• Journal of dental hygiene science
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• v.5 no.3
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• pp.105-112
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• 2005

In spite of relatively low level of radiation dose used at dental clinics, long term exposure may be harmful, so radiation workers at dental clinics must be well aware of its danger. This study was to analyze the factors to have an influence on safety management behavior in the radiography chamber by understanding the relationship among the knowledge, attitudes and behavior in regard with radiation safety management by dental hygienists in order to take preventive measures for dental hygienists and suggest ideas to develop radiation safety training programs. For this, we contacted dental hygienists working at the local dental clinics for 4 months from December of 2003 to march of 2004 and obtained the following findings. 1. Concering the knowledge level of radiation safety management, $8.59{\pm}2.36$ was average score with the highest of 13 and the lowest of 3 from 15-scale test. In addition, knowledge level of radiation safety management by general characteristics showed statistically significant difference according to working experience (p < 0.001), marital status (p < 0.001), attendance rate of radiation safety management training program (p < 0.001), and type of clinic (p < 0.001). 2. Concering the attitude level of radiation safety management, $4.08{\pm}0.50$ is average score with the highest of $4.31{\pm}0.73$ and the lowest of $3.82{\pm}0.89$ by item from 5-scale test. Besides, attitude level of radiation safety management by general characteristics showed statistically significant difference according to age (p < 0.001), working experience (p < 0.05), attendance rate of radiation safety management training program (p < 0.01), and type of clinic (p < 0.001). 3. Concering the behavior level of radiation safety management, $2.89{\pm}0.77$ is average score from 5-scale test, which was relatively low in comparison with the level of attitude and the highest score was $3.82{\pm}0.94$ and the lowest $2.37{\pm}1.04$ by item. Behavior level of radiation safety management by general characteristics showed statistically significant difference according to working experience (p < 0.001) and type of clinic (p < 0.001). 4. From the survey of relationship among knowledge, attitude and behavior of radiation safety management was, we found that the higher the knowledge level of radiation safety management, the higher the level of attitude and behavior, and the higher the attitude level was, the higher the level of behavior.

• Radiation Oncology Journal
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• v.15 no.3
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• pp.215-224
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• 1997

Purpose : Stereotactic radiosurgery with external beam irradiation successfully obliterates carefully selected intracranial arteriovenous malformation (AVM) . We Present clinical and radiological long term results after treatment with a single high dose irradiation using a linear accelerator. Materials and Methods : Rrom January 1991 to June 1994, fifteen patients with intracranial AVM were treated in our hospital with the stereotactic radiosurgery using a linear accelerator. The radiation was delivered using a 6 MV linear accelerator. The prescribed doses at the isocenter varied from 1800 to 2500cGy (median : 2000cGy) and were given as a sin91e fraction. The radiation doses at the periphery of the lesion typically corresponded to the 80-90% isodose line. In 14 patients, complete clinical and/or radiological follow-up examination were available. Results : Angiography was available in 13 patients with a follow-up Period from 18 months to 27 months. Of 13 patients, the overall complete obliteration rate was 92.3% (12 patients). This incidence did not correlate with lesion size. Seizure, headache and progressive neurologic deficit were complete recovered. One Patient experienced hemorrhage at 2 months after treatment. One patient developed radiation induced brain edema in the white matter surrounding nidus at 16 months after treatment and showed complete resolution of the edema in MR image obtained at 27 months after treatment. After a follow-up period of up to 6 years, no radiation induced severe late complications occurred. Conclusion : We conclude that stereotactic radiosurgery using a linear accelerator is an effective and safe therapy for symptomatic and surgically inaccessible intracranial AVMs and the results compare favorably to the more expensive and elaborate systems that are currently available for stereotactic radiosurgery.

• Radiation Oncology Journal
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• v.28 no.3
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• pp.133-140
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• 2010

