• Korean Journal of Head & Neck Oncology
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• v.14 no.2
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• pp.156-163
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• 1998

Background & Objectives: Frameless fractionated stereotactic radiotherapy(FFSRT) is a modification of stereotactic radiosurgery(SRS) with radiobiologic advantage of fractionation without losing mechanical accuracy of SRS. Local recurrence of head and neck cancer at or near skull base benefit from reirradiation. Main barrier to successful palliation is dose limitation secondary to normal tissue tolerance. We try to evaluate the efficacy and safety of FFSRT as a new modality of reirradaton in these challenging patients. Materials & Methods: Seven patients with recurrent head & neck cancer involving at or near skull base received FFSRT from September 1995 to November 1997. Six patients with nasopharyngeal cancer had received induction chemotherapy and curative radiation therapy. One patient with maxillary sinus cancer had received total maxillectomy and postoperative radiation therapy as a initial treatment. Follow-up ranged from 11 to 32 months with median of 24 months. Three of 7 patients received hyperfractionated radiation therapy(1.1-1.2Gy/fraction, bid, total 19.8-24Gy) just before FFSRT. All patients received FFSRT(3-5Gy/fraction, total 15-30Gy/5-10fractions). Chemotherapy(cis-platin $100mg/m^2$) were given concurrently with FFSRT in four patients. Second course of FFSRT were given in 4 patients with progression or recurrence after initial FFSRT. Because IF(irregularity factor; ratio of surface area of target to the surface area of sphere with same volume as a target) is too big to use conventional stereotactic RT using multiple arc method for protection of radiation damage to critical normal tissue, all patients received FFSRT with conformal method using irregular static ports. Results: Five of 7 patients showed complete remission in follow-up CT &/or MRI. Three of these five patients who developed marginal, in-field, and out-field recurrences, respectively. Another one of complete responders has been dead of G-I bleeding without evidence of local recurrence. One partial responder who showed progressive disease 15 months after initial FFSRT has received additional FFSRT, and then he is well-being with symptomatic improvement. One minmal responder who showed progression of locoregional disease 9 months after $1^{st}$ FFSRT has received 2nd FFSRT, and then he is alive with stable disease. Five of 7 case had showed direct invasion to skull base and had complaint headache and various symptoms of cranial nerve involvement. Four of these five case showed improvement of neurologic symptoms after FFSRT. No significant neurologic complicaltion related to FFSRT was observed during follow-up periods. Tumor volumes were ranged from 3.9 to 50.7 cc and surface area ranged from 16.1 to $114.9cm^2$. IF ranged from 1.21 to 1.74. The average ratio of volume of prescription isodose shell to target volume was 1.02 that indicated the improvement of target coverage and dose distribution with FFSRT with conformal method compared to target coverage with FFSRT with multiple arc method. Conclusion: Our initial experience suggests that FFSRT with conformal method was relatively effective and safe modality in the treatment of recurrent head and neck cancer involving at or near skull base. Treatment benefit included good palliation of symptoms and reasonable radiographic response. However, more experience and additional follow-up are needed to better assess its ultimate role in treating these challenging patients.

• Progress in Medical Physics
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• v.27 no.1
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• pp.14-24
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• 2016

Since the head and neck region is densely located with organs at risk (OAR), OAR-sparing is an important issue in the treatment of head and neck cancers. This study-in which different treatment plans were performed varying the head tilt angle on brain tumor patients-investigates the optimal head elevation angle for sparing normal organs (e.g. the hippocampus) and further compares the dosimetric characteristics of different types of radiation equipment. we performed 3D conformal radiation therapy (3D-CRT), intensity-modulated radiation therapy (IMRT), and tomotherapy on 10 patients with brain tumors in the frontal lobe while varying the head tilt angle of patients to analyze the dosimetric characteristics of different therapy methods. In each treatment plan, 95% of the tumor volume was irradiated with a dose of 40 Gy in 10 fractions. The step and shoot technique with nine beams was used for IMRT, and the same prescription dose was delivered to the tumor volume for the 3D-CRT and tomotherapy plans. The homogeneity index, conformity index, and normal tissue complication probability (NTCP) were calculated. At a head elevation angle of $30^{\circ}$, conformity of the isodose curve to the target increased on average by 53%, 8%, and 5.4%. In 3D-CRT, the maximum dose received by the brain stem decreased at $15^{\circ}$, $30^{\circ}$, and $40^{\circ}$, compared to that observed at $0^{\circ}$. The NTCP value of the hippocampus observed in each modality was the highest at a head and neck angle of $0^{\circ}$ and the lowest at $30^{\circ}$. This study demonstrates that the elevation of the patients' head tilt angle in radiation therapy improves the target region's homogeneity of dose distribution by increasing the tumor control rate and conformity of the isodose curve to the target. Moreover, the study shows that the elevation of the head tilt angle lowers the NTCP by separating the tumor volume from the normal tissues, which helps spare OARs and reduce the delivered dose to the hippocampus.

