For applying the quality assurance (QA) of volumetric modulated arc therapy (VMAT) introduced in Eulji Hospital, we classify it into three different QA steps, treatment planning QA, pretreatment delivering QA, and treatment verifying QA. These steps are based on the existing intensity modulated radiation therapy (IMRT) QA that is currently used in our hospital. In each QA step, the evaluated items that are from QA program are configured and documented. In this study, QA program is not only applied to actual patient treatment, but also evaluated to establish a reference of clinical acceptance in pretreatment delivering QA. As a result, the confidence limits (CLs) in the measurements for the high-dose and low-dose regions are similar to the conventional IMRT level, and the clinical acceptance references in our hospital are determined to be 3 to 5% for the high-dose and the low-dose regions, respectively. Due to the characteristics of VMAT, evaluation of the intensity map was carried out using an ArcCheck device that was able to measure the intensity map in all directions, $360^{\circ}$. With a couple of dosimetric devices, the gamma index was evaluated and analyzed. The results were similar to the result of individual intensity maps in IMRT. Mapcheck, which is a 2-dimensional (2D) array device, was used to display the isodose distributions and gave very excellent local CL results. Thus, in our hospital, the acceptance references used in practical clinical application for the intensity maps of $360^{\circ}$ directions and the coronal isodose distributions were determined to be 93% and 95%, respectively. To reduce arbitrary uncertainties and system errors, we had to evaluate the local CLs by using a phantom and to cooperate with multiple organizations to participate in this evaluation. In addition, we had to evaluate the local CLs by dividing them into different sections about the patient treatment points in practical clinics.
Jang, Hee Jin;Cho, Hyung Rae;Lee, Jae Hee;Bae, Kun Yuk;Seo, Jong Jin;Moon, Hyung Nam;Im, Ho Joon
Clinical and Experimental Pediatrics
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v.53
no.2
/
pp.210-214
/
2010
Purpose : Cisplatin is highly effective for the treatment of solid tumors in children. However, the clinical use of cisplatin is limited by its ototoxicity. The aim of this study was to evaluate the ototoxicity in children treated with cisplatin. Method : We performed a single institution retrospective analysis of pediatric oncology patients who received cisplatin therapy between January 2001 and January 2008. Thirty-seven patients with sufficient medical and audiologic data were included in this study. Results : The median age at the time of diagnosis was 10.7 (range 3.8-6.7) years. There were 16 males and 21 females. The underlying diseases were osteosarcoma (15 cases), medulloblastoma (14 cases), germ cell tumors (7 cases), and hepatoblastoma (1 case). The median individual dose was $100mg/m^2$/cycle (56-200). The median cumulative dose was $480mg/m^2$ (200-1,490). Sixteen patients (43%) received cranial radiotherapy. Of the 37 patients, 17 developed hearing loss, leading to an overall incidence of 46%. Logistic regression showed that age at treatment (P =0.04) and cumulative dose of cisplatin (P =0.005) were the significant risk factors in predicting hearing loss in children treated with cisplatin. In all the patients who had hearing loss, there was neither improvement nor aggravation during the follow-up (3-8 months). Conclusion : The cumulative dose of cisplatin (>$500mg/m^2$) and younger age at treatment (<12 years) were 2 most important risk factors for ototoxicity in patients treated with cisplatin. Serial audiometric evaluations are needed in the patients with risk factors during and after cisplatin treatment.
