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Independent Verification Program for High-Dose-Rate Brachytherapy Treatment Plans (고선량률 근접치료계획의 정도보증 프로그램)

  • Han Youngyih;Chu Sung Sil;Huh Seung Jae;Suh Chang-Ok
    • Radiation Oncology Journal
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    • v.21 no.3
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    • pp.238-244
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    • 2003
  • Purpose: The Planning of High-Dose-Rate (HDR) brachytherapy treatments are becoming individualized and more dependent on the treatment planning system. Therefore, computer software has been developed to perform independent point dose calculations with the integration of an isodose distribution curve display into the patient anatomy images. Meterials and Methods: As primary input data, the program takes patients'planning data including the source dwell positions, dwell times and the doses at reference points, computed by an HDR treatment planning system (TPS). Dosimetric calculations were peformed in a $10\times12\times10\;Cm^3$ grid space using the Interstitial Collaborative Working Group (ICWG) formalism and an anisotropy table for the HDR Iridium-192 source. The computed doses at the reference points were automatically compared with the relevant results of the TPS. The MR and simulation film images were then imported and the isodose distributions on the axial, sagittal and coronal planes intersecting the point selected by a user were superimposed on the imported images and then displayed. The accuracy of the software was tested in three benchmark plans peformed by Gamma-Med 12i TPS (MDS Nordion, Germany). Nine patients'plans generated by Plato (Nucletron Corporation, The Netherlands) were verified by the developed software. Results: The absolute doses computed by the developed software agreed with the commercial TPS results within an accuracy of $2.8\%$ in the benchmark plans. The isodose distribution plots showed excellent agreements with the exception of the tip legion of the source's longitudinal axis where a slight deviation was observed. In clinical plans, the secondary dose calculations had, on average, about a $3.4\%$ deviation from the TPS plans. Conclusion: The accurate validation of complicate treatment plans is possible with the developed software and the qualify of the HDR treatment plan can be improved with the isodose display integrated into the patient anatomy information.

The Prognostic Factors in Progression of Pneumoconiosis (진폐증의 예후에 영향을 미치는 인자)

  • Kim, Hyung-Ju;Jang, An-Soo;Kim, Sang-Guk;Choi, Soo-In;Park, Sang-Hoo;Yang, Seung-Won;Seo, Jeong-Pyeong;Lee, Soong;Park, Hong-Bae;Son, Myung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.1
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    • pp.57-65
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    • 1999
  • Backround : Pneumoconiosis is the parenchymal lung disease that results from the inhalation and deposition of dust, usually mineral dust of occupational or environmental origin. Most of the pneumoconiosis can be categorized to coal workers' pneumoconiosis (CWP) in Korea. No effective treatement is currently available, and the therapy for symptomatic CWP is limited to treatment of complication. Therefore authors analyzed and reviewed clinical features and radiological findings of 95 patients with pneumoconiosis for assessing the prognostic factors in disease progression. Method: We reviewed medical records of 95 cases with pneumoconiosis including history, chest X-ray, pulmonary function test, electrocardiography, AFB stain and culture of sputum, and routine blood examination between June 1995 and June 1997 in Seonam University Namkwang Hospital. Results: All of cases are male(mean age, 57.4 years), 91 cases out of them are miners. The mean duration of exposure to dust is 18.8 years. Major clinical symptoms are dyspnea (100%), sputum (71.6%), chest pain (55.8%), cough (23.2%), and hemoptysis (6.3%). 82 % of cases are over Morgan-Seaton Grade 2 in the degree of dyspnea. Small opacity on chest x-ray is 82.1 % and large opacity is 17.9%. Small opacity has tit type (37.2%), q/q type (25.6%) and r/r type (11.5%). B type is 42.2% in large opacity. For the pulmonary function test, restrictive type is 40.3%, mixed type 19.5% and obstructive type 8.3%. The more increasing chest Xray density, the more decreasing $FEV_1$ (p<0.01). 38% of patients show tuberculosis in chest X-ray, 15.8% positive smear of acid fast bacilli in sputum. The prevalence of pulmonary tuberculosis is high in patients with poor clinical condition. The cases with the active pulmonary tuberculosis have severe dyspnea. Expired cases show 100% and 75% of positive pulmonary tuberculosis in chest X-ray and sputum examination, respectively. 75% of expired cases show the chronic cor pulmonale, who died of acute respiratory failure. Conclusion: These findings indicate that tuberculoois infection has a decisive influence on the progress and prognoois of pneumoconioois.

