• Title/Summary/Keyword: portion size

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Clinical Experience of the Surgical Treatment of Cardiac Tumor (심장 종양의 수술적인 치료의 임상적 고찰)

  • Bang, Jung-Hee;Woo, Jong-Soo;Choi, Pill-Jo;Cho, Gwang-Jo;Kim, Si-Ho;Park, Kwon-Jae
    • Journal of Chest Surgery
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    • v.43 no.4
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    • pp.375-380
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    • 2010
  • Background: Primary cardiac tumors are extremely rare. The most common type are benign myxomas, and these are almost completely curable with early surgery. Malignant tumors, however, such as sarcomas, are difficult to remove surgically, and their prognosis is known to be poor. In this study, data on patients who had undergone surgical treatment of cardiac tumor in the authors' hospital were collected and analyzed. Material and Method: The subjects included 28 patients who had undergone surgical treatment of cardiac tumor from August 1993 to December 2008. Their medical records were reviewed and retrospectively analyzed. Result: The patients were aged from 20 to 76 years (mean age: $54.2{\pm}15.6$), and 11 were male (39%) and 17 female (61%). Fifteen of them (54%) underwent emergency surgery to improve heart failure symptoms. The most common preoperative symptom was dyspnea (15 cases, 54%). Preoperative echocardiography was performed on all the patients. The average size of the tumor as measured during the operation was $7.0{\pm}6.9cm$ (the average length of the long axis was 2∼40 cm), and the sites of tumor attachment were the interatrial septum (18 cases, 64%), the left atrium (9 cases, 32%), the mitral valve annulus (2 cases, 7%), and the left ventricle (2 cases, 7%). The operation was performed with an incision through both atria in all the patients, and a complete excision was made in 25 cases (89%). According to the biopsy results, there were 4 cases of sarcoma (14%), 1 case of lipoma (4%), and 23 cases of myxoma (82%). The three cases in which the tumors were not completely excised were sarcomas. No operative deaths occurred after the operations. Outpatient follow-up was possible for 24 cases (86%), with a mean follow-up period of $46.8{\pm}42.7$ months. Late death occurred in 3 of the 24 patients; each of these patients had sarcomas. Of these patients, the first had undergone two repeat surgeries, the second had metastatic sites removed, and the last had only chemotherapy. The average recurrence time was $12.7{\pm}10.8$ months, and the average metastasis time was $20.5{\pm}16.8$ months. Conclusion: Most cardiac tumors are benign myxomas. In principle, they should be surgically treated because they can create risks such as embolism, and can be radically treated when surgically removed. In most cases, however, malignant sarcomas are already considerably advanced with severe infiltration into the neighboring tissues at the time of diagnosis. The surgical removal of malignant sarcomas is known to be difficult because of the advanced stage and degree of infiltration. We suggest that excision of the removable portion of the tumor sites to alleviate symptoms such as heart failure can improve quality of life.

A Study on Clothing purchase Behavior through internet of Middle and High School Students (${\cdot}$고등학생들의 인터넷을 이용한 의복 구매 행동 연구)

  • Kweon Li-Ra;Kim Mi-Jeong;Lee hye-Ja;Yu Nan-Sook
    • Journal of Korean Home Economics Education Association
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    • v.17 no.2
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    • pp.29-47
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    • 2005
  • In this study. we tried to provide basic materials for teachers to develop consumer's guide of internet shopping for middle and high school students through surveying their Purchase realities, clothing purchase behaviors. and clothing purchase attitudes when they use internet shopping mall. The questionaires were distributed to middle and high school students in Seoul, Daegu, Kyunggi, Chungbuk, Chungnam, Kyungbuk, and Kyungnam November, 2004. The followings are the results of this study. First, clothing items which were bought in internet shopping malls were shirts. shoes, pants, bags in order and they were below $20,000\~30,000$ won. Main payment method used was sending money to seller's account. Second, clothing purchase satisfaction degree was comparatively high but the satisfaction degree for the compensation policy was low. If they had any claims for the products. they were likely to behave more actively than passively. Third. returned items were shirts, pants, shoes in order which are the same as purchasing items and they were due to the size and the difference between the products recognised by computer screen and the real products. The $89.0\%$ of the subjects who have purchased clothing through internet expressed high intention to purchase in the future through internet. Forth the degree of attitude toward the internet shopping concerned with clothing purchase was high in the factor of 'convenience of shopping', especially they thought that the purchase through internet had the advantage of varieties and prices. The significant differences were found (1) in the experience of purchase and clothing purchase through internet according to their regions. school years, allowances per month, (2) in the purchased items through internet according to only their sexes, and (3) in the desired Purchase items through internet according to school years, their sexes. regions. The more frequently the middle and high school students use internet, the more goods they purchase through internet, especially the portion of the purchased clothing is getting bigger year by year. This suggests that we need to develope well-organized programs to teach good consumer's attitude to the middle and high school students when they purchase through internet.

