• Title/Summary/Keyword: Remote Treatment

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Packing effects on the intracavitary radiation therapy of the utaine lervix cancer ($^{192}Ir$source를 이용할 자궁경부암 강내치료시 사용하는 packing의 효과에 대한 고찰)

  • Cho, Jung-Kun;Lee, Du-Hyun;Si, Chang-Kun;Choi, Yoon-Kyung;Kim, Tae-Yoon
    • The Journal of Korean Society for Radiation Therapy
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    • v.16 no.1
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    • pp.73-77
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    • 2004
  • Purpose of the radio-therapy is maximize the radiation dose to the tumor while minimizing the dose to the critical organ. Carcinoma of the uterine cervix treatment are external irradiation or an interstitial brachtheraphy make use of isotope. Brachytherapy is a method of radiotherapy in advantage to achieve better local control with minimum radiation toxicity in comparison with external irradiation because radiation dose is distributed according to the inverse square low of gamma-ray emitted from the implanted sources. Authors make use of the patients data which 192Ir gives medical treatment intrcavity. Intracavitary radiation of the uterine cervix cancer, critical organ take $20\%$ below than exposure dose of A point in the ICRU report. None the less of the advice, Radiation proctitis and radiation cystitis are frequent and problematic early complications in patients treated with radiation for the uterine cervix cancer. In brachytherapy of uterine cervical cancer using a high dose rate remote afterloading system, it is of prime importance to deliver a accurate dose in each fractionated treatment by minimizing the difference between the pre-treatment planned and post-treatment calculated doses. Use of packing to reduce late complications intracavitary radiation of the uterine cervix cancer. Bladder and rectum changes exposure dose rate by radiotherphy make use of packing.

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The Effects of High Dose Rate Brachytherapy in Recurrent Obstructive Bronchogenic Cancer after External Irradiation Therapy (외부 방사선 치료 조사후 재발한 기관지내 악성종양에서 고선량율 근접조사치료(High Dose Rate Brachytherapy)의 효과)

  • Cho, Jae-Youn;In, Kwang-Ho;Suh, Jung-Kyung;Kang, Sea-Yong;Shim, Jae-Jeong;Kang, Kyung-Ho;Kim, Kwang-Taak;Kim, Cheol-Yong;Yoo, Sa-Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.1
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    • pp.68-76
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    • 1998
  • Background: Patients with centrally recurred bronchogenic carcinoma make a complaint of many symptoms like hemoptysis, cough & dyspnea. At these conditions, the goal of treatment is only to relieve their symptoms. High dose rate brachytherapy(HDR-BT) is the palliative treatment modality of centrally located endobronchial tumor regardless of previous external irradiation(XRT) on the same site in symptomatic patients. Methods: We studied the effects of HDR-BT in 26 patients with symptomatic recurrent lung cancer. Patients(male: 24, mean age: 54yrs)were treated with HDR-BT underwent bronchoscopic placement of $^{192}Ir$ HDR after loading unit(Gammamed$^{(T)}$, Germany) to deliver 500cGY intraluminal irradiation at a depth of 1cm every lwk on 3 occasions. Evaluation at base line and 4wks after HDR brachytherapy included chest X-ray, bronchscopy, symptoms (Standadized Scale for dyspnea,cough,hemoptysis), and Karnofsky performance scale. Results: Endobronchial obstruction was improved in 11/26 patients(37%). Atelectasis in chest X-ray was improved in 5/15 patients(33%). Hemoptysis, dyspnea & cough were improved in 5/10 patients (50%), 5/8 patients (62%) & 10/18 patients (56%) respectively. Karnofsky performance status was changed from 76.4 scores in pretreatment to 77.6 scores after treatment. During HDR-BT, massive hemoptysis (2 patients) and pneumothorax(1 patient) were occurred as complications. Conclusion: We concluded that HDR-BT gave additional benefits for the control of symptoms and general performance and endobronchial obstruction & atelectasis. And HDR-BT will be an additional treatment for the recurrent and endobronchial obstructive lung cancer.

