• Title/Summary/Keyword: Evaluation condition

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Possibility of Combined Meningitis in Under 90-Day-Old Infants With Urinary Tract Infection (생후 90일 미만 영아의 요로 감염에서 세균성 수막염의 동반 가능성)

  • Hwang, Jun Ho;Kim, Su Yeong;Lee, Na Mi;Yi, Dae Yong;Yun, Sin Weon;Chae, Soo Ahn;Lim, In Seok;Park, Ji Young
    • Pediatric Infection and Vaccine
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    • v.29 no.2
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    • pp.84-95
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    • 2022
  • Purpose: Urinary tract infections (UTIs) are the most common serious bacterial infections in young infants. Lumbar puncture (LP) has been used to diagnose coexisting meningitis in infants under 90 days of age with suspected UTI in many hospitals. However, the incidence of bacterial meningitis associated with UTIs is low. We aimed to describe the prevalence of concomitant bacterial meningitis in young infants with UTIs. Methods: The medical records of infants with the first episode of UTI admitted to the Chung-Ang University Hospital from January 2010 to December 2019 were retrospectively reviewed. Infants aged < 90 days who underwent LP with initial evaluation were included. Demographic and clinical features, laboratory findings, and imaging findings were collected and analyzed. Results: Eighty-six infants with UTIs were enrolled in the study. The median age was 61.5 days (interquartile range, 42.3-73.8 days) and boys (90.7%) were predominant. Escherichia coli was the most common pathogen (n=80, 93.0%) and followed by Klebsiella species (n=5, 5.8%). Fifteen (18.1%) specimens produced extended spectrum β-lactamase (ESBL). Five (5.8%) infants had positive blood culture results. Seven (8.1%) infants showed pleocytosis in the cerebrospinal fluid, but none had coexisting bacterial meningitis. Twenty-four (30.8%) infants showed renal dilatation or hydronephrosis on ultrasonography. Dimercaptosuccinic acid (DMSA) scans revealed cortical defects in 17 (21.3%) infants while voiding cystourethrography revealed vesicoureteral reflux in 6 (46.2%) infants. Conclusion: Co-existing bacterial meningitis was not observed in young infants with UTIs. LP could not be routinely performed considering the clinical condition of <90 days old UTI patients.

Evaluation of water drainage according to hydraulic properties of filling material of sand dam in Mullori, Chuncheon (춘천 물로리 지역 샌드댐 채움재 수리특성에 따른 배수량 평가)

  • Chung, Il-Moon;Lee, Jeongwoo;Kim, Min-Gyu;Kim, Il-Hwan
    • Journal of Korea Water Resources Association
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    • v.55 no.11
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    • pp.923-929
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    • 2022
  • The Chuncheon Mullori area is an underprivileged area of water welfare where local water supply is not supplied, and it is supplying water to the villages with small water supply facilities using lateral flow and groundwater as water sources. This is an area with poor water supply conditions, such as relying on water trucks due to water shortages during the recent severe drought. Therefore, in order to solve the problem of water shortage during drought and to prepare for the increasing water demand, a sand dam was installed along the valley, and this facility has been operating since May 2022. In this study, repeated simulations were performed according to the hydraulic conductivity of the filler material and the storage coefficient value for the inflow condition for about two years from mid-March 2020 to mid-March 2022. For each case, the amount of discharge through the perforated drain pipe was calculated. Overall, as the hydraulic conductivity increased, the amount of discharge and its ratio increased. However, when the hydraulic conductivity of the second floor was relatively low, the amount of discharge increased and then decreased as the hydraulic conductivity of the third floor increased. This is considered to be due to the fact that the water level was kept low due to the rapid drainage compared to the net inflow into the third floor because the water permeability of the third floor and the drainage coefficient of the drain pipe were large. As a result of simulating the flow of the open channel in the upper part of the sand dam as a hypothetical groundwater layer with very high hydraulic conductivity, the decrease in discharge rate was slower than the increase in the hydraulic conductivity of the hypothetical layer, but it was clearly shown that the discharge volume decreased relatively as the hydraulic conductivity of the virtual layer increased.

