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A Clinical Study of Corrosive Esophagitis (식도부식증에 대한 임상적 고찰)

  • 조진규;차창일;조중생;최춘기
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1981.05a
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    • pp.7-8
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    • 1981
  • Authors observed clinically 34 cases of the corrosive esophagitis caused by various corrosive agents at Kyung Hee University Hospital from Aug. 1978 to Dec. 1980. The results obtained were as follows; 1. Among the 34 patients, male was 19 (55.9%) and female 15(44.1%). Most frequently found age was 3rd decade. 2. 18 cases(52.9%) came to the hospital within 24 hours after ingestion of the agents, and 13 cases(38.2%) within 2 to 7 days. 3. Seasonal distribution showed most frequently in spring(35.3%). 4. The moment of the accident was suicidal attempt in 27 cases(79.4%) and misdrinking in 7 cases(20.6%). 5. Acetic acid was a most commonly used agent, showing 23 cases(67.6%), lye and insecticides were next in order. 6. Common chief complaints were swallowing difficulty and sore throat. 7. The average hospital days was 14.8 days. 8. Esophagogram was performed between 3 to 7 days after ingestion in 13 cases(38.2 %), findings were constrictions on the 1st narrowing portion in 4 cases(30.8%) and within normal limits in 3 cases(23.1%). 9. Esophagoscopy was performed in 31 cases(91.2%) between 2 to 7 days after ingestion, which revealed edema and coating on entrance of the esophagus in 9 cases (29.0 %). Diffuse edema on entire length of the esophagus and within normal limits were next in order. 10. Laboratory results were as follows: Anemia was in 1 cases(2.9%), leukocytosis. in 21 cases (61.8%), increase ESR in 9 cases (26.5%), markedly increased BUN and creatinine in 3 cases (8.8%), and hypokalemia in 1 cases(2.9%). Proteinuria in 10 cases(29.4%) hematuria in 4 cases(l1.8%), and coca cola urine in 3 cases (8.8%). 11. Associated diseases were 3 cases(8.8%) of cancer, 1 cases (2.9%) of diabetes mellitus, and 1 cases(2.9%) of manic depressive illness. 12. Various treatment was given: Esophageal and gastric washing in 23 cases(67.6%) for the emergent treatment, antibiotics in 32 cases(94.1%), steroids in 30 cases(88.2%), bougienation in 5 cases(14.7%), hemodialysis in 1 case(2.9%), and partial esophagectomy with gastrostomy and gastroileal anastomosis in 1 cases(2.9%). 13. Serious complications were observed in 9 cases (26.5%), consisted of 6 cases(17.6%) of esophageal stricture, 1 cases(2.9%), of aute renal failure, 1 cases (2.9%) of pneu momediastinum with pneumonia, and 1 cases (2.9%) of pneumonia.

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Prediction of Salvaged Myocardium in Patients with Acute Myocardial Infarction after Primary Percutaneous Coronary Angioplasty using early Thallium-201 Redistribution Myocardial Perfusion Imaging (급성심근경색증의 일차적 관동맥성형술 후 조기 Tl-201 재분포영상을 이용한 구조심근 예측)

  • Choi, Joon-Young;Yang, You-Jung;Choi, Seung-Jin;Yeo, Jeong-Seok;Park, Seong-Wook;Song, Jae-Kwan;Moon, Dae-Hyuk
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.4
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    • pp.219-228
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    • 2003
  • Purpose: The amount of salvaged myocardium is an important prognostic factor in patients with acute myocardial infarction (MI). We investigated if early Tl-201 SPECT imaging could be used to predict the salvaged myocardium and functional recovery in acute MI after primary PTCA. Materials and Methods: In 36 patients with first acute MI treated with primary PTCA, serial echocardiography and Tl-201 SPECT imaging ($5.8{\pm}2.1$ days after PTDA) were performed. Regional wall motion and perfusion were quantified with on 16-segment myocardial model with 5-point and 4-point scaling system, respectively. Results: Wall motion was improved in 78 of the 212 dyssynergic segments on 1 month follow-up echocardiography and 97 on 7 months follow-up echocardiography, which were proved to be salvaged myocardium. The areas under receiver operating characteristic curves of Tl-201 perfusion score for detecting salvaged myocardial segments were 0.79 for 1 month follow-up and 0.83 for 7 months follow-up. The sensitivity and specificity of Tl-201 redistribution images with optimum cutoff of 40% of peak thallium activity for detecting salvaged myocardium were 84.6% and 55.2% for 1 month follow-up, and 87.6% and 64.3% for 7 months follow-up, respectively. There was a linear relationship between the percentage of peak thallium activity on early redistribution imaging and the likelihood of segmental functional improvement 7 months after reperfusion. Conclusion: Tl-201 myocardial perfusion SPECT imaging performed early within 10 days after reperfusion can be used to predict the salvaged myocardium and functional recovery with high sensitivity during the 7 months following primary PTCA in patients with acute MI.