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A Study on the Mobile Medical Service Program -Based on the Community Diagnosis of a Remote Farm Area- (순회진료사업(巡回診療事業)의 문제점(問題点)과 개선방향(改善方向) (일부(一部) 무의지역에 대(對)한 지역사진단(地域社診斷)을 중심(中心)으로))

  • Park, Hung-Bae;Choi, Dong-Wook
    • Journal of Preventive Medicine and Public Health
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    • v.11 no.1
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    • pp.86-97
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    • 1978
  • The mobile medical service has been operated for many years by a number of medical schools and hospitals as a most convenient means of medical service delivery to the people residing in such area where the geographical and socioeconomic conditions are not good enough to enjoy modern medical care. Despite of official appraisal showing off simply with numbers of outpatients treated and medical persons participated, however, as well recognized, the capability (in respect of budget, equipment and time) of those mobile medical teams is so limitted that it often discourages the recipients as well as medical participants themselves. In the midst of rising need to secure medical service of good quality to all parts of the country, and of developing concept of primary health care system, authors evaluated the effectiveness of and problems associated with mobile medical servies program through the community diagnosis of a village (Opo-myun, Kwangju-gun) to obtain the information which may be halpful for future improvement. 1. Owing to the nationwide Sae-Maul movement powerfully practiced during last several years, living environment of farm villages generally and remarkably improved including houses, water supply and wastes disposal etc. Neverthless, due to limitations in budget time and lack of knowledge (probably the most important), these improvements tend to keep up appearances only and are far from the goal which may being practical benefit in promoting the health of the community. 2. As a result of intensive population policy led by the government since 1962, there has been considerable advances in understanding and the rate of practicing family planning through out the villages and yet, one should see many things, especially education, to be done. Fifty eight per cent of mothers have not received prenatal check and the care for most (72%) delivery was offered by laymen at home. 3. Approximately seven per cent of the population was reported to have chronic illness but since only a few (practically none) of the people has had physical check up by doctors, the actual prevalence of chronic diseases may reach many times of the reported. The same fact was observed also in prevalence of tuberculosis; the patients registered at local health center totaled 31 comprising only 0.51% while the numbers in two neighboring villages (designated as demonstration area of tuberculosis control and mass examination was done recently) were 3.5 and 4.0% respectively. Prevalence rate of all dieseses and injuries expereinced during one month (July, 1977) was 15.8%. Only one tenth of those patients received treatment by physicians and one fifth was not treated at all. The situation was worse as for the chronic patients; 84% of all cases either have never been treated or discontinued therapy, and the main reasons were known to be financial difficulty and ignorance or indifference. 4. Among the patients treated by our mobile clinic, one third was chronic cases and 45% of all patients, by the opinion of doctors attended, were those who may be treated by specially trained nurses or other paramedics (objects of primary care). Besides, 20% of the cases required professional managements of level beyond the mobile team's capability and in this sense one may conclude that the effectiveness (performance) of present mobile medical team is quite limitted. According to above findings, the authors would like to suggest following for mobile medical service and overall medicare program for the people living in remote country side. 1. Establishment of primary health care system secured with effective communication and evacuation (between villages and local medical center) measures. 2. Nationwide enforcement of medical insurance system. 3. Simple outpatient care which now constitutes the main part of the most mobile medical services should largely be yielded up to primary health care unit of the village and the mobile team itself should be assigned on new and more urgent missions such as mass screening health examination of the villagers, health education with modern and effective audiovisual aids, professional training and consultant services for the primary health care organization.

