• Sim-seong Yeon-gu
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• v.25 no.1
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• pp.65-101
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• 2010

By considering the final purpose and meaning of two fairy-tales, we can summarize two things. Firstly, a woman with father complex not only positive, but also negative can easily sacrifice her femininity and her own personality as an individual. A woman with father complex has to get out of father imago. By separating from father imago, she can make her own steps to realize her own personality, namely individuation. During normal development, detachment to instinct and archetypal contents can cause problems normally to the ego consciousness. Contrary to this developmental notion, women with father complex experience problems because they are too closely attached to father archetype. Therefore, continuous excessive identification of ego with father imago or a state of ego caught by father imago leads to death of her own personality. Some women intentionally attach to father imago in order to be powerful or to receive magical power of father archetype to make compensation to her inferiority and deficiency. Weak ego wants to be stronger and superior by intentional attachment to father imago. Then, she can succeed in some tasks in life. But These successes are not by her own effort, but by magical or superhuman power of father imago. During early childhood, young girl with weak ego strongly attaches to father imago to make success and achieve goals by magical power. She wants to compensate her weak ego. But the more her ego makes successes in real life with help of father imago, the more she loses her own character or personality. Ego can be strong enough only when it is detached or separated itself from father imago. In other side, there is a woman destined to realize request by the father imago. She is chosen by the collective unconscious, though she try to run away from dominant power. In this case, ego of selected woman is not weak. She is destined to be a heroine. She knows that she has to complete every task given to her to realize what father imago wants, and she will not own any of her products at all. She is a real or true heroine. She wants to avoid her destiny, but she can't and should not do it. Secondly, a woman with father complex is called for again to save father imago or to solve problems of father imago. In this case, father imago of a woman should be considered to be related to the collective conscious. Therefore, it is said that all women with father complex are invited for healing the society or the collective consciousness. To complete this request, she has to heal herself by recovering her femininity. The healing power is based on the maternal receptive capacity. In modern society, the women are always demanded to be a social being. These social demands can make women caught by father complex. In this sense, number of women with father complex are increasing. Through the understanding of two fairy-tales, increased number of women with father complex should be easily considered as events at personal level, but seriously considered as a phenomenon reflecting problems in the collective consciousness of our age. In the other hand, all women with father complex are invited to solve the problem of modern society. She will be able to realize her own individuation without being possessed by father imago, to save our society and to become a heroine of our age.

• Journal of Applied Biological Chemistry
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• v.66
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• pp.204-212
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• 2023

Whitening is inhibitory activity of the melanin synthesis of melanocytes. Recently, whitening materials have been developed on natural materials because of its side effects on skin. Figs (Ficus Carica L.) is a fruit belonging to the Moraceae family and whitening activity was reported in focusing on the fig's stem and leaf components, but whitening activity of the figs fruit was not known. Thus, in this study, we tried to observe its anti-melanogenesis as well as antioxidant and anti-inflammation. The radical scavenging activity of figs fruits extract (FFE) was observed as the level of 34.52±1.98%/60.71±1.26% compared to the control in the its maximum concentration in the DPPH/ABTS assay. Cytotoxicity of FFE was observed at 10% concentration by CCK8 assay, so the maximum concentration was set at 5% and applied to all experiments. FFE concentration dependently decreased NO production associated with inducible nitric oxide synthase, cyclooxygenase-2, interleukin-6 and tumor necrosis factor-α gene expression, these strongly suggesting anti-inflammatory activity. In melanin contents assay, FFE significantly down-regulated melanin production in α-MSH-stimulated B16F10 cell as well as tyrosinase inhibition in vitro. In addition, FFE decreased the Microphthalmia-associated transcription factor (MITF) mRNA expression about 94.34% compared to the α-MSH treatment group in RT-PCR. Finally, FFE significantly reduced the MITF, cAMP response element-binding protein and tyrosinase protein expression in the α-MSH stimulated B16F10 cell. Through these results, we found that FFE can not only directly inhibit tyrosinase enzyme activity but also suppress melanogenesis through regulation of MITF gene expression in α-MSH signal transduction.