Optimization of Characteristic Change due to Differences in the Electrode Mixing Method (전극 혼합 방식의 차이로 인한 특성 변화 최적화)

  • Jeong-Tae Kim;Carlos Tafara Mpupuni;Beom-Hui Lee;Sun-Yul Ryou
    • Journal of the Korean Electrochemical Society
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    • v.26 no.1
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    • pp.1-10
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    • 2023
  • The cathode, which is one of the four major components of a lithium secondary battery, is an important component responsible for the energy density of the battery. The mixing process of active material, conductive material, and polymer binder is very essential in the commonly used wet manufacturing process of the cathode. However, in the case of mixing conditions of the cathode, since there is no systematic method, in most cases, differences in performance occur depending on the manufacturer. Therefore, LiMn2O4 (LMO) cathodes were prepared using a commonly used THINKY mixer and homogenizer to optimize the mixing method in the cathode slurry preparation step, and their characteristics were compared. Each mixing condition was performed at 2000 RPM and 7 min, and to determine only the difference in the mixing method during the manufacture of the cathode other experiment conditions (mixing time, material input order, etc.) were kept constant. Among the manufactured THINKY mixer LMO (TLMO) and homogenizer LMO (HLMO), HLMO has more uniform particle dispersion than TLMO, and thus shows higher adhesive strength. Also, the result of the electrochemical evaluation reveals that HLMO cathode showed improved performance with a more stable life cycle compared to TLMO. The initial discharge capacity retention rate of HLMO at 69 cycles was 88%, which is about 4.4 times higher than that of TLMO, and in the case of rate capability, HLMO exhibited a better capacity retention even at high C-rates of 10, 15, and 20 C and the capacity recovery at 1 C was higher than that of TLMO. It's postulated that the use of a homogenizer improves the characteristics of the slurry containing the active material, the conductive material, and the polymer binder creating an electrically conductive network formed by uniformly dispersing the conductive material suppressing its strong electrostatic properties thus avoiding aggregation. As a result, surface contact between the active material and the conductive material increases, electrons move more smoothly, changes in lattice volume during charging and discharging are more reversible and contact resistance between the active material and the conductive material is suppressed.

Studies on the Evaluation of the Spent Composts of Selenium-Enriched Mushrooms as a Feed Selenium Source (셀레늄강화 버섯폐배지에 대한 사료 셀레늄공급원으로의 평가 연구)

  • Kim, W.Y.;Min, J.K.
    • Journal of Practical Agriculture & Fisheries Research
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    • v.7 no.1
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    • pp.118-130
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    • 2005
  • This study was conducted to evaluate the spent composts of selenium-enriched mushrooms as a feed selenium Source. Total selenium (Se) contents and Se profiles in the spent mushroom composts (SMC) were determined. In addtion, we also investigated the metabolism in relation to Se accumulation in the mushroom. Mushrooms used in this study were Flammulina velutipes and Se enriched mushrooms were grown for 60 days by adding 2 mg of inorganic Se (Na2SeO3) per kg of mushroom composts (MC) on as-fed basis and it was compared with mushrooms not to add Se to the MC. Total Se contents for Se-treated mushrooms were significantly increased (P<0.0001) by 20-fold (4.51 ㎍/g of dry) compared to Se-untreated (0.23 ㎍/g of dry). On the contrary, organic Se proportion was significantly lower (P<0.0001) in the Se-treated mushroom (72.3%) than Se-untreated (100%, not analytically detected of inorganic Se). Se distribution upon a length in the Se-treated mushrooms was the highest in the bottom part (6.86 ㎍/g of dry) near to MC, and top and middle parts were significantly lower (3.71 and 3.01 ㎍/g of dry, respectively) than the bottom (P<0.001). In the SMC from Se-treated mushrooms, a high concentration of Se (5.04 ㎍/g of dry) was still remained, but that from Se-untreated mushrooms was significantly low (P<0.0001) as 0.08 ㎍/g of dry. Se-treated SMC showed a high rate of organic Se (65.67%), suggesting that most of inorganic Se in the SMC was converted to organic Se by mushroom mycelia, and Se-untreated SMC showed 100% of organic Se, not being detected of inorganic Se. Prior to mycelia inoculation in the mushroom culture, the sterilization of MC brought approximately 18% of Se loss in the MC. This result is in accordance with facts generally known that Se is weak in the high temperature and it is consequently volatilized under that condition. Apparent and net accumulation rates (%) for Se into mushrooms were 14.81 and 10.14%, respectively and their difference (4.67%) is considered that it is due to the volatilization into the air via metabolic process of mushroom itself. From the result of this study, inorganic Se addition to MC for mushroom improved the Se content in the mushroom and SMC from Se-enriched mushrooms contained a high concentration of Se. Mycelium and fruiting body from mushrooms converted inorganic Se in MC to organic Se, indicating a high proportion of organic Se in the mushroom and SMC. Therefore, Se in Se-enriched mushroom and SMC was recognized as Se sources of food for human as well as feed for livestock.

