• The Korean Journal of Nuclear Medicine Technology
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• v.17 no.2
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• pp.3-9
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• 2013

Purpose: Currently commercially available phantom can reproduce and evaluate only a static situation, the study is incomplete research on phantom and system which is can confirmed functional situation in the kidney by time through dynamic phantom and blood flow velocity, various difference according to the amount of radioactive. Therefore, through this study, it has produced the dynamic kidney phantom to reproduce images through the dynamic flow of the kidney, it desire to evaluate the usefulness of nuclear medicine imaging. Materials and Methods: The production of the kidney phantom was fabricated based on the normal adult kidney, in order to reproduce the dynamic situation based on the fabricated kidney phantom, in this study it was applied the volume pump that can adjust the speed of blood flow, so it can be integrated continuously radioactive isotopes in the kidney by using $^{99m}Tc-pertechnate$. Used the radioactive isotope was supplied through the two pump. It was confirmed the changes according to the infusion rate, radioactive isotopes and the different injection speeds on the left and right, analysis of the acquired images was done by drawn ten times ROI in order to check the reproducibility of each on the front and rear of the kidney and bladder. Results: Under the same conditions infusion rate 40 mL/min fixed to adjust the pressure of the pump when the radiopharmaceuticals between 2-3 minutes in the most integrated in the kidney phantom was excreted inthe bladder. Glomerular filtration rate (GFR), respectively, by each device SYMBIA 1,091 mL/min, FORTE 1,232 mL/min, ARGUS 1,264 mL/min, INFINIA 1,302 mL/min in that there isno statistically significant difference was found, Tmax values and T1/2 values stars from all equipment with no statistically significant difference was found. CV values of the coefficient of variation less than 5% was found to be repeatable, and to 2.67% of the lowest SYMBIA appeared, INFINIA was the highest in the 4.86%. Conclusion: Through this study, the results showed that the dynamic kidney phantom system is able to similarly reproduce renogram in the actual clinical. Especially, the depicted over time for the flow to be excreted through the kidney into the bladder was adequately reproduce, it is expected to be utilized as basic data to check the quality of the dynamic images. In addition, it is considered to help in the field of functional imaging and quality control.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2005.04a
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• pp.68-70
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• 2005

To precisely localize target in prostate cancer, image-guided radiotherapy was performed using the $ExacTrac^{\circledR}$ x-ray system (Brainlab, Germany) with implanted markers. For three prostate cancer patients, three gold markers were implanted into prostate. Orthogonal portal images were acquired every treatment and CT scans were repeated 3～5 times during the course of treatment. After correcting setup errors calculated by the system, the position of the implanted markers and the distance between them were detected in daily portal images and in CT images, and analyzed retrospectively. Deviation of the relative position of the implanted markers and the distance between them were less than 1 mm in lateral, longitudinal, and vertical direction for three patients, both in portal images and CT images. This study reveals that image-guided radiotherapy using the $ExacTrac^{\circledR}$ system is useful to verify positioning errors and localize prostate target with implanted markers, reducing the planning target volume (PTV) margin as well as irradiation to rectum and bladder.

• Journal of Menopausal Medicine
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• v.24 no.3
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• pp.163-168
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• 2018

Objectives: To investigate the rate of postoperative urinary retention (POUR) and identify the risk factors for this complication in women who underwent transvaginal uterosacral suspension surgery. Methods: A retrospective chart review was conducted for 75 women who underwent transvaginal uterosacral suspension surgery with vaginal hysterectomy, repair of cystocele, and levator myorrhaphy with/without transobturator anti-incontinence surgery. POUR was defined as a need for continuous intermittent catheterization on the third day subsequent to removal of the urethral indwelling catheter. Results: Acute POUR was reported in 18 women (24.0%). Thirty-six of the 75 patients (48.0%) had undergone anti-incontinence surgery. Crude analysis revealed significant association between the following variables and the risk of POUR: hypertension, the lower average flow rate in the pressure-flow study (PFS), greater post-void residual (PVR) urine volume in PFS, and PVR >30% of the total bladder capacity (TBC) in PFS. In the logistic regression analysis, PVR >30% of the TBC in PFS was identified as the only significant predictor of POUR (odds ratio, 15.4; 95% confidence interval, 2.5-90.9; P = 0.003). Conclusions: The PVR >30% of the TBC in PFS was identified as the only predictive factor of acute POUR in women who underwent transvaginal uterosacral suspension surgery.

