• Radiation Oncology Journal
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• v.32 no.3
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• pp.198-207
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• 2014

Purpose: To evaluate the effects of total body irradiation (TBI), as a conditioning regimen prior to allogeneic stem cell transplantation (allo-SCT), in pediatric acute leukemia patients. Materials and Methods: From January 2001 to December 2011, 28 patients, aged less than 18 years, were treated with TBI-based conditioning for allo-SCT in our institution. Of the 28 patients, 21 patients were diagnosed with acute lymphoblastic leukemia (ALL, 75%) and 7 were diagnosed with acute myeloid leukemia (AML, 25%). TBI was completed 4 days or 1 day before stem cell infusion. Patients underwent radiation therapy with bilateral parallel opposing fields and 6-MV X-rays. The Kaplan-Meier method was used to calculate survival outcomes. Results: The 2-year event-free survival and overall survival rates were 66% and 56%, respectively (71.4% and 60.0% in AML patients vs. 64.3% and 52.4% in ALL patients, respectively). Treatment related mortality rate were 25%. Acute and chronic graft-versus-host disease was a major complication; other complications included endocrine dysfunction and pulmonary complications. Common complications from TBI were nausea (89%) and cataracts (7.1%). Conclusion: The efficacy and toxicity data in this study of TBI-based conditioning to pediatric acute leukemia patients were comparable with previous studies. However, clinicians need to focus on the acute and chronic complications related to allo-SCT.

• Korean Journal of Biological Psychiatry
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• v.14 no.1
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• pp.61-67
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• 2007

Objectives : The purpose of this study was to test stage model in Traumatic Brain Injury(TBI) patients. According to the stage model, attention deficits which is basic stage in information processing lead to memory disturbance and subsequently affect higher-order cognitive function such as memory, decision-making, abstract thinking, and judgement related to executive function. Therefore, it was hypothesized that attention affect recall(retrieval efficacy) related to executive function mostly relative to other cognitive function, in TBI patients with low executive function. Methods : Participants were referred to a TBI clinic and then was rated on K-WAIS and Executive Intelligence Test(EXIT). Participants were divided into two groups according to Executive IQ(EIQ) score, which of high function group(N=67) was more than 80(above low average) and of low function group(N=52) was under 80 (under borderline). To test the stage model, using hierarchical regression analysis, recall(retrieval efficacy) was regressed on 3 subscales(attention, verbal, visuospatial scale) after controlling for IQ according to each group. Furthermore, the mediation effect of attention between retrieval efficacy and verbal, visuospatial score was analyzed. Results : In the low function group, only attention area predicted significantly recall(retrieval efficacy), indicating that lower attention were related to lower EIQ after controlling for IQ. In the high function group, no area predicted significantly retrieval efficacy. In the low function group, verbal and visuospatial scale did not predicted significantly retrieval efficacy, indicating that there was no evidences supporting the mediation model. Conclusion : Only attention affect retrieval efficacy in TBI patients with low executive function. But, the mediation effect of attention between retrieval efficacy and verbal and visuospatial scale was not tested in the low function group. These results implied that stage model was tested partially. In treating cognitive deficit in TBI patients, it is necessary to develop cognitive rehabilitation program based on stage model. Furthermore, it is necessary to necessary to test mediation model in the future study.

• Progress in Medical Physics
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• v.12 no.2
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• pp.147-153
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• 2001

We have discussed that the total body irradiation(TBI) dose distribution of 6 and 10 MV photon beams, also differences between calculation dose use of compensator sheet and measurements in humanoid phantom. Total body irradiation and hemi-body irradiation(HBI) can be effectively performed when uniformity of dose distribution is estabilished. The method of TBI and HBI dosimatry requires special considerations related to technique, long distance and very large field, machine parameter, patient positioning. TBI and HBI with megavoltage photon beams requires basic dosimatric data which have to be measured directly or derived from the standard beam data. The semiconductor detector and ion chamber were positioned at a dmax depth, mid depth, and its specific ratio was determined using a scanning data by RFA-7 3-dimensional water phantom and solid phantom. The effective source axis distance 380 cm, the field size from 120 cm to 152 cm, isodose distributions were analyzed as a function of the thickness in phantom. Also, have discussed that the measurement of basic data for clinical photon beams for dosage calculations, data calculation sheet and the use of tissue compensation to improve dose uniformity. We have improved a dose uniformity in the TBI and HBI method.

• The Journal of Korean Society for Radiation Therapy
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• v.7 no.1
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• pp.156-166
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• 1995

Total body irradiation (TBI) requires large radiation field and extended source to axis distance (SAD), therefore in needs large size treatment room and it needs compensators which components. Appropriate thickness beam spoiler should be used to raise skin dose. Treatment machine, photon energy, total dose, dose rate, dose fractionation, patient position, shield of normal tissues and organs were known to important parameters for TBI. TBI disturbes regular daily treatment schedule and significantly overloads Radiation on oncology departments and during the treatment session it requires accurate reproduction of radiation field and patient position. We were enable to TBI in small size treatment room and short SAD with parallel opposing lateral fields technique and achieved homogenious whole body dose distribution using pb compensators and controled lung dose by lung shield blocks. Drawing a patient shadow on the wall, we could shortened set up time and possible to accurate reproduction of radiation field and patient position.