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Treatment of Carcinoma of the Uterine Cervix with High-Dose-Rate Intracavitary Irradiation using Ralstron (고선량률 강내조사를 사용한 자궁경부암의 치료)

  • Suh Chang Ok;Kim Gwi Eon;Loh John J.K.
    • Radiation Oncology Journal
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    • v.8 no.2
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    • pp.231-239
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    • 1990
  • From May 1979 through December 1981 a total of 524 patients with carcinoma of the uterine cervix were treated by radiation therapy with curative intent. Among the 524 patients, 350 were treated with a high-dose-rate (HDR), remote-controlled, afterloading intracavitary irradiation (ICR) system using a cobalt source (Ralstron), and 168 patients received a low-dose-rate (LDR) ICR using a radium source. External beam irradiation with a total dose of 40-50 Gy to the whole pelvis followed by intracavitary irradiation with a total dose of 30-39 Gy in 10-13 fractions to point A was the treatment protocol. ICR was given three times a week with a dose of 3 Gy per fraction. Five-year actuarial survival rates in the HDR-ICR group were $77.6{\%}$ in stage IB (N=20), $68.2{\%}$ in stage II (N=182), and $50.9{\%}$ in stage III (N=148). In LDR-ICR group, 5-year survival rates were $87.5{\%}$ in stage IB (N=22), $66.3{\%}$ in stage II (N=91), and $55.4{\%}$ in stage III (N=52). Survival rates showed a statistically significant difference by stage, but there was no significant difference between the two ICR groups. Late bowel complications after radiotherapy were noted in $3.7{\%}$ of the HDR-ICR group and $8.4{\%}$ of the LDR-ICR group. There was no severe complication requiring surgical management. The incidence of bladder complications was $1.4{\%}$ in the HDR-ICR group and $2.4{\%}$ in the LDR-ICR group. The application of HDR-ICR was technically simple and easily performed on an outpatient basis without anesthesia, and the patients tolerated it very well. Radiation exposure to personnel was virtually nil in contrast to that of LDR-ICR. Within a given period of time, more patients can be treated with HDR-ICR because of the short treatment time. Therefore, the HDR-ICR system is highly recommended for a cancer center, particularly one with a large number of patients to be treated. In order to achieve an improved outcome, however, the optimum dose-fractionation schedule of HDR-ICR and optimum combination of intracavitary irradiation with external beam irradiation should be determined through an extensive protocol.

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Studies on Low Temperature Injury at each Growth Stage in Rice Plant (수도 생육과정별 저온장해에 관한 연구)

  • Hyun-Ok Choi;Jong-Hoon Lee
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.21 no.2
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    • pp.203-210
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    • 1976
  • To abtain basic information in process developing cold tolerance rice variety, used 8 varieties which are the close crossing and the remote crossing in order to clarify how is being the differences of low temperature injury in same variety and the varietal difference at each growth stage under the low temperature treatment, 18$^{\circ}C$-12$^{\circ}C$ (day-night), and to establish the effective testing method for low temperature injury in rice plant. In this experiment, the varietal ifferences of low temperature injury were significant in rice plant, and found out that low temperature injury at the each growth stage from sowing to heading in same variety was not horizontal.

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Measurement of Ir-192 Source Activity for High Dose Rate Brachytherapy (고 선량률 근접치료시 사용되는 Ir-192 선원의 방사능 평가)

  • 최동락;허승재;안용찬;임도훈;김대용;우홍균
    • Progress in Medical Physics
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    • v.8 no.1
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    • pp.25-29
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    • 1997
  • Ir-192 source activity for high dose rate brachytherapy is measured using Farmertype ionization chamber. The source-to-chamber distance is 10 cm and the measured charge unit is converted to activity unit. The measured values are compared to the values provided from vendor. Because of time dependency of Ir-192 source activity, the activities are regularly checked and compared to calculated values. As the accuracy of Ir-192 source activity is depend on the mechanical measurement setup, we estimated the precision of remote controlled source dwell position using home-made device and film scanner. The difference between measured and predicted dwell position is within 1 mm. As a result, the errors of source activity are 0.7${\pm}$1.5 % for measured and vendor-provided values and 0.l${\pm}$1.2% for measured and time-dependent calculated vlaues. In conclusion, our measured activity has been comparable to the values provided from vendor and our brachytherapy unit has been very accurate until now. Regular quality control of brachytherapy is essential for successful treatment which depends on the accuracy of source position and activity.