• The Journal of Internal Korean Medicine
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• v.45 no.3
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• pp.335-341
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• 2024

Objectives: Patients with cancer eventually fail to respond to therapy when malignant cells develop effective ways to evade immunosurveillance. Conventional cancer treatments, such as radiation therapy and chemotherapy, aim to cure the disease or prolong the patient's life. However, the toxicity and side effects of conventional treatments limit their efficacy. Herbal medicine is a typical complementary and integrative form of medicine for cancer treatment in Asia. This protocol evaluates the effectiveness of herbal medicines in improving the immune function of patients with cancer. Methods: The following electronic databases will be searched: MEDLINE via PubMed, EMBASE via Elsevier, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure (CNKI), and Korean databases including Regional Information Sharing Systems (RISS), National Digital Science Library (NDSL), and Oriental Medicine Advanced Searching Integrated System (OASIS). Additionally, prospective randomized controlled trials that evaluate the effectiveness of herbal medicines on immune function in patients with cancer will be included in this review. All outcomes related to the immune function of patients with cancer (e.g., CD3, CD4, CD8, CD4/CD8 ratio, CD19 (B cells), dendritic cells (CD11), CD56 (NK cells), and macrophages) will be included in this review. Results: This review is expected to provide data on the effectiveness of herbal medicines on improving immune functions in patients with cancers. Conclusion: This systematic review will help patients and clinicians establish new management options for cancer treatment.

• Journal of the Korean Wood Science and Technology
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• v.13 no.1
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• pp.19-62
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• 1985

