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Peak Expiratory Flow(PEF) Measured by Peak Flow Meter and Correlation Between PEF and Other Ventilatory Parameters in Healthy Children (정상 소아에서 최고호기유량계(peak flow meter)로 측정한 최고호기유량(PEF)와 기타 환기기능검사와의 상관관계)

  • Oak, Chul-Ho;Sohn, Kai-Hag;Park, Ki-Ryong;Cho, Hyun-Myung;Jang, Tae-Won;Jung, Maan-Hong
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.3
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    • pp.248-259
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    • 2001
  • Background : In diagnosis or monitor of the airway obstruction in bronchial asthma, the measurement of $FEV_1$ in the standard method because of its reproducibility and accuracy. But the measurement of peak expiratory flow(PEF) by peak flow meter is much simpler and easier than that of $FEV_1$ especially in children. Yet there have been still no data of the predicted normal values of PEF measured by peak flow meter in Korean children. This study was conducted to provide equations to predict the normal value of PEF and correlation between PEF and $FEV_1$ in healthy children. Method : PEF was measured by MiniWright peak flow meter, and the forced expiratory volume and the maximum expiratory flow volume curves were measured by Microspiro HI 501(Chest Co.) in 346 healthy children(age:5-16 years, 194 boys and 152 girls) without any respiratory symptoms during 2 weeks before the study. The regression equations for various ventilatory parameters according to age and/or height, and the regression equations of $FEV_1$ by PEF were derived. Results : 1. The regression equation for PEF(L/min) was: $12.6{\times}$age(year)+$3.4{\times}$height(cm)-263($R^2=0.85$) in boys, and $6{\times}$age(year)+$3.9{\times}$height(cm)-293($R^2=0.82$) in girls. 2. The value of FEFmax(L/sec) derived from the maximum expiratory flow volume curves was multiplied by 60 to compare with PEF(L/min), and PEF was faster by 125 L/min in boys and 118 L/min in girls, respectively. 3. The regression equation for $FEV_1$(ml) by PEF(L/min) was:$7{\times}$PEF-550($R^2=0.82$) in boys, and $5.8{\times}$PEF-146 ($R^2=0.81$) in girls, respectively. Conclusion : This study provides regression equations predicting the normal values of PEF by age and/or height in children. And the equations for $FEV_1$, a gold standard of ventilatory function, was predicted by PEF. So, in taking care of children with airway obstruction, PEF measured by the peak flow meter can provide useful information.

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A Study of Nutritional Intake, Eating Habit, Iron Status of Urban and Rural Middle School Girls (도시와 농촌 여중생의 영양섭취상태, 식습관 및 철영양상태 연구)

  • Hong, Soon-Myung;Seo, Yeong-Eun;Hwang, Hye-Jin
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.33 no.10
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    • pp.1634-1640
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    • 2004
  • This study was designed to compare the nutritional intake and iron nutritional status between urban and rural middle school girls. Along with a questionnaire, blood samples were obtained from 311 middle school girls (urban 129 girls, rural 182 girls). Nutrient intakes were measured with a convenient method, and clinical symptoms relating anemia was investigated by 4-point Likert scale. For the nutrient intake, the total energy intake was 1722.2 kcal (82.0% of RDA) for the urban group and 1649.5 kcal (78.6% of RDA) for rural group. The rural group showed significantly lower level than the urban group in all nutrients except fat, carbohydrate and total energy intake. Regarding the food frequency, students from the rural group marked significantly lower intake of milk (p<0.00l), kimchi (p<0.05), fruit (p<0.05), tofu, bean (p<0.00l) than the urban group. For every clinical finding regarding anemia, the rural group marked higher value than the urban group but the difference was not significant. The hemoglobin concentration of urban group was 13.28 g/dL, and rural group showed 12.51 g/dL which was significantly lower than urban group (p<0.00l). The hematocrit rate was 37.82% for the urban group and 38.13% for the rural group and there was no significant difference between two groups. The red blood cell (RBC) count of the rural group was significantly lower than the urban group (p<0.00l). Evaluating with the iron deficiency standard which is less than 12 g/dL, the urban group was 6.2% and the rural group was 34.6% thus the deficiency rate was significantly higher in the rural group. This study showed that nutrient and iron status of the girls of rural group is not as good as the urban group. As middle school girls require high level of iron absorption due to blood loss which occurs during abrupt physical growth and menstruation, dietary counselling is required to enhance the iron status. When iron deficiency is serious, they need to take more positive action such as iron supplement in addition to food-iron fortification.