The Journal of Korean Society for Radiation Therapy
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v.20
no.2
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pp.109-113
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2008
Purpose: To evaluate the detector dependency in the various collimator size for Stereotactic Radiosugery (SRS). Materials and Methods: This study was performed with 6 MV photon beam (Varian 21EX, Varian, US) and the measurement detectors are used by ion chamber CC01, CC13 (Wellhofer, Germany) and stereotactic diode detector (SFD, Wellhofer, Germany). SRS collimator size was used by ${\varphi}$5, 10, 20, 30 mm (Brain Lab, Germany). Percentage depth dose (PDD) was measured at SSD 100 cm and field size 10×10 cm from individual detectors. Ouput factor was measured by using same setup of PDD and with maximum dose depth. Data was normalized at field size $10{\times}10\;cm$. Beam profile was measured at SSD 100 cm in SRS collimator ${\varphi}$10, 30 mm and field $10{\times}10\;cm$ and a comparison of FWHM (full width half maximum), penumbra width (20~80%). Results: The CC13 detector was overestimated 16% than other detectors from the PDD in the 5 mm collimator. Output factors were underestimated CC01 28%, CC13 72% in the 5 mm collimator and CC01 9.6%, CC13 25% in the 10 mm collimator than the SFD. Maximum difference was 3% at the FWHM of the dose profile in the 10 mm collimator and difference of the 30 mm collimator was 0% at the FWHM. Penumbra width was increased CC01 122%, CC13 194% in the 10 mm collimator and CC01 68%, CC13 185% in the 30 mm collimator than the SFD. Conclusion: It is very important for accurate dosimetry to select a detector in small field. The SFD was considered with the most accurate dosimeter for small collimator dosimetry in this study.
Recently a high-quality voxel model of a Korean adult male was constructed at Hanyang University by using very high resolution serially-sectioned anatomical images of a cadaver, which was provided by the Korean Institute of Science and Technology Information (KISTI). Most existing voxel phantoms are developed based on an individual in the supine posture. This study converted the HDRK-Man voxel model into surface model and adjusted the flattened back of the HDRK-Man to a normal shape in the upright posture using 3D graphic softwares such as $3D-DOCTOR^{TM}$, $Rapidform^{(R)}$2006, $Rhinoceros^{(R)}$4.0, $MAYA^{(R)}$8.5. The effective doses of adjusted model were compared with those of unadjusted model for some standard irradiation geometries (i.e., AP, PA, LLAT, RLAT). In general, the differences were not very large and, among those, the largest difference was found for the PA radiation geometry, as expected. These methodologies can be used for the development of various deformed posture models of HDRK-Man in the later stage of this project.
A total of 90 one-day-old male broilers (Ross 308) were randomly assigned to one of the three dietary treatments, each consisting of six replicates (5 broilers/cage). The dietary treatments were 1) control (CON: fresh clean water with no supplement); 2) low dose [LD: CON + 1.56% extractions from the wooden chips (EWC)] and 3) high dose (HD: CON + 12.5% EWC). Drinking water supplemented with EWC was provided using specifically designed individual nipple drinker units. Average daily water intake (ADWI), average daily gain (ADG), average daily feed intake (ADFI), and feed conversion ratio (FCR) were measured weekly for 21 days. One broiler from each cage was euthanized for measuring the visceral organ weights and collecting ileal tissue samples for ileal architecture analysis on day 21. Broilers assigned to the LD and HD watery groups showed higher ADWI than that in broilers consumed CON on day 7 (P<0.05). The broilers subjected to HD treatment showed a deeper crypt depth (P<0.05) than that in broilers subjected to LD and CON on day 21. Therefore, broilers consumed HD showed a lower (P<0.05) villus height:crypt depth ratio than that broilers consumed CON on day 21. Broilers provided drinking water containing any of the tested concentrations of EWC showed no effect (P > 0.05) on growth performance, ileal villus height, and visceral organ weights as compared with those in the CON from hatch to 21 days. In conclusion, broilers fed HD showed reduction in villus height:crypt depth ratio without impairing growth performance and visceral organ weights for the experimental period.