Development and Testing of a RIVPACS-type Model to Assess the Ecosystem Health in Korean Streams: A Preliminary Study (저서성 대형무척추동물을 이용한 RIVPACS 유형의 하천생태계 건강성 평가법 국내 하천 적용성)

  • Da-Yeong Lee;Dae-Seong Lee;Joong-Hyuk Min;Young-Seuk Park
    • Korean Journal of Ecology and Environment
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    • v.56 no.1
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    • pp.45-56
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    • 2023
  • In stream ecosystem assessment, RIVPACS, which makes a simple but clear evaluation based on macroinvertebrate community, is widely used. In this study, a preliminary study was conducted to develop a RIVPACS-type model suitable for Korean streams nationwide. Reference streams were classified into two types(upstream and downstream), and a prediction model for macroinvertebrates was developed based on each family. A model for upstream was divided into 7 (train): 3 (test), and that for downstream was made using a leave-one-out method. Variables for the models were selected by non-metric multidimensional scaling, and seven variables were chosen, including elevation, slope, annual average temperature, stream width, forest ratio in land use, riffle ratio in hydrological characteristics, and boulder ratio in substrate composition. Stream order classified 3,224 sites as upstream and downstream, and community compositions of sites were predicted. The prediction was conducted for 30 macroinvertebrate families. Expected (E) and observed fauna (O) were compared using an ASPT biotic index, which is computed by dividing the BMWPK score into the number of families in a community. EQR values (i.e. O/E) for ASPT were used to assess stream condition. Lastly, we compared EQR to BMI, an index that is commonly used in the assessment. In the results, the average observed ASPT was 4.82 (±2.04 SD) and the expected one was 6.30 (±0.79 SD), and the expected ASPT was higher than the observed one. In the comparison between EQR and BMI index, EQR generally showed a higher value than the BMI index.

Performance evaluation of hyperspectral bathymetry method for morphological mapping in a large river confluence (초분광수심법 기반 대하천 합류부 하상측정 성능 평가)

  • Kim, Dongsu;Seo, Youngcheol;You, Hojun;Gwon, Yeonghwa
    • Journal of Korea Water Resources Association
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    • v.56 no.3
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    • pp.195-210
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    • 2023
  • Additional deposition and erosion in large rivers in South Korea have continued to occur toward morphological stabilization after massive dredging through the four major river restoration project, subsequently requiring precise bathymetry monitoring. Hyperspectral bathymetry method has increasingly been highlighted as an alternative way to estimate bathymetry with high spatial resolution in shallow depth for replacing classical intrusive direct measurement techniques. This study introduced the conventional Optimal Band Ratio Analysis (OBRA) of hyperspectral bathymetry method, and evaluated the performance in a domestic large river in normal turbid and flow condition. Maximum measurable depth was estimated by applying correlation coefficient and root mean square error (RMSE) produced during OBRA with cascadedly applying cut-off depth, where the consequent hyperspectral bathymetry map excluded the region over the derived maximum measurable depth. Also non-linearity was considered in building relation between optimal band and depth. We applied the method to the Nakdong and Hwang River confluence as a large river case and obtained the following features. First, the hyperspectal method showed acceptable performance in morphological mapping for shallow regions, where the maximum measurable depth was 2.5 m and 1.25 m in the Nakdong and Hwang river, respectively. Second, RMSE was more feasible to derive the maximum measurable depth rather than the conventional correlation coefficient whereby considering various scenario of excluding range of in situ depths for OBRA. Third, highly turbid region in Hwang River did not allow hyperspectral bathymetry mapping compared with the case of adjacent Nakdong River, where maximum measurable depth was down to half in Hwang River.

