• Title/Summary/Keyword: Tissue therapy

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The Effect of Bee Venom Therapy on Skin Aging (봉독이 피부 노화에 미치는 영향)

  • Kim, Jin-Myoung;Kim, Yoon-Bum
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.23 no.2
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    • pp.27-40
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    • 2010
  • Background and Objective : Increasing interest in anti-aging and anti-wrinkling agents for the skin has triggered the recent outflow of researches and studies in this field. This study was designed to investigate the effects of bee venom on skin wrinkling and skin aging by testing the skin wrinkling, skin elasticity, trans-epidermal water loss (TEWL), free radical level, anti-oxidative agent level, and skin tissue after infusion of bee venom on hairless mouse. Materials and Methods : Fifteen hairless mice aged between 36~40 weeks were divided randomly into 3 Group; the Bee Venom Syringe Group, the Bee Venom Needle Group, and the control group. The Bee Venom Syringe Group were injected subcutaneously with bee venom (0.1cc in total) using an insulin syringe on three spots in the lumbar spine (one spot on the center and two spots 1~2cm to the side bilaterally). The Bee Venom Needle Group were pricked with bee venom-smeared acupuncture needles on three longitudinal spots in the lumbar spine each 1cm apart, after which the needles were removed 10 minutes later. The Control Group did not receive any form of intervention. All procedures took place thrice a week for four weeks, during which the mice were allowed free access to water and fodder. The mice were measured and compared in the weight, skin wrinkling scale, skin elasticity, and TEWL before and after the experiment. After the experiment, blood samples were taken to measure the free radical and anti-oxidative agent level, and the skin tissue was sliced for examination. Data was analyzed using the SPSS program (ver 12.0). The ANOVA analysis was used to compare and contrast the three groups, and t-test for paired samples was used to evaluate skin-wrinkling before and after experiment. The cut-off p-value of significance was set at p<0.05. Results : 1. Administration of bee venom did not cause serious weight loss or gain. 2. Compared to the control group, the Bee Venom Syringe Group and the Bee Venom Needle Group both showed a decrease in skin wrinkling scale after intervention. Especially, the Bee Venom Syringe Group showed a significant decrease (p<0.05). 3. Compared to the control group, the Bee Venom Syringe Group and the Bee Venom Needle Group both showed an increase in skin elasticity. Especially, the Bee Venom Syringe Group showed a significant increase (p<0.05). 4. No significant change in TEWL was found in the mice in all the three groups before and after experiment. 5. Free radical level was normal in all 15 mice in all the three groups, and anti-oxidative agent was not significantly different across the three groups. 6. The Bee Venom Syringe Group, the Bee Venom Needle Group, and the control group did not show any significant difference in the thickness of epidermis and dermis, infiltration of inflammatory cells, and skin wrinkling. The epidermis layer was relatively better preserved in the Bee Venom Syringe Group as compared to the Bee Venom Needle Group and the control group. Conclusion : Direct injection of bee venom on the hairless mouse using a syringe was found to improve wrinkling of the skin and increase skin elasticity but did not show effectiveness on skin dryness due to water loss. The bee venom appears to have suppressive effects on skin wrinkling, one of the symptoms of skin aging, through a process independent of suppression of free radicals or increase of anti-oxidative agent.

The Relationship between Heme Oxygenase-1 Expression and Response to Cisplatin Containing Chemotherapy in Advanced Non-Small Cell Lung Cancer (진행성 비소세포폐암에서 Heme oxygenase-1 발현과 Cisplatin을 포함하는 항암화학요법의 치료반응과의 연관성)

  • Yang, Doo Kyung;Roh, Mee Sook;Lee, Kyung Eun;Kim, Ki Nam;Lee, Ki Nam;Choi, Pil Jo;Bang, Jung Hee;Kim, Bo Kyung;Seo, Hyo Rim;Kim, Min Ji;Kim, Seul Ki;Lee, Soo-Keol;Son, Choon Hee
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.3
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    • pp.314-320
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    • 2006
  • Background : The overall response (20-30%) to chemotherapy in non-small cell lung cancer (NSCLC) is quite poor. Heme oxygenase-1 (HO-1) is the rate-limiting enzyme in heme degradation. There is increasing evidence suggesting that the induction of HO-1 might have an important protective effect against oxidative stress including cisplatin containing chemotherapy. This study retrospectively investigated the relationship between HO-1 expression and the response to chemotherapy containing cisplatinin advanced NSCLC patients. Material and Methods : The medical records including the responses to chemotherapy of fifty nine cases were evaluated retrospectively, and the tissue samples of these patients were immunohistochemically stained for HO-1. Results : Forty three of the fifty nine patients(72.8%) showed positive staining for HO-1 in their cancer tissues. There was no significant difference according to the cell type, stage and tumor size. In addition, there was no correlation between HO-1 expression and the responses to chemotherapy. Conclusion : HO-1 expression in tumor tissue dose not predict the response to cisplatin containing chemotherapy in advanced NSCLC. Further prospective studies with a larger number of patients will be needed to confirm these results.