Suggestion of Urban Regeneration Type Recommendation System Based on Local Characteristics Using Text Mining (텍스트 마이닝을 활용한 지역 특성 기반 도시재생 유형 추천 시스템 제안)

  • Kim, Ikjun;Lee, Junho;Kim, Hyomin;Kang, Juyoung
    • Journal of Intelligence and Information Systems
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    • v.26 no.3
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    • pp.149-169
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    • 2020
  • "The Urban Renewal New Deal project", one of the government's major national projects, is about developing underdeveloped areas by investing 50 trillion won in 100 locations on the first year and 500 over the next four years. This project is drawing keen attention from the media and local governments. However, the project model which fails to reflect the original characteristics of the area as it divides project area into five categories: "Our Neighborhood Restoration, Housing Maintenance Support Type, General Neighborhood Type, Central Urban Type, and Economic Base Type," According to keywords for successful urban regeneration in Korea, "resident participation," "regional specialization," "ministerial cooperation" and "public-private cooperation", when local governments propose urban regeneration projects to the government, they can see that it is most important to accurately understand the characteristics of the city and push ahead with the projects in a way that suits the characteristics of the city with the help of local residents and private companies. In addition, considering the gentrification problem, which is one of the side effects of urban regeneration projects, it is important to select and implement urban regeneration types suitable for the characteristics of the area. In order to supplement the limitations of the 'Urban Regeneration New Deal Project' methodology, this study aims to propose a system that recommends urban regeneration types suitable for urban regeneration sites by utilizing various machine learning algorithms, referring to the urban regeneration types of the '2025 Seoul Metropolitan Government Urban Regeneration Strategy Plan' promoted based on regional characteristics. There are four types of urban regeneration in Seoul: "Low-use Low-Level Development, Abandonment, Deteriorated Housing, and Specialization of Historical and Cultural Resources" (Shon and Park, 2017). In order to identify regional characteristics, approximately 100,000 text data were collected for 22 regions where the project was carried out for a total of four types of urban regeneration. Using the collected data, we drew key keywords for each region according to the type of urban regeneration and conducted topic modeling to explore whether there were differences between types. As a result, it was confirmed that a number of topics related to real estate and economy appeared in old residential areas, and in the case of declining and underdeveloped areas, topics reflecting the characteristics of areas where industrial activities were active in the past appeared. In the case of the historical and cultural resource area, since it is an area that contains traces of the past, many keywords related to the government appeared. Therefore, it was possible to confirm political topics and cultural topics resulting from various events. Finally, in the case of low-use and under-developed areas, many topics on real estate and accessibility are emerging, so accessibility is good. It mainly had the characteristics of a region where development is planned or is likely to be developed. Furthermore, a model was implemented that proposes urban regeneration types tailored to regional characteristics for regions other than Seoul. Machine learning technology was used to implement the model, and training data and test data were randomly extracted at an 8:2 ratio and used. In order to compare the performance between various models, the input variables are set in two ways: Count Vector and TF-IDF Vector, and as Classifier, there are 5 types of SVM (Support Vector Machine), Decision Tree, Random Forest, Logistic Regression, and Gradient Boosting. By applying it, performance comparison for a total of 10 models was conducted. The model with the highest performance was the Gradient Boosting method using TF-IDF Vector input data, and the accuracy was 97%. Therefore, the recommendation system proposed in this study is expected to recommend urban regeneration types based on the regional characteristics of new business sites in the process of carrying out urban regeneration projects."