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Effect of microwave radiation on physical special quality of normal, high amylose and waxy corn starches (마이크로웨이브를 조사한 옥수수전분의 물리적 특성변화)

  • Lee Su Jin;Choe Yeong Hui
    • Journal of Applied Tourism Food and Beverage Management and Research
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    • v.15 no.1
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    • pp.113-125
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    • 2004
  • Effect of microwave radiation on physico-chemical properties of cor'n starches was studied. Waxy com, com and high amylose com starches of varying moisture content(20~35%) were subjected to microwave processing(2450MHz) at $120^{\circ}$ and the experimental starch samples were examined by a X-ray diffractometry, rapid viscosity analyzer(RVA) and. with the samples in temperature was observed and the peaks of high amylose com starches at $2^{\circ}$=5.0, 15.0 and $23.0^{\circ}$, were disappeared indicating the melting of crystallines while those of com and waxy com had not changed. A change in gelatinization pattern was observed in the case of corn starches from type A with nearly no peak-viscosity and breakdown to type C. Except a decreased viscosity, no change was observed in those of waxy com starches.

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Plant Physiological Responses in Relation to Temperature, Light Intensity, and CO2 Concentration for the Selection of Efficient Foliage Plants on the Improvement of Indoor Environment (실내 환경 개선에 적합한 식물 선발을 위한 온도, 광도, 이산화탄소 농도에 따른 관엽식물들의 생리적 반응)

  • Park, Sin-Ae;Kim, Min-Gi;Yoo, Mung-Hwa;Oh, Myung-Min;Son, Ki-Cheol
    • Horticultural Science & Technology
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    • v.28 no.6
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    • pp.928-936
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    • 2010
  • This study was conducted to select efficient foliage plants for improving indoor environment conditions through the investigation of physiological responses including photosynthetic rate according to temperature, light intensity, and $CO_2$ level. Eight popular foliage plants used in this study were $Hedera$ $helix$ L., $Cissus$ $rhombifolia$ Vahl, $Ficus$ $benjamina$ L. 'Hawaii', $Syngonium$ $podophyllum$ Schott 'Albo-Virens', $Dieffenbachia$ $sp.$ 'Marrianne', $Pachira$ $aquatica$ Aubl., $Spathiphyllum$ $wallisii$ Regel, and $Scindapsus$ $aureus$ Engler. Photosynthetic rate and transpiration rate of the plants subjected to various light intensities (0, 25, 50, 75, 100, 150, 300, and $600{\mu}mol{\cdot}m^{-2}{\cdot}s^{-1}$ PPFD), $CO_2$ levels (0, 50, 100, 200, 400, 700, and $1,000{\mu}molCO_2{\cdot}mol^{-1}$), and two different temperatures (16 and $22^{\circ}C$) were measured. In addition, various parameters in relation to photosynthesis were calculated from the measured data. As a result, the patterns of photosynthesis varied among 8 foliage plants according to light intensity, $CO_2$ level, and temperature. Most foliage plants except $Dieffenbachia$ had high levels of apparent quantum yield, which represents the photosynthetic rate under low light intensity (PPFD $0-100{\mu}mol{\cdot}m^{-2}{\cdot}s^{-1}$). $Hedera$ $helix$, $Ficus$ $benjamina$, $Pachira$ $aquatica$, and $Spathiphyllum$ $wallisii$ exposed to high light intensity (PPFD $200-600{\mu}mol{\cdot}m^{-2}{\cdot}s^{-1}$) showed high levels of photosynthesis. $Cissus$ $rhombifolia$ and $Syngonium$ $podophyllum$ were low in $CO_2$ fixation efficiency compared to the other 6 foliage indoor plants. $Hedera$ $helix$ and $Spathiphyllum$ $wallisii$ showed high photosynthetic rate under high $CO_2$ level and vigorous photosynthesis was also observed in $Ficus$ $benjamina$ and $Pachira$ $aquatica$ grown under $22^{\circ}C$. Considering characteristics of indoor environment such as low light, high $CO_2$ level, and low relative humidity, therefore, $Hedera$ $helix$, $Spathiphyllum$ $wallisii$, $Ficus$ $benjamina$, and $Pachira$ $aquatica$ were efficient indoor foliage plants to improve indoor environmental conditions.