This study was performed to investigate: (i) the bending processing properties of silk worm oak (Quercus acutissima Carr.) and Korean red pine (Pinus densiflora S. et Z.) by boiling and steaming treatments; (ii) the effects of interrelated factors - sapwood and heartwood, annual ring placement, softening temperature and time, moisture content. and wood defects on bending processing properties; (iii) the changing rates of bending radii after release from a tension strap, and (iv) the improving methods of bending process by treatment with chemicals. The size of specimens tested was $15{\times}15{\times}350mm$ for boiling and steaming treatments and $5{\times}10{\times}200mm$ for treatments with chemicals. The specimens were green for boiling treatments and dried to 15 percent for steaming treatments. The specimens for treatments with chemicals were soaked in saturated urea solution, 35 percent formaldehyde solution, 25 percent polyethylene glycol -400 solution, and 25 percent ammonium hydroxide solution for 5 days and immediately followed the bending process, respectively. The results obtained were as follows: 1. The internal temperature of silk worm oak and Korean red pine by boiling and steaming time was raised slowly to $30^{\circ}C$ but rapidly from $30^{\circ}C$ to $80-90^{\circ}C$ and then slowly from $80-90^{\circ}C$ to $100^{\circ}C$. 2. The softening time required to the final temperature was directly proportional to the thickness of specimen. The time required from $25^{\circ}C$ to $100^{\circ}C$ for 15mm-squared specimen was 9.6-11.2 minutes in silk worm oak and 7.6-8.1 minutes in Korean red pine. 3. The moisture content (M.C.) of specimen by steaming time was increased rapidly first 4 minutes in the both species, and moderately from 4 to 20 minutes and then slowly and constantly in silk worm oak, and moderately from 4 to 15 minutes and then slowly and constantly in Korean red pine. The M.C. of 15mm-squared specimen in 50 minutes of steaming was increased to 18.0 percent in the oak and 22.4 percent in the pine from the initial conditioned M.C. of 15 percent The rate of moisture adsorption measured was therefore faster in the pine than in the oak. 4. The mechanical properties of the both species were decreased significantly with the increase of boiling rime. The decrement by the boiling treatment for 60 minutes was measured to 36.6-45.0 percent in compressive strength, 12.5-17.5 percent in tensile strength, 31.6-40.9 percent in modulus of rupture, and 23.3-34.6 percent in modulus of elasticity. 5. The minimum bending radius (M.B.R.) of sapwood and heartwood was 60-80 mm and 90 mm in silk worm oak, and 260 - 300 mm and 280 - 300 mm in Korean red pine, respectively. Therefore, the both species showed better bending processing properties in sapwood than in heartwood. 6. The M.B.R. of edge-grained and flat-grained specimen in suk worm oak was 60-80 mm, but the M.B.R. in Korean red pine was 240-280 mm and 260-360 mm, respectively. Comparing the M.B.R. of edge-grained with flat-grained specimen, in the pine the edge-grained showed better bending processing property than the flat-grained. 7. The bending processing properties of the both species were improved by the rising of softening temperature from $40^{\circ}C$ to $100^{\circ}C$. The minimum softening temperature for bending was $90^{\circ}C$ in silk worm oak and $80^{\circ}C$ in Korean red pine, and the dependency of softening temperature for bending was therefore higher in the oak than in the pine. 8. The bending processing properties of the both species were improved by the increase of softening time as well as temperature, but even after the internal temperature of specimen reaching to the final temperature, somewhat prolonged softening was required to obtain the best plastic conditions. The minimum softening time for bending of 15 mm-squared silk worm oak and Korean red pine specimen was 15 and 10 minutes in the boiling treatment, and 30 and 20 minutes in the steaming treatment, respectively. 9. The optimum M.C. for bending of silk worm oak was 20 percent, and the M.C. above fiber saturation point rather degraded the bending processing property, whereas the optimum M.C. of Korean red pine needed to be above 30 percent. 10. The bending works in the optimum conditions obtained as seen in Table 24 showed that the M.B.R. of silk worm oak and Korean red pine was 80 mm and 240 mm in the boiling treatment, and 50 mm and 280 mm in the steaming treatment, respectively. Therefore, the bending processing property of the oak was better in the steaming than in the boiling treatment, but that of the pine better in the boiling than in the steaming treatment. 11. In the bending without a tension strap, the radio r/t of the minimum bending radius t to the thickness t of silk worm oak and Korean red pine specimen amounted to 16.0 and 21.3 in the boiling treatment, and 17.3 and 24.0 in the steaming treatment, respectively. But in the bending with a tension strap, the r/t of the oak and the pine specimen decreased to 5.3 and 16.0 in t he boiling treatment, and 3.3 and 18.7 in the steaming treatment, respectively. Therefore, the bending processing properties of the both species were significantly improved by the strap. 12. The effect of pin knot on the degradation of bending processing property was very severe in silk worm oak by side, e.g. 90 percent of the oak specimens with pin knot on the concave side were ruptured when bent to a 100 mm radius but only 10 percent of the other specimens with pin knot on the convex side were ruptured. 13. The changing rate in the bending radius of specimen bent to a 300 mm radius after 30 days of exposure to room temperature conditions was measured to 4.0-10.3 percent in the boiling treatment and 13,0-15.0 percent in the steaming treatment. Therefore, the degree of spring back after release was higher in the steaming than in the boiling treatment. And the changing rate of moisture-proofing treated specimen by expoxy resin coating was only -1.0.0 percent. 14. Formaldehyde, 35 percent solution, and 25 percent polyethylene glycol-400 solution found no effect on the plasticization of the both species, but saturated urea solution and 25 percent ammonium hydroxide solution found significant effect in comparison to non-treated specimen. But the effect of the treatment with chemicals alone was inferior to that of the steaming treatment, and the steaming treatment after the treatment with chemicals improved 10-24 percent over the bending processing property of steam-bent specimen. 15. Three plasticity coefficients - load-strain coefficient, strain coefficient, and energy coefficient - were evaluated to be appropriate for the index of bending processing property because the coefficients had highly significant correlation with the bending radius. The fitness of the coefficients as the index was good at load-strain coefficient, energy coefficient, and strain coefficient, in order.

• Journal of Chest Surgery
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• v.37 no.3
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• pp.201-209
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• 2004