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Technical Efficiency in Korea: Interindustry Determinants and Dynamic Stability (기술적(技術的) 효율성(效率性)의 결정요인(決定要因)과 동태적(動態的) 변화(變化))

  • Yoo, Seong-min
    • KDI Journal of Economic Policy
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    • v.12 no.4
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    • pp.21-46
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    • 1990
  • This paper, a sequel to Yoo and Lee (1990), attempts to investigate the interindustry determinants of technical efficiency in Korea's manufacturing industries, and also to conduct an exploratory analysis on the stability of technical efficiency over time. The hypotheses set forth in this paper are most found in the existing literature on technical efficiency. They are, however, revised and shed a new light upon, whenever possible, to accommodate any Korea-specific conditions. The set of regressors used in the cross-sectional analysis are chosen and the hypotheses are posed in such a way that our result can be made comparable to those of similar studies conducted for the U.S. and Japan by Caves and Barton (1990) and Uekusa and Torii (1987), respectively. It is interesting to observe a certain degree of similarity as well as differentiation between the cross-section evidence on Korea's manufacturing industries and that on the U.S. and Japanese industries. As for the similarities, we can find positive and significant effects on technical efficiency of relative size of production and the extent of specialization in production, and negative and significant effect of the variations in capital-labor ratio within industries. The curvature influence of concentration ratio on technical efficiency is also confirmed in the Korean case. There are differences, too. We cannot find any significant effects of capital vintage, R&D and foreign competition on technical efficiency, all of which were shown to be robust determinants of technical efficiency in the U.S. case. We note, however, that the variables measuring capital vintage effect, R&D and the degree of foreign competition in Korean markets are suspected to suffer from serious measurement errors incurred in data collection and/or conversion of industrial classification system into the KSIC (Korea Standard Industrial Classification) system. Thus, we are reluctant to accept the findings on the effects of these variables as definitive conclusions on Korea's industrial organization. Another finding that interests us is that the cross-industry evidence becomes consistently strong when we use the efficiency estimates based on gross output instead of value added, which provides us with an ex post empirical criterion to choose an output measure between the two in estimating the production frontier. We also conduct exploratory analyses on the stability of the estimates of technical efficiency in Korea's manufacturing industries. Though the method of testing stability employed in this paper is never a complete one, we cannot find strong evidence that our efficiency estimates are stable over time. The outcome is both surprising and disappointing. We can also show that the instability of technical efficiency over time is partly explained by the way we constructed our measures of technical efficiency. To the extent that our efficiency estimates depend on the shape of the empirical distribution of plants in the input-output space, any movements of the production frontier over time are not reflected in the estimates, and possibilities exist of associating a higher level of technical efficiency with a downward movement of the production frontier over time, and so on. Thus, we find that efficiency measures that take into account not only the distributional changes, but also the shifts of the production frontier over time, increase the extent of stability, and are more appropriate for use in a dynamic context. The remaining portion of the instability of technical efficiency over time is not explained satisfactorily in this paper, and future research should address this question.

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Measuring Attitudes and Satisfaction Level towards Military Foodservices (군 급식소의 이용실태 및 만족도 조사)