A Study on Pulmonary Toxic Effect of High-Dose Cisplatin Administered by Isolated Lung Perfusion in Dogs (잡견에서 분리폐관류 방법으로 투여된 고농도 cisplatin의 페독성에 관한 연구)

  • 김관민;한정호;김주현
    • Journal of Chest Surgery
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    • v.33 no.9
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    • pp.697-706
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    • 2000
  • Background: Isolated lung perfusion(ILP) was developed as a new treatment approach to non-resectable primary or metastatic lung cancer, because of its ability to reduce systemic toxicity while delivering high-dose chemotherapeutic agents to the target organs. This research was planned to evaluate the direct toxic effect of high-dose cisplatin to the lung tissue during isolated lung perfusion. Material and Method: Fifteen mongrel dogs were divided in the perfusate for 40 minutes. The second group was composed of 5 mongrel dogs which underwent ILP with cisplatin 2.5 mg/Kg added to the perfusate for 30 minutes and 10 minutes with washing solution without cisplatin. The third group underwent the same procedure as the second group except cisplatin 5.0 mg/Kg in the perfusate. Activities of serum angiotensin converting enzyme(ACE), tumor necrosis factor-$\alpha$(TNF-$\alpha$), and concentration of serum lactate dehydrogenase(LDH) and blood urea nitrogen/creatinine (BUN/Cr) were analyzed in each groups at the time of pre-perfusion, 1 hour, 1 day, 1 week, and 2 weeks after ILP. Result: Serum ACE activities before and 1 hour, 1 day, 1 week, and 2 weeks after ILP in control group were 45.1$\pm$6.3, 44.6$\pm$9.3, 46.7$\pm$9.5, 50.8$\pm$9.1, 46.1$\pm$4.3 U/L. Those in cisplatin 2.5 and 5.0 mg/Kg groups were 49.4$\pm$12.6, 39.0$\pm$8.6, 42.3$\pm$15.9, 50.0$\pm$2.6, 53.8$\pm$8.3 and 55.5$\pm$12.3, 47.0$\pm$6.3, 45.1$\pm$6.9, 74.8$\pm$19.5, 60.2$\pm$12.0 U/L, respectively. Serum TNF-$\alpha$ activities in each group before and after ILP were 5.0$\pm$1.5 / 7.7$\pm$2.2 / 6.6$\pm$2.5 / 4.3$\pm$1.3 / 5.2$\pm$1.1(control), 8.7$\pm$1.6 / 9.9$\pm$2.2 / 7.9$\pm$1.5 / 6.3$\pm$2.2 / 7.4$\pm$2.4 (cisplatin 2.5 mg/Kg), and 6.9$\pm$0.7 / 8.9$\pm$3.4 / 7.9$\pm$4.0 / 3.3$\pm$0.9 / 5.8$\pm$1.3 pg/ml(cisplatin 5.0 mg/Kg). Mean LDH levels of each group were 225.7 / 271.3 / 328.9 / 350.8 / 255.7(control), 235.7 / 265.7 / 336.0 / 379.5 / 299.2 (cisplatin 2.5 mg/Kg), and 259.6 / 285.2 / 340.6 / 433.4 / 292.4 IU/L(cisplatin 5.0 mg/Kg). So there was no significant difference in serum ACE, TNF-$\alpha$, and LDH activity changes after ILP between the 3 groups. And, there was no significant changes in BUN/Cr in each groups, which was independent of ILP and perfused concentration of cisplatin. In addition, all dogs survived the ILP and there was no significant evidence of pulmonary vascular injury after 2 weeks of ILP with cisplatin. Conclusion: There was no harmful effect of cisplatin to the lund tissue of the mongrel dog up to 5.0 mg/Kg in perfusate. Therefore, it is perceived to be safe and effective to deliver high-dose cisplatin to the lung without pulmonary toxicity and renal damage with ILP.

