• Radiation Oncology Journal
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• v.31 no.4
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• pp.252-259
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• 2013

Purpose: To report the results of dosimetric comparison between intensity-modulated radiotherapy (IMRT) using Tomotherapy and four-box field conformal radiotherapy (CRT) for pelvic irradiation of locally advanced rectal cancer. Materials and Methods: Twelve patients with locally advanced rectal cancer who received a short course preoperative chemoradiotherapy (25 Gy in 5 fractions) on the pelvis using Tomotherapy, between July 2010 and December 2010, were selected. Using their simulation computed tomography scans, Tomotherapy and four-box field CRT plans with the same dose schedule were evaluated, and dosimetric parameters of the two plans were compared. For the comparison of target coverage, we analyzed the mean dose, $V_{nGy}$, $D_{min}$, $D_{max}$, radical dose homogeneity index (rDHI), and radiation conformity index (RCI). For the comparison of organs at risk (OAR), we analyzed the mean dose. Results: Tomotherapy showed a significantly higher mean target dose than four-box field CRT (p = 0.001). But, $V_{26.25Gy}$ and $V_{27.5Gy}$ were not significantly different between the two modalities. Tomotherapy showed higher $D_{max}$ and lower $D_{min}$. The Tomotherapy plan had a lower rDHI than four-box field CRT (p = 0.000). Tomotherapy showed better RCI than four-box field CRT (p = 0.007). For OAR, the mean irradiated dose was significantly lower in Tomotherapy than four-box field CRT. Conclusion: In locally advanced rectal cancer, Tomotherapy delivers a higher conformal radiation dose to the target and reduces the irradiated dose to OAR than four-box field CRT.

• The Journal of the Korea Contents Association
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• v.12 no.12
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• pp.694-701
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• 2012

This study set put to measure the environmental radiation for mountainous regions of National Parks where Integrated Environmental Radiation Monitoring Network is not installed. For the measurement method, the space dose was classified at 1 meter high from the surface and the index dose at the surface. The measured radiation energy measured gamma, alpha and beta rays. For selection of national parks, we selected 10 national parks which are within the same distribution in the southern part and central part of the nation. For measurement equipment, INTERCEPTOR$^{TM}$(Thermo, USA, 2006) was used for gamma rays. As for the results of the measurements, for the space gamma dose, a high level was measured at a sea level of 500 meter in national parks with an altitude of less than 1,000 meter. It was found that the value was more than $0.23{\mu}Svh^{-1}$ especially in Bukhan Mountain, Gyeryong Mountain and Wolchul Mountain. In national parks with an altitude of more than 1,000 meter, $1.77{\mu}Svh^{-1}$ was measured at 1,500 meter at Seorak Mountain. Therefore, this is 10 times greater than the background standard dose. The national parks were there were no significant changes in dose were Naejang Mountain, Sobaek and Jiri Mountains. For the measurement of the index dose, a high dose level was measured at middle altitudes of 500 meter and 1,000 meter. For measurement according to the composition types of crust, high doses were recorded at national parks composed of rocks and a lower environmental radiation level was measured at Hanra Mountain where volcanic activities have occurred.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.8
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• pp.3257-3265
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• 2015

Background: Radiotherapy is an important treatment of choice for breast cancer patients after breast-conserving surgery, and we compare the feasibility of using dual arc volumetric modulated arc therapy (VMAT2), single arc volumetric modulated arc therapy (VMAT1) and Multi-beam Intensity Modulated Radiotherapy (M-IMRT) on patients after breast-conserving surgery. Materials and Methods: Thirty patients with breast cancer (half right-sided and half left-sided) treated by conservative lumpectomy and requiring whole breast radiotherapy with tumor bed boost were planned with three different radiotherapy techniques: 1) VMAT1; 2) VMAT2; 3) M-IMRT. The distributions for the planning target volume (PTV) and organs at risk (OARs) were compared. Dosimetries for all the techniques were compared. Results: All three techniques satisfied the dose constraint well. VMAT2 showed no obvious difference in the homogeneity index (HI) and conformity index (CI) of the PTV with respect to M-IMRT and VMAT1. VMAT2 clearly improved the treatment efficiency and can also decrease the mean dose and V5Gy of the contralateral lung. The mean dose and maximum dose of the spinal cord and contralateral breast were lower for VMAT2 than the other two techniques. The very low dose distribution (V1Gy) of the contralateral breast also showed great reduction in VMAT2 compared with the other two techniques. For the ipsilateral lung of right-sided breast cancer, the mean dose was decreased significantly in VMAT2 compared with VMAT1 and M-IMRT. The V20Gy and V30Gy of the ipsilateral lung of the left-sided breast cancer for VMAT2 showed obvious reduction compared with the other two techniques. The heart statistics of VMAT2 also decreased considerably compared to VMAT1 and M-IMRT. Conclusions: Compared to the other two techniques, the dual arc volumetric modulated arc therapy technique reduced radiation dose exposure to the organs at risk and maintained a reasonable target dose distribution.

