• Title/Summary/Keyword: Skin Cancer

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Antibacterial Activity of Platycarya strobilacea Extract and Stability of the Extract-containing Cream (굴피나무 추출물의 항균 활성 및 추출물을 함유한 크림의 안정성 분석)

  • Yang, Hee-Jung;Kim, Eun-Hee;Kang, Sung-Tae;Park, Soo-Nam
    • Microbiology and Biotechnology Letters
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    • v.37 no.2
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    • pp.170-175
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    • 2009
  • The extract of Platycarya strobilacea is known to possess a wide range of pharmacological activities including anti-inflammatory, anti-fungal, and anti-cancer properties. We have reported that the ethyl acetate fraction of Platycarya strobilacea (PS-ET fraction) has high potential as an antioxidant agent (J. Soc. Cosmet. Scientists Korea 34(4) 275, 2008). In this study, antibacterial activity of the fraction and stability of the cream containing 0.2% PS-ET fraction were investigated for the application to cosmetics. Antibacterial activity of PS-ET fraction against various skin pathogenic bacteria (Propionibacterium acnes, Staphylococcus aureus, and Pityrosporum ovale) was measured by minimum inhibitory concentration (MIC). MIC values of PS-ET fraction on P. acnes, S. aureus, and P. ovale were 0.13%, 0.06% and 0.25%, respectively. The results showed that the antibacterial activity of the fraction was the highest in the S. aureus. For the stability evaluation, pH and viscosity of the cream containing 0.2% PS-ET fraction were measured. The results showed that pH changes of the cream containing PS-ET fraction was lower than the control cream without PS-ET fraction. And the PS-ET fraction could repress the decrease of viscosity of the cream against sunlight treatment. These results suggest that the fraction of Platycarya strobilacea has high potential as bactericide against the skin pathogenic bacteria and could be added to improve the stability of cosmetic products.

Studies on the Radiation Induced Apoptosis by Morphological and Biochemical Analysis in A431 Cells (방사선에 조사된 인체세포주(A431)에서 형태학적 분석법과 생화학적 분석법을 이용한 방사선 유도 세포고사에 관한 연구)

  • Choi, Keun-Hee;Bom, Hee-Seung;Kim, Ji-Yeul
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.3
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    • pp.306-315
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    • 1999
  • Purpose: We performed this study to evaluate the process of radiation induced apoptosis in A431 skin epithelial cancer cell line. Materials and Methods: Low to high dose radiation (0, 2, 5, 10, 25 Gy) was given to A431 cells by Cs-137 cell irradiator. Apoptosis was evaluated by cell morphology, dye exclusion test, and DNA laddering. Results: Cell viability decreased as the radiation dose increased. Number of apoptotic bodies increased as radiation dose increased. It increased most significantly at 12 hours after irradiation. Lactate dehydrogenase activity in culture medium increased according to radiation dose and time after irradiation. DNA ladders could be identified in irradiated cells, but, it had no correlation with radiation dose or time after irradiation. Conclusion: Radiation-induced apoptosis which was the main course of cell death in A431 cells could be analyzed quantitatively by counting apoptotic bodies under microscope. Apoptosis increased as radiation dose increased.

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Usefulness of Tuberculin Test in Adult Patients with Suspected Pulmonary Tuberculosis (폐결핵이 의심되는 성인 환자에서 투베르쿨린 검사의 유용성)