• International Neurourology Journal
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• v.22 no.4
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• pp.275-286
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• 2018

Purpose: OnabotulinumtoxinA (BoNT-A) is a promising therapy for treating neurogenic detrusor overactivity (NDO) in individuals with spinal cord injury (SCI). This systematic review and meta-analysis aimed to carry out an in-depth review and to make an objective estimation of the efficacy and safety of BoNT-A on NDO after SCI. Methods: The PubMed, Embase, and Cochrane databases were searched for all relevant articles published from 2001 to 2016 that referred to NDO, SCI, and BoNT-A or botulinum toxin A. All data were recorded in an Excel spreadsheet by 2 individual reviewers. Review Manager version 5.3 was used to carry out the meta-analysis. Results: This analysis included 17 studies involving 1,455 patients. Compared with placebo and baseline, BoNT-A was effective in increasing maximum cystometric capacity, volume at first involuntary detrusor contraction, cystometric bladder capacity (all P<0.00001), compliance (P=0.001), and the number of patients with complete dryness (P=0.0003), and decreasing detrusor pressure, the number of patients with no involuntary detrusor contractions, the maximum flow rate, the incidence of detrusor overactivity (all P<0.00001), and the number of urinary incontinence episodes (P=0.001). There were no statistically significant differences between doses of 200 U and 300 U or between injections into the detrusor and submucosa. There were no life-threatening adverse events. Conclusions: BoNT-A is effective and safe in treating NDO after SCI. There were no statistically significant differences between doses of 200 U and 300 U or between injecting into the detrusor and submucosa. However, more high-quality randomized controlled trials are still needed.

• Journal of Korean Medical classics
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• v.32 no.1
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• pp.133-143
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• 2019

Objectives : In this study, we analyze the medical significance of feces symptoms so that the daily records of the feces of individuals can be not only used as a measure of individual health monitoring in daily life, but also more actively connected to the medical treatment of the Korean Medicine (KM). Methods : Categories and clinically significant attributes for symptoms of Urination and defecation in the KM ontology DB are determined, and connected to KM related dialectical indicators by experts' common criteria including Viscera and Bowels [臟腑], eight principles [八綱], Qi Blood fluid and humor phlegm-retained fluid static blood [氣血津液痰飮瘀血], six excesses [六淫]. Results : The analysis of the symptoms of feces in the Korea Medicine ontology shows that the symptoms of stool in categories of 'stool stiffness', 'blood swelling', 'discomfort' are highly ranked among the overall clinical symptom categories. In the case of urine symptoms, symptoms corresponding to 'urine color,' 'urine discomfort,' and 'urine volume' are the top rankers among other total clinical symptoms. In the case of stool, the relationship between the symptom of stool and the categories of spleen, stomach, and colon is increased as the weighted symptom is considered. The relationship between the symptom of urine and the categories of the small intestine and the bladder is increased in the same way. Conclusions : This study could help better utilize the personal generated health records of feces in clinical practice of Korean Medicine.

• Progress in Medical Physics
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• v.29 no.4
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• pp.157-163
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• 2018

Plans converted using dose-volume-histogram-based plan conversion (DPC) were evaluated by comparing them to the original plans. Changes in the dose volumetric (DV) parameters of five volumetric modulated arc therapy (VMAT) plans for head and neck (HN) cancer and five VMAT plans for prostate cancer were analyzed. For the HN plans, the homogeneity indices (HIs) of the three planning target volumes (PTV) increased by 0.03, 0.02, and 0.03, respectively, after DPC. The maximum doses to the PTVs increased by 1.20, 1.87, and 0.92 Gy, respectively, after DPC. The maximum doses to the optic chiasm, optic nerves, spinal cord, brain stem, lenses, and parotid glands increased after DPC by approximately 4.39, 3.62, 7.55, 7.96, 1.77, and 6.40 Gy, respectively. For the prostate plans after DPC, the HIs for the primary and boost PTVs increased by 0.05 and 0.03, respectively, and the maximum doses to each PTV increased by 1.84 and 0.19 Gy, respectively. After DPC, the mean doses to the rectum and femoral heads increased by approximately 6.19 and 2.79 Gy, respectively, and those to the bladder decreased by 0.20 Gy when summing the primary and boost plans. Because clinically unacceptable changes were sometimes observed after DPC, plans converted by DPC should be carefully reviewed before actual patient treatment.

• Journal of Veterinary Clinics
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• v.40 no.2
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• pp.104-112
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• 2023

The change in the position of the abdominal organs due to movement by respiration is one of the reasons behind inaccurate irradiation of organs during radiotherapy (RT). Although studies in human medicine have revealed on the respiratory movements of abdominal organs, there is little information and no reference data for dogs. The purpose of this study was to establish the reference values of abdominal organs movement in various postures using computed tomography (CT), and to compare the movements of organs between dorsal recumbency and ventral, right and left lateral recumbency during respiration. CT images for kidney, adrenal gland, medial iliac lymph node, urinary bladder, gallbladder, liver, stomach, and thoracic and lumbar vertebral body of five beagle dogs were acquired. The movements of organs were evaluated by comparing the end-expiratory and end-inspiratory images. Movements of the organs were evaluated by dividing it into right-to-left, dorsal-to-ventral, and cranial-to-caudal directions. The movements of abdominal organs according to the change in postures and respiration were establish. The movement of the bilateral organs was the least when the organs were in the downward position (p < 0.017). The movement of cranial-to-caudal direction was greater than the movement of the other directions in most of the organs. Data obtained in this study may be useful in selecting the appropriate posture that can reduce the movements of organs to be treated with RT, and the data could be useful for setting the planning target volume to consider the movements of the abdominal organs by respiration.

