Patient dose verification is one of the most Important responsibilities of the physician in the treatment delivery of radiation therapy. For the task, it is necessary to use an accurate dosimeter that can verify the patient dose profile, and it is also necessary to determine the physical characteristics of beams used in intensity modulated radiation therapy (IMRT) The Beam Intensity Scanner (BInS) System is presented for the dosimetric verification of the two dimensional photon beam. The BInS has a scintillator, made of phosphor Terbium-doped Gadolinium Oxysulphide (Gd$_2$O$_2$S:Tb), to produce fluorescence from the irradiation of photon and electron beams. These fluoroscopic signals are collected and digitized by a digital video camera (DVC) and then processed by custom made software to express the relative dose profile in a 3 dimensional (3D) plot. As an application of the BInS, measurements related to IWRT are made and presented in this work. Using a static multileaf collimator (SMLC) technique, the intensity modulated beam (IMB) is delivered via a sequence of static portals made by controlled leaves. Thus, when static subfields are generated by a sequence of abutting portals, the penumbras and scattered photons of the delivered beams overlap in abutting field regions and this results in the creation of “hot spots”. Using the BInS, inter-step “hot spots” inherent in SMLC are measured and an empirical method to remove them is proposed. Another major MLC technique in IMRT, the dynamic multileaf collimator (DMLC) technique, has different characteristics from SMLC due to a different leaf operation mechanism during the irradiation of photon and electron beams. By using the BInS, the actual delivered doses by SMLC and DMLC techniques are measured and compared. Even if the planned dose to a target volume is equal in our experimental setting, the actual delivered dose by DMLC technique is measured to be larger by 14.8% than that by SMLC, and this is due to scattered photons and contaminant electrons at d$_{max}$.
The Journal of Korean Society for Radiation Therapy
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v.28
no.1
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pp.7-16
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2016
Purpose : This study aimed to compare and evaluate between the efficiency of two respective devices, 3D-bolus and step-bolus when the devices were used for the treatment of patients whose chest walls were required to undergo the electron beam therapy after the surgical procedure of modified radical mastectomy, MRM. Materials and Methods : The treatment plan of reverse hockey stick method, using the photon beam and electron beam, had been set for six breast cancer patients and these 6 breast cancer patients were selected to be the subjects for this study. The prescribed dose of electron beam for anterior chest wall was set to be 180 cGy per treatment and both the 3D-bolus, produced using 3D printer(CubeX, 3D systems, USA) and the self-made conventional step-bolus were used respectively. The surface dose under 3D-bolus and step-bolus was measured at 5 measurement spots of iso-center, lateral, medial, superior and inferior point, using GAFCHROMIC EBT3 film (International specialty products, USA) and the measured value of dose at 5 spots was compared and analyzed. Also the respective treatment plan was devised, considering the adoption of 3D-bolus and stepbolus and the separate treatment results were compared to each other. Results : The average surface dose was 179.17 cGy when the device of 3D-bolus was adopted and 172.02 cGy when step-bolus was adopted. The average error rate against the prescribed dose of 180 cGy was -(minus) 0.47% when the device of 3D-bolus was adopted and it was -(minus) 4.43% when step-bolus was adopted. It was turned out that the maximum error rate at the point of iso-center was 2.69%, in case of 3D-bolus adoption and it was 5,54% in case of step-bolus adoption. The maximum discrepancy in terms of treatment accuracy was revealed to be about 6% when step-bolus was adopted and to be about 3% when 3D-bolus was adopted. The difference in average target dose on chest wall between 3D-bolus treatment plan and step-bolus treatment plan was shown to be insignificant as the difference was only 0.3%. However, to mention the average prescribed dose for the part of lung and heart, that of 3D-bolus was decreased by 11% for lung and by 8% for heart, compared to that of step-bolus. Conclusion : It was confirmed through this research that the dose uniformity could be improved better through the device of 3D-bolus than through the device of step-bolus, as the device of 3D-bolus, produced in consideration of the contact condition of skin surface of chest wall, could be attached to patients' skin more nicely and the thickness of chest wall can be guaranteed more accurately by the device of 3D-bolus. It is considered that 3D-bolus device can be highly appreciated clinically because 3D-bolus reduces the dose on the adjacent organs and make the normal tissues protected, while that gives no reduction of dose on chest wall.
