• The Korean Journal of Emergency Medical Services
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• v.16 no.2
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• pp.67-74
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• 2012

Purpose : The purpose of this study is to get basal user guidelines of safer bag-valve-mask application on patient with normal pulmonary patho-physiologic condition. Methods : This study was accomplished by pre-qualified 25 EMS junior grade students. Participants were instructed randomly compress bag to one-third, half and total and also with differesnt compression speed. Resultant tidal volumes and mean airway pressures obtained in RespiTrainer were analysed in relation to the each compression depth and rate. Results : Demographic difference does not affect tidal volume with any compression depth and rate change. Increasing compression depth is correlated with tidal volume increasement at any compression rate and also with mean airway pressure. If the compression depth is same, compression rate change did not affect significantly the resultant tidal volume or mean airway pressure. Conclusion : Hand size, Experience, BMI dose not affect tidal volume. Compress the 1600 ml bag half to total amount is safe way to offer sufficient tidal volume without risky high airway pressure delivery to patient airway who with normal lung patho-physiologic condition.

• Progress in Medical Physics
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• v.20 no.2
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• pp.88-96
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• 2009

Radiation treatment for skin cancer has recently increased in tomotherapy. It was reported that required dose could be delivered with homogeneous dose distribution to the target without field matching using electron and photon beam. Therapeutic beam of tomotherapy, however, has several different physical characteristic and irradiation of helical beam is involved in the mechanically dynamic factors. Thus verification of skin dose is requisite using independent tools with additional verification method. Modified phantom for dose measurement was developed and skin dose verification was performed using inserted thermoluminescent dosimeters (TLDs) and GafChromic EBT films. As the homogeneous dose was delivered to the region including surface and 6 mm depth, measured dose using films showed about average 2% lower dose than calculated one in treatment planning system. Region indicating about 14% higher and lower absorbed dose was verified on measured dose distribution. Uniformity of dose distribution on films decreased as compared with that of calculated results. Dose variation affected by inhomogeneous material, Teflon, little showed. In regard to the measured dose and its distribution in tomotherapy, verification of skin dose through measurement is required before the radiation treatment for the target located at the curved surface or superficial depth.

• Journal of radiological science and technology
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• v.23 no.2
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• pp.75-79
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• 2000

This study was performed for the clinical applications applying the Monte Carlo methods. In this study we calculated the absorbed dose distributions for the 6 MeV electron beam in water phantom and compared the results with measured values. The energy data of electron beam used in Monte Carlo calculation is the energy distribution for 6 MeV electron beam which is assumed as a Gaussian form. We calculated percent depth doses and beam profiles for three field sizes of $10{\times}10,\;15{\times}15$, and $20{\times}20\;cm^2$ in water phantom using Monte Carlo methods and measured those data using a semiconductor detector and other devices. We found that the calculated percent depth doses and beam profiles agree with the measured values approximately. However, the calculated beam profiles at the edge of the fields were estimated to be lower than the measured values. The reason for that result is that we did not consider the angular distributions of the electrons in phantom surface and contamination of X-rays in our calculations. In conclusion, in order to apply the Monte Carlo methods to the clinical calculations we are to study the source models for electron beam of the linear accelerator beforehand.

• Journal of Periodontal and Implant Science
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• v.32 no.2
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• pp.415-428
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• 2002

Periodontal disease is a complex infectious disease caused by bacteria in the oral mucosa, which results in gingival inflammation, breakdown of periodontal tissues, bone resorption, and finally tooth loss. Mechanical plaque control methods-scaling and root planing are effective methods to stop the progression of such periodontal disease. It was reported that subantimicrobial dose of doxycycline(SDD) regimen could improve clinical conditions of periodontal tissues without causing the overgrowth of opportunistic organisms that was a typical antibiotic side effect. Therefore pharmacological therapy, used in conjunction with mechanical therapy could be considered a useful treatment modality in the treatment of chronic periodontal disease. In this study, 30 patients diagnosed as moderate to advanced chronic periodontitis were divided into 2 groups. In this double-blind, placebo-controlled study, the patients were administered 20mg doxycycline capsule or placebo capsule b.i.d. for 4months, after scaling and root planing. Clinical parameters-bleeding on probing, pocket depth and clinical attachment level were compared and evaluated between these groups at periods of first visit, 1 month, 2 months, 3 months, 4 months. The results were as follows ; 1. In case of moderate periodontitis, pocket depth showed significant reduction after treatment in both the control & experiment groups, when compared with the baseline values(p<0.01), but in case of advanced periodontitis, only the experiment group showed significant reduction after treatment when compared with the baseline values(p<0.05). Statistically significant reduction in pocket depth was observed in the experiment group compared to the control group(p<0.05). 2. In case of moderate periodontitis, clinical attachment level showed significant reduction after treatment in both the control & experiment groups, when compared with the baseline values(p<0.01), but in case of advanced periodontitis, only the experiment group showed significant reduction after treatment when compared with the baseline values(p<0.05). Statistically significant reduction in clinical attachment level was observed in the experiment group compared to the control group(p<0.05). 3. Bleeding on probing improved after treatment in both the groups. In case of moderate periodontitis, the experiment group showed statistically significant reduction of bleeding on probing when compared with the control group at 1 and 4 months after treatment(p<0.05). In case of advanced periodontitis, treatment resulted in statistically significant reduction of bleeding on probing in both the groups(p<0.05). These results indicate that the use of subantimicrobial dose of doxycycline is a useful supplement to mechanical treatment for periodontal patients in ameliorating the clinical parameters such as periodontal pocket, attachment level, and bleeding on probing.