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Study on a Methodology for Developing Shanghanlun Ontology (상한론(傷寒論)온톨로지 구축 방법론 연구)

  • Jung, Tae-Young;Kim, Hee-Yeol;Park, Jong-Hyun
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.25 no.5
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    • pp.765-772
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    • 2011
  • Knowledge which is represented by formal logic are widely used in many domains such like artificial intelligence, information retrieval, e-commerce and so on. And for medical field, medical documentary records retrieval, information systems in hospitals, medical data sharing, remote treatment and expert systems need knowledge representation technology. To retrieve information intellectually and provide advanced information services, systematically controlled mechanism is needed to represent and share knowledge. Importantly, medical expert's knowledge should be represented in a form that is understandable to computers and also to humans to be applied to the medical information system supporting decision making. And it should have a suitable and efficient structure for its own purposes including reasoning, extendability of knowledge, management of data, accuracy of expressions, diversity, and so on. we call it ontology which can be processed with machines. We can use the ontology to represent traditional medicine knowledge in structured and systematic way with visualization, then also it can also be used education materials. Hence, the authors developed an Shanghanlun ontology by way of showing an example, so that we suggested a methodology for ontology development and also a model to structure the traditional medical knowledge. And this result can be used for student to learn Shanghanlun by graphical representation of it's knowledge. We analyzed the text of Shanghanlun to construct relational database including it's original text, symptoms and herb formulars. And then we classified the terms following some criterion, confirmed the structure of the ontology to describe semantic relations between the terms, especially we developed the ontology considering visual representation. The ontology developed in this study provides database showing fomulas, herbs, symptoms, the name of diseases and the text written in Shanghanlun. It's easy to retrieve contents by their semantic relations so that it is convenient to search knowledge of Shanghanlun and to learn it. It can display the related concepts by searching terms and provides expanded information with a simple click. It has some limitations such as standardization problems, short coverage of pattern(證), and error in chinese characters input. But we believe this research can be used for basic foundation to make traditional medicine more structural and systematic, to develop application softwares, and also to applied it in Shanghanlun educations.

Present Status and Future Aspects of Radiation Oncology in Korea (방사선 치료의 국내 현황과 미래)

  • Huh, Seung-Jae
    • Radiation Oncology Journal
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    • v.24 no.4
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    • pp.211-216
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    • 2006
  • $\underline{Purpose}$: An analysis of the infrastructure for radiotherapy in Korea was performed to establish a baseline plan in 2006 for future development. $\underline{Materials\;and\;Methods}$: The data were obtained from 61 radiotherapy centers. The survey covered the number of radiotherapy centers, major equipment and personnel. Centers were classified into technical level groups according to the IAEA criteria. $\underline{Results}$: 28,789 new patients were treated with radiation therapy in 2004. There were 104 megavoltage devices in 61 institutions, which included 96 linear accelerators, two Cobalt 60 units, three Tomotherapy units, two Cyberknife units and one proton accelerator in 2006. Thirty-five high dose rate remote after-loading systems and 20 CT-simulators were surveyed. Personnel included 132 radiation oncologists, 50 radiation oncology residents, 64 medical physicists, 130 nurses and 369 radiation therapy technologists. All of the facilities employed treatment-planning computers and simulators, among these thirty-two percent (20 facilities) used a CT-simulator. Sixty-six percent (40 facilities) used a PET/CT scanner, and 35% (22 facilities) had the capacity to implement intensity modulated radiation therapy. Twenty-five facilities (41%) were included in technical level 3 group (having one of intensity modulated radiotherapy, stereotactic radiotherapy or intra-operative radiotherapy system). $\underline{Conclusion}$: Radiation oncology in Korea evolved greatly in both quality and quantity recently and demand for radiotherapy in Korea is increasing steadily. The information in this analysis represents important data to develop the future planning of equipment and human resources.