Current Status and Perspectives in Varietal Improvement of Rice Cultivars for High-Quality and Value-Added Products (쌀 품질 고급화 및 고부가가치화를 위한 육종현황과 전망)

  • 최해춘
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.47
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    • pp.15-32
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    • 2002
  • The endeavors enhancing the grain quality of high-yielding japonica rice were steadily continued during 1980s-1990s along with the self-sufficiency of rice production and the increasing demands of high-quality rices. During this time, considerably great progress and success was obtained in development of high-quality japonica cultivars and quality evaluation techniques including the elucidation of interrelationship between the physicochemical properties of rice grain and the physical or palatability components of cooked rice. In 1990s, some high-quality japonica rice cultivars and special rices adaptable for food processing such as large kernel, chalky endosperm, aromatic and colored rices were developed and its objective preference and utility was also examined by a palatability meter, rapid-visco analyzer and texture analyzer, Recently, new special rices such as extremely low-amylose dull or opaque non-glutinous endosperm mutants were developed. Also, a high-lysine rice variety was developed for higher nutritional utility. The water uptake rate and the maximum water absorption ratio showed significantly negative correlations with the K/Mg ratio and alkali digestion value(ADV) of milled rice. The rice materials showing the higher amount of hot water absorption exhibited the larger volume expansion of cooked rice. The harder rices with lower moisture content revealed the higher rate of water uptake at twenty minutes after soaking and the higher ratio of maximum water uptake under the room temperature condition. These water uptake characteristics were not associated with the protein and amylose contents of milled rice and the palatability of cooked rice. The water/rice ratio (in w/w basis) for optimum cooking was averaged to 1.52 in dry milled rices (12% wet basis) with varietal range from 1.45 to 1.61 and the expansion ratio of milled rice after proper boiling was average to 2.63(in v/v basis). The major physicochemical components of rice grain associated with the palatability of cooked rice were examined using japonica rice materials showing narrow varietal variation in grain size and shape, alkali digestibility, gel consistency, amylose and protein contents, but considerable difference in appearance and texture of cooked rice. The glossiness or gross palatability score of cooked rice were closely associated with the peak, hot paste and consistency viscosities of viscosities with year difference. The high-quality rice variety "IIpumbyeo" showed less portion of amylose on the outer layer of milled rice grain and less and slower change in iodine blue value of extracted paste during twenty minutes of boiling. This highly palatable rice also exhibited very fine net structure in outer layer and fine-spongy and well-swollen shape of gelatinized starch granules in inner layer and core of cooked rice kernel compared with the poor palatable rice through image of scanning electronic microscope. Gross sensory score of cooked rice could be estimated by multiple linear regression formula, deduced from relationship between rice quality components mentioned above and eating quality of cooked rice, with high probability of determination. The $\alpha$-amylose-iodine method was adopted for checking the varietal difference in retrogradation of cooked rice. The rice cultivars revealing the relatively slow retrogradation in aged cooked rice were IIpumbyeo, Chucheongyeo, Sasanishiki, Jinbubyeo and Koshihikari. A Tonsil-type rice, Taebaegbyeo, and a japonica cultivar, Seomjinbyeo, showed the relatively fast deterioration of cooked rice. Generally, the better rice cultivars in eating quality of cooked rice showed less retrogradation and much sponginess in cooled cooked rice. Also, the rice varieties exhibiting less retrogradation in cooled cooked rice revealed higher hot viscosity and lower cool viscosity of rice flour in amylogram. The sponginess of cooled cooked rice was closely associated with magnesium content and volume expansion of cooked rice. The hardness-changed ratio of cooked rice by cooling was negatively correlated with solids amount extracted during boiling and volume expansion of cooked rice. The major physicochemical properties of rice grain closely related to the palatability of cooked rice may be directly or indirectly associated with the retrogradation characteristics of cooked rice. The softer gel consistency and lower amylose content in milled rice revealed the higher ratio of popped rice and larger bulk density of popping. The stronger hardness of rice grain showed relatively higher ratio of popping and the more chalky or less translucent rice exhibited the lower ratio of intact popped brown rice. The potassium and magnesium contents of milled rice were negatively associated with gross score of noodle making mixed with wheat flour in half and the better rice for noodle making revealed relatively less amount of solid extraction during boiling. The more volume expansion of batters for making brown rice bread resulted the better loaf formation and more springiness in rice breed. The higher protein rices produced relatively the more moist white rice bread. The springiness of rice bread was also significantly correlated with high amylose content and hard gel consistency. The completely chalky and large grain rices showed better suitability far fermentation and brewing. The glutinous rice were classified into nine different varietal groups based on various physicochemical and structural characteristics of endosperm. There was some close associations among these grain properties and large varietal difference in suitability to various traditional food processing. Our breeding efforts on improvement of rice quality for high palatability and processing utility or value-adding products in the future should focus on not only continuous enhancement of marketing and eating qualities but also the diversification in morphological, physicochemical and nutritional characteristics of rice grain suitable for processing various value-added rice foods.ice foods.