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Comparison of Distribution of Cadmium-109 and Gallium-67 in Sarcoma-Bearing Mice (Sarcoma-bearing Mice에서 Cadmium-109과 Gallium-67의 체내 분포의 비교)

  • Sohn, Myung-Hee;Chang, Sook-Kyeong;Chung, Kyung-Ho;Han, Young-Min;Kim, Chong-Soo;Choi, Ki-Chul;Yim, Chang-Yeol;Kang, Shin-Hwa
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.1
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    • pp.98-105
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    • 1994
  • The search for tumor-avid agents for use in nuclear medicine imaging or therapy is a field of ongoing importance. Metallothionein (MT) is an intracellular protein that binds many metals with isotopes having imaging or radiotherapeutic potential. The purpose of the study was to determine whether uptake of radioisotopes that bind to MT is increased in tumor. We measured the uptake of Cd-109 and Ga-67 in tumor and normal tissues of sarcoma-bearing mice. Tumors were grown subcutaneously in female Balb/C mice from cultured Balb/3T3 cells transformed by the Moloney murine sarcoma virus (MMSV). When the tumors reached about 1 cm in diameter, mice were injected subcutaneously with Cd-109 and Ga-67. Eighteen and seventy-two hours later, the mice were sacrified. Organs and tissues were removed, weighed, and activity per mg tissue determined by gamma well-counting. Uptake of Cd-109 by MMSV tumors exceeded that by normal tissues examined, with the exception of liver and kidney (the organs known to be richest in MT). The tumor-to-tissue ratios of uptake for Cd-109 were far greater than those for Ga-67 for many normal tissues of great importance in terms of background activity (bone, intestine, fat, muscle, and blood). We concluded that metals that bind to MT may be useful for oncologic imaging or rediotherapy of cancer.

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Expression of NGF in Estradiol Valerate-Induced Polycystic Ovary and CHO Cells (Estradiol Valerate에 의해 유도된 다낭성난소와 CHO세포에서 NGF발현)

  • Choi, Baik-Dong;Jeong, Soon-Jeong;Jeong, Moon-Jin;Lim, Do-Seon;Lee, Soo-Han;Kim, Seung-Hyun;Go, A-Ra;Kim, Se-Eun;Kang, Seong-Soo;Bae, Chun-Sik
    • Applied Microscopy
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    • v.41 no.2
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    • pp.109-116
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    • 2011
  • Polycystic ovary syndrome (PCOS) is hormonal imbalance condition as the endocrine and metabolic disorder that induces the infertility and various complications in reproductive age women. Estradiol valerate (EV) is used hormone replacement therapy in menopausal women and is reported that excessive administration of EV induces the PCOS. Nerve growth factor (NGF) is the factor to regulate the survival and maturation of developing neuronal cell and is also synthesized in ovary. And NGF is overexpressed in EV-induced polycystic ovary (PCO) as previously reported. Therefore, this study examined the possibility of NGF as can be used the biological marker in diagnosis of PCOS, the hormonal imbalance condition, using PCO and CHO (chinese hamster ovarian) cell lines. The concentration of EV treatment is optimized a 1 mg as not influence on the proliferation of CHO cell but 2 mg and 3 mg of EV treatment have the inhibition effect at initial stage. The morphological change was not observed in CHO cell after dose dependent manner treatment of EV. Expression of NGF mRNA and protein is significantly increased at 30 min after EV treatment in CHO cells compared to that of control. And NGF protein expression is strongly increased in PCO tissue, which observed many follicular cysts compared to normal ovary tissue. Taken together, overexpression of NGF may be act as a molecule to induce an abnormal development of follicle, suggesting that NGF can be used as a biological marker in diagnosis of PCOS.

