• Tuberculosis and Respiratory Diseases
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• v.50 no.6
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• pp.686-692
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• 2001

Background : Outbreaks of multidrug-resistant tuberculosis(MDR-TB) are caused by the low rate of treatment response due to limitation in number of available drugs and high rates of adverse drug side-effects. This study analysed the risk factors for MDR-TB patients, who did not respond to treatment, with an aim to improve the rate of treatment response. Methods : Retrospective study of 111 MDR-TB patients at National Mokpo Tuberculosis Hospital from Jan. 1996 to Dec. 1998 was made. The patients were separated into two groups ; group I comprised of patients who were treated successfully and group II comprised of those were not treated successfully. In order to analyze the risk factors for treatment failure, differences between the two groups were compared and the confidence limit regarding the results were tested using an independent t-test. chi-square test and a Fisher's exact test. Results : The treatment failure rate of MDR-TB patients was 32% (36 patients), and treatment success rate 68%(75 patients). This study found no significant difference between two groups in terms of age, sex, family history, extent of the disease on the chest X-ray, the number of sensitive drugs in the treatment regimen, and the number of sensitive bactericidal drugs in the treatment regimen (p>0.05). However, a past history of pulmonary tuberculosis, cavitary lesions on the chest X-ray, the number of treatments, the number of resistant drugs and the number of drugs used showed a significant difference(p<0.05). Conclusion : The rate of treatment failure in MDR-TB was increased by a past history of pulmonary tuberculosis, cavitary lesions on the chest X-ray, the number of treatments, the number of resistant drugs and the number of drugs used. For improving the treatment response of MDR-TB, every effort should be made to reduce the drug resistance caused by failure of the first treatment.

• Journal of the Korean Society of Radiology
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• v.9 no.7
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• pp.449-457
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• 2015

In this study, to evaluate the usefulness of the treatment plan of tomotherapy and volumetric modulated arc therapy (VMAT) in the radiotherapy for prostate cancer, the absorbed dose, dose volume histogram (DVH), treatment efficiency, and the results of dose verification accuracy using MapCHECK2 were compared and analyzed. Of the prostate cancer patients who underwent tomotherapy treatment in the Radiologic Oncology of H University Hospital between July 2014 and December 2014, 12 patients were randomly selected. As a result of analyzing the absorbed dose and DVH, both radiologic treatment plans showed slight differences in the treatment of the cancer tissues and the bladder, but the difference was in the error range of -5% to +3%, and did not exceed the side effect guideline or the tolerance dose limit. VMAT showed higher treatment efficiency than tomotherapy with a 2.5 times shorter treatment time and a 10.3 times less monitor unit (MU). Both showed 95% or higher dose accuracy satisfying the standard. VMAT showed 2.3% higher efficiency than tomotherapy. In both tomotherapy and VMAT, appropriate doses were absorbed for cancer tissues, and did not exceed the tolerance dose for normal tissues showing no significant difference in dose distribution. However, considering the shorter treatment time, lower total MU, and better treatment efficiency and dose verification accuracy, VMAT may be more useful than tomotherapy in cancer treatments.

• Journal of radiological science and technology
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• v.39 no.4
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• pp.535-541
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• 2016

This study aimed to identify dose reduction measures by retrospectively analyzing the entrance surface dose at computed tomography and angiography in cardiovascular examination and to contribute the patients with renal impairmend and a high probability of side effects to determine the inspection's direction by measuring the contrast usages actually to active actions for the dose by actually measuring the contrast medium dose. The CTDIvol value and air kerma value, which are the entrance surface doses of the two examinations, and the contrast medium dose depending on the number of slides were compared and analyzed. This study was conducted in 21 subjects (11 males; 10 females) who underwent Cardiac Computed Tomographic Angiography (CCTA) and Coronary Angiography (CAG) in this hospital during the period from May 2014 to May 2016. The subject's age was 48~85 years old (mean $65{\pm}10$ years old), and the weight was 37.6~83.3 kg (mean $63{\pm}6kg$). Dose reduction could be expected in the cardiovascular examination using CCTA rather than in the examination using CAG. In terms of contrast medium dose, CAG used a smaller dose than CCTA. In particular, as the number of slides increases at CAG, the contrast medium dose increases. Therefore, in order to reduce the contrast medium dose, the number of slides suitable for the scan range must be selected.