Anti-climacterium Effects of Gagamguibiondam-tang in Ovariectomized Rats (난소적출로 유발된 랫트 갱년기 장애에 대한 가감귀비온담탕의 생리활성 효과 평가)

  • Han, Sang-Gyeom;Kim, Dong-Chul
    • The Journal of Korean Obstetrics and Gynecology
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    • v.30 no.4
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    • pp.18-44
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    • 2017
  • Purpose: The object of this study was to observe the anti-climacterium activity of Gagamguibiondam-tang (GGOT) on ovariectomized (OVX) rats, a well-documented rodent models resembles with women postmenopausal climacterium symptoms, as including cardiovascular diseases, obesity, hyperlipidemia, osteoporosis, organ steatosis and mental disorders. Methods: In this study, anti-climacteric effects were evaluated separated into three categories; 1) anti-obese, 2) anti-uterine atrophy and 3) anti-osteoporotic effects. Five groups were used (8 rats in each group); sham control, OVX control, GGOT 500, 250 and 125 mg/kg administered groups. Twenty-eight days after bilateral OVX surgery, GGOT were orally administered, once a day for 84 days, and then the changes on the body weight and gain during experimental periods, serum estradiol levels, abdominal fat pad and uterus weights with histopathology of abdominal fat pads (total thickness and mean adipocyte diameters) and uterus (total, epithelial and mucosal thickness, percentages of uterine gland regions) for anti-obese and estrogenic effects. In addition, femur, tibia and fourth or fifth lumbar vertebrae (L4 or L5) wet, dry and ash weights, mineral density (BMD), bone strength (failure load), serum osteocalcin and bone specific alkaline phosphatase (bALP) contents, histological and histomorphometrical analyses - bone mass and structure with bone resorption, were monitored for anti-osteoporosis activity. Results: As a result of OVX, noticeable increases of body weight and gains, food and water consumption, weights of abdominal fat pad deposited in dorsal abdominal cavity, serum osteocalcin levels were demonstrated in this experiment with decrease of uterus, femur, tibia and L5 weights, serum bALP and estradiol levels. In addition, marked hypertrophic changes of adipocytes located in deposited abdominal fat pads, uterine disused atrophic changes, decreases of bone mass and structures of femur, tibia and L4 were also observed in OVX control rats with dramatic increases of bone resorption markers, the Ocn and OS/BS at histopathological and histomorphometrical analysis in this study as compared with sham-operated control rats, suggesting the estrogen-deficient climacterium symptoms - obese and osteoporosis were induced by OVX, respectively. However, these estrogen-deficient climacterium symptoms induced by bilateral OVX in rats were significantly inhibited by 84 days of continuous oral treatment of GGOT 500, 250 and 125 mg/kg, respectively. Especially, GGOT 500, 250 and 125 mg/kg showed clear dose-dependent inhibitory activities on the OVX-induced climacterium signs. Conclusion: The results suggest that oral administration of GGOT 500, 250 and 125 mg/kg has clear dose-dependent favorable anti-climacterium effects - estrogenic, anti-obese and anti-osteoporotic activities in OVX rats in this experiment.

Heritabilities and Genetic Correlations on Egg Compositions in Layers (난용계의 난구함분에 관한 유전력 및 유전상관)