The Bone regenerative effects of tetracycline blended chitosan membranes on the calvarial critical size defect in Sprague dawley rats (백서 두개골 결손부에서 항생제를 함유한 키토산 차단막의 골재생 유도 효과)

  • Chae, Gyung-Joon;Kim, Tae-Gyun;Jung, Ui-Won;Lee, Soo-Bok;Jung, Yong-Sik;Lee, Yong-Keun;Kim, Chang-Sung;Chae, Jung-Kiu;Cho, Kyoo-Sung;Kim, Chong-Kwan;Choi, Seong-Ho
    • Journal of Periodontal and Implant Science
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    • v.35 no.4
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    • pp.1019-1037
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    • 2005
  • The major goals of periodontal therapy are the functional regeneration of periodontal supporting structures already destructed by periodontal disease as well as the reduction of signs and symptoms of progressive periodontal disease. There have been many efforts to develop materials and therapeutic methods to promote periodontal wound healing. There have been increasing interest on the chitosan made by chtin. Chitosan is a derivative of chitin made by deacetylation of side chains. Chitosan has been widely studied as bone substitution and membrane material in periodontology. Many experiments using chitosan in various animal models have proven its beneficial effects. Tetracycline has been considered for use in the treatment of chronic periodontal disease and gingivitis. The aim of this study is to evlauate the osteogenesis of tetracycline blended chitosan membranes on the calvarial critical size defect in Sprague Dawley rats. An 8mm surgical defect was produced with a trephine bur in the area of the midsagittal suture. The rats were divided into five groups: Untreated control group versus four experimental group. Four types of membranes were made and comparative study was been done. Two types of non-woven membranes were made by immersing non-woven chitosan into either the tetracycline solution or chitosan-tetracycline solution. Other two types of sponge membranes were fabricated by immersing chitosan sponge into the tetracycline solution, and subsequent freeze-drying. The animals were sacrificed at 2 and 8 weeks after surgical procedure. The specimens were examined by histologic analyses. The results are as follows: 1. Clinically the use of tetracycline blended chitosan membrane showed great healing capacity. 2. The new bone formations of all the experimental group, non-woven and sponge type membranes were greater than those of control group. But, there was no significant difference between the experimental groups. 3. Resorption of chitosan membranes were not shown in any groups at 2 weeks and 8 weeks. These results suggest that the use of tetracycline blended chitosan membrane on the calvarial defects in rats has significant effect on the regeneration of bone tissue in itself. And it implicate that tetracycline blended chitosan membrane might be useful for guided tissue regeneration.

THE EFFECTS OF POLYTETRAFLUOROETHYLENE MEMBRANE AND MILLIPORE FILTER COMBINED WITH FIBRIN ON THE REGENERATION OF PERIODONTIUM IN DOGS (Polytetrafluoroethylene membrane 및 millipore filter를 섬유소와 병용사용시 성견 치주조직 재생에 미치는 영향)

  • Joo, Sang-Don;Park, Jae-Wan;Suh, Jo-Young
    • Journal of Periodontal and Implant Science
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    • v.23 no.3
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    • pp.577-594
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    • 1993
  • The ultimate goal of periodontal therapy is the regeneration of the periodontium that have been destroyed as a result of periodontal disease. This study were done in order to determine the healing status of periodontium under Polytetrafluoroethylene and millipore fillter combined with fibrin and the effect of the guided tissue regeneration procedures were performed as follows : 1) flap operation using PTFE membrane(control group) 2) flap operation using PTFE membrane which was fixed with fibrin(experimental group 1) 3) flap operation using millipore filter which was fixed with suture(experimental group II) 4) flap operation using millipore filter which was fixed with fibrin(experimental group II) After 1, 2, 4, 8, 12 weeks, dogs were sacrificed by perfusion technique and tissue block was excised including the tooth and prepared for light microscope with H-E & Masson’s trichrome staining. The result were as follows : In control and experimental group, there is no siginificant difference on epithelial cell down growth within 1st week, but more epithelial cell downgrowth in millipore or millipore combined with fibrin group. In this experiment, there were no significant difference in new cementum and alveolar bone formation whether PTFE membrane was fixed with suture or fibrin. In control and each experimental group, bone maturation appeared in 4 weeks, bone width increased bucco-lingually in control and experimental 1 group especially. Both control group and experimental group showed mild mew cementum formation on root surface and irregular arrangement of collagen fiber at 4 weeks, that showed obvious increased cementum formation at 8 weeks, and that was observed the functional arrangement of collagen fiber between new cementum and new alveolar bone at 12 weeks.