The Study of Characteristics of Consumer Purchasing Private Brand Products at Large-Scale Mart (국내 대형마트의 유통업체 브랜드 상품 구매 소비자의 특성 분석에 관한 연구)

  • Hwang, Seong-Huyk;Lee, Jung-Hee;Roh, Eun-Jung
    • Journal of Distribution Research
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    • v.15 no.4
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    • pp.1-19
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    • 2010
  • As having the movement of developing private brand (PB) goods, domestic big retailers are facing up with new problems. Thus, it is required studies of PB products, and how consumers recognize PB products as a consideration commodity set. Also, it is worthy in order that it gives us the important meaning on the marketing strategy with focusing on evaluating the differences between customers buying PB grocery goods with respect to demographic characteristics and purchasing behaviors. PB has some advantages for customers and retailers. However, according to AC Nielson's report (2005), Asian and emerging market has 1/5 sales relatively to Western countries. But we can assume that the emerging market has the most potential growth through this result. As a result from several other studies, it becomes necessary to not only increase the rate of selling composition of PB product temporarily, but also analyze the characteristics of customers using big retailers and segmenting customer groups to make PB product as a consideration commodity set for them. In addition, it is needed to have a variety of acts of marketing. From studies related to PB, there is a prejudice - cheap products have low quality - but, evaluation by customers who have used those products shows neutral stand, and there is a study representing that it is the most important to accumulate the belief between the retailers selling PB products and consumers using those for the accurate evaluation and intention on purchasing. Also, by the result from analyzing the characteristics of customers buying PB products, we could assume that higher income and higher education level, more preference on PB products. Especially, according to TNS's research, the primary targets of PB product are 30's who seeks value for money and planned spending habits, and 40's who have teenager children, and are interested in encouraging themselves. This paper used Probit model to analyze the characteristics of consumers. This model helps us to analyze with the variables representing the demographic characteristics of consumers (gender, age, educational level, occupation, income level, living area), and variables related to purchasing behavior (visiting frequency on big retailers, the average amount that they pay for goods in there, and check-up which brand made those goods). The method we used in this study is by man to man interview and survey on-line with the rate of 89% and 11% in Seoul and Gyunggi Province, respectively, for about one month from the beginning of February, 2008. As a result of this, under the assumption that people buy PB products more as long as they go shopping more, it was not meaningful for target groups which we pointed out as frequently visiting customers to be. Although, we have expected women buy more PB products than men do, gender doesn't mean anything for the result. And, it has inferred that married people buy more PB goods than singles do. It was also meaningless with variables related to occupation. Because housewives are often exposed to any kind of supermarket than workers are, we could not get any relatives. Moreover, we couldn't proof that younger generation prefer big retailers more than older people who 50~60's. Education levels doesn't affect on the purchase of PB product as well. Related to living area, the result is statistically not similar as we expected whether living in Seoul or not. It shows there is no relationship with the preference on retail brands and PB products, and it is similar with the study researched by TNS(2008) that customers tend to buy PB product impulsively no matter which brand it is and where they are even though their shopping place is the big market where customers are often using. Variables on which we had meaningful results are income level and living place. That is, customers who have 3,000,000~6,000,000 WON every month on average are more willing to buy PB products than other customers whose income is over 6,000,000 WON, and residents not living in Seoul prefer PB goods than those who are living in Seoul. To explain more about what we got, if there is only one condition