A Study on The Relation between Psychological Stress and Stress Hormone, Nutritional Status of Patients with Non-Insulim Dependent Diabetes Mellitus (인슐린 비의존형 당뇨병 환자의 심리적 스트레스와 스트레스호르몬 및 영양상태와의 상관관계에 관한 연구)

  • 문수재
    • Journal of Nutrition and Health
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    • v.29 no.8
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    • pp.889-898
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    • 1996
  • This study estimated the re!ation between psychological stress and stress hormones, nu­t tritional status of patients with non-insulin dependent diabetes mellitus(NIDDM). Psycho­l logical stress such as depr'ession and anxiety in 34 diabetics was analyzedin relation to nutrient intake, blood components such as fasting blood sugar(FBS), hemoglobin AIC, stress hormones a and amino acids. The IeveIs of depression and anxiety were measured by The center for ep­i idemiological studies-depc$pm$111.49pg/ml for total catecholamine ( (norepmephrine and epinephrine) and 233.95 $pm$73.99pg/ml for norepinephrine, 94.03$pm$75. 9 97pg/ml for epinephrine, 13.lS$pm$5.55pl/dl for cortisol and 171.50$pm$62.50pg/ml for gul c cagon respectlveIy. The leveIs of stress hormones in diabetics such as total catecholamine, norep­i mephrine cortisol and glucagon were significantly higher than those in normal control. The lev­el of epmephrine was higher in diabetics but the diffierenee was not significant. The calorie m t take in diabetics was 1762$pm$292keal which is S1.4% lower than Korean recommended dietary a allowances(RDA). Calcium intake was slightly low but other nutrients intakeswere higher than R RDA. The value of fasting blood sugar(FBS), usual fasting blood sugar(usual FBS) which refteet a average FBS during 3 months and hemoglobin Al C in diabetics was 1S4.1S$pm$74.22mg/dl, 177.76$pm$42.77mg/dl and S.S4$pm$2.S2% respec디VeIy. The distribution of plasma amino acids in d diabetics was generally in the normal range. The leveI of anxiety in diabetics was positively cor­related with norepinephrine, concentration and usual FBS. The levels of glucagon, usual FBS a and hemoglobin Aj C were pOSI디veIy correlated with the branched chaimamino acid(BCM : leucme, isoleucme and valine)

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A Case of Rapidly Developed Obesity Hypoventilation Syndrome in a Patient with Kyphoscoliosis (척추후측만증 환자에서 급속히 진행된 비만성 저환기 증후군 1례)

  • Kim, Min Young;Jeong, Jee Sun;Jang, Yu Na;Go, Se-eun;Lee, Sang Haak;Moon, Hwa Sik;Kang, Hyeon Hui
    • Sleep Medicine and Psychophysiology
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    • v.22 no.1
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    • pp.30-34
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    • 2015
  • Obesity hypoventilation syndrome (OHS) is characterized by severe obesity, excessive daytime sleepiness, hypoxemia and hypercapnea. Because OHS mimics pulmonary hypertension or cor pulmonale, clinicians should recognize and treat this syndrome appropriately. A 58-year-old female visited the emergency room because of dyspnea. She was obese and had kyphoscoliosis. The patient also experienced snoring, recurrent choking during sleep and daytime hypersomnolence which worsened after gaining weight in the recent year. The arterial blood gas analysis showed she experienced hypoxemia and hypercapnea not only during nighttime but also daytime. We suspected OHS and the patient underwent polysomnography to confirm whether obstructive sleep apnea was present. During the polysomnography test, sleep obstructive apnea was observed and apnea-hypopnea index was 9.2/hr. The patient was treated with bilevel positive airway pressure therapy (BiPAP). After BiPAP for 4 days, hypoxemia and hypercapnia were resolved and she is currently well without BiPAP. We report a case successfully treated with clinical improvement by presuming OHS early in a patient who had typical OHS symptoms, even while having other conditions which could cause hypoventilation.

The Role of Plasma B-type Natriuretic Peptide Measurements in the Differential Diagnosis of Acute Dyspnea (급성호흡곤란의 감별진단에서 혈장 B-type Natriuretic Peptide의 역할)

