ABSTRACT
OBJECTIVE: The objective of present study was to identify the rehabilitation outcome measures currently used in Korea. METHOD: The survey was conducted by e-mail questionnaire to 165 department of rehabilitation medicine in hospitals of Korea. Non-responders were sent a second copy of the questionnaire if they did not answer within 1 week. Data from the returned questionnaires were entered into a Microsoft Excel and subjected to descriptive and simple quantitative analysis. RESULTS: A total of 99 (60%) responses were received. Of these, 95% units collected some outcome assessment measure as part of routine clinical practice. Korean version of Modified Barthel Index (K-MBI) (80%) was the most popular global outcome measures. The Korean version of Berg Balance Scale (K-BBS) (53%) was used most frequently for balance assessment. Upper extremity function was checked with hand grip strength test (70%) and Box and block test (67%) most commonly. Korean version of Mini Mental State Examination (K-MMSE) was the most popular cognitive function test (75%). PARADISE Korean version-Western Aphasia Battery (PARADISE K-WAB) was the most popular language test (67%). Sixty-three (67%) units used outcome results for discussion and goal setting. Seventy-eight (78%) units responded that they would use a standardized outcome measures if there is an agreed standardized outcome measures lists (80%) and support of money and time (43%). CONCLUSION: The survey demonstrated that quite widespread use of outcome assessments in routine clinical rehabilitation within Korea. There is also an agreement for need of common 'basket' of recommended instruments for rehabilitation.
Subject(s)
Aphasia , Coat Protein Complex I , Electronic Mail , Hand , Hand Strength , Korea , Language Tests , Outcome Assessment, Health Care , Treatment Outcome , Upper Extremity , Surveys and QuestionnairesABSTRACT
OBJECTIVE: The objective of present study was to identify the rehabilitation outcome measures currently used in Korea. METHOD: The survey was conducted by e-mail questionnaire to 165 department of rehabilitation medicine in hospitals of Korea. Non-responders were sent a second copy of the questionnaire if they did not answer within 1 week. Data from the returned questionnaires were entered into a Microsoft Excel and subjected to descriptive and simple quantitative analysis. RESULTS: A total of 99 (60%) responses were received. Of these, 95% units collected some outcome assessment measure as part of routine clinical practice. Korean version of Modified Barthel Index (K-MBI) (80%) was the most popular global outcome measures. The Korean version of Berg Balance Scale (K-BBS) (53%) was used most frequently for balance assessment. Upper extremity function was checked with hand grip strength test (70%) and Box and block test (67%) most commonly. Korean version of Mini Mental State Examination (K-MMSE) was the most popular cognitive function test (75%). PARADISE Korean version-Western Aphasia Battery (PARADISE K-WAB) was the most popular language test (67%). Sixty-three (67%) units used outcome results for discussion and goal setting. Seventy-eight (78%) units responded that they would use a standardized outcome measures if there is an agreed standardized outcome measures lists (80%) and support of money and time (43%). CONCLUSION: The survey demonstrated that quite widespread use of outcome assessments in routine clinical rehabilitation within Korea. There is also an agreement for need of common 'basket' of recommended instruments for rehabilitation.
Subject(s)
Aphasia , Coat Protein Complex I , Electronic Mail , Hand , Hand Strength , Korea , Language Tests , Outcome Assessment, Health Care , Treatment Outcome , Upper Extremity , Surveys and QuestionnairesABSTRACT
The compatibility with GammaMed-12i brachytherapy machine for an Ir-192 encapsulated source (IRRS20, KAERI, Korea) manufactured by Korea atomic energy research institute (KAERI) has been investigated. As a mechanical testing of compatibility, precise measurement of step movement with channels, measurement of curvature of radius for wire, and emergency return testing were performed. Periodic measurements of air kerma strength for 45 days were carried out to evaluate decay characteristics of Ir-192 radioisotope and comparison of dose distributions in phantom between KAERI and old sources previously used were performed by film dosimetry. KAERI source has a good compatibility with GammaMed12i machine as a result of mechanical testing. There are in good agreement with calculated values in activity characteristics and there were small differences in dose distributions around the source in comparison between KAERI and old source.
Subject(s)
Academies and Institutes , Brachytherapy , Emergencies , Film Dosimetry , Korea , Nuclear Energy , RadiusABSTRACT
The quality correction in the air kerma dosimetry for Ir-192 using farmer type ionization chambers calibrated by Co-60 quality is required. In this study we determined quality factor (kappa u) of two ionization chambers of PTW-N30001 and N23333 for Ir-192 source using dosimetric method. The quality factors for energy spectrum of microSelectron were determined as kappa u=1.016 and 1.017 for PTW-N30001 and N23333 ionization chambers respectively. We applied quality factors in air kerma dosimetry for microSelectron source and compared with reference values. As a results we found that the differences between reference air kerma rate and measured it with and without quality correction were about -0.5% and -2.0% respectively.
