Background: To compare the KKU-model rectal tube (KKU-tube) and the conventional rectal tube (CRT) for checking rectal doses during high-dose-rate intracavitary brachytherapy (HDR-ICBT) of cervical cancer. Materials and Methods: Between February 2010 and January 2011, thirty -two patients with cervical cancer were enrolled and treated with external beam radiotherapy (EBRT) and intracavitary brachytherapy (ICBT). The KKU-tube and CRT were applied intrarectally in the same patients at alternate sessions as references for calculation of rectal doses during ICBT. The gold standard references of rectum anatomical markers which are most proximal to radiation sources were anterior rectal walls (ARW) adjacent to the uterine cervix demonstrated by barium sulfate suspension enema. The calculated rectal doses derived from actual anterior rectal walls, CRT and the anterior surfaces of the KKU-tubes were compared by using the paired t-test. The pain caused by insertion of each type of rectal tube was assessed by the visual analogue scale (VAS). Results: The mean dose of CRT was lower than the mean dose of ARW ($Dmean_0-Dmean_1$) by $80.55{\pm}47.33cGy$ (p-value <0.05). The mean dose of the KKU-tube was lower than the mean dose of ARW ($Dmean_0-Dmean_2$) by $30.82{\pm}24.20cGy$ (p-value <0.05). The mean dose difference [($Dmean_0-Dmean_1$)-($Dmean_0-Dmean_2$)] was $49.72{\pm}51.60cGy$, which was statistically significant between 42.32 cGy -57.13 cGy with the t-value of 13.24 (p-value <0.05). The maximum rectal dose by using CRT was higher than the KKU-tube as much as 75.26 cGy and statistically significant with the t-score of 7.55 (p-value <0.05). The mean doses at the anterior rectal wall while using the CRTs and the KKU-tubes were not significantly different (p-value=0.09). The mean pain score during insertion of the CRT was significantly higher than the KKU-tube by a t-score of 6.15 (p-value <0.05) Conclusions: The KKU-model rectal tube was found to be an easily producible, applicable and reliable instrument as a reference for evaluating the rectal dose during ICBT of cervical cancer without negative effects on the patients.
Purpose: The purpose of this study is to compare the accuracy of digital scans of implants according to different shapes of scanbodies, and to compare the accuracy of library merging according to different oral exposure height. Materials and methods: A master model with a single tooth edentulous site was prepared. For the first experiment, three types of intraoral scanbodies were prepared, divided into three groups, and the following experiments were conducted for each group: An internal hex implant was placed. The master model with the scanbody connected was scanned with a model scanner, and a master reference file (control group) was created. 10 files (experimental group) were created by performing 10 consecutive scans with an intraoral scanner. After superimposing the control and experimental groups, the following values were calculated: 1) Distance deviation of a designated point on the scanbody 2) Angle deviation of the major axis of the scanbody. For the second experiment, the scanbody scan data were prepared in 6 different heights. Library files were merged with each of the scan data. The distance and angular deviation were calculated using the 7 mm scan data as control group. Results: In the first experiment, there were no significant differences between A and B (P=.278), B and C (P=.568), and C and A (P=.711) in the distance deviations. There were no significant differences between A and B (P=.568), B and C (P=.546), and C and A (P=.112) in the angular deviations. Also, the scanbody showed significantly higher library merging accuracy in the groups with high oral exposure height (P<.5). Conclusion: There were no significant differences in scan accuracy according to the different shapes of scanbodies, and the accuracy of library merging increased according to exposure height of the scanbody in the oral cavity.
The distance between the source and the detector, the diameter of the detector, and the volume effect of the radiation source result in a change in solid angle at the detector entrance, which affects the determination of detection efficiency by causing a difference in path length within the detector. A typical analysis method for calculating solid angles was useful only for a source (60Co) with a simple geometric structure, so in this experiment, the distance between the detector and the source was measured by switching on for up to 25 cm with the reference point of window cap 0.5 cm. In addition, 450 and 1000 ㎖ Marinelli beaker of standard volumetric sources were closely adhered to the detector. For circular point sources co-axial with the detector, the change in the solid angle to the distance from the detector window is equal to half the square radius of the source versus the square radius of the detector, if the resulting relationship of the calculation analysis results in the detector being less than the radius of the source. Since the solid angular difference is 0.5 the result of Monte Carlo is acceptable. The relationship between detector and source distance is shown. Solid angles have been verified to decrease rapidly with distance. Measurement and simulation results for a volumetric source show a difference of ±1.01% from a distance of 0 cm and less than 4 % when the distance is reduced to 5 and 10 cm. It can be seen that the longer distance, the smaller efficiency angle, and the exponential increase in attenuation as the energy decreases, is reflected in the calculation of efficiency. Thus, the detection efficiency has proved sufficient for the use of solid angle and Monte Carlo codes.