  • 상병찬;한성욱;정선부
    • Korean Journal of Poultry Science
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    • v.16 no.2
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    • pp.83-89
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    • 1989
  • This study was conducted to estimate heritabilities, genetic and phenotypic correlations on egg compositions in layers. The data analysis were a total of 6,097 eggs in S. C. W. Leghorn and R. I. Red from March 1, 1980 to July 31, 1981. The results obtained are summarized as follows; 1. The average albumen weight at first egg, 300 and 500 days of age were 28.67, 36.25 and 37.51g in the S. C. W. Leghorn, and 28.95, 36.01 and 36.85g in the R. I. Red, respectively. The yolk weigh at first egg ,300 and 500 days were 9.21, 15.94 and17.86g in the S. C. W. Leghorn,9.46, 16.43 and 18.54g in the R. I. Red, respectively. The shell weight at first egg, 300 and 500 days were 4.04, 5.39 and 5.40g in the S. C. W. Leghorn, and 3.66, 5.13 and 5.28g, respectively. 2. The heritability estimates based on the variance of sire and dam components were 0.631-0.164 and 0.412-0.496 in the S. C. W. Leghorn,0.234-0.563 and 0.477-0.610 in the R. I. Red for albumen weight; 0.213-0.530 and 0.343-0.613 in the S. C. W. Leghorn, 0.253-0.437 and 0.389-0.477 in the R. I. Red for yolk weight; 0.427-0.602 and 0.336-0.409 in the S. C. W. Leghorn, 0.141-0.281 in the R. I. Red for shell weight, respectively. 3. The genetic correlation coefficients of egg compositions were as follows; In the S. C. W. Leghorn and R. I. Red, the coefficients between albumen weight and yolk weight, 0.082-0.339 and 0.142-0.465; between albumen weight and shell weight, 0.674-0.952 and 0.216-0.546; between yolk weight and shell weight,0.173-0.171 and 0.121-0.749, respectively.

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Effect of cadmium on immune responses and enzyme activities of BALB/c mice 1. Cellular immune responses (카드뮴이 BALB/c 마우스의 면역반응 및 효소활성에 미치는 영향 1. 세포성 면역반응)

  • Yoon, Chang-yong;Kim, Tae-joong;Song, Hee-jong
    • Korean Journal of Veterinary Research
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    • v.35 no.3
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    • pp.543-552
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    • 1995
  • This study was undertaken to investigate the eftects of Cd administered ad libitum for 6 weeks on the cellular immune responses of Balb/c mice. The results were summarized as follows; 1. The mice fed 25, 50 and 100ppm Cd drank as much as control, but the mice fed 200ppm Cd drank significantly less water after Cd exposure than did control. Increasing rates of body weight of Cd-fed mice for 6 weeks were as this, control group 27.0%, Cd administered groups(25, 50, 100 and 200ppm) 28.54%, 28.31%, 20.49% and 18.04%, respectively. 2. Absolute spleen to body weight(mg/g) of control, 25, 50, 100 and 200ppm Cd administered groups were $4.34{\pm}0.23$, $4.20{\pm}0.54$, $4.80{\pm}0.87$, $4.25{\pm}0.32$ and $4.40{\pm}0.32$, respectively. Splenic cellularity(${\times}10^7$) of control was $24.29{\pm}5.98$ but increased to $27.72{\pm}5.48$, $32.96{\pm}8.44$, $28.32{\pm}8.76$ and $29.64{\pm}4.08$ in 25, 50, 100 and 200ppm Cd-fed groups, respectively. 3. Total $CD_4{^+}$ cells(${\times}10^7$) of control, 25, 50, 100 and 200ppm Cd-fed groups were $9.15{\pm}2.24$, $10.40{\pm}2.04$, $12.04{\pm}3.08$, $10.20{\pm}3.16$ and $10.80{\pm}1.48$, respectively and total $CD_8{^+}$ cells(${\times}10^7$) of these groups were $2.32{\pm}0.56$, $2.54{\pm}0.27$, $3.12{\pm}0.80$, $2.25{\pm}0.70$ and $2.24{\pm}0.28$, in order. On the other hand, $CD_4{^+}/CD_8{^+}$ ratios in total cells were increased significantly except for 50ppm Cd-fed group($3.88{\pm}0.01$). And that of control was $3.97{\pm}0.02$, but those of 25, 100 and 200ppm were $4.35{\pm}0.01$, $4.54{\pm}0.03$ and $4.81{\pm}0.03$. 4. Phagocytosis rates of peritoneal macrophages were increased significantly in 25 and 50ppm Cd groups($36.34{\pm}9.45$ and $37.15{\pm}9.22$, respectively), but 100 and 200ppm groups showed similar rates($18.20{\pm}3.04$ and $19.48{\pm}3.22$ respectively) to that of control($21.43{\pm}3.62$). 5. In mitogen-induced splenocyte proliferation, various concentraions of $CdCl_2(10^{-4}-10^{-7}M)$ were added to mitogen-stimulated culture in vitro. Splenocyte proliferation induced by LPS was decreased dose dependently, but proliferation by Con-A was increased slightly in concentrations of $10^{-7}-10^{-6}M$. 6. Significant cytotoxicity of splenocytes with $CdCl_2$ were shown at $10^{-4}M$ treated group, especially at 24 hrs. From these results, it could be concluded that Cd might modulate the immune responses by modifying a distribution of T cell subpopulations.