  • Kang, Bo-Kyoung;Lee, Young-Eun
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.40 no.7
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    • pp.1032-1042
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    • 2011
  • The purpose of this study was to examine the attitudes and satisfaction level towards military foodservices as well as suggest effective ways to increase foodservice quality. A questionnaire survey was administered to 413 subjects, which included 400 soldiers and 13 foodservice managers. The survey period was from August 6 to August 25, 2008. The collected data were statistically treated using SPSS V12.0. Most of the investigated soldiers were 20~25 years old. The foodservice managers were male general officials and the majority of them had no prior food service training. None of the foodservice managers had a dietician certificate. Menu was planned through a local foodservice conference, and most food materials were delivered in the form of center-type and military unit-type. Deficiency and deterioration of food service facilities (28.6%) as well as deficiency in the number of cooking personnel (14.3%) increased the difficulty of operational management. Soldiers expressed a desire for increases in Western (25.7%) and Korean traditional foods (21.5%), which meant menu diversity. To increase the quality of military foodservices, taste of food (40.6%), increased portion size (30.4%), and improvement in hygienic conditions (13.6%) were demanded by the soldiers. Food taste (30.8%), improvement in hygienic conditions (23.1%), and better job management were all demanded by the foodservice managers. After factor analysis, quality attributes were rearranged into five dimensions, including facilities, food, menu, service, and sanitation most attributes were over 4 points out of 5 total in importance, but only 3 points in performance. The importance score was higher than the performance score. Soldiers' overall satisfaction level was on average 3.43 points out of 5 points.

A Baseline Survey on Development of Primary Health Care in the Rural Korea -Sanpuk Village, Kumsa-Myun, Yuju- Gun, Kyunggi-Do- (농촌지역의 일차보건사업 개발을 위한 기초조사 연구 - 경기도 여주군 금사면 산북부락을 중심으로 -)

  • Kim, Myung-Ho;Yun, Suk-Woo;Rhee, Hae-Soak
    • Journal of agricultural medicine and community health
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    • v.12 no.1
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    • pp.5-27
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    • 1987
  • It is widely recognized that primary health care in the community is one of the most important and effective health measures in these days. However, it is reality that unsatisfactory health care system, ineffective utilization of health care by the community people in the rural area are hampering better understanding for primary health care. Therefore promoting health for the rural people and increasing understanding about primary health care, the baseline survey in the community focused in examination for safe community water supply was carried out. The survey was conducted through August 25-31, 1986 in order to find out health problems and relevant factors and to define the demographic characteristics of $^*$Sanpuk village, Kumsa-Myun, Yuju-Gun, Kyunggi-Do, Korea. Household survey was carried out for every home by trained interviewers. The major results are found out as follows : 1) 84.2%(400 houses) of total households were surveyed because 15.8%(75 houses) were unable to survey due to either refusal against interview or absence of family. These 400 households were composed of 1,697 residents(male:830, female 867). Educational level of respondents showed 34.1% as elementary school graduated. Religion distribution showed Buddism(23.8%) as the most dominant. 50.7% of respondents married in the area. 2) Most households(91.5%) have lived in their own house in Sanpuk area. Average family size showed 4.3. More than half of residents(64.2%) have used public supplied water tap. Only 1.5% of the households had a flush toliet. The rest of households have still used primitive insanitary latrines. 3) 32.5% of residents have used gas burner for cooking and for heating in the house, and the coal briquet were used for boiler. Lack of convenient public transportation was the chief complaint for their day life. 4) Each household occupied 1,990 pyungs of rice paddy and 1,170 pyungs of ordinary field in average. Beside farming products, mushroom was the highest product. 5) Sixth percent of households in the survey area regularly participated in community meeting one hand and on the other hand 39.5% never participated. Most of respondents closely contacted with their neighbours and they seemed very friendly each other. 6) The prevalence rate of illness and injury during recent 15 days showed 48.3 per 1,000. The prevalence rate of chronic illnesses during the past one year showed 74 per 1,000. Injury and accident lead the higher portion(22.0%) in the former and in the latter pain(arthritis, back-pain) showed 27.0% as the dominant sickness. 87.8% of the ill residents in the former received medical treatment. As the most frequently utilized medical facility, the clinic or hospital were counted. Among the residents suffering from chronic illnesses, 77.3% in Sanpuk area get some kind of medical treatments and they rarely utilized the clinic or hospital. The reason why the patient did not receive any medical care was found out the fact that symptoms of illness was light or mild and economic problems was serious. 7) Average age of marriage showed 21.6 years old in the women and the average duration of marital period was shown for 15.1 years. The married woman in reproductive age in Sanpuk area had experienced pregnancies 4 times in the aver-age including 0.7 time of pregnancy in average were interrupted by induced abortion and 0.3 time by spontaneous abortion respectively. The practicing rate of the family planning of the married woman during reproductive ages showed 70.7% and the tuballigation was found out as the most frequently used contraceptives. 8) Among woman who has children under 2 years old, 70.0% had received the prenatal care for the last pregnancy. However, the average number of prenatal care visitis per woman showed 3.3 times. Fifty-two % of woman who received the postnatal care for the last delivery showed only 37.5%. 9) Immunization rate of the children under 2 years old showed relatively high and looked successful. The breast feeding for these children showed dominantly in the most. Most of the mothers in Sanpuk area had started the supplementary diet during weaning period of their infants of 6th and 7th month after birth. * : Sanpuk area is a demstration area for community development which has been supported by the Community Development Foundation during the part 10 years. The village is relatively closer to urban area such as Seoul, However, it has a similar characteristics shown as a remote village because of geographical location and inconvenient transportation at present.