• Biomedical Science Letters
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• v.12 no.3
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• pp.289-301
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• 2006

Cardiopulmonary bypass (CPB) for cardiac surgery triggers the production and release of numerous chemotactic substances and cytokines, ensuing systemic inflammatory response that leads to postoperative major organ dysfunction. Traditionally, corticosteroids (steroid) have been administered to patients undergoing cardiac surgery to ward off these detrimental physiologic alterations. However, the majority of the studies have been performed on adult patients with high-dose steroid. We carried out a randomized, prospective, double-blind study to compare the efficacy of low-dose steroid with that of high-dose steroid and to determine the adequate dose of pretreated-steroid for prophylactic effects in pediatric cardiac surgery. Thirty pediatric patients scheduled for elective cardiac surgery were randomly assigned to two groups; fifteen patients received low-dose methylprednisolone (10mg/kg intravenously, n=15, low-dose group) and the others received high-dose methylprednisolone (30mg/kg intravenously, n=15, high-dose group) 1 hour prior to CPB. Arterial blood samples were taken before CPB (Pre-CPB), 10 minutes after start of CPB (CPB-10), and immediately after CPB-end (CPB-OFF) for measuring total leukocyte counts (T-WBC) and diff-counts, platelet counts, interleukin-6 (IL-6), myeloperoxidase (MPO), total antioxidant (TAO), neuron-specific enolase (NSE), troponin I (TNI), aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatinine, and blood urea nitrogen (BUN) levels. Other parameters such as volumes of urine output, pulmonary index $(PI,\;PaO_2/FiO_2)$, mechanical ventilating period, intensive care unit (ICU)-staying period, postoperative complications (fever, wound problem), postoperative 24 hrs and total volumes in blood loss, and hospitalized days were also assessed. All parameters were compared between two groups. There were no significant differences in T-WBC counts, monocyte fraction, platelet counts, TA levels, NSE levels, creatinine levels, BUN levels, the volumes of total urine output, PI, the incidences of fever and wound problem, postoperative 24hrs- and total-blood loss volumes and ICU-staying period between two groups (P>0.05). At CPB-OFF, neutrophil fraction, MPO level, TNI level, and AST level were higher in the high-dose group than in the low-dose group (P<0.05). IL-6 level at CPB-10 was higher in the high dose-group than in the low-dose group (P<0.05). Furthermore, mechanical ventilating periods and hospitalized days of the high-dose group were significantly longer than those of low-dose group (P<0.05). The high-dose group had significantly low lymphocyte fi-action at CPB-OFF compared with the low-dose group (P<0.001). These findings suggest that pretreatment of high-dose steroid is not superior to that of low-dose steroid regrading its potential benefits in pediatric cardiac surgery. Therefore, the conventional strategy of steroid treatment, high-dose pretreatment, should be modified in the cardiac surgery with CPB. However, further studies must be performed on the larger number of patients in as much as small number of patients in this study.