• The Journal of Korean Society for Radiation Therapy
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• v.17 no.2
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• pp.113-124
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• 2005

Purpose : The using of endo-rectal balloon has proposed as optimal method that minimized the motion of prostate and the dose of rectum wall volume for treated prostate cancer patients, so we make the customized rectal balloon device. In this study, we analyzed the efficiency of the Self-customized rectal balloon in the aspects of its reproducibility. Materials and Methods : In 5 patients, for treatment planning, each patient was acquired CT slice images in state of with and without rectal balloon. Also they had CT scanning samely repeated third times in during radiation treatment (IMRT). In each case, we analyzed the deviation of rectal ballon position and verified the isodose distribution of rectum wall at closed prostate. Results : Using the rectal balloon, we minimized the planning target volume (PTV) by decreased the internal motion of prostate and overcome the dose limit of radiation therapy in prostate cancer by increased the gap between the rectum wall and high dose region. Conclusion : The using of rectal balloon, although, was reluctant to treat by patients. View a point of immobilization of prostate internal motion and dose escalation of GTV (gross tumor volume), its using consider large efficients for treated prostate cancer patients.

• Progress in Medical Physics
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• v.25 no.3
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• pp.176-184
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• 2014

In this study, we compared dose distributions from simultaneously integrated boost (SIB) method versus the RTOG 0631 protocol for spine radiosurgery. Spine radiosurgery plans were performed in five patients with localized spinal metastases from hepatocellular carcinoma. The computed tomography (CT) and T1- and T2-weighted magnetic resonance imaging (MRI) were fused for delineating of GTV and spinal cord. In SIB plan, the clinical target volume (CTV1) was included the whole compartments of the involved spine, while RTOG 0631 protocol defines the CTV2 as the involved vertebral body and both left and right pedicles. The CTV2 includes transverse process and posterior element according to the extent of GTV. The doses were prescribed 18 Gy to GTV and 10 Gy to CTV1 in SIB plan, while the prescription of RTOG 0631 protocol was applied 18 Gy to CTV2. The results of dose-volume histogram (DVH) showed that there were competitive in target coverage, while the doses of spinal cord and other normal organs were lower in SIB method than in RTOG 0631 protocol. The 85% irradiated volume of VB in RTOG 0631 protocol was similar to that in the SIB plan. However, the dose to normal organs in RTOG 0631 had a tendency to higher than that in SIB plan. The SIB plan might be an alternative method in case of predictive serious complications of surrounded normal organs. In conclusion, although both approaches of SIB or RTOG 0631 showed competitive planning results, tumor control probability (TCP) and normal tissue complication probability (NTCP) through diverse clinical researches should be analyzed in the future.

• Progress in Medical Physics
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• v.23 no.2
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• pp.106-113
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• 2012

The purpose of this study is to evaluate the variation of radiation dose distribution for liver tumor located in liver dome and for the interest organs(normal liver, kidney, stomach) with the pencil beam convolution (PBC) algorithm versus anisotropic Analyticalal algorithm (AAA) of the Varian Eclipse treatment planning system, The target volumes from 20 liver cancer patients were used to create treatment plans. Treatment plans for 10 patients were performed in Stereotactic Body Radiation Therapy (SBRT) plan and others were performed in 3 Dimensional Conformal Radiation Therapy (3DCRT) plan. dose calculation was recalculated by AAA algorithm after dose calculation was performed by PBC algorithm for 20 patients. Plans were optimized to 100% of the PTV by the Prescription Isodose in Dose Calculation with the PBC algorithm. Plans were recalculated with the AAA, retaining identical beam arrangements, monitor units, field weighting and collimator condition. In this study, Total PTV was to be statistically significant (SRS: p=0.018, 3DCRT: p=0.006) between PBC and AAA algorithm. and in the case of PTV, ITV in liver dome, plans for 3DCRT were to be statistically significant respectively (p=0.013, p=0.024). normal liver and kidney were to be statistically significant (p=0.009, p=0.037). For the predictive index of dose variation, CVF ratio was to be statistically significant for PTV in the liver dome versus PTV (SRS r=0.684, 3DCRT r=0.732, p<0.01) and CVF ratio for Tumor size was to be statistically significant (SRS r=-0.193, p=0.017, 3DCRT r=0.237, p=0.023).