$K^+$ channel openers (KCOs) are known to have a wide range of effects by opening the $K^+$ channel in plasma membranes of various smooth muscles, cardiac muscle and pancreatic ${\beta}-cell$. In the present study, we investigated the effects of 5 types of KCOs, cromakalim, RP49356, pinacidil, nicorandil and diazoxide on the contractility of isolated rat uterus. All KCOs tested inhibited the uterine contraction induced by 0.2 nM oxytocin in a dose-dependent manner. Individual KCO and its $pD_2$ values were cromakalim 6.5, RP49356 6.3, pinacidil 5.92, nicorandil 4.43 and diazoxide 4.18. The relaxant effects of KCO were inhibited by glibenclamide (0.3, 1 and $10\;{\mu}M$) with $pA_2$ values of cromakalim 6.91, RP49356 6.59, pinacidil 6.55, nicorandil 5.97 and diazoxide 6.37. In addition, the relaxant effect of cromakalim or pinacidil was antagonised by TEA, a non-selective $K^+$ channel blocker, but not by apamin. Contractions induced by low concentration of KCI (< 40 mM) were inhibited by cromakalim $(100{\mu}M)$ and nicorandil $(300{\mu}M)$, but those evoked by higher concentration (> 40 mM) of KCI were little affected. In ovariectomized rat uterus, cromakalim dose-dependently inhibited oxytocin-induced contraction and glibenclamide $(10{\mu}M)$ inhibited the relaxant effect of cromakalim with $pD_2$ and $K_B$ values of 7.48 and $1.26{\times}10^{-7}M$, respectively. In estrogen-primed rat uterus, these values were 6.51 and $1.57{\times}10^{-7}M$, respectively, indicating that the cromakalim is less effective on the estrogen-treated uterine smooth muscle. Our results suggest that the KCO-sensitive $K^+$ channels participate in the motility of uterine smooth muscle and such channels are, at least in part, under the control of estrogen. In addition, our data Indicate that the type of $K^+$ channels activated by KCO is ATP-sensitive $K^+$ channels which is blocked by glibenclamide.
In this paper, We are evaluated about bio-signal between general workers and nuclear medicine workers which is more radiation exposure relatively. In order to reciprocal evaluated two group, we experimented nuclear medicine workers in Chung-Buk National University Hospital at department of nuclear medicine and worker in Chon-Nam National University Hospital at CT room, general radiographic room, medical recording room, receipt room, general office room. Used of experimental Equipments as follows, for a level of radiation measurement by pocket dosimeter which made by Arrow-Tech company, for heart rate and blood pressure measurement by TONOPORT V which made by GE medical systems company, for heat flux and skin temperature and energy expenditure measurement by Armband senseware 2000 which made by Bodymedia company. Result of experiment obtains as follows: 1) Individual radiation exposure is recorded 3.05 uSv at department of nuclear medicine and order as follows CT room, general radiograpic room, medical recording room, receipt room, general office room. Department of nuclear medicine more 1.5 times than other places. 2) Radiation accumulated dose is not related to Heat flux, Skin temperature, Energy expenditure. 3) Blood pressure is recorded equal to nuclear medical workers, general officer, general people about systolic blood pressure and diastolic blood pressure. Compared to blood pressure between nuclear medical works which is more radiation exposure and other workers was not changed. Consequently, more radiation exposed workers at nuclear medicine field doesn't have hazard.
Depth of prostate volume from the skin can vary due to intra-fractional and inter-fractional movements, which may result in dose reduction to the target volume. Therefore we evaluated the feasibility of automated depth determination-based adaptive proton therapy to minimize the effect of inter-fractional movements of the prostate. Based on the center of mass method, using three fiducial gold markers in the prostate target volume, we determined the differences between the planning and treatment stages in prostate target location. Thirty-eight images from 10 patients were used to assess the automated depth determination method, which was also compared with manually determined depth values. The mean differences in prostate target location for the left to right (LR) and superior to inferior (SI) directions were 0.9 mm and 2.3 mm, respectively, while the maximum discrepancies in location in individual patients were 3.3 mm and 7.2 mm, respectively. In the bilateral beam configuration, the difference in the LR direction represents the target depth changes from 0.7 mm to 3.3 mm in this study. We found that 42.1%, 26.3% and 2.6% of thirty-eight inspections showed greater than 1 mm, 2 mm and 3 mm depth differences, respectively, between the planning and treatment stages. Adaptive planning based on automated depth determination may be a solution for inter-fractional movements of the prostate in proton therapy since small depth changes of the target can significantly reduce target dose during proton treatment of prostate cancer patients.