Lee, Seung Hoon;Kwak, Keun Tak;Park, Ju Kyeong;Gim, Yang Soo;Cha, Seok Yong
The Journal of Korean Society for Radiation Therapy
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v.25
no.2
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pp.145-151
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2013
Purpose: In this study, we analyzed how the dose change by field size effects on atomic number of shielding materials while using 6 MeV election beam. Materials and Methods: The parallel plate chamber is mounted in $25{\times}25cm^2$ the phantom such that the entrance window of the detector is flush with the phantom surface. phantom was covered laterally with aluminum, copper and lead which thickness have 5% of allowable transmission and then the doses were measured in field size $6{\times}6$, $10{\times}10$ and $20{\times}20cm^2$ respectively. 100 cGy was irradiated using 6 MeV electron beam and SSD (Source Surface Distance) was 100 cm with $10{\times}10cm^2$ field size. To calculate the photon flux, electron flux and Energy deposition produced after pass materals respectively, MCNPX code was used. Results: The results according to the various shielding materials which have 5% of allowable transmission are as in the following. Thickness change rate with field size of $6{\times}6cm^2$ and $20{\times}20cm^2$ that compared to the field size of $10{\times}10cm^2$ found to be +0.06% and -0.06% with aluminum, +0.13% and -0.1% with copper, -1.53% and +1.92% with lead respectively. Compare to the field size $10{\times}10cm^2$, energy deposition for $6{\times}6cm^2$ and $20{\times}20cm^2$ had -4.3% and +4.85% respectively without shielding material. With aluminum it had -0.87% and +6.93% respectively and with lead it had -4.16% and +5.57% respectively. When it comes to photon flux with $6{\times}6cm^2$ and $20{\times}20cm^2$ of field sizes the chance -8.95% and +15.92% without shielding material respectively, with aluminum the number -15.56% and +16.06% respectively and with copper the chance -12.27% and +15.53% respectively, with lead the number +12.36% and -19.81% respectively. In case of electron flux in the same condition, the number -3.92% and +4.55% respectively without shielding material respectively, with aluminum the number +0.59% and +6.87% respectively, with copper the number -1.59% and +3.86% respectively, with lead the chance -5.15% and +4.00% respectively. Conclusion: In this study, we found that the required thickness of the shielding materials got thinner with low atomic number substance as the irradiation field is increasing. On the other hand, with high atomic number substance the required thickness had increased. In addition, bremsstrahlung radiation have an influence on low atomic number materials and high atomic number materials are effected by scattered electrons.
Purpose: This study was performed to evaluate the disease-free survival and risk factors of recurrence in early breast cancer patients who have undergone breast conserving surgery and radiation therapy. Materials and Methods: From March 1997 to December 2002, 77 breast cancer patients who underwent breast conserving surgery and radiation therapy were reviewed retrospectively. The median follow-up time was 58.4 months (range $43.8{\sim}129.4$ months) and the mean subject age was 41 years. The frequency distribution of the different T stages, based on the tumor characteristics was 38 (49.3%) for T1, 28 (36.3%) for T2, 3 for T3, 7 for T is and 1 for an unidentified sized tumor. In addition, 52 patients (67.5%) did not have axillary lymph metastasis, whereas 14 patients (18.1%) had $1{\sim}3$ lymph node metastases and 3 (0.03%) had more than 4 lymph node metastases. The resection margin was negative in 59 patients, close (${\leq}2\;mm$) in 15, and positive in 4. All patients received radiation therapy at the intact breast using tangential fields with a subsequent electron beam boost to the tumor bed at a total dose ranging from 59.4 Gy to 66.4 Gy. Patients with more than four positive axillary lymph nodes received radiation therapy ($41.4{\sim}60.4\;Gy$) at the axillary and supraclavicular area. Chemotherapy was administered in 59 patients and tamoxifen or fareston was administered in 29 patients. Results: The 5 year overall survival and disease-free survival rates were 98.08% and 93.49%, respectively. Of the 77 patients, a total of 4 relapses (5.2%), including 1 isolated supraclavicular relapse, 1 supraclavicular relapse with synchronous multiple distant relapses, and 2 distant relapses were observed. No cases of local breast relapses were observed. Lymph node metastasis or number of metastatic lymph nodes was not found to be statistically related with a relapse (p=0.3289) nor disease-free survival (p=0.1430). Patients with positive margins had a significantly shorter disease-free survival period (p<0.0001) and higher relapse rates (p=0.0507). However, patients with close margins were at equal risk of relapse and disease-free survival as with negative margins (p=1.000). Patients younger than 40 years of age had higher relapse rates (9.3% vs. 0%) and lower disease-free survival periods, but the difference was not statistically significant (p=0.1255). The relapse rates for patients with tumors was 14% for tumor stage T2, compared to 0% for tumor stage T1 tumors (p=0.0284). A univariate analysis found that disease-free survival and relapse rates, T stage, positive resection margin and mutation of p53 were significant factors for clinical outcome. Conclusion: The results of this study have shown that breast conservation surgery and radiation therapy in early breast cancer patients has proven to be a safe treatment modality with a low relapse rate and high disease-free survival rate. The patients with a positive margin, T2 stage, and mutation of p53 are associated with statistically higher relapse rates and lower disease-free survival.