  • Kang, Eun Hae;Koh, Won-Jung;Kwon, O Jung;Kim, Kyung Chan;Lee, Byoung-Hoon;Hwang, Jung Hye;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong;Lee, Kyung Soo
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.3
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    • pp.268-279
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    • 2004
  • Background : The tuberculin skin test has been used to diagnose latent tuberculosis infection, but is not widely used to diagnose or exclude pulmonary tuberculosis. The objective of this study was to evaluate the diagnostic utility of the tuberculin test in diagnosing and excluding pulmonary tuberculosis, and differentiating pulmonary tuberculosis from nontuberculous mycobacteria (NTM) pulmonary disease, when a sputum acid-fast bacilli (AFB) smear was positive. Material and Methods : From October 2002 to August 2003, among all the inpatients of the Division of Pulmonary and Critical Care Medicine at Samsung Medical Center, 258 patients with clinical suspicion of pulmonary tuberculosis were enrolled and underwent a tuberculin test. Results : 156 males and 102 females were included, with a mean age of 57.5 years. The final diagnoses included lung cancer in 89 cases (34.5%), pulmonary tuberculosis in 59 cases (22.9%), bacterial pneumonia in 33 cases (12.8%) and NTM pulmonary disease in 24 cases (9.3%). The positive tuberculin test rate was higher in the tuberculosis than non-tuberculosis group; 81.4 (48/59) vs. 42.4% (81/199). (p<0.001). In 208 patients with a negative sputum AFB smear, the result of the tuberculin test was positive in 69.4% (25/36) of the tuberculosis group and in 44.8% (77/172) of the non-tuberculosis group (p=0.007), so a positive result of the tuberculin test could predict pulmonary tuberculosis with 69.4% sensitivity, 55.2% specificity, a 24.5% positive predictive value and a 89.6% negative predictive value. In 50 patients with a positive sputum AFB smear, the positive rates of the tuberculin test were 83.9% (26/31) in tuberculosis group and 21.1% (4/19) in NTM pulmonary disease group (p<0.001), so a positive result of the tuberculin skin test could predict pulmonary tuberculosis with 83.9% sensitivity, 78.9% specificity, a 86.7% positive predictive value and a 75.0% negative predictive value. Conclusion : The tuberculin test could be useful in excluding pulmonary tuberculosis when the sputum AFB smear is negative, and to differentiate pulmonary tuberculosis from NTM pulmonary disease when the sputum AFB smear is positive.

Evaluation of the Potential of Nitrogen Plasma to Cosmetics (질소 플라즈마의 화장품 가능성 평가)

  • Lee, So Min;Jung, So Young;Brito, Sofia;Heo, Hyojin;Cha, Byungsun;Lei, Lei;Lee, Sang Hun;Lee, Mi-Gi;Bin, Bum-Ho;Kwak, Byeong-Mun
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.48 no.3
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    • pp.189-196
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    • 2022
  • Plasma refers to an ionized gas that is often referred to as "the fourth phase of matter", following solid, liquid, and gas. Plasma has traditionally been utilized for industrial applications such as welding and neon signs, but its promise in biomedical fields such as cancer treatment and dermatology has lately been recognized. Indeed, due to its beneficial effects in promoting collagen production, improving skin tone, and eliminating harmful bacteria in the skin, plasma treatment constitutes an important target for dermatological research. In this study, a plasma device for cosmetic manufacturing based on nitrogen, the main component of the atmosphere, was designed and assembled. Moreover, nitric oxide (NO) was selected since is easier to follow and evaluate than other nitrogen plasma active species, and its contents were measured to perform a quantitative and qualitative evaluation of plasma. First, an injection method, using different proximities labeled "sinking" and "non sinking" treatments, was performed to test the most efficient plasma treatment method. As a result, it was observed that the formulation obtained by a non sinking treatment was more effective. Furthermore, toner and ampoule were selected as cosmetics formulations, and the characteristics of the formulation and changes in the injected plasma state were observed. In both formulations, the successful injection of NO plasma was 2 times higher in toner formulation than ampoule formulation, and it gradually decreased with time, having dissipated after a week. It was confirmed that the nitrogen plasma used did not affect the stability of the toner and ampoule formulations at low temperature (4 ℃), room temperature (25 ℃), and high temperature (37 ℃ and 50 ℃) conditions. The results of this study demonstrate the potential of plasma cosmetics and highlight the importance of securing the stability of the injected plasma.