Purpose: We retrospectively investigated the effect of irradiation using helical tomotherapy in recurrent pelvic tumors that underwent prior irradiation. Materials and Methods: Fourteen patients with recurrent pelvic tumors consisting of rectal cancer (57.1%), cervical cancer (35.7%) and cancer with an unknown origin (7.1%) were treated with tomotherapy. At the time of irradiation, median tumor size was 3.5 cm and 7 patients complained of pain originating from a recurrent tumor. The median radiation dose delivered to the gross tumor volume, clinical target volume, and planning target volume was 50 Gy, 47.8 Gy and 45 Gy, respectively and delivered at 5 fractions per week over the course of 4 to 5 weeks. Treatment response and duration of local disease control were evaluated using the Response Evaluation Criteria in Solid Tumors (ver. 1.0) and the Kaplan-Meyer method. Treatment-related toxicities were assessed through Common Terminology Criteria for Adverse Events (ver. 3.0). Results: The median follow-up time was 17.3 months, while the response rate was 64.3%. Symptomatic improvement appeared in 6 patients (85.7%). The median duration time of local disease control was 25.8 months. The rates of local failure, distant failure, and synchronous local and distant failure were 57.1%, 21.4%, and 7.1%, respectively. Acute toxicities were limited in grade I or II toxicities, except for one patient. No treatment related death or late toxicity was observed. Conclusion: Helical tomotherapy could be suggested as a feasible palliative option in recurrent pelvic tumors with prior radiotherapy. However, to increase treatment effect and overcome the limitation of this outcome, a large clinical study should be performed.

• Journal of the korean academy of Pediatric Dentistry
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• v.28 no.3
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• pp.412-420
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• 2001

In the growing children with normal occlusion and class III malocclusion who need the early treatment to be helped to diagnose and to set up treatment plan by calculating the mean values of the lateral cephalometric measurements, cephalometric measurements by McNamara alalysis were achieved and compared on both the 84 elementary school children with normal occlusion and 83 class III malocclusion children at the age of 7 to 9 in Kwangju city and the results were as follows: 1. On the boys group, between normal occlusion and class III malocclusion, Effective maxillary length, Maxillomandibular differential, Facial axis, Nasion perpendicualr to pogonion, Point A perp to Mx 1, and A-Pog line to Mn 1 showed significant differences(p<0.05). 2. On the girls group, between normal occlusion and class III malocclusion significant differences were shown in Effective Maxillary length, Maxillomandibular differential, Mandibular plan angle, Nasion perpendicualr to Point A, Point A perp to Mx 1, A-Pog line to Mn 1(p<0.01). 3. There were no significant differences between normal occlusion and class III malocclusion of boys group but significant differences between them of girls group in Effective mandibular length(P<0.01). On the boys and girls group, Effective maxilla length of class III malocclusion was shorter than that of normal occlusion. 4. There were no significant differences between normal occlusion and class III malocclusion both in boys and girls at Anterior lower facial height. 5. There were significant differences between boys and girls both in class III malocclusion and normal occlusion at Anterior lower facial height and Mandibular plane angle(p<0.01).

• Journal of the korean academy of Pediatric Dentistry
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• v.30 no.2
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• pp.291-297
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• 2003

While making diagnosis and the treatment plan for the growing children who visited at Chonnam National University Hospital for orthodontic treatment, authors obtained 8 lateral cephalometric measurements in antero-posterior and vertical relationship such as APDI, WITS, ANB, SN-MP, ODI, PFH/AFH, Y-axis, SUM for children aged 7 to 9 with class III malocclusion and compared them with these of 73 children of elementary school aged 7 to 9 with proper profile and normal occlusion in Gwangju. The results were as follows: 1. Between normal occlusion and class III malocclusion, ANB, SN-MP, ODI, SUM, except PFH/AFH and Y-axis showed statistically significant differences(p<0.05). 2. Between mesurements to describe skeletal disorder of antero-posterior relationship such as APDI, WITS, ANB and skeletal disorder of vertical relationship such as SN-MP, ODI, PFH/AFH, Y-axis, SUM, all of them in both normal occlusion and Class III malocclusion showed significant correlation, except Y-axis, SUM correlation(p<0.01). 3. Wald' statistics of WITS, ANB and APDI expressing skeletal disorder of antero-posterior relationship showed 7.118, 5.148, 0.741, respectively and Wald' statistics of ODI, Y-axis, PFH/AFH, SN-MP, SUM were presented 28.348, 2.238, 1.376, 0.090, 0.089, respectively. Therefore, WITS and ODI could be considered as useful diagnotic measurements for class III malocclusion.