• The Journal of Korean Society for Radiation Therapy
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• v.31 no.2
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• pp.75-81
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• 2019

Purpose: Tomo therapy and Proton therapy treatment plans for the treatment of prostate cancer patients were established, and the characteristics of dose distribution according to beam delivery method using Tomo therapy IMRT method and Proton therapy PBS method to compare and analyze the treatment effect were sought. Materials and Methods: Tomo IMRT treatment plan and Proton PBS treatment plan were established using the Hi.art planning station 5.1.1.6 of Tomo therapy and Eclipse 13.7 of VARIAN for three prostate cancer patients who were treated with radiotherapy only for radical purposes without surgery. For the evaluation of two treatment plans, the average dose (Dmean) and maximum dose (Dmax) of PGTV were calculated from dose volume histogram (DVH) to confirm the coverage and calculate CI and HI. In OAR evaluation, the dose received from the rectal volume 25% and the dose received from the bladder were evaluated to compare the normal long-term protection effect. Results: The mean maximum doses of the three patients were 71.4Gy, 75.3Gy and the mean doses were 70.4Gy and 72.8Gy in the DVH of the Tomo IMRT and Proton PBS. The CI was 1.16 and 1.31, and the HI was 0.04 and 0.12 respectively, and the Tomo IMRT was superior to the Proton PBS in dose suitability. Conclusion: The mean dose of PGTV in prostate cancer patients was 3.4% higher in Proton PBS than in Tomo IMRT. This is because the Dose suitability of Tomo IMRT was better, but it is considered to be a small difference to be seen as a significant result. However, the results of the two methods were 51.2% in D 25% and 55.7% less in the average dose of bladder, which could reduce the side effects of patients in proton PBS.

• Applied Biological Chemistry
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• v.37 no.2
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• pp.130-141
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• 1994

A continuous two-stage membrane (1st-SCMR, MWCO 10,000; 2nd-SCMR, MWCO 5,000) reactor was developed and optimized for the production of fish skin gelatin hydrolysate with different molecular size distribution profiles using trypsin and pronase E. The optimum operating conditions in the 1st-step membrane reactor using trypsin were: temperature, $55^{\circ}C$ ; pH 9.0; enzyme concentration, 0.1 mg/ml; flux, 6.14 ml/min; reaction volume, 600 ml; and the ratio of substrate to trypsin, 100 (w/w). After operating for 1 hr under the above conditions, 79% of total amount of initial gelatin was hydrolysed. In the 2nd-step using pronase E under optimum operating conditions[temperature, $50^{\circ}C$ ; pH 8.0; enzyme concentration, 0.3 mg/ml; flux, 6.14 ml/min; reaction volume, 600 ml; and the ratio of substrate to pronase E, 33 (w/w)], the 1st-step hydrolysate was hydrolysed above 80%. Total enzyme leakages in the 1st-step and 2nd-step membrane reactors were about 11.5% at $55^{\circ}C$ for 5hrs and 9.0% at $50^{\circ}C$ for 4 hrs, respectively. However, there was no apparent correlation between enzyme leakage and substrate hydrolysis. The membrane has a significant effect on activity lose of trypsin and pronase E activity for 1 hr of the membrane reactors operation. The loss of initial activity of enzymes were 34% and 18% in the 1st-step and 2nd-step membrane reactor, whereas were 23% and 10% after operating time 3 hr in the 1st-step and 2nd-step membrane reactor lacking the membrane, respectively. The productivities of 1st-step and 2nd-step membrane reactor for 8 times of volume replacement were 334 mg and 250 mg per mg enzyme, respectively.

• Journal of the Korea Concrete Institute
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• v.27 no.2
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• pp.127-136
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• 2015

To evaluate the effects of limestone powder and silica fume on the properties of high-strength high-volume ground granulated blast-furnace slag (GGBFS) blended cement concrete, this study investigated the rheology, strength development, hydration and pozzolanic reaction characteristics, porosity and pore size distribution of high-strength mortars with the water-to-binder ratio of 20, 50 to 80% GGBFS, up to 20% limestone powder, and up to 10% silica fume. According to test results, compared with the Portland cement mixture, the high-volume GGBFS mixture had much higher flow due to the low surface friction of GGBFS particles and higher strength in the early age due to the accelerated cement hydration by increase of free water; however, because of too low water-to-binder ratio and cement content, and lack of calcium hydroxide content, the pozzolanic reactio cannot be activated and the long-term strength development was limited. Limestone powder did not affect the flowability, and also accelerate the early cement hydration. However, because its effect on the acceleration of cement hydration is not greater than that of GGBFS, and it does not have hydraulic reactivity unlikely to GGBFS, compressive strength was reduced proportional to the replacement ratio of limestone powder. Also, silica fume and very fine GGBFS lowered flow and strength by absorbing more free water required for cement hydration. Capillary porosities of GGBFS blended mortars were smaller than that of OPC mortar, but the effect of limestone powder on porosity was not noticeable, and silica fume increased porosity due to low degree of hydration. Nevertheless, it is confirmed that the addition of GGBFS and silica fume increases fine pores.