[ $^1H$ ] MR Spectroscopy of the Normal Human Brains: Comparison between Signa and Echospeed 1.5 T System (정상 뇌의 수소 자기공명분광 소견: 1.5 T Signa와 Echospeed 자기공명영상기기에서의 비교)

  • Kang Young Hye;Lee Yoon Mi;Park Sun Won;Suh Chang Hae;Lim Myung Kwan
    • Investigative Magnetic Resonance Imaging
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    • v.8 no.2
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    • pp.79-85
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    • 2004
  • Purpose : To evaluate the usefulness and reproducibility of $^1H$ MRS in different 1.5 T MR machines with different coils to compare the SNR, scan time and the spectral patterns in different brain regions in normal volunteers. Materials and Methods : Localized $^1H$ MR spectroscopy ($^1H$ MRS) was performed in a total of 10 normal volunteers (age; 20-45 years) with spectral parameters adjusted by the autoprescan routine (PROBE package). In all volunteers, MRS was performed in a three times using conventional MRS (Signa Horizon) with 1 channel coil and upgraded MRS (Echospeed plus with EXCITE) with both 1 channel and 8 channel coil. Using these three different machines and coils, SNRs of the spectra in both phantom and volunteers and (pre)scan time of MRS were compared. Two regions of the human brain (basal ganglia and deep white matter) were examined and relative metabolite ratios (NAA/Cr, Cho/Cr, and mI/Cr ratios) were measured in all volunteers. For all spectra, a STEAM localization sequence with three-pulse CHESS $H_2O$ suppression was used, with the following acquisition parameters: TR=3.0/2.0 sec, TE=30 msec, TM=13.7 msec, SW=2500 Hz, SI=2048 pts, AVG : 64/128, and NEX=2/8 (Signa/Echospeed). Results : The SNR was about over $30\%$ higher in Echospeed machine and time for prescan and scan was almost same in different machines and coils. Reliable spectra were obtained on both MRS systems and there were no significant differences in spectral patterns and relative metabolite ratios in two brain regions (p>0.05). Conclusion : Both conventional and new MRI systems are highly reliable and reproducible for $^1H$ MR spectroscopic examinations in human brains and there are no significant differences in applications for $^1H$ MRS between two different MRI systems.

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The relationships between lead exposure indicies and urinary δ-ALA by HPLC and colorimetric method in lead exposure workers (연노출근로자에 있어서 흡광광도법과 HPLC법에 의한 요중 δ-ALA 배설량과 연노출지표들 간의 관련성)