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TIMP-2 Gene Transfer Via Adenovirus Inhibits the Invasion of Lung Cancer Cell (TIMP-2 유전자 재조합 아데노바이러스의 폐암세포 침윤 억제 효과)

  • Oh, Yeon-Mok;Lee, Jae-Ho;Yoo, Chul-Gyu;Chung, Hee-Soon;Kim, Young-Whan;Han, Sung-Koo;Shim, Young-Soo;Lee, Choon-Taek
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.2
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    • pp.189-197
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    • 2000
  • Background : Tissue inhibitor of metalloproteinase is a natural inhibitor that counteracts pro teolytic enzymes essential to the invasion of cancer cell. Whether or not TIMP-2 gene transfer via adenovirus could inhibit the invasion of lung cancer cell iη vitro was evaluated for the future purpose of gene therapy against lung cancer. Methods : Recombinant adenovirus-TIMP-2(Ad-TIMP-2) was generated by homologous recombination after pACCMV-TIMP-2 and pJM17 were cotransfected into 293 cell by standard calcium phosphate coprecipitate method. Calu-6, one of the most invasive lung cancer cells, was transduced with Ad-TIMP-2 or Ad-$\beta$gal. Anchorage-independent growth and invasiveness were assessed by soft agar clonogenicity assay and invasion assay using two-chamber, well divided by matrigel. Results : Ad-TIMP-2 transduced calu-6 cells produced biologically active TIMP-2 more than 50 times more than parental calu-6. TIMP-2 gene transfer did not suppress the in vitro tumorigenicity. However, two chamber well assay revealed that Ad-TIMP-2 transduction reduced the invasiveness of calu-6 efficiently (12% compared with parental cell) even at low 10moi. Conclusion : Even though TIMP-2 gene transfer did not inhibit in vitro tumorigenicity, it did inhibit invasion of lung cancer cell in vitro. The inhibition of invasion by Ad-TIMP-2 may be a useful strategy for the treatment of lung cancer.

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Analysis of Frequent Disease and Medical Expenses Structure of Patients Admitted in a Vaterans Hospital (일개 보훈병원 입원환자의 상병 및 진료비 구조분석)

  • Kim, Kyoung-Hwan;Lee, Sok-Goo;Kim, Jeong-Yeon
    • Journal of agricultural medicine and community health
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    • v.30 no.1
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    • pp.1-14
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    • 2005
  • Objectives: This study attempts to analyze the length of hospital stay and expenses of frequent disease admitted in a Vaterans Hospital. Methods: Data was collected from January 1, 2001 to December 31, 2003 from the Claim records of 9,640 patients in a Vaterans Hospital. Results: The results were as follows: 1. In age & sex distribution, there was male 70.9%, female 29.1%, and 35.8% of them is 70 age group. Frequency by insurance program was Health insurance 78.1%, Medical aid 14.2%, no insurance 4.1%, others 3.6%. Distribution of each department was internal medicine 28.3%, orthopedic surgery 21.3%, surgery 16.6%, neurosurgey 7.1%, pediatrics 5.9%. Also, in the veterans group, male to female patient ratio was 99.3% male to 0.7% female, them over 70 years old was 51.6%, and them which live in daejeon was 43.5%. 2. In frequency of disease, there was gastroenteritis 4.8%, pneumonia 3.8%, cartaract 3.7%, cerebral infarct 3.2%, hyperplasia of prostate 3.0%. In frequency of korean standard classification of diseases, there was injury and poisoning and certain other consequences of external causes 17.1%, diseases of digestive system 16.1%, diseases of musculoskeletal system and connective tissue 13.9%, diseases of respiratory system 9.4%, diseases of genitourinary system 8.6%. Also, in veterans group, frequency of them was diseases of musculoskeletal system and connective tissue 19.4%, diseases of digestive system 16.8%, injury and poisoning and certain other consequences of external causes 15.7%, diseases of genitourinary system 9.7%, diseases of circuatory system 8.2%. 3. Average length of hospital stay was 29.0 days for total patients, 51.8 days for the veterans group, 15.7 days for the non-veterans one. Average total expenses was 3,669,579 won, the veterans group 7,263,877 won, the non-veterans one 1,560,333 won. The ratio of insurer to insuree was 55.2 : 44.8, the ratio of amount paid by patient in the veterans group 61.7%, in the non-veterans one 33.0%. 4. In items of medical expenses, fee for hospital accommodation was 34.7%, fee for medication 13.2%(injection 7.8%, drug 5.4%), fee for service 48.6%(physical therapy 26.3%, operation 9.7%, laboratory examination 5.2%, radiological examination 3.1%, etc), others 3.4%. In them for the veterans group, fee for physical therapy was 35.3%, fee for hospital accommodation 35.2%, fee for injection 6.2%, fee for operation 5.9%, for the non-veterans one, fee for hospital accommodation 35.7%, fee for operation 16.4%, fee for injection 11.4%, fee for laboratory examination 8.3%. 5. In the comparison of the frequency by Korean standard classification of diseases and distance between the hospital and home, the region under 21.5Km was more frequent in symptoms, signs an abnormal clinical and laboratory findings 56.0%, injury and poisoning and certain other consequences of external causes 55.6%, diseases of the eye and adnexa 52.9%, the one over 21.5Km was more frequent in neoplasms 57.4%, diseases of musculoskeletal system and connective tissue 55.9%, diseases of genitourinary system 53.5%.

