Background: Our aim was to conduct a meta-analysis to compare the efficacy and safety of pemetrexed and docetaxel for non-small cell lung cancer (NSCLC). Materials and Methods: We systematically searched the Cochrane Library, PubMed, Embase, China Biology Medicine Database for randomized controlled trials (RCTs) comparing the efficacy and toxicities of pemetrexed versus docetaxel as a treatment for advanced NSCLC. We limited the languages to English and Chinese. Two reviewers independently screened articles to identify eligible trials according to the inclusion and exclusion criteria and assessed the methodological quality of included trials, and then extracted data. The meta-analysis was performed using STATA12.0. Results: Six RCTs involving 1,414 patients were identified. We found that there was no statistically significant differences in overall response rate, survival time, progression-free survival, disease control rate, and 1-2yr survival rate (p>0.050) but it is worthy of mention that patients in the pemetrexed arms had significantly higher 3-yr survival rate (P=0.002). With regard to the grade 3 or 4 hematological toxicity, compared with docetaxel, pemetrexed led to lower rate of grade 3-4 febrile neutropenia, neutropenia, and leukocyts toxicity (p<0.001). There was no significant difference in anemia between the two arms (p=0.08). In addition, pemetrexed led to higher rate of grade 3-4 thrombocytopenia toxicity (p=0.03). As for the non-hematological toxicities, compared with docetaxel, pemetrexed group had lower rate of grade 3-4 diarrhea and alopecia. Conclusions: Pemetrexed was almost as effective as docetaxel in patients with advanced NSCLC. At the same time, pemetrexed might increase the 3-yr survival rate. As for safety, pemetrexed led to lower rate of grade 3-4 febrile neutropenia, neutropenia, leukocytes, diarrhea and alopecia toxicity. However, it was associated with a higher rate of grade 3-4 thrombocytopenia.
Kim, Jong-Eon;Yoon, Chun-Sil;Kim, Sung-Hyun;Park, Chang-Hee;Cha, Byung-Youl
Progress in Medical Physics
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v.17
no.4
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pp.201-206
/
2006
In this study, we have fabricated the noninvasive tube voltage meter which can observe the waveform of tube voltage and measure the tube voltage by using the Intensity of X-ray beam irradiated from radiotherapy simulator and also investigated the feasibility for clinical applications. Two pin photodiodes acting as X-ray detectors were arranged in parallel at the position of ${\pm}1.4cm$ in the y-axis of X-ray field and the aluminum filters with different thickness were placed above them. Using this detector, we could get the ratio ($r_{eff}$) of the relative output voltage which is proportional to the thickness of the filters. And the logarithm of effective peak tube voltage ($InkV_{p,eff}$) was obtained by Victoreen's NERO 6000M used as reference tube voltage meter. From the linear regression analysis of $r_{eff}$ and In $kV_{p,eff}$ the correlation coefficient (r) of linear equation was obtained to be 0.996 for the calibration of the tube voltage meter. Therefore, we suggest that the noninvasive tube voltage meter fabricated in this study can be used for clinical applications due to Its high accuracy.
Kim, Eng-Chan;Heo, Yeong-Cheol;Cho, Jae-Hwan;Lee, Hyun-Jeong;Lee, Hae-Kag
Journal of Magnetics
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v.19
no.2
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pp.185-191
/
2014
In this study we evaluated that flow rate changes affect the (time of flight) TOF image and contrast-enhanced (CE) in a three-dimensional TOF angiography. We used a 3.0T MR System, a nonpulsatile flow rate model. Saline was used as a fluid injected at a flow rate of 11.4 cm/sec by auto injector. The fluid signal strength, phantom body signal strength and background signal strength were measured at 1, 5, 10, 15, 20 and 25-th cross-section in the experienced images and then they were used to determine signal-to-noise ratio and contrast-to-noise ratio. The inlet, middle and outlet length were measured using coronal images obtained through the maximum intensity projection method. As a result, the length of inner cavity was 2.66 mm with no difference among the inlet, middle and outlet length. We also could know that the magnification rate is 49-55.6% in inlet part, 49-59% in middle part and 49-59% in outlet part, and so the image is generally larger than in the actual measurement. Signal-to-noise ratio and contrast-to-noise ratio were negatively correlated with the fluid velocity and so we could see that signal-to-noise ratio and contrast-to-noise ratio are reduced by faster fluid velocity. Signal-to-noise ratio was 42.2-52.5 in 5-25th section and contrast-to-noise ratio was from 34.0-46.1 also not different, but there was a difference in the 1st section. The smallest 3D TOF MRA measure was $2.51{\pm}0.12mm$ with a flow velocity of 40 cm/s. Consequently, 3D TOF MRA tests show that the faster fluid velocity decreases the signal-to-noise ratio and contrast-to-noise ratio, and basically it can be determined that 3D TOF MRA and 3D CE MRA are displayed larger than in the actual measurement.