  • Ahn, Kyu-Dong;Lee, Sung-Soo;Hwangbo, Young;Lee, Gab-Soo;Yeon, You-Yong;Kim, Yong-Bae;Lee, Byung-Kook
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.6 no.1
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    • pp.77-87
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    • 1996
  • In order to compare the difference of the measurement of delta aminolevulinic acid(${\delta}$-ALA) in urine between HPLC method(HALA) and colorimetric method(CALA), and also to provide useful information for the new diagnostic criteria of ${\delta}$-ALA in urine in lead poisoning, if at all possible in the future, authors studied 234 male lead workers who were selected from 7 storage battery factories, 3 secondary smelting industries, and 2 litharge making industries. Study subjects were selected on the basis of blood Zinc protoporphyrin(ZPP) level from low to high concentration to cover wide range of lead exposure. Study variables for this study were ${\delta}$-ALA measured by two different methods, blood lead(PbB), and blood ZPP. The results were as follows: 1. There was very high correlation between ${\delta}$-ALA measured by two method(r = 0.989 : HALA = -0.8194 + 0.8110 ${\times}$ CALA), but the value of CALA was measured about 2mg/L greater than HALA. 2. While the correlations of ${\delta}$-ALA by two method with blood lead and blood ZPP were 0.46 and 0.37 respectively, they were increased to 0.63 and 0.57 if ${\delta}$-ALA values were log-transformed. 3. Simple linear regression of ${\delta}$-ALA measured by two method on ZPP were as follows: CALA = 2.0421 + 0.0341 ${\times}$ ZPP ($R^2=0.1385$ p = 0.0001) HALA = 0.8006 + 0.0280 ${\times}$ ZPP ($R^2=0.1389$ p = 0.0001) 4. Simple linear regression of ${\delta}$-ALA measured by two method on PbB were as follows: CALA = - 0.4134 + 0.1545 ${\times}$ PbB ($R^2=0.2085$ p = 0.0001) HALA = -1.2893 + 0.1287 PbB ($R^2=0.2154$ p = 0.0001), 5. Simple linear regression of log-transformed ${\delta}$-ALA by two method on ZPP and PbB were as follows: logHALA = 0.3078 + 0.0060 ZPP ($R^2=0.3329$ p = 0.0001) logCALA = 1.0189 + 0.0044 ZPP ($R^2=0.3290$ p = 0.0001) logHALA = -0.0221 + 0.0246 PbB ($R^2=0.4046$ p = 0.0001) logCALA = 0.7662 + 0.0184 PbB ($R^2=0.4108$ p = 0.0001) 6. The cumulative percent of colorimetric method to detect lead workers whose value of PbS and ZPP were over screening level such as $40{\mu}/dl$ and $100{\mu}/dl$ respectively was higher than HPLC method if cut-off level of ${\delta}$-ALA for screening of lead poisoning was 5 mg/L. But if cut-off level of ${\delta}$-ALA measured by HPLC was reduced to 3 mg/L which is compatible to 5 mg/L of ${\delta}$-ALA measured by colorimetric method, there were good agreement between two methods and showed dose-response relationship with other lead exposure indices such as PbB and ZPP.

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The evaluation of the feasibility about prostate SBRT by analyzing interfraction errors of internal organs (분할치료간(Interfraction) 내부 장기 움직임 오류 분석을 통한 전립선암의 전신정위적방사선치료(SBRT) 가능성 평가)

  • Hong, soon gi;Son, sang joon;Moon, joon gi;Kim, bo kyum;Lee, je hee
    • The Journal of Korean Society for Radiation Therapy
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    • v.28 no.2
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    • pp.179-186
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    • 2016
  • Purpose : To figure out if the treatment plan for rectum, bladder and prostate that have a lot of interfraction errors satisfies dosimetric limits without adaptive plan by analyzing MR image. Materials and Methods : This study was based on 5 prostate cancer patients who had IMRT(total dose: 70Gy) Using ViewRay MRIdian System(ViewRay, ViewRay Inc., Cleveland, OH, USA) The treatment plans were made on the same CT images to compare with the plan quality according to adaptive plan, and the Eclipse(Ver 10.0.42, Varian, USA) was used. After registrate the 5 treatment MR images to the CT images for treatment plan to analyze the interfraction changes of organ, we measured the dose volume histogram and the changes of the absolute volume for each organ by appling the first treatment plan to each image. Over 5 fractions, the total dose for PTV was $V_{36.25}$ Gy $${\geq_-}$$ 95%. To confirm that the prescription dose satisfies the SBRT dose limit for prostate, we measured $V_{100%}$, $V_{95%}$, $V_{90%}$ for CTV and $V_{100%}$, $V_{90%}$, $V_{80%}$ $V_{50%}$ of rectum and bladder. Results : All dose average value of CTV, rectum and bladder satisfied dose limit, but there was a case that exceeded dose limit more than one after analyzing the each image of treatment. After measuring the changes of absolute volume comparing the MR image of the first treatment plan with the one of the interfraction treatment, the difference values were maximum 1.72 times at rectum and maximum 2.0 times at bladder. In case of rectum, the expected values were planned under the dose limit, on average, $V_{100%}=0.32%$, $V_{90%}=3.33%$, $V_{80%}=7.71%$, $V_{50%}=23.55%$ in the first treatment plan. In case of rectum, the average of absolute volume in first plan was 117.9 cc. However, the average of really treated volume was 79.2 cc. In case of CTV, the 100% prescription dose area didn't satisfy even though the margin for PTV was 5 mm because of the variation of rectal and bladder volume. Conclusion : There was no case that the value from average of five fractions is over the dosimetric limits. However, dosimetric errors of rectum and bladder in each fraction was significant. Therefore, the precise delivery is needed in case of prostate SBRT. The real-time tracking and adaptive plan is necessary to meet the precision delivery.