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The Role of Bronchoscopy for the Staging in Patient with Peripheral Lung Cancer (말초형 폐암 환자에 있어서 병기판정을 위한 기관지 내시경검사의 필요성)

  • Baek, Seung-Min;Sea, Hyang-Eun;Kim, Se-Hwan;Kim, Seong-Kyu;Kim, Yean-Jae;Lee, Byung-Ki;Kim, Won-Ho;Park, Jae-Yang;Jung, Tae-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.2
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    • pp.147-154
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    • 2001
  • Background : Bronchoscopy has been widely used for a histologic diagnosis through a transbronchial lung biopsy or for staging of patients with peripheral lung cancer. However a transthoracic needle aspiration (TTNA) has been used more widely for a histologic diagnosis in patient with a small size nodule or a nodule located in the outer portion of the lung because of the low diagnostic yield of bronchoscopy in these cases. The role of bronchoscopy for staging is not well established in patients with peripheral lung cancer diagnosed by a TTNA or patients who are undergoing surgery without a histologic diagnosis. Method: To evaluate the role of bronchoscopy for the staging in patients with peripheral lung cancer, who were diagnosed by TTNA, the medical records of 86 patients with peripheral lung cancer who underwent bronchoscopyat Kyungpook National University Hospital between January 1995 and May 1997 were reviewed. Results : While 53 cases had normal bronchoscopic findings, 33 cases had abnormal bronchoscopic findings comprising 9 cases of tumor, 10 cases of infiltration and 14 cases of compression of which there were 25 cases of T1 and 8 T2 endoscopically. The bronchoscopic staging did not influence the changes of the clinical stage of lung cancer. The frequencies of bronchial involvement tended to increase as the sizes of the nodule increased. Among the 42 patients who underwent surgery, 9 patients staged higher after operation because of lymph node involvement in 8 patients and the involvement of the pulmonary artery in 1 patient. No case staged above after operation due to a bronchial invasion. Conclusion : These findings suggests that bronchoscopy is not useful for staging in patients with peripheral lung cancer diagnosed by a TTNA.

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Perspective of breaking stagnation of soybean yield under monsoon climate

