• The Korean Journal of Pain
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• v.35 no.2
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• pp.129-139
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• 2022

C-arm fluoroscopy is a useful tool for interventional pain management. However, with the increasing use of C-arm fluoroscopy, the risk of accumulated radiation exposure is a significant concern for pain physicians. Therefore, efforts are needed to reduce radiation exposure. There are three types of radiation exposure sources: (1) the primary X-ray beam, (2) scattered radiation, and (3) leakage from the X-ray tube. The major radiation exposure risk for most medical staff members is scattered radiation, the amount of which is affected by many factors. Pain physicians can reduce their radiation exposure by use of several effective methods, which utilize the following main principles: reducing the exposure time, increasing the distance from the radiation source, and radiation shielding. Some methods reduce not only the pain physician's but also the patient's radiation exposure. Taking images with collimation and minimal use of magnification are ways to reduce the intensity of the primary X-ray beam and the amount of scattered radiation. It is also important to carefully select the C-arm fluoroscopy mode, such as pulsed mode or low-dose mode, for ensuring the physician's and patient's radiation safety. Pain physicians should practice these principles and also be aware of the annual permissible radiation dose as well as checking their radiation exposure. This article aimed to review the literature on radiation safety in relation to C-arm fluoroscopy and provide recommendations to pain physicians during C-arm fluoroscopy-guided interventional pain management.

• Neonatal Medicine
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• v.18 no.2
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• pp.310-319
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• 2011

Purpose: The aim of this study was to investigate the effect of perinatal risk factors on brain maturation and the relationship of brain maturation and neurodevelopmental outcomes with brain maturation scoring system in brain MRI. Methods: ELBWI infants born at the Seoul National University Children's Hospital from January 2006 to December 2010 were included. A retrospective analysis was performed with their medical record and brain MR images acquired at near full term. We read brain MRI and measured maturity with total maturation score (TMS). TMS is a previously developed anatomic scoring system to assess brain maturity. The total maturation score was used to evaluate the four parameters of maturity: (1) myelination, (2) cortical infolding, (3) involution of glial cell migration bands, and (4) presence of germinal matrix tissue. Results: Images from 124 infants were evaluated. Their mean gestational age at birth was 27.1${\pm}$2.1 weeks, and mean birth weight was 781.5${\pm}$143.9 g. The mean TMS was 10.8${\pm}$2.0. TMS was significantly related to the postmenstrual age (PMA) of the infant, increasing with advancing postmenstrual age (P<0.001). TMS showed no significance with neurodevelopmental delay, and with brain injury, respectively. Conclusion: TMS was developed for evaluating brain maturation in conventional brain MRI. The results of this study suggest that TMS was not useful for predicting neurodevelopmental delay, but further studies are needed to make standard score for each PMA and to re-evaluate the relationship between brain maturation and neurodevelopmental delay.

• Radiation Oncology Journal
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• v.35 no.3
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• pp.289-294
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• 2017

Sorafenib is widely used for unresectable and metastatic hepatocellular carcinomas. Radiation recall dermatitis (RRD) is an acute inflammatory reaction confined to previously irradiated skin that occurs after the administration of certain drugs. RRD after sorafenib treatment is rare; five cases have been reported thus far. We describe a 44-year-old man irradiated for chest wall bone metastasis from hepatocellular carcinoma. Eight days after radiotherapy completion, systemic therapy for metastatic hepatocellular carcinoma was initiated with sorafenib treatment. Eleven days after starting sorafenib, the patient complained of erythematous rash with pruritus in the chest wall, in a location consistent with the previous radiation field. Sorafenib was continued at the same dose, despite the RRD. The skin reaction subsided over the next 2 weeks without any medical intervention.

• Progress in Medical Physics
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• v.20 no.3
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• pp.167-173
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• 2009

As the radiotherapy technique development, the needs for using of medical electronic chart in the department of radiation oncology is growing. However, the complexity of affairs of radiation oncology make it difficult to develop a electronic medical chart. In this study, we introduce the electronic medical chart developed by domestic hospital. The function and example of electronic medical chart designed as radiation treatment progress was showed and the future study was presented.

• 순환기질환의공학회:학술대회논문집
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• 2002.11a
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• pp.35-35
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• 2002

• Radiation Oncology Journal
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• v.35 no.3
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• pp.268-273
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• 2017

Purpose: We performed this retrospective study to investigate the outcomes of patients with hemangioma of the cavernous sinus after fractionated radiotherapy. Materials and Methods: We analyzed 10 patients with hemangioma of the cavernous sinus who were treated with conventional radiotherapy between January 2000 and December 2016. The median patient age was 54 years (range, 31-65 years), and 8 patients (80.0%) were female. The mean hemangioma volume was $34.1cm^3$ (range, $6.8-83.2cm^3$), and fractionated radiation was administered to a total dose of 50-54 Gy with a daily dose of 2 Gy. Results: The median follow-up period was 6.8 years (range, 2.2-8.8 years). At last follow-up, the volume of the tumor had decreased in all patients. The average tumor volume reduction rate from the initial volume was 72.9% (range, 18.9-95.3%). All 10 of the cranial neuropathies observed before radiation therapy had improved, with complete symptomatic remission in 9 cases (90%) and partial remission in 1 case (10%). No new acute neurologic impairments were reported after radiotherapy. One probable compressive optic neuropathy was observed at 1 year after radiotherapy. Conclusion: Fractionated radiotherapy achieves both symptomatic and radiologic improvements. It is a well-tolerated treatment modality for hemangiomas of the cavernous sinus.