• Progress in Medical Physics
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• v.13 no.3
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• pp.114-119
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• 2002

A immobilizing device that is essential for correct lung and lens shielding with homogenous dose distribution in fractionated total body irradiation was developed and it's efficiency was evaluated. The main frame was made of stainless steel bar (5 cm in diameter) to withstand up to 230 cm in height and 100 kg in weight to prevent any injury even in unconsciousness condition. The saddle was designed to adjust the body weight and hight of standing patients. Chest and back supporter were made of 1 cm acryl which could fix the lung block and cassette holder. Leather and sponge pedding were used for head rest to keep patients comfortable. The device was strongly fixed by specially designed bolts on the bottom panel which was made of 1 cm stainless steel and 10 cm thick wooden board. Precise manipulation ($\pm$2 mm) was possible by upper two pulleys and side handles. Average four minutes twenty five seconds were needed for exact setting in fractionated TBI. No significant difference of lung block location on repeated verification films was confirmed and relatively homogeneous dose distribution was measured in rando phantom experiments and patient treatments ($\pm$5%). This immobilizing device was very efficient to keep correct position of patients, which is essential for better result and less complication in fractionated TBI.

• Korean Journal of Psychosomatic Medicine
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• v.23 no.1
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• pp.12-19
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• 2015

Objectives : This study examined the characteristics and differences of PAI(Personality Assessment Inventory) profile between compensation-seeking(CS) and treatment-seeking(TS) patients with traumatic brain injury(TBI) and assessed the clinical meaning of the characteristics and differences of profiles between the two groups. Methods : 36 TBI patients who visited the Wonkwang University Hospital were selected. The patients were categorized as compensation-seeking TBI patients(n=22) and treatment-seeking TBI patients(n=14). The PAI scales and subscales were used to compare differences between two groups. t-verification for each variable and comparison analysis were performed. Results:In validity scales, CS group showed significantly higher NIM scores and lower PIM scores than TS groups. In full scales, CS group showed significantly higher SOM, ANX, ARD, DEP, and SCZ scores than TS group. In subscales, CS group showed significantly higher SOM-S, ANX-A, ARD-P, DEP(-C, A, P), (MAN-I), PAR-H, SCZ(-T, P), BOR(-A, N), and ANT-S scores than TS groups. In supplementary scales, CS group showed significantly higher SUI, NON and AGG-P, and lower RXR scores than TS group. Conclusions:There were significant differences in PAI scales with validity scales, some full and subscales according to compensation seeking status in TBI patients. The CS patients tended to exaggerate their symptoms on PAI, and showed higher scores representing somatic preoccupation and emotional distress. These results show the usefulness of PAI in reflecting the significant psychological differences between two groups.

• 대한방사선치료학회:학술대회논문집
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• 2003.03a
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• pp.7-8
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• 2003

• Journal of Trauma and Injury
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• v.33 no.3
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• pp.175-180
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• 2020

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is widely performed as an adjunct to resuscitation or bridge to definitive control of non-compressible torso hemorrhage in patients with hemorrhagic shock. It is a crucial adjunct for the maintenance of cerebral and coronary perfusion during resuscitation. However, in polytrauma patients with concomitant neurotrauma, such as traumatic brain injury (TBI) or spinal cord injury, the physiological effects of REBOA are unclear. In this report on REBOA performed in a clinical setting for polytrauma patients with spinal cord injury or TBI, the physiological effects of REBOA in neurotrauma are reviewed.

• Journal of Korean Neurosurgical Society
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• v.43 no.5
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• pp.242-245
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• 2008

A 64-year-old man with TBI was admitted to our institute. In following days, he showed unusual behavior of agitation, restlessness, emotional instability and inattention. Post-traumatic delirium was tentatively diagnosed, and donepezil was given for his cognitive dysfunction. Although there was partial relief of agitation, he sustained back pain despite medication. Lumbar magnetic resonance image revealed SDH along the whole lumbar spine, and surgical drainage was followed. Postoperatively, his agitation disappeared and further medication was discontinued. We report a unique case of post-traumatic delirium in a patient with concomitant TBI and spinal subdural hemorrhage (SDH) that resolved with operative drainage of spinal hemorrhage.

• Journal of Mechanical Science and Technology
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• v.19 no.7
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• pp.1424-1431
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• 2005

In this study, head injury by impact force was evaluated by numerical analysis with 3-dimensional finite element (FE) model. Brain deformation by frontal head impact was analyzed to evaluate traumatic brain injury (TBI). The variations of head acceleration and intra-cranial pressure (ICP) during the impact were analyzed. Relative displacement between the skull and the brain due to head impact was investigated from this simulation. In addition, pathological severity was evaluated according to head injury criterion (HIC) from simulation with FE model. The analytic result of brain damage was accorded with that of the cadaver test performed by Nahum et al.(1977) and many medical reports. The main emphasis of this study is that our FE model was valid to simulate the traumatic brain injury by head impact and the variation of the HIC value was evaluated according to various impact conditions using the FE model.