about customer's visiting frequency on big retails, we could come up with this result that more exposed to PB products, more purchasing frequency. Consequently, it brings the important insight that large retailers have to prepare something to make customers visit them often to increase selling rate of PB products. To demonstrate the result of analyzing more, what is more efficient variables are demographically including marital status, income level, and residential area to buy items that affect the PB products and could include the frequency of visiting large markets by the purchase habits. Specifically, then, married couples rather than singles, middle-income customers than high-income customers, and local residents not living in Seoul than customers in Seoul are more likely to purchase PB goods. In addition, as long as a customer visits two times more, then the purchasing rate of PB products is to increase over 5.3%. Therefore, it seems that retailers are better to make a shopping place as fun and comfortable places. With overwhelming the idea that PB products are just cheap, one-time purchase goods, it is needed to increase the loyalty on those goods like NB products, try to make PB products as a consideration products set, and occur to sustainable sales. Especially, as suggested by this paper, it seems like it strongly needs to identify the characteristics of customers who prefer PB, to segment those customers, and to select the main target, and to do positioning with well-planned marketing strategies. Then, it is able to give us a meaningful point on marketing strategy by developing the field of PB study, identifying the difference of life style and shopping habits of customers.

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The evaluation of contralateral breast's dose and shielding efficiency by breast size about breast implant patient for radiation therapy (인공 유방 확대술을 받은 환자의 유방암 치료 시 크기에 따른 반대 측 유방의 피폭 선량 및 차폐 효율 평가)

  • Kim, Jong Wook;Woo, Heon;Jeong, Hyeon Hak;Kim, Kyeong Ah;Kim, Chan Yong;Yoo, Suk Hyun
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.2
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    • pp.329-336
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    • 2014
  • Purpose : To evaluate the dose on a contralateral breast and the usefulness of shielding according to the distance between the contralateral breast and the side of the beam by breast size when patients who got breast implant receive radiation therapy. Materials and Methods : We equipped 200 cc, 300 cc, 400 cc, and 500 cc breast model on the human phantom (Rando-phantom), acquired CT images (philips 16channel, Netherlands) and established the radiation treatment plan, 180 cGy per day on the left breast (EclipseTM ver10.0.42, Varian Medical Systems, USA) by size. We set up each points, A, B, C, and D on the right(contralateral) breast model for measurement by size and by the distance from the beam and attached MOSFET at each points. The 6 MV, 10 MV and 15 MV X-ray were irradiated to the left(target) breast model and we measured exposure dose of contralateral breast model using MOSFET. Also, at the same condition, we acquired the dose value after shielding using only Pb 2 mm and bolus 3 mm under the Pb 2 mm together. Results : As the breast model is bigger from 200 cc to 500 cc, The surface of the contralateral breast is closer to the beam. As a result, from 200 cc to 500 cc, on 180 cGy basis, the measurement value of the scattered ray inclined by 3.22 ~ 4.17% at A point, 4.06 ~ 6.22% at B point, 0.4~0.5% at C point, and was under 0.4% at D point. As the X-ray energy is higher, from 6 MV to 15 MV, on 180 cGy basis, the measurement value of the scattered ray inclined by 4.06~5% at A point, 2.85~4.94% at B point, 0.74~1.65% at C point, and was under 0.4% at D point. As using Pb 2 mm for shield, scattered ray declined by average 9.74% at A and B point, 2.8% at C point, and is under 1% at D point. As using Pb 2 mm and bolus together for shield, scattered ray declined by average 9.76% at A and B point, 2.2% at C point, and is under 1% at D point. Conclusion : Commonly, in case of patients who got breast implant, there is a distance difference by breast size between the contralateral breast and the side of beam. As the distance is closer to the beam, the scattered ray inclined. At the same size of the breast, as the X-ray energy is higher, the exposure dose by scattered ray tends to incline. As a result, as low as possible energy wihtin the plan dose is good for reducing the exposure dose.