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Experimental investigation of the photoneutron production out of the high-energy photon fields at linear accelerator (고에너지 방사선치료 시 치료변수에 따른 광중성자 선량 변화 연구)

  • Kim, Yeon Su;Yoon, In Ha;Bae, Sun Myeong;Kang, Tae Young;Baek, Geum Mun;Kim, Sung Hwan;Nam, Uk Won;Lee, Jae Jin;Park, Yeong Sik
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.2
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    • pp.257-264
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    • 2014
  • Purpose : Photoneutron dose in high-energy photon radiotherapy at linear accelerator increase the risk for secondary cancer. The purpose of this investigation is to evaluate the dose variation of photoneutron with different treatment method, flattening filter, dose rate and gantry angle in radiation therapy with high-energy photon beam ($E{\geq}8MeV$). Materials and Methods : TrueBeam $ST{\time}TM$(Ver1.5, Varian, USA) and Korea Tissue Equivalent Proportional Counter (KTEPC) were used to detect the photoneutron dose out of the high-energy photon field. Complex Patient plans using Eclipse planning system (Version 10.0, Varian, USA) was used to experiment with different treatment technique(IMRT, VMAT), condition of flattening filter and three different dose rate. Scattered photoneutron dose was measured at eight different gantry angles with open field (Field size : $5{\time}5cm$). Results : The mean values of the detected photoneutron dose from IMRT and VMAT were $449.7{\mu}Sv$, $2940.7{\mu}Sv$. The mean values of the detected photoneutron dose with Flattening Filter(FF) and Flattening Filter Free(FFF) were measured as $2940.7{\mu}Sv$, $232.0{\mu}Sv$. The mean values of the photoneutron dose for each test plan (case 1, case 2 and case 3) with FFF at the three different dose rate (400, 1200, 2400 MU/min) were $3242.5{\mu}Sv$, $3189.4{\mu}Sv$, $3191.2{\mu}Sv$ with case 1, $3493.2{\mu}Sv$, $3482.6{\mu}Sv$, $3477.2{\mu}Sv$ with case 2 and $4592.2{\mu}Sv$, $4580.0{\mu}Sv$, $4542.3{\mu}Sv$ with case 3, respectively. The mean values of the photoneutron dose at eight different gantry angles ($0^{\circ}$, $45^{\circ}$, $90^{\circ}$, $135^{\circ}$, $180^{\circ}$, $225^{\circ}$, $270^{\circ}$, $315^{\circ}$) were measured as $3.2{\mu}Sv$, $4.3{\mu}Sv$, $5.3{\mu}Sv$, $11.3{\mu}Sv$, $14.7{\mu}Sv$, $11.2{\mu}Sv$, $3.7{\mu}Sv$, $3.0{\mu}Sv$ at 10MV and as $373.7{\mu}Sv$, $369.6{\mu}Sv$, $384.4{\mu}Sv$, $423.6{\mu}Sv$, $447.1{\mu}Sv$, $448.0{\mu}Sv$, $384.5{\mu}Sv$, $377.3{\mu}Sv$ at 15MV. Conclusion : As a result, it is possible to reduce photoneutron dose using FFF mode and VMAT method with TrueBeam $ST{\time}TM$. The risk for secondary cancer of the patients will be decreased with continuous evaluation of the photoneutron dose.