Journal of the Korean Society of Food Science and Nutrition
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v.32
no.3
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pp.428-436
/
2003
Epidemiological studies have observed a negative association between increased consumption of green and yellow vegetables and cancer incidence. These vegetables contain carotenoids, which are reported to exhibit anticarcinogenic effects. Overexpression of ErbB2 and ErbB3 genes is a frequent event in several human cancers. The present study was performed to determine whether $\alpha$-carotene, $\beta$-carotene, lutein, or lycopene inhibits cell growth and to assess such an effect is related to changes in the levels of the ErbB receptor family and tile ErbB3 receptor signaling pathway in HT-29 cells. HT-29 cells were cultured in serum-free medium in the presence of various concentrations (0~100 $\mu$M) of the individual carotenoids. $\alpha$ -Carotene and lycopene significantly inhibited cell growth in a dose-dependent manner, whereas lutein slightly inhibited cell growth and $\beta$-carotene increased cell growth. Lycopene is more potent than $\alpha$ -carotene in inhibiting HT-29 cell growth. Lycopene inhibited DNA synthesis and induced apoptosis of HT-29 cells. The ErbB3 ligand heregulin (HRG) increased cell growth but did not prevent the lycopene-induced inhibition of cell growth. Lycopene decreased ErbB2 protein levels in a dose-dependent manner. Immunoprecipitation/Western blot studies revealed that lycopene inhibited HRG-induced phosphorylation of ErbB3, recruitment of the 985 regulatory subunit of phosphatidylinositol 3-kinase (PI3K) to the ErbB3 receptor, and phosphorylation of Akt. These results indicate that downregulation of ErbB2/ErbB3/PI3K/Akt signaling may be one of the mechanisms by which lycopene inhibits HT-29 cell pro-liferation and induces apoptosis.
Purpose: Surgery for thyroid gland requires skin incisions that can result in postsurgical neck scar. To overcome this, many surgeons performed a endoscopic thyroidectomy. But, this approach had a some problems. One of postoperative problems, iatrogenic cervical dystonia (CD) may occur. At common, CD is defined as a syndrome characterized by prolonged muscle contraction causing twisting, repetitive movements or abnormal posture. Botulinum toxin A (BTA, Botox$^{(R)}$, Allergan, Irvine, CA, USA) is well known treatment agent in the treatment of CD. So, the authors applied BTA injection in rare case with iatrogenic CD resulting in endoscopic thyroidectomy. Methods: A 43-year-old female had endoscopic subtotal thyroidectomy operation 3 years ago. She had symptoms such as progressive cervical pain, abnormal neck posture, depression, and sleep difficulty. About 1 year later, the patient who had previous myomectomy of the clavicular head of sternocleidomastoid muscle, however, symptoms were not improved. And then the patient received BTA therapy in our department. The 2 units per 0.1 mL solution was administered in a 1 mL tuberculin syringe. Results: The dose of BTA used in the patient was 36 units for vertical platysmal bands, superficially, and 10 units for ipsilateral sternocleidomastoid muscle, intramuscularly. After 2 weeks, additional the dose of BTA used in the patient was 5 points for remained scar bands, superficially. Complications related to injection such as significant swallowing difficulties, neck muscle weakness, or sensory change were not observed. In 9 months follow-up, the patient maintained a good result from the method of BTA injection alone. Conclusion: The basic concept is selective denervation for the hyperactive individual muscles and scar bands. We conclude that BTA is an effective and safe treatment for CD despite the iatrogenic and complex presentation of this complication.
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