Extracorporeal life support (ECLS) system is a device for respiratory and/or heart failure treatment, and there have been many trials for development and clinical application in the world. Currently, a non-pulsatile blood pump is a standard for ECLS system. Although a pulsatile blood pump is advantageous in physiologic aspects, high pressure generated in the circuits and resultant blood cell trauma remain major concerns which make one reluctant to use a pulsatile blood pump in artificial lung circuits containing a membrane oxygenator. The study was designed to evaluate the hypothesis that placement of a pressure-relieving compliance chamber between a pulsatile pump and a membrane oxygenator might reduce the above mentioned side effects while providing physiologic pulsatile blood flow. The study was performed in a canine model of oleic acid induced acute lung injury (N=16). The animals were divided into three groups according to the type of pump used and the presence of the compliance chamber, In group 1, a non-pulsatile centrifugal pump was used as a control (n=6). In group 2 (n=4), a single-pulsatile pump was used. In group 3 (n=6), a single-pulsatile pump equipped with a compliance chamber was used. The experimental model was a partial bypass between the right atrium and the aorta at a pump flow of 1.8∼2 L/min for 2 hours. The observed parameters were focused on hemodynamic changes, intra-circuit pressure, laboratory studies for blood profile, and the effect on blood cell trauma. In hemodynamics, the pulsatile group II & III generated higher arterial pulse pressure (47$\pm$ 10 and 41 $\pm$ 9 mmHg) than the nonpulsatile group 1 (17 $\pm$ 7 mmHg, p<0.001). The intra-circuit pressure at membrane oxygenator were 222 $\pm$ 8 mmHg in group 1, 739 $\pm$ 35 mmHg in group 2, and 470 $\pm$ 17 mmHg in group 3 (p<0.001). At 2 hour bypass, arterial oxygen partial pressures were significantly higher in the pulsatile group 2 & 3 than in the non-pulsatile group 1 (77 $\pm$ 41 mmHg in group 1, 96 $\pm$ 48 mmHg in group 2, and 97 $\pm$ 25 mmHg in group 3: p<0.05). The levels of plasma free hemoglobin which was an indicator of blood cell trauma were lowest in group 1, highest in group 2, and significantly decreased in group 3 (55.7 $\pm$ 43.3, 162.8 $\pm$ 113.6, 82.5 $\pm$ 25.1 mg%, respectively; p<0.05). Other laboratory findings for blood profile were not different. The above results imply that the pulsatile blood pump is beneficial in oxygenation while deleterious in the aspects to high pressure generation in the circuits and blood cell trauma. However, when a pressure-relieving compliance chamber is applied between the pulsatile pump and a membrane oxygenator, it can significantly reduce the high circuit pressure and result in low blood cell trauma.

• Journal of Hospice and Palliative Care
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• v.1 no.1
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• pp.47-55
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• 1998

Background : It is almost important therapy modality to control pain for the terminal cancer patients for the last 24 hours because those terminally illed patient deserved to have pain free and peaceful time before death. Physician who is deal with terminal cancer patients for their last 24 hours does not need to worry about drug addiction or other untoward side reactions of pain medications. The purpose of this study was to evaluate if terminally illed cancer patient was given pain medication properly and sufficiently and if there was any different behavior to control pain of terminal cancer patients between medical physicians and surgeons in terms of type, amount and administration route and frequency. Methods : A retrospective chart audit of analgesic type, amount and administration route was performed on the medical recorders of 160 hospitalized terminal cancer patients who had died in the Korea University Medical Center Anam Hospital during the period of July 1, 1994 to June 30, 1995. Patients were classified into 103 patients were cared for by medical physicians and 57 patients were cared for by surgeons. After then, we analysed the difference of pain control pattern between them. Different types and amount of analgesics were converted to a common standard, an oral morphine equivalents(OME) relative to 1mg of oral morphine. Results : 1) The total number of patients was 160, male 102 cases(63.8%), and the female was 58 cases(36.2%) respectively. 2) The mean age was 56.4(${\pm}14.62$) years old and mean admission period was 27.8 days(${\pm}34.85$). 3) The frequent cancer site was stomach 42 cases(26.315), lung and liver 29 cases(18.1%) each, pancreas 10 cases(6.2%) in order 4) 125 out of 160 subjects (78.13%) complained pain, and 66 out of 103(64.08%) and 31 out of 57(54.39%) were treated with analgesics to relieve pain. 50 out of 97(51.55%) were able to continue on oral medication. 5) 86 cases(53.75%) were well oriented 24 hours prior to death. 6) The frequent analgesics for regular basis were long acting form of oral morphine 34 cases(Medical phsicians 24, Surgeons 10), intravenous morphine 26 cases(Medical physicians 20, Surgeons 6) in order, and the most common p.r.n.(pro re nata) analgesics used was intravenous morphine. 7) The mean amount of analgesics on regular basis was 115.41 OME by medical physicians and 52.7 OME by surseons(P<0.05). The mean amount of p.r.n. analgesics was significantly larger in patients are for by surgeons(66.64 OME) than medical physicians 23.49 OME(P<0.01). 8) The mean frequency of administrated number of p.r.n. analgesics was 0.62 times/day on medical part and 1.88 times/day on surgical part (P<0.001). Conclusion : Of the 97 patients with advanced cancer, 51.55% were able to take oral medications in the last day of life. The parenteral analgesics were more frequently used in the patients cared for by surgeons than medical physicians. Over the half of terminal cancer patients were well oriented in the last day of life. Doctor's knowledge and attitude towards pain is very important to mange the pain, effectively.