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Prevalence of Enteyobius vermiculuris infection and preventive effects of masts treatment among children in rural and urban areas, and children in orphanages (농촌, 도시 및 집단생활 아동의 요충 감염과 집단 구충에 의한 예방 효과)

  • Kim, Jong-Su;Lee, Hae-Yong;An, Yeong-Gyeom
    • Parasites, Hosts and Diseases
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    • v.29 no.3
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    • pp.235-244
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    • 1991
  • An epidemiological study and mass treatments of Enterobius vermicularis infection among children near Wonju area of Kangwon province were carried out. The children were divided into 4 groups according to their residing localities; children in the mountainous area, rural area, urban area and in orphanage. They were examined by adhesive cellotape anal swab technique, and egg positive rates were obtained. The rates of egg reduction and re-infection rates after repeated mass treatments were also observed. The results obtained were as follows: 1. The overall egg Positive rate of E. vermicularis in the first screening was 19.9% (251 out of 1, 262 examinees; 19.7% in males and 20.1% in females). The positive rates were 13.0% in the mountainous area, 11 9% in the rural area, 15.1% in the urban (medium-sized) area and 61.9% in orphanages. 2. The highest positive rates were observed in the kindergarten children, and 1st and 2nd grade children of primary schools (26.2~32.2%), and the lowest rate (13.6%) in 6-year grade children of primary schools. 3. Cumulative detection rates from 3 repeated anal swabs at 4~5 days interval were higher (70.8%) than those from single anal swabs (50.0~59.2%). 4. Out of the examinees who showed the highest cumulative positive rate (70.8%), about 39.2% were consecutively positive in 3 anal swabs. Among different groups of children, the higher the total egg detection rates (87.5%), the higher the consecutive positive rates (71.9%) . 5. A total of 2, 609 (male : female=1 : 12.4) worms were collected from 17 egg-positive cases treated with anthelinintics. The mean number of worms per child was 153 (range: 4-824) . 6. The egg-positive cases in several studied groups (180 children) were treated with anthelmintics 6 times at 3-week intervals. In this case, the overall positive rate was decreased from 54.8% to 2.2% at 15 weeks after the treatments, but no complete negative conversion was experienced. However, in a group of children (154 children) including egg Positive and negative cases who were both treated with anthelmintics at 3-week interval, a complete egg-negative conversion was observed in the 9th week after treatments. 7. The egg-detection rate in the brothers or sisters of egg Positive children was 70.0% (28 out of 40 examined), and the egg-positive rate according to the family unit was 69.7%. In summarizing the above results, it is concluded that Enterobius vermicularis infection is still highly prevalent among children in Korea, and that repeated mass treatments of more than 3 times will be effective for control of this infection.

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Coffee consumption behaviors, dietary habits, and dietary nutrient intakes according to coffee intake amount among university students (일부 대학생의 커피섭취량에 따른 커피섭취행동, 식습관 및 식사 영양소 섭취)