• Progress in Medical Physics
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• v.29 no.1
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• pp.42-46
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• 2018

The purpose of this study was to perform a survey of the radiation shielding design goals (P) and workload (W) based on the radiation safety reports concerned with structural shielding design for the IMRT treatment technique in Tomotherapy vaults. The values of the P and W factors as well as of a verified concrete thickness of the ceiling, bottom, sidewalls (sidewall-1 and sidewall-2), and door have been obtained from radiation safety reports for a total of 16 out of 20 vaults. The recommended and most widely used report for P values was the NCRP No. 151 report, which stated that the P factor in controlled and uncontrolled areas was 0.1 and 0.02 mSv/week, respectively. The range of the W factor was 600~14,720 Gy/week. The absorbed dose delivered per patient was 2~3 Gy. The maximum number of patients treated per day was 10~70. The quality assurance (QA) dose was 100~1,000 Gy/week. Fifteen values of the IMRT factor (F) were mostly used but a maximum of 20 values was also used. The concrete thickness for primary structures including the ceiling, bottom, sidewalls, and door was sufficient for radiation shielding. The P and W factors affect the calculation of the structural shielding design, and several parameters, such as the absorbed dose, patients, QA dose, days and F factor can be varied according to the type of shielding structure. To ensure the safety of the radiation shielding, it is necessary to use the NCRP No. 151 report for the standard recommendation values.

• Biomolecules & Therapeutics
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• v.24 no.6
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• pp.616-622
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• 2016

Baicalein (5,6,7-trihydroxy-2-phenyl-chromen-4-one) is a flavone, a type of flavonoid, originally isolated from the roots of Scutellaria baicalensis. This study evaluated the protective effects of baicalein against oxidative damage-mediated apoptosis induced by ultraviolet B (UVB) radiation in a human keratinocyte cell line (HaCaT). Baicalein absorbed light within the wavelength range of UVB. In addition, baicalein decreased the level of intracellular reactive oxygen species (ROS) in response to UVB radiation. Baicalein protected cells against UVB radiation-induced DNA breaks, 8-isoprostane generation and protein modification in HaCaT cells. Furthermore, baicalein suppressed the apoptotic cell death by UVB radiation. These findings suggest that baicalein protected HaCaT cells against UVB radiation-induced cell damage and apoptosis by absorbing UVB radiation and scavenging ROS.

• Radiation Oncology Journal
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• v.33 no.2
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• pp.75-82
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• 2015

Purpose: We evaluated the prognostic significance of T3 subtypes and the role of adjuvant radiotherapy in patients with resected the American Joint Committee on Cancer stage IIB T3N0M0 non-small cell lung cancer (NSCLC). Materials and Methods: T3N0 NSCLC patients who underwent resection from January 1990 to October 2009 (n = 102) were enrolled and categorized into 6 subgroups according to the extent of invasion: parietal pleura chest wall invasion, mediastinal pleural invasion, diaphragm invasion, separated tumor nodules in the same lobe, endobronchial tumor <2 cm distal to the carina, and tumor-associated collapse. Results: The median overall survival (OS) and disease-free survival (DFS) were 55.3 months and 51.2 months, respectively. In postoperative T3N0M0 patients, the tumor size was a significant prognostic factor for survival (OS, p = 0.035 and DFS, p = 0.035, respectively). Patients with endobronchial tumors within 2 cm of the carina also showed better OS and DFS than those in the other T3 subtypes (p = 0.018 and p = 0.016, respectively). However, adjuvant radiotherapy did not cause any improvement in survival (OS, p = 0.518 and DFS, p = 0.463, respectively). Only patients with mediastinal pleural invasion (n = 25) demonstrated improved OS and DFS after adjuvant radiotherapy (n = 18) (p = 0.012 and p = 0.040, respectively). Conclusion: The T3N0 NSCLC subtype that showed the most favorable prognosis is the one with endobronchial tumors within 2 cm of the carina. Adjuvant radiotherapy is not effective in improving survival outcome in resected T3N0 NSCLC.

• Progress in Medical Physics
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• v.27 no.4
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• pp.258-266
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• 2016

We have treated various disease sites using wobbling and scanning proton therapy techniques since December 2015 at the Samsung Medical Center. In this study, we analyze the treatment time for each disease site in 65 wobbling and 50 scanning patient treatments. Treatment times are longest for liver and lung patients using the respiratory gating technique in the wobbling treatment and for cranio-spinal irradiation in pediatric patients with anesthesia in the scanning treatment. Moreover, we analyze the number of incidents causing treatment delays and the corresponding treatment delay time. The X-ray panel was the main reason for delays in the wobbling treatment; this decreased continually from January to June 2016, related closely to the proficiency of the human operators involved. The main reason for delays in the scanning treatment was interlocks during scanning pattern delivery; this was resolved by proton machine engineers. Through this work, we hope to provide other institutes with useful insight for initial operation of their proton therapy machines.