The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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v.25
no.4
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pp.81-96
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2020
Berthlot's reaction spectrophotometric method is generally used for the analysis of dissolved ammonium in seawater, but in recent years, a fluorescence method using an orthophthaldialdehyde-sulfite (OPA) fluorescent reagent is actively used internationally. In this study, we investigated the effects of the detection limit between the analysis methods, the reagent refractive index inherent in the spectrophotometric method, and the use of different calibration curves to understand the cause of the difference in dissolved ammonium concentration (about 0.31 𝜇M) observed in the seawater samples and a nutrient reference material between two institutions (KIOST (spectrophotometric method, one-order linear regression gradient only), Australia CSIRO (fluorescence method, quadratic formula)) conducted onboard the Australian R/V Investigator in 2017. The method detection limit (0.063 𝜇M) and the reagent refractive index background value (0.054 𝜇M) of the spectrophotometric method measured in this study could explain the difference in dissolved ammonium concentration values of the two institutes about 20% and 17%, respectively. However, when the concentration of the calibration curve of the spectrophotometric method was calculated using the same quadratic as the fluorescence method or the slope and intercept of linear regression, the difference in the dissolved ammonium concentration between the two institutions was reduced to less than the detection limit of the spectrophotometric method. Therefore, the difference in the concentration of dissolved ammonium between the two institutions, found in the nutrient reference materials and the seawater field sample during the international onboard nutrient inter-comparison experiment, may be attributed to be the effect of the different calibration curves used in the two methods rather than the effect of the difference in two analytical methods. When comparing the dissolved ammonium data from seawater samples in the future, it is recommended to pay attention to the information on the baseline, number of standard solutions, and calibration curve used in the analysis.
The aim of this study was to develop the calculation algorithm of source strength of Ir-192 source In terms of the absorbed dose to water instead of an apparent activity (Ci). For this work the Multi Purpose Brachytherapy Phantom(MPBP) was developed, which was designed to locate the source and the chamber precisely at a specific position Inside the water phantom. The reference point of measurement was set at the 5 cm distance along the transverse axis of the source. For a brachytherapy source calibration, the absorbed dose to water calibration factor ($N_{D.W.Q}$) of an lonization chamber were determined and then apply standard protocols of absorbed dose to water. The calibration factor ($N_{D.W.Q}$) of the ion chamber (TM30013, PTW, Germany) was determined using the EGSnrcCPP Monte Carlo Code. The calculated calibration factor ($N_{D.W.Q}$) was 5.28 cGy/nC. The calculated factor was then used to determine the absorbed dose to water from which the air kerma strength for an Ir-192 source can be easily derived at the reference point (5 cm). The calculated air kerma strength showed discrepancies of -0.6% to +1.8% relative to the air kerma strength provided by the vendor, In this work we demonstrated that the air kerma strength ($S_k$) could be determined from the absorbed dose to water calibration factor for Ir-192 source. In audition, this source calibration method could be applied directly to the dose Calculation formalism of AAPM report TG-43.