  • Kim, Sun-Hyo
    • Journal of Nutrition and Health
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    • v.50 no.3
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    • pp.270-283
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    • 2017
  • Purpose: This study was conducted to examine coffee consumption behaviors, dietary habits, and nutrient intakes by coffee intake amount among university students. Methods: Questionnaires were distributed to 300 university students randomly selected in Gongju. Dietary survey was administered during two weekdays by the food record method. Results: Subjects were divided into three groups: NCG (non-coffee group), LCG (low coffee group, 1~2 cups/d), and HCG (high coffee group, 3 cups/d) by coffee intake amount and subjects' distribution. Coffee intake frequency was significantly greater in the HCG compared to the LCG (p < 0.001). The HCG was more likely to intake dripped coffee with or without milk and/or sugar than the LCG (p < 0.05). More than 80% of coffee drinkers chose their favorite coffee or accompanying snacks regardless of energy content. More than 75% of coffee takers did not eat accompanying snacks instead of meals, and the HCG ate them more frequently than LCG (p < 0.05). Breakfast skipping rate was high while vegetable and fruit intakes were very low in most subjects. Subjects who drank carbonated drinks, sweet beverages, or alcohol were significantly greater in number in the LCG and HCG than in the NCG (p < 0.01). Energy intakes from coffee were $0.88{\pm}5.62kcal/d$ and $7.07{\pm}16.93kcal/d$ for the LCG and HCG. For total subjects, daily mean dietary energy intake was low at less than 72% of estimated energy requirement. Levels of vitamin C and calcium were lower than the estimated average requirements while that of vitamin D was low (24~34% of adequate intake). There was no difference in nutrient intakes by coffee intake amount, except protein, vitamin A, and niacin. Conclusion: Coffee intake amount did not affect dietary nutrient intakes. Dietary habits were poor,and most nutrient intakes were lower than recommend levels. High intakes of coffee seemed to be related with high consumption of sweet beverages and alcohol. Therefore, it is necessary to improve nutritional intakes and encourage proper water intake habits, including coffee intake, for improved nutritional status of subjects.

A Study on ChoSonT'ongPaeJiIn (조선통폐지인(朝鮮通幣之印) 연구)

  • Moon, Sangleun
    • Korean Journal of Heritage: History & Science
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    • v.52 no.2
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    • pp.220-239
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    • 2019
  • According to the National Currency (國幣) article in GyeongGukDaeJeon (經國大典), the ChoSonT'ongPaeJiIn (朝鮮通幣之印) was a seal that was imprinted on both ends of a piece of hemp fabric (布). It was used for the circulation of hemp fabric as a fabric currency (布幣). The issued fabric currency was used as a currency for trade or as pecuniary means to have one's crime exempted or replace one's labor duty. The ChoSonT'ongPaeJiIn would be imprinted on a piece of hemp fabric (布) to collect one-twentieth of tax. The ChoSonT'ongPaeJiIn (朝鮮通幣之印) was one of the historical currencies and seal materials used during the early Chosun dynasty. Its imprint was a means of collecting taxes; hence, it was one of the taxation research materials. Despite its value, however, there has been no active research undertaken on it. Thus, the investigator conducted comprehensive research on it based on related content found in JeonRokTongGo (典錄通考), Dae'JeonHu-Sok'Rok (大典後續錄), JeongHeonSwaeRok (貞軒?錄) and other geography books (地理志) as well as the materials mentioned by researchers in previous studies. The investigator demonstrated that the ChoSonT'ongPaeJiIn was established based on the concept of circulating Choson fabric notes (朝鮮布貨) with a seal on ChongOseungp'o (正五升布) in entreaty documents submitted in 1401 and that the fabric currency (布幣) with the imprint of the ChoSonT'ongPaeJiIn was used as a currency for trade, pecuniary or taxation means of having one's crime exempted, or replacing one's labor, and as a tool of revenue from ships. The use of ChoSonT'ongPaeJiIn continued even after a ban on fabric currencies (布幣) in March 1516 due to a policy on the "use of Joehwa (paper notes)" in 1515. It was still used as an official seal on local official documents in 1598. During the reign of King Yeongjo (英祖), it was used to make a military service (軍布) hemp fabric. Some records of 1779 indicate that it was used as a means of taxation for international trade. It is estimated that approximately 330 ChoSonT'ongPaeJiIn were in circulation based on records in JeongHeonSwaeRok (貞軒?錄). Although there was the imprint of ChoSonT'ongPaeJiIn in An Inquiry on Choson Currency (朝鮮貨幣考) published in 1940, there had been no fabric currencies (布幣) with its imprint on them or genuine cases of the seal. It was recently found among the artifacts of Wongaksa Temple. The seal imprint was also found on historical manuscripts produced at the Jikjisa Temple in 1775. The investigator compared the seal imprints found on the historical manuscripts of the Jikjisa Temple, attached to TapJwaJongJeonGji (塔左從政志), and published in An Inquiry on Choson Currency with the ChoSonT'ongPaeJiIn housed at the Wongaksa Temple. It was found that these seal imprints were the same shape as the one at Wongaksa Temple. In addition, their overall form was the same as the one depicted in Daerokji (大麓誌) and LiJaeNanGo (?齋亂藁). These findings demonstrate that the ChoSonT'ongPaeJiIn at Wongaksa Temple was a seal made in the 15th century and is, therefore, an important artifact in the study of Choson's currency history, taxation, and seals. There is a need for future research examining its various aspects.