Kim, Seon-Hong;Lee, Su-Yeon;Cho, Seong-Min;Hong, Chang-Young;Park, Mi-Jin;Choi, In-Gyu
Journal of the Korean Wood Science and Technology
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v.44
no.1
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pp.113-123
/
2016
This study was to investigate the antifungal activity of A. holophylla essential oil against dermatophytes, such as Epidermophyton floccosum, Trichophyton mentagrophytes and Trichophyton rubrum, and to determine the potential effective compound as dermatitis treatment. To evaluate the potential antifungal activities of A. holophylla essential oil and its fractions, paper disc diffusion and agar dilution method tested with morphological observation. Also, their major constituents were analyzed by GC/MS. To determine synergic effects of active ingredient from A. holophylla essential oil were carried out by checkerboard microtiter plate testing. The morphological changes of the dermatophytes exposed to active fraction G4 were observed by electron microscopes. As the results, the highest activities were identified in the fraction containing ${\alpha}$-bisabolol. A mixture of ${\alpha}$-bisabolol and bornyl acetate showed the synergy effects, expressing high potential effects. Also, morphological observation using electron microscopes showed a dramatic changes of cell membrane of E. floccosum and T. rubrum exposed to fraction G4 containing ${\alpha}$-bisabolol. In conclusion, A. holophylla essential oil and its constituents were expected to be used as antifungal agent or raw material for dermatitis therapy.
Park, Tae-Il;Lee, Hyung-Seok;Lee, Hee-Jong;Chae, Chang-Hoon;Lee, Young-Joo;Byeon, Kwang-Seob;Hong, Soon-Min;Choi, Mee-Ra;Park, Jun-Woo
Maxillofacial Plastic and Reconstructive Surgery
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v.32
no.5
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pp.396-405
/
2010
Purpose: This study was performed to find out the effects of the Er:YAG laser (Key Laser) & Er,Cr:YSGG laser (Water Laser) on inflammatory tissues. Materials and Methods: It was performed on about 20 g, 6 weeks male ICR mouses. They were grouped into the control (negative), the inflammation induced 'control'(positive), Er,Cr:YSGG laser exposured group after inducing inflammation, Er:YAG lasere exposured group after inducing inflammation each 15 mouses. The mouses were applicated 0.5% DNFB 1 cc on ear skin twice a day for 4 days until symptom expression. After laser exposure, ear tissues were extracted and defined gene expression by RT-PCR. Then, tissue staining, lymphocytes observation, electromicroscophic laboratory were carried out. Results: Interleukin-$1{\beta}$ was expressed much less in the A-laser exposed group. Interleukin-$1{\beta}$ & Tumor Necrosis Factor-${\alpha}$ were expressed 7 times lesser in the A-laser exposed group. The number of Lymphocytes related to inflammation was decreased rapidly in the A-laser exposed group in vivo. he number of cavity recovered normal was a little bigger in the A-laser exposed group after 5 days Conclusion: The expression of IL-$1{\beta}$ & TNF-${\alpha}$, hitologic change, observation with electron microscope shows that Erbium laser exposure causes lesser inflammation with A-laser rather than B-laser.
The finding of long lived free radicals produced by ionizing radiation in organic crystals and the quantification of this effect by electron spin resonance(ESR) spactroscopy has proven excellent dosimetric applicability. The tissue equivalent alanine dosimeter also appear appropriate for radiation therapy level dosimetry. The dose measurement was performed in a Rando phantom using high energy photons as produced by high energy medical linear accelerator and cobalt-60 teletherapy unit. The absorbed dose range of the ESR/alanine dosimetry system could be extended down to 0.1 Gy. The response of the alanine dosimeters was determined for photons at different therapeutic dose levels from less than 0.1 Gy to 100 Gy and the depth dose measurements were carried out for photon energies of 1.25MeV, 6 and 10 MV with alanine dosimeters in Rando phantom. Comparisons between ESR/alanine in a Rando phantom and ion chamber in a water phantom were made performing depth dose measurements to examine the agreement of both methods under field conditions.