  • Shiraiwa, Tatsuhiko
    • Proceedings of the Korean Society of Crop Science Conference
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    • 2017.06a
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    • pp.8-9
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    • 2017
  • Soybean yield has been low and unstable in Japan and other areas in East Asia, despite long history of cultivation. This is contrasting with consistent increase of yield in North and South America. This presentation tries to describe perspective of breaking stagnation of soybean yield in East Asia, considering the factors of the different yields between regions. Large amount of rainfall with occasional dry-spell in the summer is a nature of monsoon climate and as frequently stated excess water is the factor of low and unstable soybean yield. For example, there exists a great deal of field-to-field variation in yield of 'Tanbaguro' soybean, which is reputed for high market value and thus cultivated intensively and this results in low average yield. According to our field survey, a major portion of yield variation occurs in early growth period. Soybean production on drained paddy fields is also vulnerable to drought stress after flowering. An analysis at the above study site demonstrated a substantial field-to-field variation of canopy transpiration activity in the mid-summer, but the variation of pod-set was not as large as that of early growth. As frequently mentioned by the contest winners of good practice farming, avoidance of excess water problem in the early growth period is of greatest importance. A series of technological development took place in Japan in crop management for stable crop establishment and growth, that includes seed-bed preparation with ridge and/or chisel ploughing, adjustment of seed moisture content, seed treatment with mancozeb+metalaxyl and the water table control system, FOEAS. A unique success is seen in the tidal swamp area in South Sumatra with the Saturated Soil Culture (SSC), which is for managing acidity problem of pyrite soils. In 2016, an average yield of $2.4tha^{-1}$ was recorded for a 450 ha area with SSC (Ghulamahdi 2017, personal communication). This is a sort of raised bed culture and thus the moisture condition is kept markedly stable during growth period. For genetic control, too, many attempts are on-going for better emergence and plant growth after emergence under excess water. There seems to exist two aspects of excess water resistance, one related to phytophthora resistance and the other with better growth under excess water. The improvement for the latter is particularly challenging and genomic approach is expected to be effectively utilized. The crop model simulation would estimate/evaluate the impact of environmental and genetic factors. But comprehensive crop models for soybean are mainly for cultivations on upland fields and crop response to excess water is not fully accounted for. A soybean model for production on drained paddy fields under monsoon climate is demanded to coordinate technological development under changing climate. We recently recognized that the yield potential of recent US cultivars is greater than that of Japanese cultivars and this also may be responsible for different yield trends. Cultivar comparisons proved that higher yields are associated with greater biomass production specifically during early seed filling, in which high and well sustained activity of leaf gas exchange is related. In fact, the leaf stomatal conductance is considered to have been improved during last a couple of decades in the USA through selections for high yield in several crop species. It is suspected that priority to product quality of soybean as food crop, especially large seed size in Japan, did not allow efficient improvement of productivity. We also recently found a substantial variation of yielding performance under an environment of Indonesia among divergent cultivars from tropical and temperate regions through in a part biomass productivity. Gas exchange activity again seems to be involved. Unlike in North America where transpiration adjustment is considered necessary to avoid terminal drought, under the monsoon climate with wet summer plants with higher activity of gas exchange than current level might be advantageous. In order to explore higher or better-adjusted canopy function, the methodological development is demanded for canopy-level evaluation of transpiration activity. The stagnation of soybean yield would be broken through controlling variable water environment and breeding efforts to improve the quality-oriented cultivars for stable and high yield.

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Investigations of the Potential Fisheries Resources in the Southern Waters of Korea - Biological Composition of Demersal Trawl Catches - (한국 남해안의 잠재어업자원 조사연구 - 저층크롤 어획량의 생물학적 조성 -)

  • Lee, Dae-Jae;Kim, Jin-Kun;Shin, Hyong-Ho
    • Journal of the Korean Society of Fisheries and Ocean Technology
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    • v.34 no.3
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    • pp.241-258
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    • 1998
  • The experimental demersal trawl surveys to provide the essential information for the assessment, management and utilization of commercially important fish stocks in the southern waters of Korea were carried out during five research cruises between October 1996 and October 1997 by the training ship “KAYA” of Pukyong National University. The biological sampling was conducted by using the trawl net with a cover net of 36 mm in mesh size at 64 planned trawl stations during daylight to identify the biological characteristics of fish. Each catch was standardized into catch per unit of time and the catches at each trawl station were sorted, weighed and counted by species. The changes in catches of each fish species and the shifts in dominant species by seasions and sampling regions in the research area were analyzed, and the abundance of fish was estimated from the relationship between the trawl catches and the volume of the water column sampled by demersal trawls. The results obtained can be summarized as follows : 1. During the 64 demersal trawls conducted in the southern waters of Korea, 129 species including 112 species of fishes, 8 species of Cephalopoda and 7 species of Crustacea, were identified Also, during the 1996 and 1997 trawl surveys in the reseach area, a large number of commercially important species with small differences in proportion was found. me proportion of Japanese horse mackerel which comprised 19.8% of the total catch by weight was highest, followed by chub mackerel(15.0%), swordtip squid(9.0%), redwing searobin(6.2%), konoshiro gizzard shad(6.1%), Japanese flying squid(5.8%), silver pomfet(5.1%), blackmouth goosefish(5.1%), etc. Swordtip squid, Japanese flying squid, blackmouth goosefish and blackthroat seaperch were among the dominant species in all seasons with a relatively high and stab1e proportion(3.6~9.0%), and were widely distributed in the entire southern water of Korea. 2. The catch rates by cover net varied at 0.7~91.9% by weight of the total trawl catch by codend and cover net at 64 planned trawl stations and the mean catch rate was 44.4%. Species comprising a major portion of the catches by cover net mainly were swordtip squid, konoshiro gizzard shad, the juveniles of Japanese horse mackerel, blackthroat seaperch and chub mackerel, etc. 3. The distribution density of fish in terms of biomass per unit volume which derived from the catch data by 63 bottom trawl hauls in the southern waters of Korea ranged from 17.9 $\times$ 10-6 to 1,440.9 $\times$ 10-6kg/m3 with the mean value of 153.8 $\times$ 10-6 kg/m3. These fish densities varied between seasons, location of sampling stations and sea conditions. From these results, it is worth noting that the catch composition of multispecies and the increased occurrence of small fish in the southern waters of Korea may also result in new problems in determining the total allowable catch(TAC) levels for economically important species.