• Progress in Medical Physics
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• v.15 no.2
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• pp.105-111
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• 2004

The parallel plate detector with dielectric film for dosimetry was designed to measure detection characteristic of 6 MV X-ray with medical linear accelerator. PTFE film was inserted into FEP films that are made by two one-side metal coated materials for ion source. The thicknesses of PTFE dielectric film was 100 ${\mu}{\textrm}{m}$ and the thickness of FEP dielectric film was 100 ${\mu}{\textrm}{m}$, respectively. This detector was fixed by two acrylic plate for physical hardness ad geometrical consistency. The geometrical condition for measurement with parallel-plate for detector was below; SSD=100 cm and the 5 cm depth between detector and phantom surface The major parameter of detector characteristics such as zero drift current, leakage current, charge response by applied voltage, reproducibility, linearity, TMR measurement, dose rate effect were measured. The zero drift currents are 8.3 pA and leakage currents are 10 pA. The charge response of applied voltage is showing linearity in 414 voltage. The measurement deviation of reproducibility in this detector is within 1% for dose and the linearity of applied dose shows in this detector. The TMR curves in phantom between this parallel plate detector and reference detector are matched within 3% deviation from maximum dose depth to 7.5 cm depth. It is considered that this dosimetric system is satisfactory for the purpose of the constancy check of the 6 MV x-ray from medical linear accelerator.

• Progress in Medical Physics
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• v.29 no.3
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• pp.92-100
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• 2018

The manufacturer of a linear accelerator (LINAC) has reported that the target melting phenomenon could be caused by a non-recommended output setting and the excessive use of monitor unit (MU) with intensity-modulated radiation therapy (IMRT). Due to these reasons, we observed an unexpected beam interruption during the treatment of a patient in our institution. The target status was inspected and a replacement of the target was determined. After the target replacement, the beam profile was adjusted to the machine commissioning beam data, and the absolute doses-to-water for 6 MV and 10 MV photon beams were calibrated according to American Association of Physicists in Medicine (AAPM) Task Group (TG)-51 protocol. To verify the beam data after target replacement, the beam flatness, symmetry, output factor, and percent depth dose (PDD) were measured and compared with the commissioning data. The difference between the referenced and measured data for flatness and symmetry exhibited a coincidence within 0.3% for both 6 MV and 10 MV, and the difference of the PDD at 10 cm depth ($PDD_{10}$) was also within 0.3% for both photon energies. Also, patient-specific quality assurances (QAs) were performed with gamma analysis using a 2-D diode and ion chamber array detector for eight patients. The average gamma passing rates for all patients for the relative dose distribution was $99.1%{\pm}1.0%$, and those for absolute dose distribution was $97.2%{\pm}2.7%$, which means the gamma analysis results were all clinically acceptable. In this study, we recommend that the beam characteristics, such as beam profile, depth dose, and output factors, should be examined. Further, patient-specific QAs should be performed to verify the changes in the overall beam delivery system when a target replacement is inevitable; although it is more important to check the beam output in a daily routine.

• Journal of radiological science and technology
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• v.31 no.4
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• pp.401-406
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• 2008