• Clinical and Experimental Pediatrics
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• v.51 no.8
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• pp.812-819
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• 2008

Purpose : Vitamin D plays a key role in bone mineralization of the skeleton and vitamin D deficiency can lead to rickets. It is well known that vitamin D deficiency is common in breast fed infants. Of these patients, clinically, some have no signs of rickets, but laboratory and radiographic findings are diagnostic for vitamin D deficiency rickets (subclinical vitamin D deficiency rickets). The purpose of this study is to clarify current causes and ways to prevent this disease. Methods : We reviewed the clinical and laboratory characteristics of children who were incidentally diagnosed as subclinical rickets during treatment of other disease such as pneumonia, gastroenteritis, urinary tract infection at Eulji Hospital, Seoul, Korea from March, 2003 to July 2007. Results : Eight patients (six boys and two girls) were diagnosed with subclinical vitamin D deficiency rickets. The mean age of the patients was $12.6{\pm}5.8months$, and they were diagnosed from January to July. The associated diseases were pneumonia, urinary tract infection, acute gastroenteritis, and iron deficiency anemia. All patients were breast-fed. Two showed growth failure. The mean serum alkaline phosphatase was $1995.8{\pm}739.5IU/L$, the mean calcium count was $9.5{\pm}0.6mg/dL$, and the mean phosphorus content was $3.6{\pm}1.5mg/dL$. The mean intact parathyroid hormone was $214.8{\pm}155.9pg/mL$ (reference range, 9-65), the mean 1,25-dihydroxyvitamin D was $82.4{\pm}49.3pg/mL$ (reference range, 2070), and the mean 25-hydroxyvitamin D was $29.6{\pm}10.6ng/mL$ (reference range, 1030). A radiographic examination showed cupping, fraying, and flaring of metaphyses in all patients. Six patients were administered calcitriol (400 IU/day) for three months. A consequent radiographic and laboratory examination showed improvement. The first two patients were initially diagnosed with metaphyseal dysplasia, without the detection of vitamin D deficiency and they spontaneously improved without vitamin D supplements. However, two years later, they showed mild scoliosis and metaphyseal dysplasia, respectively. Conclusion : Breast-feeding without supplementation involves high risk of vitamin D deficiency. Some infants may also develop rickets; therefore, such groups should be considered for vitamin D supplementation.

• The Journal of Korean Society for Radiation Therapy
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• v.22 no.2
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• pp.135-144
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• 2010

Purpose: The purpose of this study is that through production of phantom for respiration gated radiotherapy, assessing appropriacy of exposure dose for the therapy using RPM (Real-time Position Management). Materials and Methods: We located measurement object on the phantom for respiration gated radiotherapy made of 2 linear actuator, acrylic panel, stanchion, iron plate ets. to drive (up, down, front, back). Using 4D CT scan, we analyzed patient's respiration and reproduced the movement by computer. On the phantom, we located a 2D-Array (PTW) and an White water phantom (4.5 cm) and used DMLC (interval 2 cm) in the field size $10{\times}10\;cm$, then exposed 21EX X-ray 100 MU, in the case of phantom was (1) static (2) moving (3) gated using RPM respectively gantry $0^{\circ}$ and $90^{\circ}$ We measured with a 0.125 CC ionization chamber (PTW) on the phantom (7.5 cm) in the same condition. Results: Ionization chamber: There were within 0.3% of error with gating respiration and approximately 2% of error without gating in the same condition. 2D-Array: Gantry $90^{\circ}$, field size $10{\times}10\;cm$, using DMLC. There were within 3% of error with gating respiration and approximately 16% of error without gating. Conclusion: The phantom for respiration gated radiotherapy makes plans considering patient's movement, quantitative analysis of exposure dose and proper assessment therapy for IMRT patients using RPM possible.

• Journal of Chest Surgery
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• v.35 no.2
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• pp.94-101
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• 2002