• Korean Journal of Psychosomatic Medicine
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• v.30 no.2
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• pp.112-118
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• 2022

Objectives : Zolpidem is a common drug used in insomnia. However, there are several reports of side effects of the central nervous system or sleep related behavior in patients who took zolpidem. This study was conducted to investigate risk factors affecting sleep related behavior after taking zolpidem in inpatients. Methods : From January 1, 2019 to December 31, 2019, medical records of patients who took zolpidem hospitalized at Inha University Hospital were reviewed retrospectively. Results : 907 patients who took Zolpidem, 102 (11.2%) showed sleep related behavior, and if they were 65 years of age or older, men, taking antipsychotics, and taking antipsychotics and benzodiazepines at the same time, they were significantly more likely to show sleep related behavior. Conclusions : Risk factors for sleep-related behavior after use of zolpidem are estimated gender, elderly, antipsychotics, and combination of antipsychotics and benzodiazepines.

• Journal of the Korean Society of Radiology
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• v.17 no.4
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• pp.581-587
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• 2023

In this study, we tried to provide basic data for radiation safety management by comparing and analyzing the exposure doses of radiation workers and frequent workers at C University Hospital in Incheon. From January 2021 to December 2022, surface dose and deep dose were analyzed for 30 radiation workers and 8 frequent workers who worked at C university hospital in Incheon. Radiation workers were targeted at radiation technicians and nurses working in the radiation oncology department and nuclear medicine department, and frequent visitors were targeted at frequent workers who manage and clean facilities in the same radiation management area. In the radiation worker group, 3.1 per 10,000 radiation technologist, 1.2 per 100,000 nurses, and 4.5 per 1,000,000 frequent workers showed the possibility of developing side effects on the lungs. The probability of radiation oncology was 1.1 per 10,000 for radiation technologist and 5.2 per 1,000,000 for nurses, and the probability of radiation technologist in nuclear medicine was 2.9 per 10,000 and for nurses was 7.1 per 1,000,000. It is hoped that this study can be used as basic data in future revisions on frequent workers, and it is considered that it will be used as basic data in the field of obstacles in relation to the stochastic effect of radiation in the future.

• The Journal of Korean Society for Radiation Therapy
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• v.29 no.2
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• pp.19-26
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• 2017

Objectives: In the Lung, the VMAT rotates continuously and examines radiation. That increases the low doses to normal lung. Due to that, the incidence of radiation pneumonia among radiation side effects may increase. The cause of radiation pneumonia is the lower dose area of the lungs. The H-VMAT was applied to patients who applied to reduce radiation in the lower doses of the lungs. We wanted to assess the usefulness of the H-VMAT by comparing the radiation doses to the low dose areas of the lungs and the normal organs. Materials and Methods: A total of 26 patients who applied for a H-VMAT procedure were applied to the patient. The prescription dose applied to total dose 44 Gy from 22 divisions. For each patient, a plan was implemented with Conventional RT, VMAT and H-VMAT. Conventional RT was carried out in four to five fields each, considering the size, location, shape, and location of the PTV. In the case of a VMAT plan, the two Half ARC, three Half ARC method and the two Full ARC were planned. The H-VMAT was planned by adding two Static fields in the VMAT, taking into account the dose of the lung and the tolerance dose of the organs. Results: In the NSCLC, the lung doses $V_5$ and $V_{10}$ of the lungs except for the treatment plan volume were the lowest with $55.40{\pm}13.39%$ and $32.05{\pm}11.37%$ of H-VMAT. And, in the SCLC, the lung doses of V5 and V10 were the lowest at $64.32{\pm}16.15%$ and $35.50{\pm}9.91%$, respectively. The spinal dose of VMAT in NSCLC was $21.15{\pm}4.02Gy$, which was 7.94 Gy lower than other treatment methods. The lowest spinal dose was delivered at $19.72{\pm}1.82Gy$ for SCLC. The mean dose delivered to the esophagus was also $17.44{\pm}2.04Gy$ and $17.84{\pm}9.20Gy$ in SCLC and NSCLC, respectively. Conclusion: When comparing the value of the surrounding normal organ dose, the VMAT showed that less doses were transmitted from the heart, esophagus and spinal cord than the rest of the treatment plan. However, it was similar to VMAT in normal organs except for the spinal cord. VMAT has increased doses of some normal organs but did not exceed the tolerance dose. It showed a low value in $V_5$, $V_{10}$. When comparing Conventional RT, VMAT, and H-VMAT, If the dose to the heart, esophagus and spinal cord is lower than the tolerance dose, it is thought to reduce the incidence of radiation pneumonia by applying H-VMAT that show the benefits of low doses of the lungs.