Evaluation of Electron Boost Fields based on Surgical Clips and Operative Scars in Definitive Breast Irradiation (유방보존술 후 방사선치료에서 수술 흉터와 삽입된 클립을 이용한 전자설 추가 방사선 조사야 평가)

  • Lee, Re-Na;Chung, Eun-Ah;Lee, Ji-Hye;Suh, Hyun-Suk
    • Radiation Oncology Journal
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    • v.23 no.4
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    • pp.236-242
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    • 2005
  • Purpose: To evaluate the role of surgical clips and scars in determining electron boost field for early stage breast cancer undergoing conserving surgery and postoperative radiotherapy and to provide an optimal method in drawing the boost field. Materials and Methods: Twenty patients who had $4{\sim}7$ surgical clips in the excision cavity were selected for this study. The depth informations were obtained to determine electron energy by measuring the distance from the skin to chest wall (SCD) and to the clip implanted in the most posterior area of tumor bed. Three different electron fields were outlined on a simulation film. The radiological tumor bed was determined by connecting all the clips implanted during surgery Clinical field (CF) was drawn by adding 3 cm margin around surgical scar. Surgical field (SF) was drawn by adding 2 cm margin around surgical clips and an Ideal field (IF) was outlined by adding 2 cm margin around both scar and clips. These fields were digitized into our planning system to measure the area of each separate field. The areas of the three different electron boost fields were compared. Finally, surgical clips were contoured on axial CT images and dose volume histogram was plotted to investigate 3-dimensional coverage of the clips. Results : The average depth difference between SCD and the maximal clip location was $0.7{\pm}0.55cm$. Greater difference of 5 mm or more was seen in 12 patients. The average shift between the borders of scar and clips were 1.7 1.2, 1.2, and 0.9 cm in superior, inferior, medial, and lateral directions, respectively. The area of the CF was larger than SF and IF in 6y20 patients. In 15/20 patients, the area difference between SF and if was less than 5%. One to three clips were seen outside the CF in 15/20 patients. In addition, dosimetrically inadequate coverage of clips (less than 80% of prescribed dose) were observed in 17/20 patients when CF was used as the boost field. Conclusion: The electron field determined from clinical scar underestimates the tumor bed in superior-inferior direction significantly and thereby underdosing the tissue at risk. The electron field obtained from surgical clips alone dose not cover the entire scar properly As a consequence, our technique, which combines the surgical clips and clinical scars in determining electron boost field, was proved to be effective in minimizing the geographical miss as well as normal tissue complications.

Development of a Thermoplastic Oral Compensator for Improving Dose Uniformity in Radiation Therapy for Head and Neck Cancer (두경부암 방사선치료 시 선량 균일도 향상을 위한 Thermoplastic 구강 보상체의 개발)

  • Choi, Joon-Yong;Won, Young-Jin;Park, Ji-Yeon;Kim, Jong-Won;Moon, Bong-Ki;Yoon, Hyong-Geun;Moon, Soo-Ho;Jeon, Jong-Byeong;Suh, Tae-Suk
    • Progress in Medical Physics
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    • v.23 no.4
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    • pp.269-278
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    • 2012
  • Aquaplast Thermoplastic (AT) is a tissue-equivalent oral compensator that has been developed to improve dose uniformity at the common boundary and around the treated area during radiotherapy in patients with head and neck cancer. In order to assess the usefulness of AT, the degree of improvement in dose distribution and physical properties were compared to those of oral compensators made using paraffin, alginate, and putty, which are materials conventionally used in dental imprinting. To assess the physical properties, strength evaluations (compression and drop evaluations) and natural deformation evaluations (volume change over time) were performed; a Gafchromic EBT2 film and a glass dosimeter inserted into a developed phantom for dose verification were used to measure the common boundary dose and the beam profile to assess the dose delivery. When the natural deformation of the oral compensators was assessed over a two-month period, alginate exhibited a maximum of 80% change in volume from moisture evaporation, while the remaining tissue-equivalent properties, including those of AT, showed a change in volume that was less than 3%. In a free-fall test at a height of 1.5 m (repeated 5 times as a strength evaluation), paraffin was easily damaged by the impact, but AT exhibited no damage from the fall. In compressive strength testing, AT was not destroyed even at 8 times the force needed for paraffin. In dose verification using a glass dosimeter, the results showed that in a single test, the tissue-equivalent (about 80 Hounsfield Units [HU]) AT delivered about 4.9% lower surface dose in terms of delivery of an output coefficient (monitor unit), which was 4% lower than putty and exhibited a value of about 1,000 HU or higher during a dose delivery of the same formulation. In addition, when the incident direction of the beam was used as a reference, the uniformity of the dose, as assessed from the beam profile at the boundary after passing through the oral compensators, was 11.41, 3.98, and 4.30 for air, AT, and putty, respectively. The AT oral compensator had a higher strength and lower probability of material transformation than the oral compensators conventionally used as a tissue-equivalent material, and a uniform dose distribution was successfully formed at the boundary and surrounding area including the mouth. It was also possible to deliver a uniformly formulated dose and reduce the skin dose delivery.

