spinal bones, focusing on the tumor and spinal cord, in order to examine the usefulness of VMAT. For the treatment planning dose, the mean dose ($D_{max}$) and $D_{5%}$ showed statistical differences in the target dose, but no difference was shown in the spinal cord dose. For the DVH indices, tomotherapy showed the best performance was the best in terms of uniformity index, while VMAT showed better performance was better than the other two modalities in terms of the conformity index and the dose gradient index. VMAT had a much shorter treatment time than Cyberknife and tomotherapy. These findings suggest that VMAT FFF is the most effective therapy for SBRT of patients with metastatic spinal tumors for whom a high dose of radiation is prescribed.

• The Journal of Korean Society for Radiation Therapy
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• v.31 no.1
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• pp.7-15
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• 2019

Purpose: The purpose of this study is to evaluate beam delivery accuracy for small sized lung SBRT through experiment. In order to assess the accuracy, Eclipse TPS(Treatment planning system) equipped Acuros XB and radiochromic film were used for the dose distribution. Comparing calculated and measured dose distribution, evaluated the margin for PTV(Planning target volume) in lung tissue. Materials and Methods : Acquiring CT images for Rando phantom, planned virtual target volume by size(diameter 2, 3, 4, 5 cm) in right lung. All plans were normalized to the target Volume=prescribed 95 % with 6MV FFF VMAT 2 Arc. To compare with calculated and measured dose distribution, film was inserted in rando phantom and irradiated in axial direction. The indexes of evaluation are percentage difference(%Diff) for absolute dose, RMSE(Root-mean-square-error) value for relative dose, coverage ratio and average dose in PTV. Results: The maximum difference at center point was -4.65 % in diameter 2 cm size. And the RMSE value between the calculated and measured off-axis dose distribution indicated that the measured dose distribution in diameter 2 cm was different from calculated and inaccurate compare to diameter 5 cm. In addition, Distance prescribed 95 % dose($D_{95}$) in diameter 2 cm was not covered in PTV and average dose value was lowest in all sizes. Conclusion: This study demonstrated that small sized PTV was not enough covered with prescribed dose in low density lung tissue. All indexes of experimental results in diameter 2 cm were much different from other sizes. It is showed that minimized PTV is not accurate and affects the results of radiation therapy. It is considered that extended margin at small PTV in low density lung tissue for enhancing target center dose is necessary and don't need to constraint Maximum dose in optimization.

• Journal of radiological science and technology
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• v.40 no.2
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• pp.303-309
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• 2017

To evaluate the usefulness of 3-dimensional brachytherapy(BT) planning technique based on CT in cervical cancer. Patients with cervical cancer underwent 2-D BT treatment planning and then CT scan with HDR intracavitary applicators in place with same positions. Dose was prescribed to Point A with 5Gy per fraction on 2-D BT planning. For 3-D BT planning, and dose was prescribed to the High risk CTV for BT (HR CTV) with 5Gy. The 3-D BT planning goal was to cover at least 90% of the HR CTV with target 5Gy isodose surface while limiting the dose to $2cm^3$ of bladder to less than 7.5 Gy, and $2cm^3$ of rectum to less than 5Gy. In one patient of 10 patients, $D_{2cm3}$ of rectal dose was over 5Gy and 6patients at $D_{2cm3}$ of bladder dose on 2-D BT planning. There was a tendency to underestimate ICRU bladder dose than ICRU rectal dose. CT based 3-D BT planning for cervical cancer will enable evaluation of dose distributions for tumor and critical organs at risk. So, rectal and bladder morbidity as well as geographic miss will be reduced in case of the bulky disease or uterine malposition.