The purpose of the present study was to evaluate the bioequivalence of two torasemide tablets, Torem tablet (Roche Korea Co., Ltd., Korea, reference drug) and Boryung Torsemide tablet (Boryung Pharmaceutical Co., Ltd., Korea, test drug), according to the guidelines of Korea Food and Drug Administration (KFDA). After adding an internal standard (furosemide) to human serum, serum samples were extracted using 5 mL of ethyl acetate. Compounds were analyzed by reverse-phase HPLC method with UV detection. This method showed linear response over the concentration range of 0.05 ug/mL with correlation coefficient of 0.999. The lower limit of quantitation using 0.5 mL of serum was 0.05 ug/mL which was sensitive enough for pharmacokinetic studies. Twenty-eight healthy male Korean volunteers received each medicine at the torasemide dose of 20 mg in a $2{\times}2$ crossover study. There was a one-week washout period between the doses. Serum concentrations of torasemide were monitored by an HPLC-UV for over a period of 12 hr after the administration. $AUC_{t}$(the area under the serum concentration-time curve from time zero to 12 hr) was calculated by the linear trapezoidal rule method. $C_{max}$ (maximum serum drug concentration) and $T_{max}$ (time to reach $C_{max}$) were compiled from the serum concentration-time data. Analysis of variance was carried out using logarithmically transformed $AUC_{t}$ and $C_{max}$. No significant sequence effect was found for all of the bioavailability parameters indicating that the crossover design was properly performed. The 90% confidence intervals of the $AUC_{t}$ ratio and the $C_{max}$ ratio for Boryung Torsemide/Torem were log 0.97-10g 1.03 and log 0.93log 1.12, respectively. These values were within the acceptable bioequivalence intervals of log 0.80-log 1.25. Thus, the criteria of the KFDA guidelines for the bioequivalence was satisfied, indicating Boryung Torsemide tablet and Torem tablet are bioequivalent.
June-Goo Lee;HeeSoo Kim;Heejun Kang;Hyun Jung Koo;Joon-Won Kang;Young-Hak Kim;Dong Hyun Yang
Korean Journal of Radiology
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v.22
no.11
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pp.1764-1776
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2021
Objective: This study aimed to validate a deep learning-based fully automatic calcium scoring (coronary artery calcium [CAC]_auto) system using previously published cardiac computed tomography (CT) cohort data with the manually segmented coronary calcium scoring (CAC_hand) system as the reference standard. Materials and Methods: We developed the CAC_auto system using 100 co-registered, non-enhanced and contrast-enhanced CT scans. For the validation of the CAC_auto system, three previously published CT cohorts (n = 2985) were chosen to represent different clinical scenarios (i.e., 2647 asymptomatic, 220 symptomatic, 118 valve disease) and four CT models. The performance of the CAC_auto system in detecting coronary calcium was determined. The reliability of the system in measuring the Agatston score as compared with CAC_hand was also evaluated per vessel and per patient using intraclass correlation coefficients (ICCs) and Bland-Altman analysis. The agreement between CAC_auto and CAC_hand based on the cardiovascular risk stratification categories (Agatston score: 0, 1-10, 11-100, 101-400, > 400) was evaluated. Results: In 2985 patients, 6218 coronary calcium lesions were identified using CAC_hand. The per-lesion sensitivity and false-positive rate of the CAC_auto system in detecting coronary calcium were 93.3% (5800 of 6218) and 0.11 false-positive lesions per patient, respectively. The CAC_auto system, in measuring the Agatston score, yielded ICCs of 0.99 for all the vessels (left main 0.91, left anterior descending 0.99, left circumflex 0.96, right coronary 0.99). The limits of agreement between CAC_auto and CAC_hand were 1.6 ± 52.2. The linearly weighted kappa value for the Agatston score categorization was 0.94. The main causes of false-positive results were image noise (29.1%, 97/333 lesions), aortic wall calcification (25.5%, 85/333 lesions), and pericardial calcification (24.3%, 81/333 lesions). Conclusion: The atlas-based CAC_auto empowered by deep learning provided accurate calcium score measurement as compared with manual method and risk category classification, which could potentially streamline CAC imaging workflows.
Objectives : Dementia has emerged as a leading public health problem in elderly persons, and its early detection is important for the treatment of curable cases, and in the educational support for other family members. Although dementia screening tests are available, they have not gained widespread use in community or primary care settings. Our goal was to validate the Tine and Change (T&C) Test, -including its validity and reliability in patients, and to assess it as a simple, standardized method for the screening of dementia in the rural elderly. Methods : The participants in this study comprised of 59 patients from an urban hospital and 405 persons from a rural community aged 65 years or older. The time test evaluated the understanding of clock hands indicating 11:10, and the change test the ability to make 1,000 Won from a group of coins, consisting of one 500, seven 100, and seven 50 Won coins. The T&C ratings were validated against a reference standard based on the physician's diagnosis of the patients. The convergent validity in relation to other cognitive measure, test-retest agreement, and inter-observer reliability were assessed. To assess the relationship between the Korean Mini-Mental State Exam (K-MMSE) and the T&C Test, the mean K-MMSE scores were compared with the results of the T&C Test in the elderly from a rural community. Results The T&C Test had a sensitivity and specificity of 73.0, and 90.9%, and positive and negative predictive values of 93.1, and 66.7%, respectively. The test-retest and inter-observer agreement rates were both 95%. The K-MMSE scores and T&C Test were significantly related in the elderly from a rural community (p<0.01), The T&C Test was not influenced by the educational status. The Time and Change Tests took a mean of 6.3 and 12.7 seconds, respectively, to complete Conclusion : The T&C Test is a simple, accurate and reliable, performance-based tool in the screening for dementia. Because it is quick, and easy-to-use, it is hoped the T&C Test will be used for the widespread cognitive screening of aging populations.