Evaluating efficiency of application the skin flash for left breast IMRT. (왼쪽 유방암 세기변조방사선 치료시 Skin Flash 적용에 대한 유용성 평가)

  • Lim, Kyoung Dal;Seo, Seok Jin;Lee, Je Hee
    • The Journal of Korean Society for Radiation Therapy
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    • v.30 no.1_2
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    • pp.49-63
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    • 2018
  • Purpose : The purpose of this study is investigating the changes of treatment plan and comparing skin dose with or without the skin flash. To investigate optimal applications of the skin flash, the changes of skin dose of each plans by various thicknesses of skin flash were measured and analyzed also. Methods and Material : Anthropomorphic phantom was scanned by CT for this study. The 2 fields hybrid IMRT and the 6 fields static IMRT were generated from the Eclipse (ver. 13.7.16, Varian, USA) RTP system. Additional plans were generated from each IMRT plans by changing skin flash thickness to 0.5 cm, 1.0 cm, 1.5 cm, 2.0 cm and 2.5 cm. MU and maximum doses were measured also. The treatment equipment was 6MV of VitalBeam (Varian Medical System, USA). Measuring device was a metal oxide semiconductor field-effect transistor(MOSFET). Measuring points of skin doses are upper (1), middle (2) and lower (3) positions from center of the left breast of the phantom. Other points of skin doses, artificially moved to medial and lateral sides by 0.5 cm, were also measured. Results : The reference value of 2F-hIMRT was 206.7 cGy at 1, 186.7 cGy at 2, and 222 cGy at 3, and reference values of 6F-sIMRT were measured at 192 cGy at 1, 213 cGy at 2, and 215 cGy at 3. In comparison with these reference values, the first measurement point in 2F-hIMRT was 261.3 cGy with a skin flash 2.0 cm and 2.5 cm, and the highest dose difference was 26.1 %diff. and 5.6 %diff, respectively. The third measurement point was 245.3 cGy and 10.5 %diff at the skin flash 2.5 cm. In the 6F-sIMRT, the highest dose difference was observed at 216.3 cGy and 12.7 %diff. when applying the skin flash 2.0 cm for the first measurement point and the dose difference was the largest at the application point of 2.0 cm, not the skin flash 2.5 cm for each measurement point. In cases of medial 0.5 cm shift points of 2F-hIMRT and 6F-sIMRT without skin flash, the measured value was -75.2 %diff. and -70.1 %diff. at 2F, At -14.8, -12.5, and -21.0 %diff. at the 1st, 2nd and 3rd measurement points, respectively. Generally, both treatment plans showed an increase in total MU, maximum dose and %diff as skin flash thickness increased, except for some results. The difference of skin dose using 0.5 cm thickness of skin flash was lowest lesser than 20 % in every conditions. Conclusion : Minimizing the thickness of skin flash by 0.5 cm is considered most ideal because it makes it possible to keep down MUs and lowering maximum doses. In addition, It was found that MUs, maximum doses and differences of skin doses did not increase infinitely as skin flash thickness increase by. If the error margin caused by PTV or other factors is lesser than 1.0 cm, It is considered that there will be many advantages in with the skin flash technique comparing without it.

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