• Journal of the Korean Institute of Landscape Architecture
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• v.49 no.5
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• pp.1-11
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• 2021

The purpose of this study is to find out the main factors affecting air quality in urban physical space factors, and provide clues for environmental improvement. Nine monitoring stations in China's industrial city, Changchun, collected AQI concentration data from January 1, 2018 to December 31, 2019. This paper analyzes the types and distribution characteristics of urban physical facilities within a radius of 300m with the detection station as the center. The monitoring station is divided into three groups, and the difference in floating dust concentration among the three groups in different seasons is analyzed. The results show that AQI concentration is the highest in spring and winter, followed by summer, and the lowest in autumn. The place with the highest concentrations of AQI in spring are F (93.00), D (91.10), I (89.20), in summer are D (69.05), A (67.89), B (84.44), in autumn are I (62.80), G (60.84), D (53.27), D (53.27), in winter are I (95.82), H (95.60), f (94.04). Through SPSS analysis, it shows that the air index in a space with a diameter of 600 meters is related to forest land, grassland, bare land, water space, tree height, building area (average value), and building volume (average value). According to the statistical analysis results of spring and winter with the most serious pollution, forest land area (43,637m², 15.44%) and water surface area (18,736m², 6.63%) accounted for the majority, and group 1 (A, B, C) with the least average building area (448m², 0.17%) and average building volume (10,201m²) had the lowest pollution concentration. On the contrary, group 2 (D, E, F) had the highest AQI concentration, with less or no woodland (1,917m², 0.68%) and water surface area (0m², 0%), and the highest average building area (1,056m², 0.37%) and average building volume (17,470m³). It is confirmed that the characteristics of the area with the highest AQI concentration are that the more the site ratio of tree height above 12m, the smaller the site ratio of bare land, and the lower the pollution degree. On the contrary, the larger the area of bare land, the higher the pollution degree. By analyzing the characteristics of nine monitoring stations in Changchun, it can be seen that the air quality brought by the physical characteristics of urban space is closely related to the above factors.

• The Journal of Korean Society for Radiation Therapy
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• v.24 no.2
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• pp.137-147
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• 2012

Purpose: Analyze the Effectiveness of Radiation Treatment Planning by dose calculation and optimization algorithm, apply consideration of actual treatment planning, and then suggest the best way to treatment planning protocol. Materials and Methods: The treatment planning system use Eclipse 10.0. (Varian, USA). PBC (Pencil Beam Convolution) and AAA (Anisotropic Analytical Algorithm) Apply to Dose calculation, DVO (Dose Volume Optimizer 10.0.28) used for optimized algorithm of Intensity Modulated Radiation Therapy (IMRT), PRO II (Progressive Resolution Optimizer V 8.9.17) and PRO III (Progressive Resolution Optimizer V 10.0.28) used for optimized algorithm of VAMT. A phantom for experiment virtually created at treatment planning system, $30{\times}30{\times}30$ cm sized, homogeneous density (HU: 0) and heterogeneous density that inserted air assumed material (HU: -1,000). Apply to clinical treatment planning on the basis of general treatment planning feature analyzed with Phantom planning. Results: In homogeneous density phantom, PBC and AAA show 65.2% PDD (6 MV, 10 cm) both, In heterogeneous density phantom, also show similar PDD value before meet with low density material, but they show different dose curve in air territory, PDD 10 cm showed 75%, 73% each after penetrate phantom. 3D treatment plan in same MU, AAA treatment planning shows low dose at Lung included area. 2D POP treatment plan with 15 MV of cervical vertebral region include trachea and lung area, Conformity Index (ICRU 62) is 0.95 in PBC calculation and 0.93 in AAA. DVO DVH and Dose calculation DVH are showed equal value in IMRT treatment plan. But AAA calculation shows lack of dose compared with DVO result which is satisfactory condition. Optimizing VMAT treatment plans using PRO II obtained results were satisfactory, but lower density area showed lack of dose in dose calculations. PRO III, but optimizing the dose calculation results were similar with optimized the same conditions once more. Conclusion: In this study, do not judge the rightness of the dose calculation algorithm. However, analyzing the characteristics of the dose distribution represented by each algorithm, especially, a method for the optimal treatment plan can be presented when make a treatment plan. by considering optimized algorithm factors of the IMRT or VMAT that needs to optimization make a treatment plan.