• Childhood Kidney Diseases
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• v.28 no.1
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• pp.27-34
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• 2024

Purpose: The ability to concentrate urine becomes an important index in determining nocturnal enuresis (NE) treatment. The aim of our study was to investigate first-morning urine osmolality (Uosm) changes at the end of treatment compared to before treatment in children with NE. Methods: A total of 71 children with NE were divided into two groups according to the level of first-morning Uosm before treatment: high group (≥800 mOsm/kg) and low group (<800 mOsm/kg). Baseline parameters were obtained from uroflowmetry, frequency volume charts for at least 2 days, and a questionnaire for lower urinary tract symptoms. All patients were basically treated with standard urotherapy and medication. The first-morning Uosm was measured twice, before treatment and at the end of treatment. Results: The response rate was higher in the low group after 3 months of treatment than in the high group (P=0.041). However, there was no difference between the two groups at the end of the treatment. In the high group, the first-morning Uosm at the end of treatment did not show a significant change compared to before treatment. In contrast, the first-morning Uosm increased in the low group at the end of treatment (P<0.001). However, it was still lower than that of the high group (P=0.007). Conclusions: The ability to concentrate nocturnal urine improved at the end of treatment compared to before treatment in the low Uosm NE children. In addition, NE improved faster in the low Uosm group before treatment than in the high group.

• Journal of the Korean Society of Radiology
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• v.9 no.7
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• pp.449-457
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• 2015

In this study, to evaluate the usefulness of the treatment plan of tomotherapy and volumetric modulated arc therapy (VMAT) in the radiotherapy for prostate cancer, the absorbed dose, dose volume histogram (DVH), treatment efficiency, and the results of dose verification accuracy using MapCHECK2 were compared and analyzed. Of the prostate cancer patients who underwent tomotherapy treatment in the Radiologic Oncology of H University Hospital between July 2014 and December 2014, 12 patients were randomly selected. As a result of analyzing the absorbed dose and DVH, both radiologic treatment plans showed slight differences in the treatment of the cancer tissues and the bladder, but the difference was in the error range of -5% to +3%, and did not exceed the side effect guideline or the tolerance dose limit. VMAT showed higher treatment efficiency than tomotherapy with a 2.5 times shorter treatment time and a 10.3 times less monitor unit (MU). Both showed 95% or higher dose accuracy satisfying the standard. VMAT showed 2.3% higher efficiency than tomotherapy. In both tomotherapy and VMAT, appropriate doses were absorbed for cancer tissues, and did not exceed the tolerance dose for normal tissues showing no significant difference in dose distribution. However, considering the shorter treatment time, lower total MU, and better treatment efficiency and dose verification accuracy, VMAT may be more useful than tomotherapy in cancer treatments.

• Radiation Oncology Journal
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• v.16 no.2
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• pp.167-175
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• 1998

Purpose : It is not a simple task to achieve the ideal isodose curve with a standard vaginal applicator or sing1e plane needle impant in the paravaginal tissue when primary or recurrent gynecological neoplasms(cervical cancers, vaginal cancers and vulvar cancers) are treated as a boost following external beam radiotherapy. The authors introduce the development and construction of a simple, inexpensive, customized applicator for volume implant to maximize the radiation dose to the tumor while minimizing the dose to the rectum and the bladder. Materials and Methods : Nine patients underwent Ir-192 transperineal interstitial implantation for either recurrent(5 cases) or primary(3 cases) cervical cancers or primary vaginal cancer(1 case) between August 1994 and February 1998 at Ajou university hospital. First 3 cases were performed with a sing1e plane implant guided by digital palpation. Because of inadequate isodose coverage in the tumor volume in first 3 cases, we designed and constructed interstitial vaginal applicator for volume implant to improve tumor dose distribution and homogeneity while sparing the surrounding normal tissue. Our applicators consist of vaginal obturator and perineal template that made of the clear acrylamide and dental mold material$(Provil^{(R)})$. The applicators were customized individually according to the tumor size and its location Both HDR and LDR irradiation were given with these applicators accomodating 6 Fr needles(Microselectron Nucletron). The pretreatment planning prior to actual implant was performed whenever possible. Results : Needles can be inserted easily and evenly into the tumor volume through the holes of templates, requiring less efforts and time for the implant procedure. Our applicators made of materials available from commercial vendors. These have an advantage that require easy procedure, and spend relatively short time to construct. Also it was possible to fabricate applicators to individualize according to the tumor size and its location and to achieve the ideal isodose coverage. We found an accurate needle arrangement and ideal dose distribution through the CT scan that was obtained in 3 cases after needle implant. Three patients with primary cervical and vaginal cancers were controlled locally at final follow up. But all recurrent cases failed to do so. Conclusion : The authors introduce inexpensive, simple interstitial vaginal templates which were self-designed and constructed using materials available from commercial vendors such as acrylanide and dental mold material $(Provil^{(R)})$.