Journal of Korean Academy of Oral and Maxillofacial Radiology
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v.20
no.2
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pp.171-182
/
1990
The purpose of this study was to investigate the effects of irradiation on the striated duct cells of the rat submandibular gland ductal tissues which control the characteristics of saliva. For this study, the experimental group was composed of 36 irradiated Sprague Dawley strain rats divided into 8 subgroups 1 hour, 2 hours, 3 hours, 6 hours, 12 hours, 24 hours, 48 hours, 72 hours after irradiation. 4 non-irradiated rats were used as the control group. The experimental animals were singly irradiated with a dose of 18Gy gamma ray to their head and neck region by the Co-6- teletherapy unit and sacrificed after each experimental duration. The specimens were examined with a light microscope with an H-E stain and with a trans- mission electron microscope. The results of this study were as follows. In the light micrograph, a severe atrophic change occurred in the striated duct cells at 2hours after irradiation and gradual recovery occurred from 6 hours after irradiation. 2. The nuclear chromosomes of the striated duct cells were changed granular at 2 hours after irradiation. Recovery was observed at 6 hours after irradiation. Nuclear bodies were also observed from 3 hours after irradiation. 3. The mitochondria of the striated duct cells had indistinct cristae at 2 hours after irradiation, and were degenerated or swollen at 3 hours after irradiation. They recovered, however, from 6 hours, with an increasing number at 48 hours and a regular arrangement was observed at 72 hours after irradiation. 4. The microvilli showed atrophic changes at 2 hours after irradiation and were almost lost at 3 hours after irradiation. They were observed again from 48 hours after irradiation. 5. The rough endoplasmic reticulum and golgi body were not apparent at 1 hour after irradiation and were dilated with degeneration 2 hours after, but intact rough endoplasmic reticulum were observed from 3 hours after irradiation and developed well at 24 hours after irradiation. By the result of this study, showing a mild change in the functional morphology of the salivary striated duct cells immediately following irradiation, it is considered that the many complications which occur after radiation therapy, will disappear in time with the histological and the functional recovery of the glandular tissues.
The severe atrophic edentulism with poor neuromuscular control militates against successful conventional denture therapy. To such situation, a prescribing of dental implant treatment has been considered with some probability. Implant materials used as a trial for dental implants includes metals, plastic polymers and ceramics. The purpose of this study was to observe histologic response in osseointegration process at titanium implant-tissue interface based on biocompatibility at specific period of sequential natures which were divided into a half month, one, month, two months, three months and immediate as a base line. In this study, unilateral lower left premolar and molar teeth were extraced in three dogs. After allowing to heal for 6 months, three kinds of osseointegrated implant, $Br{\aa}nemark$, Corevent and kimplant(a prototype of SNU implant study)were inserted in each dog respectively according to the above sequence from front to back. The specimens were taken from those dogs at the same time since implant were inserted quite reverse order of the specified periods, and decalcified and processed for histologic examination for the light microscopy and the electron microscopy. The microscopic histologic findings at the interface between titanium implants and tissue were interpretated as follows : A. Light microscopic findings : a. Immediate : Implant were surrounded by compact bone and spongy bone. Microcrak was observed in the superficial bone tissue. Osteocytes were disappeared and bone lacunae were observed as a vacant space in some parts. In the contacting with the spongy bone, bone trabeculae and bone marrow were in contact with the implant. b. A half Month : Osteoblasts exist as a monolayer in th inner bone trabeculae and do bone additiocn. Osteoblasts&inflammatory cells were observed in some parts. c. One Month : The presence of osteoclasts decreased. Osteoblasts did active bone fromation, and bone marrow was in contact with the implant in the many places. d. Two Months : Bone formation was advanced in comparison with the b and c. The presence of osteoclsts was not observed. e. Three Months : The superficial bone tissue contacted with the implants was entirely composed by the compact bone. B. Electron microscopic findings : a. A half month and one month group : In the parts of the active bone formation, osteoblasts with the well developed endoplasmic reticulum and Golgi apparatus were arranged in the monolayer. In the parts of the bone resorption, ruffled border was well developed and many osteoclasts with the well-developed golgi apparatus, mitochondria, vacuole, vesicle and lysosome were existed. b. Three months group : No osteoblasts were observed in the superficial bone tissue. Bone matrix with collaen fiber was observed. c. No significant dirrerence in the histologic findings was observed in $Br{\aa}nemark$, Core-vent and kimplant.
Pulmonary alveolar proteinosis is a disease of unknown etiology characterized by the accumulation of PAS positive lipoproteinaceous material in the alveolar spaces sparing septum. The therapy which has enjoyed the greatest success is whole lung lavage. The authors reported here, a case of 44 year old male patient with pulmonary alveolar proteinosis, and this is the 7th case in Korea. The patient underwent whole lung lavage but expired due to brain edema complicated by the procedure. He complained exertional dyspnea and cyanotic lips, and presented fine inspiratory crackle at both lower lung fields, decreased arterial oxygen pressure, and diffuse infiltration at whole lung field. Light microscopic finding of lung tissue obtained by transbronchial lung biopsy revealed PAS positive amorphous, granular material filled in the alveolar spaces, and electron microscopy of bronchoalveolar lavage fluid concentrate showed many electron-dense multi-lamellated structures. To treat the disease, the authors tried whole lung lavage of left lung with $37^{\circ}C$ isotonic saline under general anesthesia. However, he expired due to brain edema probably due to dilutional hyponatremia complicated by the procedure, 11 days after the procedure. Whole lung lavage is known relatively safe, but fatal complication may occur like this case.
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