Purpose : To evaluate the role of LINAC-based stereotactic radiosurgery (SRS) in the management of meningiomas, we reviewed clinical response, image response, neurological deficits for patients treated at our institution. Methods and materials : Between February 1995 and December 1999, twenty-six patients were treated with SRS. Seven patients had undergone prior resection. Nineteen patients received SRS as the initial treatment. There were 7 male and 19 female patients. The median age was 51 years (range, $14\~67\;years$). At least one clinical symptom presented at the time of SRS in 17 patients and cranial neuropathy was seen in 7 patients. The median tumor volume was $4.7\;cm^3\;(range,\;0.7\~16.5\;m^3)$. The mean marginal dose was 15 Gy (range, $10\~20\;Gy$), delivered to the $80\%$ isodose surface (range, $46\~90\%$). The median clinical and imaging follow-up periods were 27 months (range, 1-71 months) and 25 months (range, $1\~52\;months$), respectively. Results : Of 14 patients who had clinical follow-up of one year or longer, thirteen patients $(93\%)$ were improved clinically at follow-up examination. Clinical symptom worsened in one patient at 4 months after SRS as a result of intratumoral edema, who underwent surgical resection at 7 months. OF 14 patients who had radiologic follow-up of one year or longer, tumor volume decreased in 7 patients $(50\%)$ at a median of 11 months (range, $6\~25\;months$), remained stable in 6 patients $(43\%)$, and increased in one patient $(7\%)$, who underwent surgical resection at 44 months. New radiation-induced neurological deficits developed in six patients $(23\%)$. Five patients $(19\%)$ had transient neurological deficits, completely resolved by conservative treatment including steroid therapy. Radiation-induced brain necrosis developed in one patient $(3.8\%)$ at 9 months after SRS who followed by surgical resection of tumor and necrotic tissue. Conclusions : LINAC-based SRS proves to be an effective and safe management strategy for small to moderate sized meningiomas, inoperable, residual, and recurrent, but long-term follow-up will be necessary to fully evaluate its efficacy. To reduce the radiation-induced neurological deficit for large size meningioma and/or in the proximity of critical and neural structure, more delicate treatment planning and optimal decision of radiation dose will be necessary.
Verification of internal organ motion during treatment and its feedback is essential to accurate dose delivery to the moving target. We developed an offline based internal organ motion verification system (IMVS) using cine EPID images and evaluated its accuracy and availability through phantom study. For verification of organ motion using live cine EPID images, a pattern matching algorithm using an internal surrogate, which is very distinguishable and represents organ motion in the treatment field, like diaphragm, was employed in the self-developed analysis software. For the system performance test, we developed a linear motion phantom, which consists of a human body shaped phantom with a fake tumor in the lung, linear motion cart, and control software. The phantom was operated with a motion of 2 cm at 4 sec per cycle and cine EPID images were obtained at a rate of 3.3 and 6.6 frames per sec (2 MU/frame) with $1,024{\times}768$ pixel counts in a linear accelerator (10 MVX). Organ motion of the target was tracked using self-developed analysis software. Results were compared with planned data of the motion phantom and data from the video image based tracking system (RPM, Varian, USA) using an external surrogate in order to evaluate its accuracy. For quantitative analysis, we analyzed correlation between two data sets in terms of average cycle (peak to peak), amplitude, and pattern (RMS, root mean square) of motion. Averages for the cycle of motion from IMVS and RPM system were $3.98{\pm}0.11$ (IMVS 3.3 fps), $4.005{\pm}0.001$ (IMVS 6.6 fps), and $3.95{\pm}0.02$ (RPM), respectively, and showed good agreement on real value (4 sec/cycle). Average of the amplitude of motion tracked by our system showed $1.85{\pm}0.02$ cm (3.3 fps) and $1.94{\pm}0.02$ cm (6.6 fps) as showed a slightly different value, 0.15 (7.5% error) and 0.06 (3% error) cm, respectively, compared with the actual value (2 cm), due to time resolution for image acquisition. In analysis of pattern of motion, the value of the RMS from the cine EPID image in 3.3 fps (0.1044) grew slightly compared with data from 6.6 fps (0.0480). The organ motion verification system using sequential cine EPID images with an internal surrogate showed good representation of its motion within 3% error in a preliminary phantom study. The system can be implemented for clinical purposes, which include organ motion verification during treatment, compared with 4D treatment planning data, and its feedback for accurate dose delivery to the moving target.