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Studies on the Effects of Various Methods of Rotation Irrigation System Affecting on The Growth, Yield of Rice Plants and Its Optimum Facilities (수환관개방법의 차이가 수도생육 및 수량에 미치는 영향과 그 적정시설에 관한 연구)

  • 이창구
    • Magazine of the Korean Society of Agricultural Engineers
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    • v.12 no.2
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    • pp.1937-1947
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    • 1970
  • This experiment was conducted, making use of the 'NONG-RIM No, 6' a recommended variety of rice plant for the year of 1969. Main purpose of the experiment are to explore possibilities of; a) ways and means of saving irrigation water and, b) overcoming drought at the same time so that an increaded yield in rice production could be resulted in Specifically, it was tried to determine the effects of the Rotation Irrigation method combined with differentiated thickess of Lining upon the growth and Yield of rice production. Some of the major finding are summarized in the follows. 1) The Different thicknesses show a significant relationship with the weight of 1000 grains. In the case of 3cm Lined plot, the grain weight is 39.0 Grams, the heaviest. Next in order is 6 cm lined plnt, 5 day control plot, 6 day control plot. 2) In rice yield, it is found that there is a considerably moderate signicant relationship with both the different thickness of lining and the number of irrgation, as shown in the table No,7. 3) There is little or no difference among different plot in terms of; a) physical and chemical properties of soil, b) quality of irrgation water, c) climatic condition, and rainfalls. 4) It is found that there is no significant relationship between differences in the method of rotation irrgation and the number of ears per hill because of too much rainydays and low temperature during irrigation season. 5) In uyny1-treated plots, it is shown that there is on difference among different plots, but the irrigation water requirement saved as much as 1/2 to actual irrigation water compare to uncontroled plot. 6) The irrigation water requirement for 48 days is saved as much 67% compared to uncontroled plot, the order are; the 9cm lined plot, the plot of vinyl with no hole, the plot with a hole of $1cm/m^2$ as shows in fig 15. 7) The rate of percolation of 40-30mm/day is decreased to 30-20/day. It is found that the decreasad rate of percolation due to vinyl-cutoff in footpath. 8) The growing condition was fine, and there was no found that decease and lageing as always submerged plot. 9) It is found that it must be constructed irrigation and drainage system, inlet and outlet perpect, respectly, of which could be irrigation water saved and would be inereased the irrigation water temperature.

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Feed Intake Evaluation of Korean Cattle (Hanwoo) Fed Diets Containing Different Levels of Compound Fattening Periods (한우의 육성 및 비육기간중 배합사료 급여 수준에 따른 사료섭취량 조사)