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Case Study of Menu Satisfaction Index in Business & Industry Food Service (산업체급식 메뉴 만족도 조사도구의 활용에 대한 사례연구)

  • Lee, Hae-Young;Ahn, Sun-Jung;Yang, Il-Sun
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.37 no.11
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    • pp.1443-1451
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    • 2008
  • This study was performed to develop menu satisfaction index in Business & Industry (B&I) food service and to survey customer's menu satisfaction using the index. The menu satisfaction index included 16 items with Likert 5 point. Cronbach's alpha to assess the internal reliability of the developed scales was 0.8917, which indicated highly reliable. Construct validity was assessed by principal components analysis and then four factors explaining 65.964% of the total variance were found. Among the 15 items of menu satisfaction, the average scores of all items were above 3.0 out of 5. As a result of analysis on menu satisfaction factors, 'propriety of food temperature' (3.52 out of 5) was the highest consideration followed by 'sufficiency of format' (3.46), 'excellence in food' (3.35) and 'well-being orientation' (3.31). It could be said that customer's perception on the menu quality was very positive. Four factors were correlated with overall menu satisfaction positively. Especially, 'excellence in food', and 'well-being orientation' and 'sufficiency of format' affected significantly on overall menu satisfaction. It concluded that customers were satisfied with portion size, temperature, price but their needs for taste and health/nutrition-related service would be increased. The menu satisfaction developed in this study should be applied to other B & I food service operation by type.

Study on the Photoneutrons Produced in 15 MV Medical Linear Accelerators : Comparison of Three-Dimensional Conformal Radiotherapy and Intensity-Modulated Radiotherapy (15 MV 의료용 선형가속기에서 발생되는 광중성자의 선량 평가 - 3차원입체조형방사선치료와 세기조절방사선치료의 비교 -)

  • Yang, Oh-Nam;Lim, Cheong-Hwan
    • Journal of radiological science and technology
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    • v.35 no.4
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    • pp.335-343
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    • 2012
  • Intensity-modulated radiotherapy(IMRT) have the ability to provide better dose conformity and sparing of critical normal tissues than three-dimensional radiotherapy(3DCRT). Especially, with the benefit of health insurance in 2011, its use now increasingly in many modern radiotherapy departments. Also the use of linear accelerator with high-energy photon beams over 10 MV is increasing. As is well known, these linacs have the capacity to produce photonueutrons due to photonuclear reactions in materials with a large atomic number such as the target, flattening filters, collimators, and multi-leaf collimators(MLC). MLC-based IMRT treatments increase the monitor units and the probability of production of photoneutrons from photon-induced nuclear reactions. The purpose of this study is to quantitatively evaluate the dose of photoneutrons produced from 3DCRT and IMRT technique for Rando phantom in cervical cancer. We performed the treatment plans with 3DCRT and IMRT technique using Rando phantom for treatment of cervical cancer. An Rando phantom placed on the couch in the supine position was irradiated using 15 MV photon beams. Optically stimulated luminescence dosimeters(OSLD) were attached to 4 different locations (abdomen, chest, head and neck, eyes) and from center of field size and measured 5 times each of locations. Measured neutron dose from IMRT technique increased by 9.0, 8.6, 8.8, and 14 times than 3DCRT technique for abdomen, chest, head and neck, and eyes, respectively. When using IMRT with 15 MV photonbeams, the photoneutrons contributed a significant portion on out-of-field. It is difficult to prevent high energy photon beams to produce the phtoneutrons due to physical properties, if necessary, It is difficult to prevent high energy photon beams to produce the phtoneutrons due to physical properties, if necessary, it is need to provide the additional safe shielding on a linear accelerator and should therefore reduce the out-of-field dose.