• Journal of Global Scholars of Marketing Science
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• v.19 no.4
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• pp.1-10
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• 2009

The purpose of this study was to categorize the gap between coffee shop 'importance' (as perceived by customers before patronizing the coffee shop) and 'satisfaction' (perception of customers after patronizing the coffee shop) as positive or negative and to analyze the effect of these gaps on purchasing behavior. To do this, I used the gap between importance and satisfaction regarding the choice of a coffee shop as the explanatory variable and performed an empirical analysis of the direction and size of the effect of the gap on purchasing behavior (overall satisfaction, willingness-to-revisit) by applying the Ordered Probit Model (OPM). A previous study that used IPA to evaluate the effects of gaps estimated the direction and size of a quadrant but failed to analyze the effect of gaps on customers. In this study, I evaluated the effects of positive and negative gaps on customer satisfaction and willingness-to-revisit. Using OPM, I quantified the effect of positive and negative gaps on overall customer satisfaction and willingness-to-revisit. Per-head expenditure, frequency of visits, and coffee-purchasing place had the most positive effects on overall customer satisfaction. Frequency of visits, followed by per-head expenditure and then coffee-purchasing place, had the most positive impact on willingness-to-visit. Thus per-head expenditure and frequency of visits had the greatest positive effects on overall satisfaction and willingness-to-revisit. This finding implies that the higher the actual satisfaction (gap) of customers who spend KRW5,000 or more once or more per week at coffee shops is, the higher their overall satisfaction and willingness-to-revisit are. Despite the fact that economical efficiency had a significant effect on overall satisfaction and willingness-to-revisit, college and university students still use coffee shops and are willing to spend KRW5,000 because they do not only purchase coffee as a product itself, but use the coffee shop for other activities, such as working, meeting friends, or relaxing. College and university students also access the Internet in coffee shops via personal laptops, watch movies, and study; thus, coffee shops should provide their customers with the appropriate facilities and services. The fact that a positive gap for coffee shop brand had a positive effect on willingness-to-revisit implies that the higher the level of customer satisfaction, the greater the willingness-to-revisit. A negative gap for this factor, on the other hand, implies that the lower the level of customer satisfaction, the lower the willingness-to-revisit. Thus, the brand factor has a comparatively greater effect on satisfaction than the other factors evaluated in this study. Given that the domestic coffee culture is becoming more upscale and college/university students are sensitive to this trend, students are attentive to brands. In most upscale coffee shops in Korea, the outer wall is built out of glass that can be opened, the interiors are exotic with an open kitchen. These upscale coffee shops function as landmarks and match the taste of college/university students. Coffee shops in Korea have become a cultural brand. To make customers feel that coffee shops are upscale, good quality establishments and measures to provide better services in terms of brand factor should be instituted. The intensified competition among coffee shop brands in Korea as a result of the booming industry indicates that provision of additional services is needed to differentiate competitors. These customers can also use a scanner free of charge. Another strategy that can be used to boost brands could be to provide and operate a seminar room for seminars and group study. If coffee shops adopt these types of strategies, college/university students would be more likely to consider the expenses they incur worthwhile and, subsequently, they would be more likely to be satisfied with the brands of these coffee shops, with an associated increase in their willingness-to-revisit. Gender and study year had the most negative effects on overall satisfaction and willingness-to-revisit. Female students were more likely to be satisfied and be willing to return than male students, and third and fourth-year students were more likely to be satisfied and willing-to-return than first or second-year students. Students who drink coffee, read books, and use laptops alone at coffee shops are easily noticeable. High-grade students tend to visit coffee shops alone in order to use their time efficiently for self-development and to find jobs. The economical efficiency factor had the greatest effect on overall satisfaction and willingness-to-revisit in terms of a positive gap. The higher the actual satisfaction (gap) of students with the price of the coffee, the greater their overall satisfaction and willingness-to-revisit. Economical efficiency with a negative gap had a negative effect on willingness-to-revisit, which implies that a less negative gap will result in a greater willingness-to-revisit. Amid worsening market conditions, coffee shops located around colleges/universities are using strategies, such as a point or membership card, strategic alliances with credit-card companies, development of a set menu or seasonal menu, and free coffee-shot services to increase their competitive edge. Product power also had a negative effect in terms of a negative gap, which indicates that a higher negative gap will result in a lower willingness-to-revisit. Because there are many more customers that enjoy coffee in this decade, as compared to previous decades, the new generation of customers, namely college/university students, want various menu items in addition to coffee, and coffee shops should, therefore, add side menu items, such as waffles, rice cakes, cakes, sandwiches, and salads. For example, Starbucks Korea is making efforts to enhance product power by selling rice cakes flavored in strawberry, wormwood, and pumpkin, and providing coffee or cream free of charge. In summary, coffee shops should focus on increasing their economical efficiency, brand, and product power to enhance the satisfaction of college/university students. Because shops adjacent to colleges or universities enjoy a locational advantage, providing differentiated services in terms of economical efficiency, brand, and product power, is likely to increase customer satisfaction and return visits. Coffee shop brands should, therefore, be innovative and embrace change to meet their customers' desires. Because this study only targeted college/university students in Seoul, comparative studies targeting diverse regions and age groups are required to generalize the findings and recommendations of this study.