  • Shin, K.J.;Oh, Y.G.;Lee, S.S.;Kim, K.H.;Kim, C.H.;Paik, B.H.
    • Journal of Animal Science and Technology
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    • v.44 no.1
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    • pp.95-104
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    • 2002
  • A study was conducted to evaluate feed intake of Hanwoo bulls and steers fed diets of compound feed and rice straw. Twenty bull calves and sixty steers at 5 to 7 months old were used. The experimental period was divided into three feeding stages which are growing period (〈300 kg body weight (BW)), early fattening period (300-450 kg BW) and late fattening period (〉450 kg BW). The animals were given the diets containing 14.1% crude protein (CP) and 70.0% total digestible nutrients (TDN) in the growing period, 12.1% CP and 70.6% TDN in the early fattening period, and 11.2% CP and 71.9% TDN in the late fattening period, respectively. Experiment 1 was designed to compare feed intake (as-fed basis) between Hanwoo bulls and steers fed the experimental diets ad libitum. In Experiment 2, Hanwoo steers were allocated in one of three compound feed feeding treatments to investigate feed intake (as-fed basis). The treatment groups were ① feeding level 1 group fed compound feed ad libitum through the whole periods; ② feeding level 2 group fed 1.0% compound feed per kg BW in the growing period, 1.5% compound feed per kg BW in the early fattening period and compound feed ad libitum in the late fattening period; and ③ feeding level 3 group fed 1.5% compound feed per kg BW in the growing period, 2.0% compound feed per kg BW in the early fattening period and compound feed ad libitum in the late fattening period. In Experiment 1, the average daily feed intake of bulls increased linearly through the whole experimental period while the feed intake of steers increased until their body weight was reached upto 521 kg, afterward reduced. Average daily feed intake was about 3.5% per kg BW of both bulls and steers at the beginning (150 kg BW) of Experiment 1 while bulls and steers at 600 kg BW consumed the diets of 2.0 and 1.5% per kg BW, respectively. In Experiment 2, the average daily feed intake of steers in the feeding level 1 group gradually increased through the growing and early fattening periods and then steadily reduced over the late fattening period. The average daily feed intake in the feeding level 2 group linearly increased through the whole period while the feed intake in the feeding level 3 group showed a relatively rapid increase and reached a peak at 455 kg BW, and then sharply dropped. The average daily feed intake of steers in the feeding level 1 at the beginning (150 kg BW) of Experiment 2 was about 3.5% per kg BW but there was a reduction (1.5% per kg BW) at 600 kg BW. Besides, The feed intake of steers in the feeding level 2 and 3 in which compound feed was given with limitation increased to 2.0-3.0% per kg BW in the growing period and then reduced to 1.5-2.0% per kg BW. The limited compound feed feeding of steers in Experiment 2 resulted in higher rice straw intakes up to two to three folds and two folds in the growing and early fattening periods, respectively, than the ad libitum feeding.

Comparison of Establishment Vigor, Uniformity, Rooting Potential and Turf Qualtiy of Sods of Kentucky Bluegrass, Perennial Ryegrass, Tall Fescue and Cool-Season Grass Mixtures Grown in Sand Soil (모래 토양에서 켄터키블루그라스, 퍼레니얼라이그라스, 톨훼스큐 및 한지형 혼합구 뗏장의 피복도, 균일도, 근계 형성력 및 잔디품질 비교)

  • 김경남;박원규;남상용
    • Asian Journal of Turfgrass Science
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    • v.17 no.4
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    • pp.129-146
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    • 2003
  • Research was initiated to compare establishment vigor, uniformity, rooting potential and turf quality in sods of cool-season grasses (CSG). Several turfgrasses grown under pure sand soil were tested. Establishment vigor, uniformity, rooting potential and turf quality were evaluated in the study. Turfgrass entries were comprised of three blends from Kentucky bluegrass (KB, Poa pratensis L.), perennial ryegrass (PR, Lolium perenne L.), and tall fescue (TF, Festuca arundinacea Schreb.), respectively and three mixtures among them. Differences by treatments were significantly observed in establishment vigor, uniformity, rooting potential and turf quality. Early establishment vigor was mainly influenced by germination speed, being fastest with PR, intermediate with TF and slowest with KB. In a late stage of growth, however, it was affected more by growth habit, resulting in highest with KB and slowest with TF. There were considerable variations in sod uniformity among turfgrasses. Best uniformity among monostand sods was associated with KB, while poorest one with TF. PR sod produced intermediate uniformity between KB and TF. The uniformity of polystand sods of CSG mixtures was inferior to that of monostands of KB, PR and TF, due to characteristics of mixtures comprised of a variety of color, density, texture and growth habit. The greatest potential of sod rooting was found with PR and the poorest with KB. Intermediate potential between PR and KB was associated with TF. In CSG mixtures, it was variable, depending on turfgrass mixing rates. Generally, the higher the PR in mixtures, the greater the sod rooting potential. At the time of sod harvest, however, turfgrass quality of KB was superior to that of PR. because of its characteristics of uniform surface, high density and good mowing quality. These results suggest that a careful expertise based on turf quality as well as sod characteristics like establishment vigor, uniformity and rooting potential be strongly required for the success of golf course or athletic field in establishment.