Simultaneous Analysis of 13 Pesticides in Groundwater and Evaluation of its Persistent Characteristics

  • Song, Dahee;Park, Sunhwa;Jeon, Sang-Ho;Kim, Ki-In;Hwang, Jong Yeon;Kim, Moonsu;Jo, Hun-Je;Kim, Deok-hyun;Lee, Gyeong-Mi;Kim, Hye-Jin;Kim, Tae-Seung;Chung, Hyen Mi;Kim, Hyun-Koo
    • Korean Journal of Soil Science and Fertilizer
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    • v.50 no.5
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    • pp.434-451
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    • 2017
  • For this study, groundwater samples for 3 years from 2011 through 2013 were collected at 106 groundwater monitoring site in Korea. These groundwater samples were analyzed for 13 pesticides such as cabofuran, pentachlorobenzene, hexachlorobenzene, simazine, atrazine, lindane (gamma-HCH), alachlor, heptachlor, chlordane (total), endosulfan (1, 2), dieldrin, endrin, 4,4-DDT. The objectives of this study were to determine the detection frequency and their concentrations of 13 pesticides and evaluate the health risk level considering ingestion, inhalation, and skin contact using concentrations of 13 pesticides in groundwater samples. An analysis was used for the simultaneous determination for 13 pesticides using GC-MS. GC-MS was performed on HP-5ms, using helium ($1ml\;min^{-1}$) as carrier gas. The average recoveries of the pesticides were from 92.8% to 120.8%. The limits of detection (LODs) were between $0.004{\mu}g\;L^{-1}$ and $0.118{\mu}g\;L^{-1}$ and the limits of quantification (LOQs) were between $0.012{\mu}g\;L^{-1}$ and $0.354{\mu}g\;L^{-1}$. 106 groundwater wells were selected. 54 wells were from well to monitor background groundwater quality and 52 wells were from well to monitor groundwater quality in industrial or contamination source area. Eight pesticides including pentachlorobenzene, lindane (Gamma-HCH), heptachlor, chlordane (total), Endosulfan (1, 2), dieldrin, endrin, and 4,4-DDT were not detected in groundwater samples. The detection frequency for hexachlorobenzene, alachlor, carbofuran and simazine was 23.4%, 11.4%, 7.3%, and 1.0%, respectively. Atrazine was detected once in 2011. The average concentrations were $0.00423{\mu}g\;L^{-1}$ for carbofuran, $0.000243{\mu}g\;L^{-1}$ for alachlor, $0.00015{\mu}g\;L^{-1}$ for simazine, and $0.00001{\mu}g\;L^{-1}$ for hexachlorobenzene. The detection frequency of hexachlorobenzene was high, but the average concentration was low. In the contaminated groundwater, the detection frequency for hexachlorobenzene, alachlor, carbofuran, simazine and atrazine was 26.1%, 21.3%, 7.1%, 1.9% and 0.3%, respectively. In the uncontaminated groundwater, detection frequency for hexachlorobenzene, carbofuran and alachlor were 20.2%, 7.5%, and 1.9% respectively. Simazine and atrazine were not detected at uncontaminated groundwater wells. According to the purpose of groundwater use, atrazine was detected for agricultural groundwater use. Hexachlorobenzene showed high detection frequency at agricultural groundwater use area where the animal feeding area and golf course area were located. Alachlor showed more than 50% detection frequency at cropping area, pollution concern river area, and golf course area. Atrazine was detected in agricultural water use area. By land use, the maximum detection frequency of alachlor was found near an orchard. For human risk assessment, the cancer risk for the 5 pesticides was between $10^{-7}$ and $10^{-10}$, while the non-cancer risk (HQ value) was between $10^{-4}$ and $10^{-6}$. For conclusion, these monitoring study needs to continue because of the possibility of groundwater contamination based on various purpose of groundwater use.

