Purpose : Measurement of transmission dose is useful for in vivo dosimetry. In this study, previous algorithm for estimation of transmission dose was modified for use in cases with tissue deficit. Materials and Methods : The beam data was measured with flat solid phantom in various conditions of tissue deficit. New algorithm for correction of transmission dose for tissue deficit was developed by physical reasoning. The algorithm was tested in experimental settings with irregular contours mimicking breast cancer patients using multiple sheets of solid phantoms. Results : The correction algorithm for tissue deficit could accurately reflect the effect of tissue deficit with errors within ${\pm}1.0\%$ in most situations and within ${\pm}3.0\%$ in experimental settings with irregular contours mimicking breast cancer treatment set-up. Conclusion : Developed algorithm could accurately reflect the effect of tissue deficit and irregularly shaped body contour on transmission dosimetry.
This study was conducted to determine the effects of vitamin C on the activity of liver function enzymes and electromicrographic changes in white rats treated with aflatoxin $B_1(AFB_1)$ or X-ray and $AFB_1$. Six week-old male Sprague-Dawley rats were randomly divided into five groups: a control group, $AFB_1$ treated group, $AFB_1$ treated group with vitamin C, X-ray and $AFB_1$ co-treated group, X-ray and $AFB_1$ co-treated group with vitamin C. On the first day of the experiment, only one dose of X-rays was exposed to the entire liver at 1,500 cGy. Next, vitamin C was injected at 10 mg/kg body weight by intraperitoneal injection, followed 1 hr later by the administration of 0.4 mg/kg of $AFB_1$ by intraperitoneal injection. These treatments were then administered every three days over a period of 15 days. On the 16th day of treatments, the animals were sacrificed. Analysis of the activity of the liver function enzymes, GOT, ALK phatase and LDH, in the sera of rats revealed that they were somewhat increased by $AFB_1$ treatment, X-ray and $AFB_1$ co-treatment when compared to the control group. Furthermore, the activity of these enzymes decreased in response to administration of vitamin C. Especially, the levels of GOT were remarkably decreased in the $AFB_1$ treated group treated with vitamin C when compared to the group treated with $AFB_1$ alone(p<0.001). Electromicrographic analysis revealed cloudy swelling, necrosis, vesicular degeneration and fat accumulation of hepatocytes in response to treatment with $AFB_1$ or co-treatment with X-ray and $AFB_1$. However, the destruction of hepatic cells was considerably lower in the vitamin C-treated group. These results indicate that vitamin C had ameliorating effects on the hepatic cell damage.
Kim, Young-Whan;Park, Gye-Young;Yoo, Chul-Gyu;Han, Sung-Koo;Shim, Young-Soo;Kim, Keun-Youl;Han, Yong-Chol
Tuberculosis and Respiratory Diseases
/
v.41
no.2
/
pp.127-134
/
1994
Background : Diffuse panbronchiolitis(DPB) is a chronic inflammatory lung disease of unknown etiology which has characteristic clinical, radiological and pathological features, and is distinguished from bronchial asthma, chronic bronchitis, pulmonary emphysema, bronchiectasis, or alveolitis. Clinically, patients with DPB have chronic cough, purulent sputum, exertional dyspnea, and finally respiratory failure. Until a few years ago, the prognosis of DPB had been thought to be very grave, because there had been no effective treatment for the disease. But recent1y, low-dose long-term erythromycin was found to be very effective on DPB. Even though DPB is prevalent in Japan, and is known to be rare outside of Japan, we have a1ready reported the clinical features of 16 DPB cases in Korea. We tried low-dose long-term erythromycin on DPB patients and analyzed the clinical effect of erythromycin. Methods : We analyzed the changes of subjective symptoms, physical signs, pulmonary function tests and chest X-rays on 14 DPB patients with more than 6 months erythromycin treatment during the period from September 1989 to August 1992 in Seoul National University Hospital. Results : 1) Subjective symptoms improved in all patients within 2-3 months, and 54.5% of the patients showed no symptom after one year of treatment. 2) Crackles and wheezing decreased in 92.9% of the patients after 3 months and completely disapppeared in 63.5% of the patients after one year of treatment. 3) FVC and FEV1 increased remarkably during the first 3 months, and slowly increased thereafter, reaching normal level after one year of treatment. 4) Small nodular lesions on chest X-ray decreased in all patients, and chest PA was normal in 36.4% of the patients after one year of treatment. 5) There was side effect in one patient, stopping medication because of dyspepsia. One patient stopped medication because of no symptom after 16 months of treatment, but her symptom recurring after one month, improving again after retreatment. Conclusion: Low-dose long-term erythromycin showed ramarkable effectiveness on DPB. Further studies are needed on the mechanism of the drug and the duration of the treatment.