• Radiation Oncology Journal
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• v.16 no.3
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• pp.265-274
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• 1998

Purpose : This prospective study has been conducted to assess the value of three dimensional conformal radiation therapy (3DCRT) for lung cancer and to determine its potential advantage over current treatment approaches. Specific aims of this study were to 1) find the most ideal 3DCRT technique 2) establish the maximum tolerance dose that can be delivered with 3DCRT and 3) identify patients at risk for development of radiation pneumonitis. Materials and Methods : Beginning in Nov. 1994, 95 patients with inoperable non-small cell lung cancer (stage I; 4, stage II; 1, stage IIIa; 14, stage IIIb; 76) were entered onto this 3D conformal trial Areas of known disease and elective nodal areas were initially treated to 45 Gy and then using 3DCRT technique 65 to 70 Gy of total dose were delivered to the gross disease. Sixty nine patients received 65 Gy of total dose and 26 received 70 Gy Seventy eight patients (82.1$\%$) also received concurrent MVP chemotherapy. 3DCRT plans were compared with 2D plans to assess the adequacy of dose delivery to target volume, dose volume histograms for normal tissue, and normal tissue complication Probabilities (NTCP). Results : Most of plans (78/95) were composed of non-coplanar multiple (4-8) fields. Coplanar segmented conformal therapy was used in 17 pateints, choosing the proper gantry angle which minimize normal lung exposure in each segment. 3DCRT gave the full dose to nearly 100$\%$ of the gross disease target volume in all patients. The mean NTCP for ipsilateral lung with 3DCRT (range; 0.17-0.43) was 68$\%$ of the mean NTCP with 2D treatment planning (range; 0.27-0.66). DVH analysis for heart showed that irradiated volume of heart could be significantly reduced by non-coplanar 3D approach especially in the case of left lower lobe lesion. Of 95 patients evaluable for response, 75 (79$\%$), showed major response including 25 (26$\%$) with complete responses and 50 (53$\%$) with partial responses. One and two rear overall survivals of stage III patients were 62.6$\%$ and 35.2$\%$ respectively. Twenty percent (19/95) of patients had pneumonitis; Eight patients had grade 1 pneumonitis and 11 other patients had grade 2. Comparison of the average of NTCP for lung showed a significant difference between patients with and without radiation pneumonitis. Average NTCP for Patients without complication was 62$\%$ of those with complications. Conclusions : This study showed that non-coplanar multiple fields (4-8) may be one of the ideal plans for 3DCRT for lung cancer. It also suggested that 3DCRT may provide superior delivery of high dose radiation with reduced risk to normal tissue and that NTCP can be used as a guideline for the dose escalation.

• Radiation Oncology Journal
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• v.18 no.1
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• pp.1-10
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• 2000