• The korean journal of orthodontics
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• v.31 no.2 s.85
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• pp.209-223
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• 2001

At intrusion of upper anterior teeth in patient with periodontal defect, the use of three-piece base arch appliance for pure intrusion is required. To investigate the change of the center of resistance and of the distal traction force according to alveolar bone height at intrusion of upper anterior teeth using this appliance, three-dimensional finite element models of upper six anterior teeth, periodontal ligament and alveolar bone were constructed. At intrusion of upper anterior teeth by three-piece base arch appliance, the following conclusions were drawn to the locations of the center of resistance according to the number of teeth, the change of distal traction force for pure intrusion and the correlation to the change of vertical, horizontal location of the center of resistance according to alveolar bone loss. 1. When the axial inclination and alveolar bone height were normal, the anteroposterior locations of center of resistance of upper anterior teeth according to the number of teeth contained were as follows : 1) In 2 anterior teeth group, the center of located in the mesial 1/3 area of lateral incisor bracket. 2) In 4 anterior teeth group. the center of resistance was located in the distal 2/3 of the distance between the bracket of lateral incisor and canine. 3) In 6 anterior teeth group, the center of resistance was located in the central area of first premolar bracket .4) As the number of teeth contained in anterior teeth group increased, the center of resistance shifted to the distal side. 2. When the alveolar bone height was normal, the anteroposterior position of the point of application of the intrusive force was the same position or a bit forward position of the center of resistance at application of distal traction force for pure intrusion. 3. When intrusion force and the point of application of the intrusive force were fixed, the changes of distal traction force for pure intrusion according to alveolar bon loss were as follows :1) Regardless of the alveolar bone loss, the distal traction force of 2, 4 anterior teeth groups were lower than that of 6 anterior teeth group. 2) As the alveolar bone loss increased, the distal traction forces of each teeth group were increased. 4. The correlations of the vertical, horizontal locations of the center of resistance according to maxillary anterior teeth groups and the alveolar bone height were as follows : 1) In 2 anterior teeth group, the horizontal position displacement to the vortical position displacement of the center of resistance according to the alveolar bone loss was the largest. As the number of teeth increased, the horizontal position displacement to the vertical position displacement of the center of resistance according to the alveolar bone loss showed a tendency to decrease. 2) As the alveolar bone loss increased, the horizontal position displacement to the vertical position displacement of the center of resistance regardless of the number of teeth was increased.

• The Journal of Korean Society for Radiation Therapy
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• v.29 no.2
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• pp.19-26
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• 2017