Inner walls of the stone chamber of West Ancient Tomb No. 1 and 2 in Neungsan-ri, Buyeo-gun have been inspected for possible trace of murals. Tomb No.1 has a rough surface finish of the stone wall and no traces of murals was observed in any part of the stone walls except the ceiling part of the main chamber. On the ceiling surface, there is black colored area, which showed same visual characteristics for both the surface and interior upon slight scratch of the surface, suggesting that it may not be a painted layer. In addition, this black material is not artificial stuff like black ink but is confirmed as biotite from X-ray diffraction analysis that is one of the constituents of the stone wall. In case of tomb No. 2, white material, that is confirmed as lime(calcite, CaCO3) by X-ray diffraction analysis, was observed on the wall surface of the east, west and north, suggesting possible existence of murals. The lime layers, however, are located mostly on the entrance of east wall of main chamber and the place of passage whereas they are observed only in lower parts on the other walls. It may have been formed by the inflow of soil and lime from the outside as the form of the lime layer in the east wall corresponds to the traces of soil and lime deposited from the thief pit. Furthermore, the filling material found in the gap between the stone slabs of the four directions and the ceiling was confirmed as clay soil, which is different material from the lime present on the stone wall surface. If the lime layer had been artificially constructed for the purpose of creating murals, it would have been more reasonable to use lime as well in the gap between the stone slabs of the four directions and ceiling. In this regard, we conclude that there are no murals in the Tomb No. 2 in the Neungsan-ri.
The Journal of Korean Society for Radiation Therapy
/
v.18
no.1
/
pp.21-28
/
2006
Purpose: The purpose of this study is to find a optimal beam spoiler condition on the dose distribution near the surface, when treating a squamous cell carcinoma of the head and neck and a lymphatic region with 10 MV photon beam. The use of a optimal spoiler allows elivering high dose to a superficial tumor volume, while maintaining the skin-sparing effect in the area between the surface to the depth of 0.4 cm. Materials and Methods: The lucite beam spoiler, which were a tissue equivalent, were made and placed between the surface and the photon collimators of linear accelerator. The surface-dose, the dose at the depth of 0.4 cm, and the maximum dose at the dmax were measured with a parallel-plate ionization chamber for $5{\times}5cm\;to\;30{\times}30cm^2$ field sizes using lucite spoilers with different thicknesses at varying skin-to-spoiler separation (SSS). In the same condition, the dose was measured with bolus and compared with beam spoiler. Results: The spoiler increased the surface and build-up dose and shifted the depth of maximum dose toward the surface. With a 10 MV x-ray beam and a optimal beam spoiler when treating a patient, a similer build-up dose with a 6 MV photon beam could be achieved, while maintaining a certain amount of skin spring. But it was provided higher surface dose under SSS of less than 5 cm, the spoiler thickness of more than 1.8 cm or more, and larger field size than $20{\times}20cm^2$ provided higher surface dose like bolus and obliterated the spin-sparing effect. the effects of the beam spoiler on beam profile was reduced with increasing depths. Conclusion: The lucite spoiler allowed using of a 10 MV photon beam for the radiation treatment of head and neck caner by yielding secondary scattered electron on the surface. The dose at superficial depth was increased and the depth of maximum dose was moved to near the skin surface. Spoiling the 10 MV x-ray beam resulted in treatment plans that maintained dose homogeneity without the consequence of increased skin reaction or treat volume underdose for regions near the skin surface. In this, the optimal spoiler thickeness of 1.2 cm and 1.8 cm were found at SSS of 7 cm for $10{\times}10cm^2$ field. The surface doses were measured 60% and 64% respectively. In addition, It showed so optimal that 94% and 94% at the depth of 0.4 cm and dmax respectively.