This study was performed to find the problems according to interference factors (organic matter, pH, Cr, Mn, Fe, clay, and etc.) when we analyzed the hexavalent chromium [Cr(VI)] in soils using UV/VIS spectrometer (US EPA 7196A), attempted to evaluate the domestic applicability of analytical method (US EPA 7199) using IC-UV/VIS spectrometer as alternative method. The recovery rate of certified reference materials was 75.0% (US EPA 7196A) and 101.4% (US EPA 7199) by the analytical methods. As the results of performing QA/QC about US EPA 7199, method detection limit (MDL) and limit of quantification (LOQ) were 0.062 mg/kg, 0.196 mg/kg, respectively. The LOQ of US EPA 7199 was lower than that of the current soil official testing method in Korea (0.5 mg/kg). Cr(VI) contents in 23 soil samples were compared by the analytical methods of EPA 7196A and 7199. Cr(VI) was detected in 13 of 23 soil samples by EPA 7196A, while EPA 7199 was not detected in any soil samples. The Cr(VI) content in 23 soil samples by EPA 7196A was not clearly correlated with Cr, Fe, Mn and clay content in the soil samples. However, the contents of Cr(VI) and organic matter of the soil samples had the highest coefficient of determination ($R^2$) of 0.80. In order to evaluate the correlation between the recovery rates of Cr(VI) and organic matter contents in the soil samples, the recovery rates of 5 soil samples added Cr(VI) standard solution were analyzed by the analytical methods. According to the results, the higher the organic matter contents in soil samples, the lower the recovery rates of Cr(VI) by US EPA 7196, while in case of US EPA 7199, the recovery rates were stable regardless of the organic matter contents.
Jiyeon Ha;Seong Ho Park;Jung Hee Son;Ji Hun Kang;Byong Duk Ye;So Hyun Park;Bohyun Kim;Sang Hyun Choi;Sang Hyoung Park;Suk-Kyun Yang
Korean Journal of Radiology
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v.23
no.1
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pp.30-41
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2022
Objective: Computed tomography enterography (CTE) and magnetic resonance enterography (MRE) are considered substitutes for each other for evaluating Crohn's disease (CD). However, the adequacy of mixing them for routine periodic follow-up for CD has not been established. This study aimed to compare MRE alone with the mixed use of CTE and MRE for the periodic follow-up of small bowel inflammation in patients with CD. Materials and Methods: We retrospectively compared two non-randomized groups, each comprising 96 patients with CD. One group underwent CTE and MRE (MRE followed by CTE or vice versa) for the follow-up of CD (interval, 13-27 months [median, 22 months]), and the other group underwent MRE alone (interval, 15-26 months [median, 21 months]). However, these two groups were similar in clinical characteristics. Three independent readers from three different institutions determined whether inflammation had decreased, remained unchanged, or increased within the entire small bowel and the terminal ileum based on sequential enterography of the patients after appropriate blinding. We compared the two groups for inter-reader agreement and accuracy (terminal ileum only) using endoscopy as the reference standard for enterographic interpretation. Results: The inter-reader agreement was greater in the MRE alone group for the entire small bowel (intraclass correlation coefficient [ICC]: 0.683 vs. 0.473; p = 0.005) and the terminal ileum (ICC: 0.656 vs. 0.490; p = 0.030). The interpretation accuracy was higher in the MRE alone group without statistical significance (70.9%-74.5% vs. 57.9%-64.9% in individual readers; adjusted odds ratio = 3.21; p = 0.077). Conclusion: The mixed use of CTE and MRE was inferior to MRE alone in terms of inter-reader reliability and could probably be less accurate than MRE alone for routine monitoring of small bowel inflammation in patients with CD. Therefore, the consistent use of MRE is favored for this purpose.
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