It is important to practice preventive method to control oral disease. Dental caries tendency has been decreased in developed countries, but early childhood caries(ECC, BBTD) became serious dental problems in many countries. To slove these problems, more positive and definite prenatal programs on infants and child are needed. Mostly the control of oral health was affected by a mother's knowledge and behavior in this stage. According to many studies, prenatal education is the most effective method to promote oral health in children. But in Korea, there is little oral health education programs for pregnant women, nursing mothers, infants and children. The purpose of this study was to access the knowledge and opinions of caries prevention among gravid women. 330 pregnant women(primiparae=181, multiparae=149), aged 23 to 39 years were randomly selected at prenatal health education courses in Seoul, Korea, 2000. Face-to-Face interviews were conducted by a trained interviewer using questionnaires included demographics, attitude toward children's dental cares, knowledge of early childhood caries, knowledge concerning pregnancy and oral health. The obtained results were as follows; (1) Most respondents were very concerned about their children's oral health. (2) 58% of the respondents were unaware of early childhood caries and the proportion was significantly higher among primipara (p<0.05). (3) Only 43% of the respondents believed that improper breast feeding could develop ECC, the proportion was significantly higher among primipara(p<0.05). (4) 82% of the respondents reportedly believed that the fetus takes away calcium from the mother's teeth during pregnancy. (5) 71% of the respondents believed that dental treatment during pregnancy was unsafe. There is a relatively low level of accurate knowledge regarding infant nutritions, maternal need for oral health and dental caries prevention among pregnant women. Oral health education and promotion programs that are science-based are needed for gravid women.
Recently PTW developed a MicroLion liquid ionization chamber which is water_equivalent and has a small sensitive volume of $0.002cm^3$. The aim of this work is to investigate such dosimetric characteristics as dose linearity, dose rate dependency, spatial resolution, and output factors of the chamber for the external radiotherapy photon beam. The results were compared to those of Semiflex chamber, Pinpoint chamber and Diode chamber with the sensitive volumes of $0.125cm^3$, $0.03cm^3$ and $0.0025cm^3$, respectively and evaluated to be suitable for small fields. This study was performed in the 6MV photon energy from a Varian 2300 C/D linac accelerator and the MP3 water phantom (PTW, Freiburg) was used. Penumbras in the varios field sizes ranged from $0.5{\times}0.5cm^2$ to $10{\times}10cm^2$ were used to evaluate the spatial resolution. Output factors were measured in the field sizes of $0.5{\times}0.5$ to $40{\times}40cm^2$. Readings of the chamber was linearly proportional to dose. Dose rate dependency was measured from 100 MU/min to 600 MU/min, showed a maximum difference of 5.0%, and outputs decreased with dose rates. The spatial resolutions determined with comparing profiles for the field sizes of $0.5{\times}0.5cm^2$ to $10{\times}10cm^2$ agreed between every detector except the Semiflex chamber to within 2%. Outputs of detectors were compared to that of Semiflex chamber and showed good agreements within 2% for every chamber. This study shows that MicroLion chamber characterized by a high signal-to-noise ratio and water equivalence could be suitable for the small field dosimetry.