Evaluating efficiency of Split VMAT plan for prostate cancer radiotherapy involving pelvic lymph nodes (골반 림프선을 포함한 전립선암 치료 시 Split VMAT plan의 유용성 평가)

  • Mun, Jun Ki;Son, Sang Jun;Kim, Dae Ho;Seo, Seok Jin
    • The Journal of Korean Society for Radiation Therapy
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    • v.27 no.2
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    • pp.145-156
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    • 2015
  • Purpose : The purpose of this study is to evaluate the efficiency of Split VMAT planning(Contouring rectum divided into an upper and a lower for reduce rectum dose) compare to Conventional VMAT planning(Contouring whole rectum) for prostate cancer radiotherapy involving pelvic lymph nodes. Materials and Methods : A total of 9 cases were enrolled. Each case received radiotherapy with Split VMAT planning to the prostate involving pelvic lymph nodes. Treatment was delivered using TrueBeam STX(Varian Medical Systems, USA) and planned on Eclipse(Ver. 10.0.42, Varian, USA), PRO3(Progressive Resolution Optimizer 10.0.28), AAA(Anisotropic Analytic Algorithm Ver. 10.0.28). Lower rectum contour was defined as starting 1cm superior and ending 1cm inferior to the prostate PTV, upper rectum is a part, except lower rectum from the whole rectum. Split VMAT plan parameters consisted of 10MV coplanar $360^{\circ}$ arcs. Each arc had $30^{\circ}$ and $30^{\circ}$ collimator angle, respectively. An SIB(Simultaneous Integrated Boost) treatment prescription was employed delivering 50.4Gy to pelvic lymph nodes and 63~70Gy to the prostate in 28 fractions. $D_{mean}$ of whole rectum on Split VMAT plan was applied for DVC(Dose Volume Constraint) of the whole rectum for Conventional VMAT plan. In addition, all parameters were set to be the same of existing treatment plans. To minimize the dose difference that shows up randomly on optimizing, all plans were optimized and calculated twice respectively using a 0.2cm grid. All plans were normalized to the prostate $PTV_{100%}$ = 90% or 95%. A comparison of $D_{mean}$ of whole rectum, upperr ectum, lower rectum, and bladder, $V_{50%}$ of upper rectum, total MU and H.I.(Homogeneity Index) and C.I.(Conformity Index) of the PTV was used for technique evaluation. All Split VMAT plans were verified by gamma test with portal dosimetry using EPID. Results : Using DVH analysis, a difference between the Conventional and the Split VMAT plans was demonstrated. The Split VMAT plan demonstrated better in the $D_{mean}$ of whole rectum, Up to 134.4 cGy, at least 43.5 cGy, the average difference was 75.6 cGy and in the $D_{mean}$ of upper rectum, Up to 1113.5 cGy, at least 87.2 cGy, the average difference was 550.5 cGy and in the $D_{mean}$ of lower rectum, Up to 100.5 cGy, at least -34.6 cGy, the average difference was 34.3 cGy and in the $D_{mean}$ of bladder, Up to 271 cGy, at least -55.5 cGy, the average difference was 117.8 cGy and in $V_{50%}$ of upper rectum, Up to 63.4%, at least 3.2%, the average difference was 23.2%. There was no significant difference on H.I., and C.I. of the PTV among two plans. The Split VMAT plan is average 77 MU more than another. All IMRT verification gamma test results for the Split VMAT plan passed over 90.0% at 2 mm / 2%. Conclusion : As a result, the Split VMAT plan appeared to be more favorable in most cases than the Conventional VMAT plan for prostate cancer radiotherapy involving pelvic lymph nodes. By using the split VMAT planning technique it was possible to reduce the upper rectum dose, thus reducing whole rectal dose when compared to conventional VMAT planning. Also using the split VMAT planning technique increase the treatment efficiency.