Comparison and evaluation between 3D-bolus and step-bolus, the assistive radiotherapy devices for the patients who had undergone modified radical mastectomy surgery (변형 근치적 유방절제술 시행 환자의 방사선 치료 시 3D-bolus와 step-bolus의 비교 평가)

  • Jang, Wonseok;Park, Kwangwoo;Shin, Dongbong;Kim, Jongdae;Kim, Seijoon;Ha, Jinsook;Jeon, Mijin;Cho, Yoonjin;Jung, Inho
    • The Journal of Korean Society for Radiation Therapy
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    • v.28 no.1
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    • pp.7-16
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    • 2016
  • Purpose : This study aimed to compare and evaluate between the efficiency of two respective devices, 3D-bolus and step-bolus when the devices were used for the treatment of patients whose chest walls were required to undergo the electron beam therapy after the surgical procedure of modified radical mastectomy, MRM. Materials and Methods : The treatment plan of reverse hockey stick method, using the photon beam and electron beam, had been set for six breast cancer patients and these 6 breast cancer patients were selected to be the subjects for this study. The prescribed dose of electron beam for anterior chest wall was set to be 180 cGy per treatment and both the 3D-bolus, produced using 3D printer(CubeX, 3D systems, USA) and the self-made conventional step-bolus were used respectively. The surface dose under 3D-bolus and step-bolus was measured at 5 measurement spots of iso-center, lateral, medial, superior and inferior point, using GAFCHROMIC EBT3 film (International specialty products, USA) and the measured value of dose at 5 spots was compared and analyzed. Also the respective treatment plan was devised, considering the adoption of 3D-bolus and stepbolus and the separate treatment results were compared to each other. Results : The average surface dose was 179.17 cGy when the device of 3D-bolus was adopted and 172.02 cGy when step-bolus was adopted. The average error rate against the prescribed dose of 180 cGy was -(minus) 0.47% when the device of 3D-bolus was adopted and it was -(minus) 4.43% when step-bolus was adopted. It was turned out that the maximum error rate at the point of iso-center was 2.69%, in case of 3D-bolus adoption and it was 5,54% in case of step-bolus adoption. The maximum discrepancy in terms of treatment accuracy was revealed to be about 6% when step-bolus was adopted and to be about 3% when 3D-bolus was adopted. The difference in average target dose on chest wall between 3D-bolus treatment plan and step-bolus treatment plan was shown to be insignificant as the difference was only 0.3%. However, to mention the average prescribed dose for the part of lung and heart, that of 3D-bolus was decreased by 11% for lung and by 8% for heart, compared to that of step-bolus. Conclusion : It was confirmed through this research that the dose uniformity could be improved better through the device of 3D-bolus than through the device of step-bolus, as the device of 3D-bolus, produced in consideration of the contact condition of skin surface of chest wall, could be attached to patients' skin more nicely and the thickness of chest wall can be guaranteed more accurately by the device of 3D-bolus. It is considered that 3D-bolus device can be highly appreciated clinically because 3D-bolus reduces the dose on the adjacent organs and make the normal tissues protected, while that gives no reduction of dose on chest wall.

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