The Journal of Korean Society for Radiation Therapy
/
v.22
no.2
/
pp.135-144
/
2010
Purpose: The purpose of this study is that through production of phantom for respiration gated radiotherapy, assessing appropriacy of exposure dose for the therapy using RPM (Real-time Position Management). Materials and Methods: We located measurement object on the phantom for respiration gated radiotherapy made of 2 linear actuator, acrylic panel, stanchion, iron plate ets. to drive (up, down, front, back). Using 4D CT scan, we analyzed patient's respiration and reproduced the movement by computer. On the phantom, we located a 2D-Array (PTW) and an White water phantom (4.5 cm) and used DMLC (interval 2 cm) in the field size $10{\times}10\;cm$, then exposed 21EX X-ray 100 MU, in the case of phantom was (1) static (2) moving (3) gated using RPM respectively gantry $0^{\circ}$ and $90^{\circ}$ We measured with a 0.125 CC ionization chamber (PTW) on the phantom (7.5 cm) in the same condition. Results: Ionization chamber: There were within 0.3% of error with gating respiration and approximately 2% of error without gating in the same condition. 2D-Array: Gantry $90^{\circ}$, field size $10{\times}10\;cm$, using DMLC. There were within 3% of error with gating respiration and approximately 16% of error without gating. Conclusion: The phantom for respiration gated radiotherapy makes plans considering patient's movement, quantitative analysis of exposure dose and proper assessment therapy for IMRT patients using RPM possible.
Purpose : To evaluate interim results in terms of failure, cosmetic results and survival after breast conserving operation and radiation therapy in early breast cancer. Material and Methods : From January 1992 through December 1997, seventy two patients with early stage 0, I and II breast cancer were treated with conservative surgery plus radiotherapy at Keimyung University Dongsan Medical Center. Age distribution was 25 to 77 years old with median age of 43. According to TNM stage, five patients had stage 0, thirty three were stage I, twenty five were IIa, and nine were IIb. Most patients underwent excision of all gross tumor and ipsilateral axillary dissection. Breast was irradiated through medial and lateral tangential fields of 6 MV photons to 50.4 Gy in 28 fractions over 5.5 weeks. We delivered a boost irradiation dose of 10 to 16 Gy in 1 to 2 weeks to excision site. Adjuvant chemotherapy was administered in forty one patients with CMF (cyclophosphamide, methotrexate, 5-fluorouracil) regimens of 6 cycles concurrently or before radiation. Cosmetic results were assessed by questionnaire to patients grading of excellent, good, fair, poor. Follow-up periods were 22 to 91 months with median 40 months. Results : Five year disease free survival rate (5YDFS) was $95.8\%$. According to stage, 5YDFS was $100\%,\;96.9\%,\;96\%\;and\;88.9\%$ in stage 0, I, IIa and IIb, respectively. Two patients had distant metastasis and one had local and distant failure. One patient with distant failure had bone and liver metastasis at 14 months after treatment and the other had lung and both supraclavicular metastasis at 21 months after treatment. Patient with local and distant failure had local recurrence on other quadrant in same breast and then salvaged with total mastectomy and chemotherapy but she died due to brain metastasis at 55 months. Complications were radiation pneumonitis in five patients (four patients of asymptomatic, one patients of symptomatic) and hand or arm edema(4 patients). Fifty nine patients answered our cosmetic result questionnaire and cosmetic results were good to excellent in fifty one patients $(86\%)$. Conclusion : We considered that conservative surgery and radiation for the treatment of early stage invasive breast cancer was safe and had excellent survival and cosmetic results. We need to assess about prognostic factors with longer follow up and with large number of patients.