All kinds of tissue valves must be pretreated for the inactivation of immunologic properties and the strengthening of tissue before implantation. However, the tissue valves are gradually denatured with the calcification process and they eventually lose their functions. Recent reports have shown the existence of specific calcium binding non collagenous proteins in the calcified area of implanted biomaterials. This experiment was intended to confirm the effect of pretreatment with RGDS(Arg-Gly-Asp-Ser) tetrapeptide on the calcification of subcutaneously implanted bovine pericardium in rats. RGDS tetrapeptide has the same amino acid sequence of attachment site of specific calcium binding non collagenous proteins. Material and Method: All bovine pericardial pieces were fixed with 0.6% glutaraldehyde. The pretreatments were done using 5 different methods, groupI, with normal saline for 60 minutes, groupII, with 0.5% GRSD(Gly-Arg-Scr-Asp) tetrapeptide solution for 60 minutes, group III : with 0.5% RGDS(Arg-Gly-Asp-Ser) tctrapeptide for 30 minutes, group IV ; with 0.5% RGDS for 60 minutes, and group V : with 0.5% RGDS for 120 minutes. The pretreated bovine pericardial pieces were implanted subcutaneously at the abdominal sites of rats. 30 days after the implantation, the implanted bovine pericardial tissue were examined radiologically, biochemically, and histologically to measure the severity of calcification. Result: On the radiological examination, group I ; 68.42$\pm$3.06, group II , 64.25$\pm$5.58 showed significant difference with group III: 48.00$\pm$3.57, group IV; 43.67$\pm$2.31, and group V ; 2.58$\pm$2.47(p<0.05). There was no difference between group I and II(p=0.105). On the biochemical examination, the amount of calcium in group I was , 33.09$\pm$6.59 mg, in group II ; 28.12$\pm$5.50mg, in group III ; 25.42$\pm$7.67mg, in group Ⅵ ; 20.51$\pm$5.11mg, and in group V : 15.43$\pm$4.25mg.

• Journal of radiological science and technology
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• v.34 no.4
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• pp.341-349
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• 2011

This study was to measure the patient dose difference between 3D treatment planning CT and 4D respiratory gating CT. Study was performed with each 10 patients who have lung and liver cancer for measured patient exposure dose by using SOMATON SENSATION OPEN(SIMENS, GERMANY). CTDIvol and DLP value was used to analyze patient dose, and actual dose was measured in the location of liver and kidney for abdominal examination and lung, heart and spinal cord for chest examination. Rando phantom were used for the experiment. OSLD was used for in-vitro and in-vivo dosimetry. Increasing overall actual dose in 4D respiratory gated CT-simulation using OSLD increase the dose by 5.5 times for liver cancer patients and 6 times for lung cancer patients. In CT simulation of 10 lung cancer patients, CTDIvol value was increased by 5.7 times and DLP 2.4 times. For liver cancer patients, CTDIvol was risen by 3.8 times and DLP 1.6 times. The accuracy of treatment volume could be increased in 4D CT planning for position change due to the breaths of patient in the radiation therapy. However, patients dose was increased in 4D CT than 3D CT. In conclusion, constant efforts is required to reduce patients dose by reducing scan time and scan range.

• Radiation Oncology Journal
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• v.16 no.2
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• pp.167-175
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• 1998

Purpose : It is not a simple task to achieve the ideal isodose curve with a standard vaginal applicator or sing1e plane needle impant in the paravaginal tissue when primary or recurrent gynecological neoplasms(cervical cancers, vaginal cancers and vulvar cancers) are treated as a boost following external beam radiotherapy. The authors introduce the development and construction of a simple, inexpensive, customized applicator for volume implant to maximize the radiation dose to the tumor while minimizing the dose to the rectum and the bladder. Materials and Methods : Nine patients underwent Ir-192 transperineal interstitial implantation for either recurrent(5 cases) or primary(3 cases) cervical cancers or primary vaginal cancer(1 case) between August 1994 and February 1998 at Ajou university hospital. First 3 cases were performed with a sing1e plane implant guided by digital palpation. Because of inadequate isodose coverage in the tumor volume in first 3 cases, we designed and constructed interstitial vaginal applicator for volume implant to improve tumor dose distribution and homogeneity while sparing the surrounding normal tissue. Our applicators consist of vaginal obturator and perineal template that made of the clear acrylamide and dental mold material$(Provil^{(R)})$. The applicators were customized individually according to the tumor size and its location Both HDR and LDR irradiation were given with these applicators accomodating 6 Fr needles(Microselectron Nucletron). The pretreatment planning prior to actual implant was performed whenever possible. Results : Needles can be inserted easily and evenly into the tumor volume through the holes of templates, requiring less efforts and time for the implant procedure. Our applicators made of materials available from commercial vendors. These have an advantage that require easy procedure, and spend relatively short time to construct. Also it was possible to fabricate applicators to individualize according to the tumor size and its location and to achieve the ideal isodose coverage. We found an accurate needle arrangement and ideal dose distribution through the CT scan that was obtained in 3 cases after needle implant. Three patients with primary cervical and vaginal cancers were controlled locally at final follow up. But all recurrent cases failed to do so. Conclusion : The authors introduce inexpensive, simple interstitial vaginal templates which were self-designed and constructed using materials available from commercial vendors such as acrylanide and dental mold material $(Provil^{(R)})$.