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Usefulness of Non-coplanar Helical Tomotherapy Using Variable Axis Baseplate (Variable Axis Baseplate를 이용한 Non-coplanar 토모테라피의 유용성)

  • Ha, Jin-Sook;Chung, Yoon-Sun;Lee, Ik-Jae;Shin, Dong-Bong;Kim, Jong-Dae;Kim, Sei-Joon;Jeon, Mi-Jin;Cho, Yoon-Jin;Kim, Ki-Kwang;Lee, Seul-Bee
    • The Journal of Korean Society for Radiation Therapy
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    • v.23 no.1
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    • pp.31-39
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    • 2011
  • Purpose: Helical Tomotherapy allows only coplanar beam delivery because it does not allow couch rotation. We investigated a method to introduce non-coplanar beam by tilting a patient's head for Tomotherapy. The aim of this study was to compare intrafractional movement during Tomotherapy between coplanar and non-coplanar patient's setup. Materials and Methods: Helical Tomotherapy was used for treating eight patients with intracranial tumor. The subjects were divided into three groups: one group (coplanar) of 2 patients who lay on S-plate with supine position and wore thermoplastic mask for immobilizing the head, second group (non-coplanar) of 3 patients who lay on S-plate with supine position and whose head was tilted with Variable Axis Baseplate and wore thermoplastic mask, and third group (non-coplanar plus mouthpiece) of 3 patients whose head was tilted and wore a mouthpiece immobilization device and thermoplastic mask. The patients were treated with Tomotherapy after treatment planning with Tomotherapy Planning System. Megavoltage computed tomography (MVCT) was performed before and after treatment, and the intrafractional error was measured with lateral(X), longitudinal(Y), vertical(Z) direction movements and vector ($\sqrt{x^2+y^2+z^2}$) value for assessing overall movement. Results: Intrafractional error was compared among three groups by taking the error of MVCT taken after the treatment. As the correction values (X, Y, Z) between MVCT image taken after treatment and CT-simulation image are close to zero, the patient movement is small. When the mean values of movement of each direction for non-coplanar setup were compared with coplanar setup group, X-axis movement was decreased by 13%, but Y-axis and Z-axis movement were increased by 109% and 88%, respectively. Movements of Y-axis and Z-axis with non-coplanar setup were relatively greater than that of X-axis since a tilted head tended to slip down. The mean of X-axis movement of the group who used a mouthpiece was greater by 9.4% than the group who did not use, but the mean of Y-axis movement was lower by at least 64%, and the mean of Z-axis was lower by at least 67%, and the mean of Z-axis was lower by at least 67%, and the vector was lower by at least 59% with the use of a mouthpiece. Among these 8 patients, one patient whose tumor was located on left frontal lobe and left basal ganglia received reduced radiation dose of 38% in right eye, 23% in left eye, 30% in optic chiasm, 27% in brain stem, and 8% in normal brain with non-coplanar method. Conclusion: Tomotherapy only allows coplanar delivery of IMRT treatment. To complement this shortcoming, Tomotherapy can be used with non-coplanar method by artificially tilting the patient's head and using an oral immobilization instrument to minimize the movement of patient, when intracranial tumor locates near critical organs or has to be treated with high dose radiation.

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