• Radiation Oncology Journal
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• v.31 no.2
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• pp.104-110
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• 2013

Purpose: Intensity modulated arc therapy (IMAT) is a form of intensity modulated radiation therapy (IMRT) that delivers dose in single or multiple arcs. We compared IMRT plans versus single-arc field (1ARC) and multi-arc fields (3ARC) IMAT plans in high-risk prostate cancer. Materials and Methods: Sixteen patients were studied. Prostate ($PTV_P$), right pelvic ($PTV_{RtLN}$) and left pelvic lymph nodes ($PTV_{LtLN}$), and organs at risk were contoured. $PTV_P$, $PTV_{RtLN}$, and $PTV_{LtLN}$ received 50.40 Gy followed by a boost to $PTV_B$ of 28.80 Gy. Three plans were per patient generated: IMRT, 1ARC, and 3ARC. We recorded the dose to the PTV, the mean dose ($D_{MEAN}$) to the organs at risk, and volume covered by the 50% isodose. Efficiency was evaluated by monitor units (MU) and beam on time (BOT). Conformity index (CI), Paddick gradient index, and homogeneity index (HI) were also calculated. Results: Average Radiation Therapy Oncology Group CI was 1.17, 1.20, and 1.15 for IMRT, 1ARC, and 3ARC, respectively. The plans' HI were within 1% of each other. The $D_{MEAN}$ of bladder was within 2% of each other. The rectum $D_{MEAN}$ in IMRT plans was 10% lower dose than the arc plans (p < 0.0001). The GI of the 3ARC was superior to IMRT by 27.4% (p = 0.006). The average MU was highest in the IMRT plans (1686) versus 1ARC (575) versus 3ARC (1079). The average BOT was 6 minutes for IMRT compared to 1.3 and 2.9 for 1ARC and 3ARC IMAT (p < 0.05). Conclusion: For high-risk prostate cancer, IMAT may offer a favorable dose gradient profile, conformity, MU and BOT compared to IMRT.

• Journal of Radiation Protection and Research
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• v.30 no.1
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• pp.9-15
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• 2005

This study was conducted to investigate the patient exposure dose during a CT examination and the present position in utilization of the CT equipments. To this end Questionnaire were sent out to 278 medical facilities registered at Korea Hospital Association and replies of 161 medical facilities were analyzed. The results were as follows ; 1) The distribution of CT examination was. Brain 40.7%, Abdomen 27.8%, Chest 15.7%, Spine 4.8%, Pelvis 4.1%, PNS 3.2%, Facial bone 2.5% and Extremity 1.1% respectively. 2) The statistics for dose index according to each part of examination were Brain 38.0mGy, Abdomen 12.0mGy for adults : Brain 13.6mGy, Abdomen 6.2mGy for infant. Our surveyed dose index appeared lower than the IAEA recommends. 3) Most medical facilities have selected the parameters for radiographic exposure in the range of $100{\sim}120kVp,\;100{\sim}250mA\;and\;1{\sim}2$ seconds.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2006.08a
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• pp.121-121
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• 2006

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.7
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• pp.3465-3468
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• 2016

Background: Fluorodeoxyglucose ($^{18}FDG$) PET/CT imaging has become an important component of the management paradigm in oncology. However, the significant imparted radiation exposure is a matter of growing concern especially in younger populations who have better odds of survival. The aim of this study was to estimate the effective dose received by patients having whole body $^{18}F$-FDG PET/CT scanning as per recent dose reducing guidelines at a tertiary care hospital. Materials and Methods: This prospective study covered 63 patients with different cancers who were referred for PET/CT study for various indications. Patients were prepared as per departmental protocol and 18FDG was injected at 3 MBq/Kg and a low dose, non-enhanced CT protocol (LD-NECT) was used. Diagnostic CT studies of specific regions were subsequently performed if required. Effective dose imparted by 18FDG (internal exposure) was calculated by using multiplying injected dose in MBq with coefficient $1.9{\times}10^{-2}mSv/MBq$ according to ICRP publication 106. Effective dose imparted by CT was calculated by multiplying DLP (mGy.cm) with ICRP conversion coefficient "k" 0.015 [mSv / (mG. cm)]. Results: Mean age of patients was $49{\pm}18$ years with a male to female ratio of 35:28 (56%:44%). Median dose of 18FDG given was 194 MBq (range: 139-293). Median CTDIvol was 3.25 (2.4-6.2) and median DLP was 334.95 (246.70 - 576.70). Estimated median effective dose imparted by $^{18}FDG$ was 3.69 mSv (range: 2.85-5.57). Similarly the estimated median effective dose by low dose (non-diagnostic) CT examination was 4.93 mSv (range: 2.14 -10.49). Median total effective dose by whole body 18FDG PET plus low dose non-diagnostic CT study was 8.85 mSv (range: 5.56-13.00). Conclusions: We conclude that the median effective dose from a whole body 18FDG PET/CT in our patients was significantly low. We suggest adhering to recently published dose reducing strategies, use of ToF scanner with CT dose reducing option to achieve the lower if not the lowest effective dose. This would certainly reduce the risk of second primary malignancy in younger patients with higher odds of cure from first primary cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.17
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• pp.7129-7135
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• 2014