Results of Preoperative Concurrent Chemoradiotherapy for the Treatment of Rectal Cancer (직장암의 수술 전 동시적 항암화학방사선치료 결과)

  • Yoon, Mee-Sun;Nam, Taek-Keun;Kim, Hyeong-Rok;Nah, Byung-Sik;Chung, Woong-Ki;Kim, Young-Jin;Ahn, Sung-Ja;Song, Ju-Young;Jeong, Jae-Uk
    • Radiation Oncology Journal
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    • v.26 no.4
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    • pp.247-256
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    • 2008
  • Purpose: The purpose of this study is to evaluate anal sphincter preservation rates, survival rates, and prognostic factors in patients with rectal cancer treated with preoperative chemoradiotherapy. Materials and Methods: One hundred fifty patients with pathologic confirmed rectal cancer and treated by preoperative chemoradiotherapy between January 1999 and June 2007. Of the 150 patients, the 82 who completed the scheduled chemoradiotherapy, received definitive surgery at our hospital, and did not have distant metastasis upon initial diagnosis were enrolled in this study. The radiation dose delivered to the whole pelvis ranged from 41.4 to 46.0 Gy (median 44.0 Gy) using daily fractions of $1.8{\sim}2.0\;Gy$ at 5 days per week and a boost dose to the primary tumor and high risk area up to a total of $43.2{\sim}54\;Gy$ (median 50.4 Gy). Sixty patients (80.5%) received 5-fluorouracil, leucovorin, and cisplatin, while 16 patients (19.5%) were administered 5-fluorouracil and leucovorin every 4 weeks concurrently during radiotherapy. Surgery was performed for 3 to 45 weeks (median 7 weeks) after completion of chemoradiotherapy. Results: The sphincter preservation rates for all patients were 73.2% (60/82). Of the 48 patients whose tumor was located at less than 5 cm away from the anal verge, 31 (64.6%) underwent sphincter-saving surgery. Moreover, of the 34 patients whose tumor was located at greater than or equal to 5 cm away from the anal verge, 29 (85.3%) were able to preserve their anal sphincter. A pathologic complete response was achieved in 14.6% (12/82) of all patients. The downstaging rates were 42.7% (35/82) for the T stage, 75.5% (37/49) for the N stage, and 67.1% (55/82) for the overall stages. The median follow-up period was 38 months (range $11{\sim}107$ months). The overall 5-year survival, disease-free survival, and locoregional control rates were 67.4%, 58.9% and 84.4%, respectively. The 5-year overall survival rates based on the pathologic stage were 100% for stage 0 (n=12), 59.1% for stage I (n=16), 78.6% for stage II (n=30), 36.9% for stage III (n=23), and one patient with pathologic stage IV was alive for 43 months (p=0.02). The 5-year disease-free survival rates were 77.8% for stage 0, 63.6% for stage I, 58.9% for stage II, 51.1% for stage III, and 0% for stage IV (p<0.001). The 5-year locoregional control rates were 88.9% for stage 0, 93.8% for stage I, 91.1% for stage II, 68.2% for stage III, and one patient with pathologic stage IV was alive without local recurrence (p=0.01). The results of a multivariate analysis with age (${\leq}55$ vs. >55), clinical stage (I+II vs. III), radiotherapy to surgery interval (${\leq}6$ weeks vs. >6 weeks), operation type (sphincter preservation vs. no preservation), pathologic T stage, pathologic N stage, pathologic overall stage (0 vs. I+II vs. III+IV), and pathologic response (complete vs. non-CR), only age and pathologic N stage were significant predictors of overall survival, pathologic overall stage for disease-free survival, and pathologic N stage for locoregional control rates, respectively. Recurrence was observed in 25 patients (local recurrence in 10 patients, distant metastasis in 13 patients, and both in 2 patients). Acute hematologic toxicity ($\geq$grade 3) during chemoradiotherapy was observed in 2 patients, while skin toxicity was observed in 1 patient. Complications developing within 60 days after surgery and required admission or surgical intervention, were observed in 11 patients: anastomotic leakage in 5 patients, pelvic abscess in 2 patients, and others in 4 patients. Conclusion: Preoperative chemoradiotherapy was an effective modality to achieve downstaging and sphincter preservation in rectal cancer cases with a relatively low toxicity. Pathologic N stage was a statistically significant prognostic factor for survival and locoregional control and so, more intensified postoperative adjuvant chemotherapy should be considered in these patients.