  • Moon, Ji Yong;Bae, Joong Ho;Kim, Tae Hyung;Sohn, Jang Won;Yoon, Ho Joo;Shin, Dong Ho;Park, Sung Soo
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.6
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    • pp.656-663
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    • 2005
  • Background : The B-type natriuretic peptide (BNP) is a cardiac neurohormone that is specifically secreted from the ventricles in response to volume expansion and a pressure overload. Differentiating congestive heart failure from the pulmonary causes of dyspnea is very important for patients presenting with acute dyspnea. Methods : A retrospective study was carried out on 261 patients who were admitted to the emergency department of Hanyang University Hospital due to acute dyspnea from March to July 2004. The serum BNP levels of the patients were measured using the ELISA method. Results : The BNP levels were 382, 111-1140 pg/ml (median, interquartile range) in the heart failure group (n=119) and 29, 7-81 pg/ml in the non-heart failure group (n=142). The BNP levels according to the subgroups of heart failure were 820, 354-1620 pg/ml, 1650, 239-1990 pg/ml, and 378, 106-1120 pg/ml for the chronic obstructive pulmonary disease (COPD) with combined left heart failure (n=5), cor pulmonale (n=3), and left heart failure groups (n=111), respectively. The BNP levels according to the subgroups of non-heart failure were 39, 21-101 pg/ml, 59, 10-129 pg/ml, and 15, 6-47 pg/ml for the COPD (n=20), other pulmonary diseases (n=56), and other causes groups (n=66), respectively. The BNP levels were significantly different according to the underlying etiology (p<0.001), and were significantly higher in the COPD patients with left heart failure than in those without (p=0.002). When the patients with no cardiovascular risk factor such as diabetes mellitus, hypertension, smoking or renal failure were analyzed, the BNP levels were also significantly higher in the patients with heart failure than in those without(p<0.001). When 133 pg/ml was designated as the BNP cut-off level the sensitivity for predicting heart failure was 73 percent and the specificity was 87 percent. Conclusion : BNP measurements are useful for determining the presence of heart failure in the patients presenting with acute dyspnea. The possibility of heart failure must be seriously considered in patients with high BNP levels even when they have a pre-existing pulmonary disease such as COPD or no risk factors for heart failure.

Clinical Experience of Long-term Home Oxygen Therapy (재택산소요법을 받고 있는 환자들에 대한 임상 관찰)

  • Lee, Young-Suk;Cha, Seung-Ick;Han, Chun-Duk;Kim, Chang-Ho;Kim, Yeun-Jae;Park, Jae-Yong;Jung, Tae-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.3
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    • pp.283-291
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    • 1993
  • Background: Long-term low flow oxygen therapy not only increases survival, but also improves the quality of life in patients with chronic obstructive pulmonary disease (COPD) with chronic hypoxemia. For the assessment and improvement of the status of home oxygen therapy, we analyzed clinical experience of 26 patients who have been administered low flow oxygen at home. Method: Twenty-six patients (18 men and 8 women) who have been received long-term oxygen therapy (LTOT) at home were examined. We reviewed physical characteristics, clinical history, pulmonary function test, ECG, arterial blood gas analysis, hemoglobin and hematocrit, types of oxygen devices, inhalation time per day, concentration of administered $O_2$, duration of $O_2$ therapy, and problems in the home oxygen therapy. Results: The underlying diseases of patients were COPD 14 cases, far advanced old pulmonary tuberculosis 9 cases, bronchiectasis 2 cases, and idiopathic pulmonary fibrosis 1 case. The reasons for LTOT at home were noted for cor pulmonale 21 cases, for dyspnea on exertion and severe ventilatory impairment 4 cases, and for oxygen desaturation during sleep 1 case. The mean values of aterial blood gas analysis before home oxygen therapy were $PaO_2$ 57.7 mmHg, $PaCO_2$ 48.2 mmHg, and $SaO_2$ 87.7%. And the mean values of each parameters in the pulmonary function test were VC 2.05 L, $FEV_1$ 0.92 L, and $FEV_1$/FVC% 51.9%. Nineteen patients have used oxygen tanks as oxygen devices, 1 patient oxygen concentrator, 2 patients oxygen tank and liquid oxygen, and other 4 patients oxygen tank together with portable oxygen. The duration of oxygen therapy was below 1 year in 3 cases, 1~2 years in 15 cases, 3~5 years in 6 cases, 9 years in 1 case, and 10 years in 1 case. All patients have inhalated oxygen with flow rate less than 2.5 L/min. And only 10 patients have inhalated oxygen more than 15 hours per day, but most of them short time per day. Conclusion: For the effective oxygen administration, it is necessary that education for long-term low flow oxygen therapy to patients, their family and neighbor should be done, and also the institutional backup for getting convenient oxygen devices is required.