Background: In this study, we aimed to evaluate the growth inhibitory effect of the combination of ethaselen (BBSKE) and low fixed dose of selenite against A549 human non-small cell lung cancer cells in vitro. Materials and Methods: Growth inhibitory effects against A549 cells were determined by SRB assay. Combination index (CI) values were calculated based on Chou-Talalay median-effect analyses. Dose reduction index (DRI) values were applied to calculate dose reduction of selenite. Contents of free thiols and GSH were determined by DTNB assay and intracellular ROS levels by DCFH-DA fluorescence labeling. Results: Compared with BBSKE or selenite single treatment, the combined application of ethaselen and a low fixed dose of selenite shortened the onset time of sodium selenite, reduced $IC_{50}$ values, and increased the maximum inhibition rates, suggesting a possible molecular mechanism of the synergism. Obvious synergistic effects were observed after different times of combination treatment, especially after 24 h. Compared with selenite single treatment, dosage of selenite could be remarkably reduced in combination therapy to gain the same inhibitory effect on cell proliferation. Compared with BBSKE single treatment, the content of free thiols and GSH were significantly reduced and ROS levels greatly elevated in the combination group. For the combination treatment, cell viability increased as greater concentrations of GSH were added. Conclusions: All these results indicate that the combination treatment of BBSKE and selenite showed synergism to inhibit A549 cell proliferation in vitro, and also reduced the selenite dosage to mitigate its toxicity which is very meaningful for combination chemotherapy of lung cancer. The synergism was probably caused by the accelerated exhaustion of intracellular reductive substances, such as free thiols and GSH, which ultimately leads to enhanced oxidative stress and apoptosis.

• Nuclear Engineering and Technology
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• v.49 no.8
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• pp.1752-1757
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• 2017

The aim of this study is to evaluate the radioactivity levels and radiological impacts of representative black sand samples collected from different locations in the Rashid area, Egypt. These samples were prepared and then analyzed using the high-resolution gamma ray spectroscopy technique with a high-purity germanium detector. The activity concentration ($A_c$), minimum detectable activity, absorbed gamma dose rate, external hazard index ($H_{ex}$), annual effective dose rate equivalent, radium equivalent, as well as external and internal hazard index ($H_{ex}$ and $H_{in}$, respectively) were estimated based on the measured radionuclide concentration of the $^{238}U$($^{226}Ra$) and $^{232}Th$ decay chains and $^{40}K$. The activity concentrations of the $^{238}U$, $^{232}Th$ decay series and $^{40}K$ of these samples varied from $45.11{\pm}3.1Bq/kg$ to $252.38{\pm}34.3Bq/kg$, from $64.65{\pm}6.1Bq/kg$ to $579.84{\pm}53.1Bq/kg$, and from $403.36{\pm}20.8Bq/kg$ to $527.47{\pm}23.1Bq/kg$, respectively. The activity concentration of $^{232}Th$ in Sample 1 has the highest value compared to the other samples; this value is also higher than the worldwide mean range as reported by UNSCEAR 2000. The total absorbed gamma dose rate and the annual effective dose for these samples were found to vary from 81.19 nGy/h to 497.81 nGy/h and from $99.86{\mu}Sv/y$ to $612.31{\mu}Sv/y$, which are higher than the world average values of 59 nGy/h and $70{\mu}Sv/y$, respectively. The $H_{ex}$ values were also calculated to be 3.02, 0.47, 0.63, 0.87, 0.87, 0.51 and 0.91. It was found that the calculated value of $H_{ex}$ for Sample 1 is significantly higher than the international acceptable limit of <1. The results are tabulated, depicted, and discussed within national and international frameworks, levels, and approaches.