Purpose : Although using the high energy Photon beam with conventional Parallel-opposed beams radiotherapy for nasopharyngeal carcinoma, radiation-induced xerostomia is a troublesome problem for patients. We conducted this study to explore a new parotid gland sparing technique in 3-D conformal radiotherapy (3-D CRT) in an effort to prevent the radiation-induced xerostomia. Materials and Methods : We peformed three different planning for four clinically node-negative nasopharyngeal cancer patients with different location of tumor(intracranial extension, nasal cavity extension, oropharyngeal extension, parapharyngeal extension), and intercompared the plans. Total prescription dose was 70.2 Gy to the isocenter. For plan-A, 2-D parallel opposing fields, a conventional radiotherapy technique, were employed. For plan-B, 2-D parallel opposing fields were used up until 54 Gy and afterwards 3-D non-coplanar beams were used. For plan-C, the new technique, 54 Gy was delivered by 3-D conformal 3-port beams (AP and both lateral ports with wedge compensator; shielding both superficial lobes of parotid glands at the AP beam using BEV) from the beginning of the treatment and early spinal cord block (at 36 Gy) was peformed. And bilateral posterior necks were treated with electron after 36 Gy. After 54 Gy, non-coplanar beams were used for cone-down plan. We intercompared dose statistics (Dmax, Dmin, Dmean, D95, DO5, V95, VOS, Volume receiving 46 Gy) and dose volume histograms (DVH) of tumor and normal tissues and NTCP values of parotid glands for the above three plans. Results : For all patients, the new technique (plan-C) was comparable or superior to the other plans in target volume isodose distribution and dose statistics and it has more homogenous target volume coverage. The new technique was most superior to the other plans in parotid glands sparing (volume receiving 46 Gy: 100, 98, 69$\%$ for each plan-A, B and C). And it showed the lowest NTCP value of parotid glands in all patients (range of NTCP; 96$\~$100$\%$, 79$\~$99$\%$, 51$\~$72$\%$ for each plan-A, B and C). Conclusion : We conclude that the new technique employing 3-D conformal radiotherapy at the beginning of radiotherapy and cone down using non-coplanar beams with early spinal cord block is highly recommended to spare parotid glands for node-negative nasopharygeal cancer patients.

• Progress in Medical Physics
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• v.25 no.2
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• pp.79-88
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• 2014

The dose distributions within the real volumes of tumor targets and critical organs during internal target volume-based intensity-modulated radiation therapy (ITV-IMRT) for liver cancer were recalculated by applying the effects of actual respiratory organ motion, and the dosimetric features were analyzed through comparison with gating IMRT (Gate-IMRT) plan results. The ITV was created using MIM software, and a moving phantom was used to simulate respiratory motion. The doses were recalculated with a 3 dose-volume histogram (3DVH) program based on the per-field data measured with a MapCHECK2 2-dimensional diode detector array. Although a sufficient prescription dose covered the PTV during ITV-IMRT delivery, the dose homogeneity in the PTV was inferior to that with the Gate-IMRT plan. We confirmed that there were higher doses to the organs-at-risk (OARs) with ITV-IMRT, as expected when using an enlarged field, but the increased dose to the spinal cord was not significant and the increased doses to the liver and kidney could be considered as minor when the reinforced constraints were applied during IMRT plan optimization. Because the Gate-IMRT method also has disadvantages such as unsuspected dosimetric variations when applying the gating system and an increased treatment time, it is better to perform a prior analysis of the patient's respiratory condition and the importance and fulfillment of the IMRT plan dose constraints in order to select an optimal IMRT method with which to correct the respiratory organ motional effect.

• The Journal of Korean Society for Radiation Therapy
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• v.29 no.2
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• pp.27-32
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• 2017

Objectives: Oncological hyperthermia is a treatment to selectively kill cancer cells by directly applying heat to cancer cells or indirectly demage cancer cells. One of the most side effects of treatment is burn that can appear on the skin. In areas with irregularities such as the umbilicus, the patient feels a sense of hot and treatment may be discontinued. Therefore, in order to eliminate the irregularities of these areas, compensators are manufactured and measured to decrease in temperature. Materials and Methods: The temperature of the four sites (umbilicus, near the umbilicus, 5 cm below the umbilicus, back) was measured five times around the umbilicus in patients who were treated at oncological hyperthermia treatment device(EHY-2000, Oncotherm Kft, Hungary). The temperature sensor (TM-100, Oncotherm Kft, Hungary) was attached to four sites and the changes were observed at 5, 15, 25, 35, and 50 minutes after treatment. Compensators of three materials were used(Vaseline, Bolus, Dental resin). The data measured five times were compared for each compensator. Results: The temperature change when the compensator was not used increase from 34.65 degrees to 42.9 degrees on average. The near umbilicus was changed from 32.20 degrees to 37.00 degrees, and the 5 cm below the umbilicus was changed from 31.90 to 34.41 degrees. When the compensator material was inserted into the umbilicus, the temperature change was measured as 5.42 degrees for bolus, 6.55 degrees for vaseline, and 6.83 degrees for resin. Conclusion: Using the compensator in the region where the irregularities such as the umbilicus, the heat sensation could be reduced. the use of a resin that can be customized not only lowers the temperature but also significantly reduces the feeling of the patient. It will be possible to reduce the heat sensation in the treatment and to treat it in a more comfortable condition.