Objectives: In the Lung, the VMAT rotates continuously and examines radiation. That increases the low doses to normal lung. Due to that, the incidence of radiation pneumonia among radiation side effects may increase. The cause of radiation pneumonia is the lower dose area of the lungs. The H-VMAT was applied to patients who applied to reduce radiation in the lower doses of the lungs. We wanted to assess the usefulness of the H-VMAT by comparing the radiation doses to the low dose areas of the lungs and the normal organs. Materials and Methods: A total of 26 patients who applied for a H-VMAT procedure were applied to the patient. The prescription dose applied to total dose 44 Gy from 22 divisions. For each patient, a plan was implemented with Conventional RT, VMAT and H-VMAT. Conventional RT was carried out in four to five fields each, considering the size, location, shape, and location of the PTV. In the case of a VMAT plan, the two Half ARC, three Half ARC method and the two Full ARC were planned. The H-VMAT was planned by adding two Static fields in the VMAT, taking into account the dose of the lung and the tolerance dose of the organs. Results: In the NSCLC, the lung doses $V_5$ and $V_{10}$ of the lungs except for the treatment plan volume were the lowest with $55.40{\pm}13.39%$ and $32.05{\pm}11.37%$ of H-VMAT. And, in the SCLC, the lung doses of V5 and V10 were the lowest at $64.32{\pm}16.15%$ and $35.50{\pm}9.91%$, respectively. The spinal dose of VMAT in NSCLC was $21.15{\pm}4.02Gy$, which was 7.94 Gy lower than other treatment methods. The lowest spinal dose was delivered at $19.72{\pm}1.82Gy$ for SCLC. The mean dose delivered to the esophagus was also $17.44{\pm}2.04Gy$ and $17.84{\pm}9.20Gy$ in SCLC and NSCLC, respectively. Conclusion: When comparing the value of the surrounding normal organ dose, the VMAT showed that less doses were transmitted from the heart, esophagus and spinal cord than the rest of the treatment plan. However, it was similar to VMAT in normal organs except for the spinal cord. VMAT has increased doses of some normal organs but did not exceed the tolerance dose. It showed a low value in $V_5$, $V_{10}$. When comparing Conventional RT, VMAT, and H-VMAT, If the dose to the heart, esophagus and spinal cord is lower than the tolerance dose, it is thought to reduce the incidence of radiation pneumonia by applying H-VMAT that show the benefits of low doses of the lungs.

• Radiation Oncology Journal
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• v.19 no.2
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• pp.127-135
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• 2001

Purpose : This study is a prospective randomized clinical trial comparing the efficacy and complication of anti-emetic drugs for prevention of nausea and vomiting after radiotherapy which has moderate emetogenic potential. The aim of this study was to investigate whether the anti-emetic efficacy of ondansetron $(Zofran^{\circledR})$ 8 mg bid dose (Group O) is better than the efficacy of metoclopramide 5 mg lid dose (Group M) in patients undergoing fractionated radiotherapy to the abdominal region. Materials and Methods : Study entry was restricted to those patients who met the following eligibility criteria: histologically confirmed malignant disease; no distant metastasis; performance status of not more than ECOG grade 2; no previous chemotherapy and radiotherapy. Between March 1997 and February 1998, 60 patients enrolled in this study. All patients signed a written statement of informed consent prior to enrollment. Blinding was maintained by dosing identical number of tablets including one dose of matching placebo for Group O. The extent of nausea, appetite loss, and the number of emetic episodes were recorded everyday using diary card. The mean score of nausea, appetite loss and the mean number of emetic episodes were obtained in a weekly interval. Results : Prescription error occurred in one patient. And diary cards have not returned in 3 patients due to premature refusal of treatment. Card from one patient was excluded from the analysis because she had a history of treatment for neurosis. As a result, the analysis consisted of 55 patients. Patient characteristics and radiotherapy characteristics were similar except mean age was $52.9{\pm}11.2$ in group M, $46.5{\pm}9.5$ in group O. The difference of age was statistically significant. The mean score of nausea, appetite loss and emetic episodes in a weekly interval was higher in group M than O. In group M, the symptoms were most significant at 5th week. In a panel data analysis using mixed procedure, treatment group was only significant factor detecting the difference of weekly score for all three symptoms. Ondansetron $(Zofran^{\circledR})$ 8 mg bid dose and metoclopramide 5 mg lid dose were well tolerated without significant side effects. There were no clinically important changes In vital signs or clinical laboratory parameters with either drug. Conclusion : Concerning the fact that patients with younger age have higher emetogenic potential, there are possibilities that age difference between two treatment groups lowered the statistical power of analysis. There were significant difference favoring ondansetron group with respect to the severity of nausea, vomiting and loss of appetite. We concluded that ondansetron is more effective anti-emetic agents in the control of radiotherapy-induced nausea, vomiting, loss of appetite without significant toxicity, compared with commonly used drug, i.e., metoclopramide. However, there were patients suffering emesis despite the administration of ondansetron. The possible strategies to improve the prevention and the treatment of radiotherapy-induced emesis must be further studied.