Breast Cancer Characteristics and Survival Differences between Maori, Pacific and other New Zealand Women Included in the Quality Audit Program of Breast Surgeons of Australia and New Zealand

  • Campbell, Ian;Scott, Nina;Seneviratne, Sanjeewa;Kollias, James;Walters, David;Taylor, Corey;Roder, David
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.6
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    • pp.2465-2472
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    • 2015
  • Background: The Quality Audit (BQA) program of the Breast Surgeons of Australia and New Zealand (NZ) collects data on early female breast cancer and its treatment. BQA data covered approximately half all early breast cancers diagnosed in NZ during roll-out of the BQA program in 1998-2010. Coverage increased progressively to about 80% by 2008. This is the biggest NZ breast cancer database outside the NZ Cancer Registry and it includes cancer and clinical management data not collected by the Registry. We used these BQA data to compare socio-demographic and cancer characteristics and survivals by ethnicity. Materials and Methods: BQA data for 1998-2010 diagnoses were linked to NZ death records using the National Health Index (NHI) for linking. Live cases were followed up to December $31^{st}$ 2010. Socio-demographic and invasive cancer characteristics and disease-specific survivals were compared by ethnicity. Results: Five-year survivals were 87% for Maori, 84% for Pacific, 91% for other NZ cases and 90% overall. This compared with the 86% survival reported for all female breast cases covered by the NZ Cancer Registry which also included more advanced stages. Patterns of survival by clinical risk factors accorded with patterns expected from the scientific literature. Compared with Other cases, Maori and Pacific women were younger, came from more deprived areas, and had larger cancers with more ductal and fewer lobular histology types. Their cancers were also less likely to have a triple negative phenotype. More of the Pacific women had vascular invasion. Maori women were more likely to reside in areas more remote from regional cancer centres, whereas Pacific women generally lived closer to these centres than Other NZ cases. Conclusions: NZ BQA data indicate previously unreported differences in breast cancer biology by ethnicity. Maori and Pacific women had reduced breast cancer survival compared with Other NZ women, after adjusting for socio-demographic and cancer characteristics. The potential contributions to survival differences of variations in service access, timeliness and quality of care, need to be examined, along with effects of comorbidity and biological factors.

Physicochemical Characteristics of Fe3O4 Magnetic Nanocomposites Based on Poly(N-isopropylacrylamide) for Anti-cancer Drug Delivery

  • Davaran, Soodabeh;Alimirzalu, Samira;Nejati-Koshki, Kazem;Nasrabadi, Hamid Tayefi;Akbarzadeh, Abolfazl;Khandaghi, Amir Ahmad;Abbasian, Mojtaba;Alimohammadi, Somayeh
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.1
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    • pp.49-54
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    • 2014
  • Background: Hydrogels are a class of polymers that can absorb water or biological fluids and swell to several times their dry volume, dependent on changes in the external environment. In recent years, hydrogels and hydrogel nanocomposites have found a variety of biomedical applications, including drug delivery and cancer treatment. The incorporation of nanoparticulates into a hydrogel matrix can result in unique material characteristics such as enhanced mechanical properties, swelling response, and capability of remote controlled actuation. Materials and Methods: In this work, synthesis of hydrogel nanocomposites containing magnetic nanoparticles are studied. At first, magnetic nanoparticles ($Fe_3O_4$) with an average size 10 nm were prepared. At second approach, thermo and pH-sensitive poly (N-isopropylacrylamide -co-methacrylic acid-co-vinyl pyrrolidone) (NIPAAm-MAA-VP) were prepared. Swelling behavior of co-polymer was studied in buffer solutions with different pH values (pH=5.8, pH=7.4) at $37^{\circ}C$. Magnetic iron oxide nanoparticles ($Fe_3O_4$) and doxorubicin were incorporated into copolymer and drug loading was studied. The release of drug, carried out at different pH and temperatures. Finally, chemical composition, magnetic properties and morphology of doxorubicin-loaded magnetic hydrogel nanocomposites were analyzed by FT- IR, vibrating sample magnetometry (VSM), scanning electron microscopy (SEM). Results: The results indicated that drug loading efficiency was increased by increasing the drug ratio to polymer. Doxorubicin was released more at $40^{\circ}C$ and in acidic pH compared to that $37^{\circ}C$ and basic pH. Conclusions: This study suggested that the poly (NIPAAm-MAA-VP) magnetic hydrogel nanocomposite could be an effective carrier for targeting drug delivery systems of anti-cancer drugs due to its temperature sensitive properties.