The major risk associated with the use of automated power injectors is the well known complication of contrast material extravasation at the injection site. Automated injection of computed tomography (CT) contrast media can produce the compartment syndrome. The purpose of this study was to assess the ability of this device during clinically important episodes of extravasation. The extravasation detection accessory (EDA) system was composed of a strain gage, an amplifier and a computer based system. A strain gage pliable adhesive patch was applied to the skin aver the intravenous catheter and the catheter was connected to the power injector with a cable to monitor the resolution data. If the programmed monitoring, which was developed with MS Visual C++, at the extravasation occurred, then the injection was interrupted the auto injector. CT was used to demonstrate the clinically important extravasation. This study was a prospective, observational study in which the EDA system was used to monitor the automated mechanical injection of contrast material in 7 dogs. There were two true-positive cases (range of extravasation volumes: $18{\sim}22ml$), twenty three true-negative cases, three false-positive cases and no false-negative cases. The EDA system had a sensitivity of 100% and a specificity of 88% for the detection of clinically important extravasation. The EDA system had good sensitivity for the detection of clinically important extravasation and the EDA system has the clinical potential for the early detection of extravasation of the contrast medium that is administered with power injectors. The EDA system is easy to use safe and accurate for the monitoring extravasation of the intravenous injections, and this system may prove especially useful in CT applications.
The existing studies of VDT syndrome have been researched only about for nurse groups without radiological technologists. The target of this study was workers who perform VDT task in general hospital placed in Daejun City such as insurance judgement, patient affairs, medical record management, medical computing service, hospital administration, and radiological sections. This study was conducted at October 15, 2009 to November 2, 2009 using structured questionnaire. Results of group A (age 20-29, less than 5 years experience at clinical site, normal staff, and unmarried group) showed significant skin and psychological conditions among recognition symptoms of VDT syndrome. Group B (age 30-39, 6-10 years experience at clinical site, managing staff, and married group) tends to be similar at orbital, whole body and muscles' frame response among recognition symptoms of VDT syndrome. Results of "Multiple Linear Regression" with dependent variable that is scores of recognition symptoms of VDT syndrome are as follows. The factors which influences for orbital-related problem is gender, health cares and obstacles during daily life. The factors which influences for whole body-related is exercise, stress and recognition for health condition and the factors which influences muscles' frame-related is 6-10 years experience at clinical site, human relationship, health cares and obstacles during daily life. These are proved to be similar by statistic analysis. There is small difference at recognition symptom of VDT syndrome between the radiological technologist and other groups in general hospital. Yet, as the working circumstance of radiological technologist gradually changes to VDT environment, the recognition symptom of VDT syndrome became conscious. This can be prevented by regular job rotation, which will escape the continuous repetition of working pattern.
Early diagnosis for upper facial trauma is difficult by using the standard Water's view (S-Water's) in general radiograph due to overlapping of anatomical structures, the uncertainty of patient positioning, and specific patients with obese, pediatric, old, or high-risk. The purpose of this study was to analyze appropriate exposure angles through a comparison of two different protocols (S-Water's vs. reverse Water's view (R-Water's)) by using a head phantom. A head phantom and general radiograph with 75 kVp, 400 mA, 45 ms 18 mAs, and SID 100 cm. Images of R-Water's were obtained by different angles in the range of $0^{\circ}$ to $50^{\circ}$, which adjusted an angle at 1 degree interval in supine position. Survey elements were developed and three observers were evaluated with four elements including the maxillary sinus, zygomatic arch, petrous ridge, and image distortion. Statistical significant analysis were used the Krippendorff's alpha and Fleiss' kappa. The intra-class correlation (ICC) coefficient for three observers were high with maxillary, 0.957 (0.903, 0.995); zygomatic arch, 0.939 (0.866, 0.987); petrous ridge, 0.972 (0.897, 1.000); and image distortion, 0.949 (0.830, 1.000). The high-quality image (HI) and perfect agreement (PA) for acquired exposure angles were high in range of the maxillary sinus ($36^{\circ}-44^{\circ}C$), zygomatic arch ($33^{\circ}-40^{\circ}$), petrous ridge ($32^{\circ}-50^{\circ}$), and image distortion ($44^{\circ}-50^{\circ}$). Consequently, an appropriate exposure angles for the R-Water's view in the supine position for patients with facial trauma are in the from $36^{\circ}$ to $40^{\circ}$ in this phantom study. The results of this study will be helpful for the rapid diagnosis of facial fractures by simple radiography.