The aim of this study is to evaluate contra-lateral breast (CLB) surface dose in Field-in-Field (FIF) technique for breast conserving surgery patients. For evaluation of surface dose in FIF technique, we have compared with other techniques, which were open fields (Open), metal wedge (MW), and enhanced dynamic wedge (EDW) techniques under same geometrical condition and prescribed dose. The three dimensional treatment planning system was used for dose optimization. For the verification of dose calculation, measurements using MOSFET detectors with Anderson Rando phantom were performed. The measured points for four different techniques were at the depth of 0cm (epidermis) and 0.5cm bolus (dermis), and spacing toward 2cm, 4cm, 6cm, 8cm, 10cm apart from the edge of tangential medial beam. The dose calculations were done in 0.25cm grid resolution by modified Batho method for inhomogeneity correction. In the planning results, the surface doses were differentiated in the range of $19.6{\sim}36.9%$, $33.2{\sim}138.2%$ for MW, $1.0{\sim}7.9%$, $1.6{\sim}37.4%$ for EDW, and for FIF at the depth of epidermis and dermis as compared to Open respectively. In the measurements, the surface doses were differentiated in the range of $11.1{\sim}71%$, $22.9{\sim}161%$ for MW, $4.1{\sim}15.5%$, $8.2{\sim}37.9%$ for EDW, and 4.9% for FIF at the depth of epidermis and dermis as compared to Open respectively. The surface doses were considered as underestimating in the planning calculation as compared to the measurement with MOSFET detectors. Was concluded as the lowest one among the techniques, even if it was compared with Open method. Our conclusion could be stated that the FIF technique could make the optimum dose distribution in Breast target, while effectively reduce the probability of secondary carcinogenesis due to undesirable scattered radiation to contra-lateral breast.

• Progress in Medical Physics
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• v.16 no.2
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• pp.77-81
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• 2005

To determine the appropriate method out of various available methods to measure build-up doses, the measurements and comparisons of depth doses of build-up region including the surface dose were executed using the Attix parallel-plate ionization chamber, the Markus chamber, a cylindrical ionization chamber, and a diode detector. Based on the measurements using the Attix chamber, discrepancies of the Markus chamber were within $2\%$ for the open field and increased up to $3.9\%$ in the case of photon beam containing the contaminant electrons. The measurements of an cylindrical ionization chamber and a diode detector accord with those of the Attix chamber within $1.5\%\;and\;1.0\%$ and after those detectors were completely immersed in the water phantom. The results suggest that the parallel-plate chamber is the best choice to measure depth doses in the build-up region containing the surface, however, using cylindrical ionization chamber or diode detector would be a reasonable choice if no special care is necessary for the exact surface dose.

• Journal of radiological science and technology
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• v.21 no.2
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• pp.36-42
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• 1998

Treatment of a large diseased area with electron often requires the use of two or more adjoining fields. In such cases, not only electron beam divergence and lateral scattering but also fields overlapping and separation may lead to significant dose inhomogeneities(${\pm}20%$) at the region of junction of fields. In this study, we made Acrylic Electron Wedges to improve dose inhomogeneities(${\pm}5%$) in these junction areas and to apply it to clinical practices. All measurements were made using 6, 9, 12, 16, 20 MeV Electron beams from a linear accelerator for a $10{\times}10\;cm$ field at 100cm of SSD. Adding a 1 mm sheet of acryl gradually from 1 mm to 15 mm acquires central axis depth dose beam profile and isodose curves in water phantom. As a result, for all energies, the practical range was reduced by approximately the same distance according to the acryl insert, e.g. a 1 mm thick acryl insert reduces the practical range by approximately 1 mm. For every mm thickness of acryl inserted, the beam energy was reduced to approximately 0.2 MeV. These effects were almost Independent of beam energy and field size. The use of Acrylic Electron Wedges produced a small increase(less than 3%) in the surface dose and a small increase(less than 1%) in X-ray contamination. For acryl inserts, thickness of 3 mm or greater, the penumbra width increased nearly linear for all energies and isodose curves near the beam edge were nearly parallel with the incident beam direction at the point of penumbra width($35\;mm{\sim}40\;mm$). We decide heel thickness and angle of the wedge at this point. These data provide the information necessary to design Acrylic Electron Wedge which can be used to improve dose uniformity at electron field junctions and it will be effectively applied to clinical practices.

• Radiation Oncology Journal
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• v.8 no.1
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• pp.115-124
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• 1990

The characteristics of 23 MV photon beam have been presented with respect to clinical parameters of central axis depth dose, tissue-maxi mum ratios, scatter-maximum ratios, surface dose and scatter correction factors. The nominal accelerating potential was found to be $18.5\pm0.5$ MV on the central axis. The half-value layer (HVL) of this photon beam was measured with narrow beam geometry from central axis, and it has been showed the thickness of $24.5\;g/cm^2$. The tissue-maximum ratio values have been determined from measured percentage depth dose data. In our experimental dosimetry, the surface dose of maximum showed only $9.6\%$ of maximum dose at $10\times10\;cm^2$, 100 cm SSD, without blocking tray in. The TMR'S of $0\times0$ field size have been determined to get average $2.3\%$ uncertainties from three different methodis; are zero effective attenuation coefficient, non-ilnear least square fit of TMR's data and effective linear attenuation coefficient from the HVL of 23 MV photon beams of dual energy linear accelerator.