The purpose of this was to investigate the measurement of fluence dose map for the specific patient quality assurance. The measurement of fluence map was performed using 2D matrixx detector. The absorbed dose was measured by a glass detector, Gafchromic film and ion chamber in Hybrid Optimized VMAT Phantom (HOVP). For 2D Matrixx, the results of comparison were average passing rate $85.22%{\pm}1.7$ (RT_Target), $89.96%{\pm}2.15$ (LT_Target) and $95.14%{\pm}1.18$ (G4). The dose difference was $11.72%{\pm}0.531$, $-11.47%{\pm}0.991$, $7.81%{\pm}0.857$, $-4.14%{\pm}0.761$ at the G1, G2, G3, G4. In HOVP, the results of comparison for film were average passing rate (3%, 3 mm) $93.64%{\pm}3.87$, $90.82%{\pm}0.99$. We were measured an absolute dose in steep gradient area G1, G2, G3, G4 using the glass detector. The difference between the measurement and calculation are 8.3% (G1), -5.4% (G2), 6.1% (G3), 7.2% (G4). The using an Ion-chamber were an average relative dose error $-1.02%{\pm}0.222$ (Rt_target), $0.96%{\pm}0.294$ (Lt_target). Though we need a more study using a transmission detector. However, a measurement of real-time fluence map will be predicting a dose for real-time specific patient quality assurance in volume modulated arc therapy.
Alcohol impacts many central nervous systems, such as dopamine, serotonin, opioids, and gamma-aminobutyric acid (GABA), leading to addiction. Many studies have investigated the relationship between GABA and alcoholism. The purpose of this study was to investigate the effects of GABA high and low rice intake on the alcohol intake behavior of mice. Black sticky rice with giant embryo (BSRGE), black sticky rice (BSR), giant embryo rice (GER), and rice (Rice) were germinated for 48 hr in brown rice. The embryos were then collected and used in the study. The diets were fed to respective C57BL/6 mouse groups ad libitum for 16 days and investigated for 2 hr alcohol intake, 22 hr water intake, 24 hr feed intake, and body weight. As a result of the repeated measure of ANOVA for the daily change of alcohol intake for 2 hr daily between the BSRGE and BSR groups, there was a significant difference in the number of days of intake (DF = 7, F = 4.812, p = 0.026). A significant daily decrease in alcohol intake was observed in the BSRGE group compared to the BSR group. This reduction was consistent from Day 10 to Day 16. Alcohol consumption also significantly decreased in the GER group compared to the Rice group. This decrease was observed from Day 12 to Day 16. In conclusion, BSRGE and GER resulted in decreased alcohol intake in C57BL/6 mice compared to BSR and rice. This suggests that BSRGE may prevent relapse in patients with alcohol use disorder.
Journal of the Korean Society of Food Science and Nutrition
/
v.38
no.10
/
pp.1353-1361
/
2009
This study investigated the effect of waxy barley on the incorporation trans fat (tFA) into plasma lipid and lipid profile through 6 weeks trial. 39 healthy volunteers were divided into 2 groups and fed waxy barley bread (WBG) or wheat bread (WG) containing equivalent amounts of tFA (elaidic acid rich, 3.75 g/day), respectively. Plasma lipid profiles and fatty acid composition at 0, 2, 4, 6 weeks after a respective bread were studied. Plasma lipid was extracted by the method of Folch, esterified by acid transmethylation and analyzed by gas chromatography. The fatty acid composition reflected the fatty acid proportion of the test fat. However, consumption of waxy barley bread with tFA for 6 weeks affected plasma fatty acid composition including tFA. Incorporation of tFA into plasma lipid was significantly lowered compared to WBG than in WG after 6 weeks of consumption. Furthermore, saturated fatty acids such as C16:0 and C18:0 levels were also significantly lowered in WBG than in WG. Furthermore, plasma total cholesterol level and TG/HDL-cholesterol ratio were also significantly lowered in WBG compared to WG at 2, 4 and 6 weeks. These results suggest that waxy barley bread with high $\beta$-glucan lowered plasma trans, saturated fatty acid and total cholesterol levels though the inhibition of lipid absorption.