Purpose : Multileaf collimator(MLC) is very suitable tool for conformal radio-therapy and commissioning measurements for a multileaf collimator installed on a dual energy accelerator with 6 and 10MV photons are required, For modeling the collimator with treament planning software, detailed dosimetric characterization of the multileaf collimator including the penumbra width, leaf transmission between leaf leakage and localization of the leaf ends and sides is an essential requirement. materials and Methods : Measurement of characteristic data of the MLC with 26 pair block leaves installed on CLINAC 2100C linear accelerator was performed. Low sensitive radiographic film(X-omatV) was used for the penumbra measurement and separate experiments using radiographic film and thermoluminescent dosimeters were performed to verify the dose distribution, Measured films were analized with a photodensitometer of WP700i scanner. Results : For 6 & 10 MV x-ray energies, approximately $2.0\%$ of photons incident on the multileaf collimator were transmitted and an additional $0.5\%$ leakage occurs between the leaves. Localizing the physical end of the leaves showed less than 1mm deviation from the $50\%$ decrement line and this difference is attributed to the curved shaped end on the leaves One side of a sin히e leaf corresponded to the $50\%$ decrement line, but the opposite face was aligned with a lower value. This difference is due to the tongue and groove used to decrease between leaf leakage. Alignment of the leaves to form a straight edge resulted larger penumbra at far position from isocenter as compare with divergent alloy blocks. When the MLC edge is stepped by sloping field, the isodose lines follow the leaf pattern and Produce scalloping isodose curves in tissue. The effective penumbra by 45 degree stepped MLC is about 10mm at 10cm depth for 6MV x-ray. The difference of effective penumbra in deep tissue between MLC and divergent alloy blocks is small (5mm). Conclusion : Using the characteristic data of MLC, the MLC has the clinlical acceptability and suitability for 3-D conformal radiotherapy except small field size.
Nah Byung Sik;Nam Taek Keun;Ahn Sung Ja;Chung Woong Ki
Radiation Oncology Journal
/
v.15
no.2
/
pp.97-104
/
1997
of $PLC-\gamma$ 1 activity. Results : In the immunohistochemistry, the expression of $PLC-\beta$ was negative for all grnups. The expression of $PLC-\gamma$ 1 was highest in the group III followed by group II in the proliferative zone of mucosa. The expression of PKC-01 was strong1y positive in group I followed by group II in the damaged surface epithelium. The above findings were also confirmed in the immunoblotting study. In the irnrnunoblotting study, the expressions of $PLC-\beta,\;PLC-\gamma\;1,\;and\;PLC-\delta$ were the same as the results of immunohistochemistry The expression of ras oncoprotein was weakly Positive in groups II, III and IV. The of EGFR was the highest in the group II, III, followed by group W and the expression of PKC was weakly positive in the group II and III. Conclusion : $PLC-\gamma$ 1 mediated signal transduction including ras oncoprotein, EGFR, and PKC play a significant role irL mucosal regeneration after irradiation. $PLC-\delta$ 1 mediated signal transduction might have an important role in mucosal damage after irradiation. Further studies will be necessary to confirm the signal transduction mediating the $PLC-\delta$ 1.
Purpose :We peformed the retrospective analysis to find the outcome of external beam radiotherapy alone in advanced esophageal cancer patients. Methods and Materials : One hundred and six Patients treated with external beam radiotherapy alone between July 1990 and December 1996 were analyzed retrospectively. We limited the site of the lesions to the thoracic esophagus and cell type to the squamous cell carcinoma. Follow-up was completed in 100 patients (94$\%$) and ranged from 1 month to 92 months (median; 6 months). Results :The median age was 62 years old and male to female ratio was 104 2. Fifty-three percent was the middle thorax lesion and curative radiotherapy was peformed in 83$\%$. Mean tumor dose delivered with curative aim was 58.6 Gy (55$\~$70.8 Gy) and median duration of the radiation therapy was 53 days. The median survival of all patients was 6 months and )-year and 2-year overall survival rate was 27$\%$ and 12$\%$, respectively, Improvement of dysphagia was obtained in most patients except for 7 patients who underwent feeding gastrostomy. The complete response rate immediately after radiation therapy was 32$\%$ (34/106). The median survival and 2-year survival rate of the complete responder was 14 months and 30$\%$ respectively, while those of the nonresponder was 4 months and 0$\%$ respectively (p=0.000). The median survival and 2-year survival rate of the patients who could tolerate regular diet was 9 months and 16$\%$ while those of the patients who could not tolerate regular diet was 3 months and 0$\%$, respectively (p=0.004). The survival difference between the patients with S cm or less tumor length and those with more than 5 cm tumor length was marginally statistically significant (u=0,06). However, the survival difference according to the periesophageal invasion or mediastinal tyrnphadenopathy in the chest CT imaging study was not statistically significant in this study. In a multivariate analysis, the statistically significant covariates to the survival were complete response to radiotherapy, tumor length, and initial degree of dysphagia in a decreasing order. The complication was observed in 10 patients (9$\%$). Conclusion :The survival outcome for advanced esophageal cancer patients treated by external beam radiotherapy alone was very poor. In the treatment of these patients, the brachytherapy and chemotherapy should be added to improve the treatment outcome.
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