Evaluation of the Positional Uncertainty of a Liver Tumor using 4-Dimensional Computed Tomography and Gated Orthogonal Kilovolt Setup Images (사차원전산화단층촬영과 호흡연동 직각 Kilovolt 준비 영상을 이용한 간 종양의 움직임 분석)

  • Ju, Sang-Gyu;Hong, Chae-Seon;Park, Hee-Chul;Ahn, Jong-Ho;Shin, Eun-Hyuk;Shin, Jung-Suk;Kim, Jin-Sung;Han, Young-Yih;Lim, Do-Hoon;Choi, Doo-Ho
    • Radiation Oncology Journal
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    • v.28 no.3
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    • pp.155-165
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    • 2010
  • Purpose: In order to evaluate the positional uncertainty of internal organs during radiation therapy for treatment of liver cancer, we measured differences in inter- and intra-fractional variation of the tumor position and tidal amplitude using 4-dimentional computed radiograph (DCT) images and gated orthogonal setup kilovolt (KV) images taken on every treatment using the on board imaging (OBI) and real time position management (RPM) system. Materials and Methods: Twenty consecutive patients who underwent 3-dimensional (3D) conformal radiation therapy for treatment of liver cancer participated in this study. All patients received a 4DCT simulation with an RT16 scanner and an RPM system. Lipiodol, which was updated near the target volume after transarterial chemoembolization or diaphragm was chosen as a surrogate for the evaluation of the position difference of internal organs. Two reference orthogonal (anterior and lateral) digital reconstructed radiograph (DRR) images were generated using CT image sets of 0% and 50% into the respiratory phases. The maximum tidal amplitude of the surrogate was measured from 3D conformal treatment planning. After setting the patient up with laser markings on the skin, orthogonal gated setup images at 50% into the respiratory phase were acquired at each treatment session with OBI and registered on reference DRR images by setting each beam center. Online inter-fractional variation was determined with the surrogate. After adjusting the patient setup error, orthogonal setup images at 0% and 50% into the respiratory phases were obtained and tidal amplitude of the surrogate was measured. Measured tidal amplitude was compared with data from 4DCT. For evaluation of intra-fractional variation, an orthogonal gated setup image at 50% into the respiratory phase was promptly acquired after treatment and compared with the same image taken just before treatment. In addition, a statistical analysis for the quantitative evaluation was performed. Results: Medians of inter-fractional variation for twenty patients were 0.00 cm (range, -0.50 to 0.90 cm), 0.00 cm (range, -2.40 to 1.60 cm), and 0.00 cm (range, -1.10 to 0.50 cm) in the X (transaxial), Y (superior-inferior), and Z (anterior-posterior) directions, respectively. Significant inter-fractional variations over 0.5 cm were observed in four patients. Min addition, the median tidal amplitude differences between 4DCTs and the gated orthogonal setup images were -0.05 cm (range, -0.83 to 0.60 cm), -0.15 cm (range, -2.58 to 1.18 cm), and -0.02 cm (range, -1.37 to 0.59 cm) in the X, Y, and Z directions, respectively. Large differences of over 1 cm were detected in 3 patients in the Y direction, while differences of more than 0.5 but less than 1 cm were observed in 5 patients in Y and Z directions. Median intra-fractional variation was 0.00 cm (range, -0.30 to 0.40 cm), -0.03 cm (range, -1.14 to 0.50 cm), 0.05 cm (range, -0.30 to 0.50 cm) in the X, Y, and Z directions, respectively. Significant intra-fractional variation of over 1 cm was observed in 2 patients in Y direction. Conclusion: Gated setup images provided a clear image quality for the detection of organ motion without a motion artifact. Significant intra- and inter-fractional variation and tidal amplitude differences between 4DCT and gated setup images were detected in some patients during the radiation treatment period, and therefore, should be considered when setting up the target margin. Monitoring of positional uncertainty and its adaptive feedback system can enhance the accuracy of treatments.