The pattern of the tree's internal swelling depends on many causes. Since it is difficult to detect these various causes of swelling with a general method, if the state of swelling for a long time cannot be confirmed, serious damage to the trees may occur due to enlargement of the swelling area. In the method of acquiring a tree tomography image, an impulse passing through the tree is generated by tapping the sensor with a rubber mallet, and the moving speed is recorded. In this paper, to measure cracks, cavities, and swelling due to physical damage, we developed a 3D viewer that can know the internal state of a tree using a tree cross-section image acquired from Arbotom to determine the degree of swelling inside the tree. Based on this, we tried to present data that can be referred to when surgical operation of trees is required. In order to acquire a tomographic image of a tree, 6 sensors were attached to the three Yangpala and Maple trees, and a 1 m-long tree was measured using the Arbotom program, and a 3D image was implemented through the 3D Viewer created using MATLAB. In addition to simply acquiring images, the cross-sectional length and volume of the tree were measured. In the actually produced 3D Viewer, the length of the part where the swelling of the maple tree occurred was 33.12 cm, and the swelling of the yangpala tree was measured as 21.41 cm. The volume of the maple tree was measured to be 78.832 ㎤. As a result of comparing the cross-sectional image of the Arbotom and the 3D image, the same result as the real aspect of the tree was obtained, so it can be judged that the reliability of the manufactured software is also secured, and data to be applied to the surgical tree operation through the created Viewer is provided. It is believed that the damage will be minimized.
In this study, standard model of medical radiation dosage quality control system will be suggested and the useful of this system in clinical field will be reviewed. Radiation dosage information of modalities are gathered from digital imaging and communications in medicine(DICOM) standard data(such as DICOM dose SR and DICOM header) and stored in database. One CT scan, two digital radiography modalities and two mammography modalities in one health promotion center in Seoul are used to derive clinical data for one month. After 1 months research with 703 CT scans, the study shows CT $357.9mGy{\cdot}cm$ in abdomen and pelvic CT, $572.4mGy{\cdot}cm$ in brain without CT, $55.9mGy{\cdot}cm$ in calcium score/heart CT, screening CT at $54mGy{\cdot}cm$ in chest screening CT(low dose screening CT scan), $284.99mGy{\cdot}cm$ in C-spine CT and $341.85mGy{\cdot}cm$ in L-spine CT as health promotion center reference level of each exam. And with 1955 digital radiography cases, it shows $274.0mGy{\cdot}cm2$ and for mammography 6.09 mGy is shown based on 536 cases. The use of medical radiation shall comply with the principles of justification and optimization. This quality management of medical radiation exposure must be performed in order to follow the principle. And the procedure to reduce the radiation exposure of patients and staff can be achieved through this. The results of this study can be applied as a useful tool to perform the quality control of medical radiation exposure.
In the field of radiation therapy using photon beams and electron beams, since each patient has a different sensitivity to radiation, skin side effects may occur even at the same dose. Therefore, if there is a risk of excessive dose to the skin, a dosimeter is attached to verify whether the correct dose is being investigated. However, since the skin dosimeter checks the attachment site visually by measuring a point dose, it is difficult to confirm an accurate dose distribution. As a result, the measurement and simulation errors of the material HgI2 in the 6 MV photon beam were 3.73% and 5.24%, respectively, at the minimum thickness of 25 ㎛, and the material PbI2 was 4.73% and 5.65%, respectively. On the other hand, as a result of the 6 MeV electron beam, the measurement and simulation errors of the material HgI2 were 1.35% and 1.12%, respectively, at a minimum thickness of 25 ㎛, and the material PbI2 showed relatively low attenuation error, 1.67% and 1.20%, respectively. Therefore, it was evaluated that the thickness of the photon beam within 25 ㎛ and the electron beam within 100 ㎛ is suitable to have a reduction rate error within 5%. This study presents a new research direction for a flexible dosimeter attached to the human body that is required in clinical practice and the construction conditions of a future skin dosimeter.
Seo, Sun-Youl;Han, Man-Seok;Jeon, Min-Cheol;Kim, Yong-Kyun;Kim, Chang-Gyu
Journal of the Korea Convergence Society
/
v.4
no.2
/
pp.9-13
/
2013
This study which improve pretreatment method was to increase effective diagnosis of barium enema to remind a more accurate action by training precautions, method of taking medicine, time and taking suitable laxative to patient. First, A total of 504 patients who received barium enema in the E university hospital were evaluated about repretreatment proportion of patients. 176 patients who were changed with precaution were evaluated about repretreatment. Second, Both 130 patients who were not changed with the type and amount of laxative and 137 patients who were changed with it were evaluated. Repretreatment rate was reduced about 10% since changed precautions. Stomachache was reduced about 21% due to chage methode to take the laxative improved. Patients who think cleanliness degree of bowel increased that it is going very well about 11.9% since improvement and decreased that it's not bad about 16.3%. The methods which accurately recognize precautions to patient decrease repretreatment rate, inconvenience and pain of patients due to repretreatment. Expectation mentlity for accurate inspection also had increased in that patients think that cleanliness degree of bowel was increased.
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