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The Changes of Arterial Oxygen Saturation During Sleep in Chronic Obstructive Pulmonary Disease Patients (만성 폐쇄성 폐질환 환자에서 수면중 동맥혈 산소 포화도의 변화)

  • Jeong, Ki-Ho;Choi, Hyung-Seok;Hyun, In-Gyu;Choi, Dong-Chull;Yoo, Chul-Gyu;Kim, Young-Whan;Han, Sung-Koo;Shim, Young-Soo;Kim, Keon-Youl;Han, Yong-Chol
    • Tuberculosis and Respiratory Diseases
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    • v.38 no.3
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    • pp.255-261
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    • 1991
  • Frequently patients with chronic obstructive pulmonary disease have lowered arterial oxygen saturation in daytime. During sleep, they are apt to experience additional hypoxemia. These episode of nocturnal hypoxemia are usually associated with periods of relative hypoventilation. Noctunal hypoxemia may be associated with cardiac arrhythmia and with acute increase in pulmonary arterial pressure and may be implicated in the development of chronic pulmonary hypertension and cor pulmonale. We selected 14 patients with chronic obstructive pulmonary disease, 9 with emphysema dominant type and 5 with chronic bronchitis dominant type, to examine the frequency and severity of nocturnal hypoxemia and the effect of oxygen in prevention of nocturnal hypoxemia. The results were as follows; 1) On PFT, FVC, $FEV_1$, and $FEV_1$/FVC showed no significant difference between the emphysema dominant type (pink puffers, PP) and the chronic bronchitis dominant type (blue bloaters, BB). But DLCO/VA for the PP group was $45.7{\pm}15.1%$ which was significantly different from BB group, $82.4{\pm}5.6%$. 2) The daytime arterial oxygen saturation ($SaO_2$) and the lowest $SaO_2$, during sleep for the BB group were significantly lower than for the PP group. 3) The hypoxemic episodes during sleep were more frequent in BB group and the duration of hypoxemic episode was longer in BB group. 4) In both group studied, although there was a tendency for a lower L-$SaO_2$ (the lowest $SaO_2$, during sleep), an increase in hypoxemic episodes and duration as the daytime $SaO_2$, fell lower, the only parameter which showed significant correlation was daytime $SaO_2$, and the frequency of hypoxemic episodes in the PP group (r=-0.68, P<0.05). 5) In PP group, with oxygen supplementation, L-$SaO_2$, during sleep showed significant increase, and there was a tendency for the frequency of hypoxemic episodes and duration to fall but it was not significant. 6) In BB group, oxygen supplementation significantly increased the L-$SaO_2$ during sleep and also significantly decreased the frequency and duration of hypoxemic episode. From these results, we can see that oxygen supplementation during sleep can prevent the decrease in $SaO_2$ to some extent and that this effect of oxygen can be seen more prominently in the BB group.

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The Application of B-Type Natriuretic Peptide Level of the Dyspneic Patients : Differentiation Between Cor Pulmonale and Left Ventricular Dysfunction (호흡곤란을 주소로 내원한 환자에서 혈청 B-type Natriuretic Peptide 검사의 유용성 : 폐성심과 좌심부전의 감별에 대하여)

  • Park, Hong-Hoon;Kim, Sehyun;Choi, Jeongeun;Kim, Kang-Ho;Cheon, Seok-Cheol;Lee, Jihyun;Lee, Yong-Gu;Kim, In-Jae;Cha, Dong-Hoon;Hong, Sang-Bum;Lee, Ji-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.3
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    • pp.320-329
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    • 2003
  • Background : The serum B-type natriuretic peptide (BNP) is released from the ventricles as a response to volume or pressure overload of the ventricles. A few studies have reported that the BNP measurements are useful in differentiating between heart failure and pulmonary causes in patients who visited the emergency department with dyspnea as the chief complaint. It is difficult to differentiate a right heart failure from a left heart failure in the emergency room. However, there is no report on the application of a BNP assay to differentiate in right heart failure from left heart failure. In this study, the BNP levels were measured from dyspneic patients in the emergency department to determine whether or not the BNP level would be useful in differentiating the cause of the dyspnea from right ventricular failure and left ventricular failure. Method : 89 patients who visited emergency department of the Bundang Cha Hospital with dyspnea from June 2002 to March 2003 were selected. The 29 patients from the outpatient clinics and inpatients were randomly selected as the control. Results : The BNP levels of patients in the left heart failure group were significantly different from that of the patients in the right heart failure group ($682{\pm}314$ pg/mL vs. $149{\pm}94$ pg/mL, p=0.000). When the BNP cut-off level was designated as 219 pg/mL using the receiver operating characteristic curve, the sensitivity was 94.3%, and specificity was 92.9%. In addition, the positive predictive value was 97% and the negative predictive value was 86.7% in differentiating right heart failure from left heart failure. Conclusion : Measurements of the serum BNP levels is an accurate and rapid method that can aid in distinguishing between right heart failure and left heart failure.