Daily Setup Uncertainties and Organ Motion Based on the Tomoimages in Prostatic Radiotherapy (전립선암 치료 시 Tomoimage에 기초한 Setup 오차에 관한 고찰)

  • Cho, Jeong-Hee;Lee, Sang-Kyu;Kim, Sei-Joon;Na, Soo-Kyung
    • The Journal of Korean Society for Radiation Therapy
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    • v.19 no.2
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    • pp.99-106
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    • 2007
  • Purpose: The patient's position and anatomy during the treatment course little bit varies to some extend due to setup uncertainties and organ motions. These factors could affected to not only the dose coverage of the gross tumor but over dosage of normal tissue. Setup uncertainties and organ motions can be minimized by precise patient positioning and rigid immobilization device but some anatomical site such as prostate, the internal organ motion due to physiological processes are challenge. In planning procedure, the clinical target volume is a little bit enlarged to create a planning target volume that accounts for setup uncertainties and organ motion as well. These uncertainties lead to differences between the calculated dose by treatment planning system and the actually delivered dose. The purpose of this study was to evaluate the differences of interfractional displacement of organ and GTV based on the tomoimages. Materials and Methods: Over the course of 3 months, 3 patients, those who has applied rectal balloon, treated for prostatic cancer patient's tomoimage were studied. During the treatment sessions 26 tomoimages per patient, Total 76 tomoimages were collected. Tomoimage had been taken everyday after initial setup with lead marker attached on the patient's skin center to comparing with C-T simulation images. Tomoimage was taken after rectal balloon inflated with 60 cc of air for prostate gland immobilization for daily treatment just before treatment and it was used routinely in each case. The intrarectal balloon was inserted to a depth of 6 cm from the anal verge. MVCT image was taken with 5 mm slice thickness after the intrarectal balloon in place and inflated. For this study, lead balls are used to guide the registration between the MVCT and CT simulation images. There are three image fusion methods in the tomotherapy, bone technique, bone/tissue technique, and full image technique. We used all this 3 methods to analysis the setup errors. Initially, image fusions were based on the visual alignment of lead ball, CT anatomy and CT simulation contours and then the radiation therapist registered the MVCT images with the CT simulation images based on the bone based, rectal balloon based and GTV based respectively and registered image was compared with each others. The average and standard deviation of each X, Y, Z and rotation from the initial planning center was calculated for each patient. The image fusions were based on the visual alignment of lead ball, CT anatomy and CT simulation contours. Results: There was a significant difference in the mean variations of the rectal balloon among the methods. Statistical results based on the bone fusion shows that maximum x-direction shift was 8 mm and 4.2 mm to the y-direction. It was statistically significant (P=<0.0001) in balloon based fusion, maximum X and Y shift was 6 mm, 16mm respectively. One patient's result was more than 16 mm shift and that was derived from the rectal expansions due to the bowl gas and stool. GTV based fusion results ranging from 2.7 to 6.6 mm to the x-direction and 4.3$\sim$7.8 mm to the y-direction respectively. We have checked rotational error in this study but there are no significant differences among fusion methods and the result was 0.37$\pm$0.36 in bone based fusion and 0.34$\pm$0.38 in GTV based fusion.

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