Kim, Seong-Hoon;Huh, Hyun-Do;Choi, Sang-Hyun;Choi, Jin-Ho;Kim, Hyeog-Ju;Lim, Chun-Il;Shin, Dong-Oh
Progress in Medical Physics
/
v.20
no.4
/
pp.317-323
/
2009
The standard dosimetry systems based on an absorbed dose to water recommend to use a planeparallel chamber for the calibration of such a low-megavoltage electron beam as a nominal energy of 6 MeV. For this energy ranges of an electron beam a cylindrical chamber should not be used for the routinely regular beam calibration, but the feasibility of the temporary use of a cylindrical chamber was studied to give temporary solutions for special situations users meet. The PTW30013 chambers and the electron beam quality of $R_{50}=2.25\;g/cm^2$ were selected for this study. 10 PTW30013 chambers, a cylindrical type of chamber, were calibrated in KFDA, the secondary standards dosimetry laboratories, and given the absorbed dose-to-water calibration factors, respectively. A "temporary" $k_{Q,Q_0}$ for each chamber were calculated using the absorbed dose determined by a cross-calibrated planeparallel chamber, with the result of an average 0.9352 for 10 chambers. This value for PTW30013 chamber was used to determine an absorbed dose to water at the reference depth. The absorbed doses determined by PTW30013 chambers were in an agreement within 2% with that by ROOS chamber. In a certain situation where a cylindrical chamber be used instead of a planeparellel chamber, the value of 0.9352 might be useful to determine an absorbed dose to water in the same beam quality of electron beam as this study.
$\underline{Purpose}$: To evaluate the effectiveness and safety of fentanyl-TTS in the management of radiotherapy induced acute pain and cancer pain treated with radiotherapy. $\underline{Materials\;and\;Methods}$: Our study was open labelled prospective phase IV multi-center study. the study population included patients with more 4 numeric rating scale(NRS) score pain although managed with other analgesics or more than 6 NRS score pain without analgesics. Patients divided into two groups; patients with radiotherapy induced pain (Group A) and patients with cancer pain treated with radiotherapy (Group B). All patients received 25 ug/hr of fentanyl transdermal patch. Primary end point was pain relief; second end points were change in patient quality of life, a degree of satisfaction for patients and clinician, side effects. $\underline{Results}$: Between March 2005 and June 2005, 312 patients from 26 participating institutes were registered, but 249 patients completed this study. Total number of patients in each group was 185 in Group A, 64 in Group B. Mean age was 60 years and male to female ratio was 76:24. Severe pain NRS score at 2 weeks after the application of fentanyl was decreased from 7.03 to 4.01, p=0.003. There was a significant improvement in insomnia, social functioning, and quality of life. A degree of satisfaction for patients and clinician was very high. The most common reasons of patients' satisfactions was good pain control. Ninety six patients reported side effect. Nausea was the most common side effect. There was no serious side effect. $\underline{Conclusion}$: Fentanyl-TTS was effective in both relieving pain with good tolerability and improving the quality of life for patients with radiotherapy induced acute pain and cancer pain treated with radiotherapy. The satisfaction of the patients and doctors was good. There was no major side effect.
Kim, Ha-Young;Lee, Jeong-Yol;Huh, Jung-Bo;Shin, Sang-Wan
The Journal of Korean Academy of Prosthodontics
/
v.49
no.3
/
pp.229-235
/
2011
Purpose: The aim of this study was to evaluate the current status of dental geriatric education in Korea. Materials and methods: One of the faculty members related in geriatric education was selected in each Korean dental school and the questionnaire on geriatric dental education was sent to them by e-mail. The questionnaire consists of the topics about undergraduate geriatric education and administration of the geriatric education. The information obtained from the questionnaire was compared with that of other countries in the aspects of curriculum, teaching methods, subjects, and existence of specific clinics, etc. Results: Seven schools have geriatric dentistry in undergraduate education curriculum. Among those, only two schools had it taught by theoretical lecture as well as clinical lecture. Two dental schools had specific geriatric clinic among seven dental schools. Compared with the USA and western European countries, the geriatric dental education in Korea is at a developing stage and was perfunctory without diverse clinical experience. Conclusion: In Korean dental schools, geriatric education was mostly conducted by lectures, and clinical teaching programs were not well organized compared with developed countries. It seems that the status of geriatric dental education in Korea has not been well established academically or administratively yet.
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