Subject(s)
Gamma Rays , Reference ValuesABSTRACT
The 4 bank mico-MLC (mMLC; Acculeaf, Direx, Isral) has been commissioned for clinical use of linac based stereotactic radiosurgery. The geometrical parameters to control the leaves were determined and comparisons between measured and calculated by the calculation model were performed in terms of absolute dose (cGy/100 MU). As a result of evaluating calculated dose for various field sizes and depths of 5 and 10 cm in water in the geometric condition of fixed SSD (source to surface distance) and fixed SCD (source to chamber distance), most of differences were within 1% for 6 MV and 15 MV x-rays. The penumbral widths at the isocenter were approximately evaluated to 0.29~0.43 cm depending on the field size for 6 MV and 0.36~0.51 cm for 15 MV x-rays. The average transmission and leakage for 6 MV and 15 MV x-rays were 6.6% and 7.4% respectively in single level of leaves fully closed. In case of dual level of leaves fully closed the measured transmission is approximately 0.5% for both 6 MV and 15 MV x-rays. Through the commissiong procedure we could verify the dose characteristics of mMLC and approximately evaluate the error ranges for treatment planning system.
Subject(s)
Radiosurgery , Silver Sulfadiazine , WaterABSTRACT
OBJECTIVE: To evaluate the pattern of associated structural anomalies, perinatal outcomes and obstetrical complications in fetuses with single umbilical artery. METHODS: 27 fetuses with a single umbilical artery were detected between May 1995 and June 2005 at our hospital. All medical records were reviewed for maternal demographics, associated anomalies, karyotypic analysis, pregnancy complications and perinatal outcome. RESULTS: Of the 27 fetuses, 1 (3.7%) was terminated and 1 (3.7%) was expired. 13 fetuses (48.1%) had an associated structural anomalies. The structural anomalies found in association with single umbilical artery were in the cardiovascular system (6 cases, 46.2%), urogenital system (6 cases, 46.2%), central nervous system (3 cases, 23.1%), neuromuscular system (3 cases, 23.1%) and gastrointestinal system (1 case, 7.7%). 6 cases (46.2%) among these had multiple malformations. Karyotypic analyses were available only in 3 cases and one of these was chromosomally abnormal. CONCLUSION: Scanning the umbilical cord should be one of the essential parts of the second trimester ultrasonographic examination. When single umbilical artery is detected, a detailed ultrasonographic examination including fetal echocardiography and fetal karyotyping should be recommended for search of associated structural and chromosomal abnormalities.
Subject(s)
Female , Humans , Pregnancy , Cardiovascular System , Central Nervous System , Chromosome Aberrations , Demography , Echocardiography , Fetus , Karyotyping , Medical Records , Pregnancy Complications , Pregnancy Trimester, Second , Single Umbilical Artery , Umbilical Cord , Urogenital SystemABSTRACT
PURPOSE: In order to develop the national guide-lines for the standardization of radiotherapy we are planning to establish a web-based, on-line data-base system for laryngeal cancer. As a first step this study was performed to accumulate the basic clinical information of laryngeal cancer and to determine the items needed for the data-base system. MATERIALS AND METHODS: We analyzed the clinical data of patients who were treated under the diagnosis of laryngeal cancer from January 1998 through December 1999 in the South-west area of Korea. Eligibility criteria of the patients are as follows: 18 years or older, currently diagnosed with primary epithelial carcinoma of larynx, and no history of previous treatments for another cancers and the other laryngeal diseases. The items were developed and filled out by radiation oncologist who are members of Korean Southwest Radiation Oncology Group. SPSS v10.0 software was used for statistical analysis. RESULTS: Data of forty-five patients were collected. Age distribution of patients ranged from 28 to 88 years (median, 61). Laryngeal cancer occurred predominantly in males (10:1 sex ratio). Twenty-eight patients (62%) had primary cancers in the glottis and 17 (38%) in the supraglottis. Most of them were diagnosed pathologically as squamous cell carcinoma (44/45, 98%). Twenty-four of 28 glottic cancer patients (86%) had AJCC (American Joint Committee on Cancer) stage I/II, but 50% (8/16) had in supraglottic cancer patients (p=0.02). Most patients (89%) had the symptom of hoarseness. Indirect laryngoscopy was done in all patients and direct laryngoscopy was performed in 43 (98%) patients. Twenty-one of 28 (75%) glottic cancer cases and 6 of 17 (35%) supraglottic cancer cases were treated with radiation alone, respectively. The combined treatment of surgery and radiation was used in 5 (18%) glottic and 8 (47%) supraglottic patients. Chemotherapy and radiation was used in 2 (7%) glottic and 3 (18%) supraglottic patients. There was no statistically significant difference in the use of combined modality treatments between glottic and supraglottic cancers (p=0.20). In all patients, 6 MV X-ray was used with conventional fractionation. The fraction size was 2 Gy in 80% of glottic cancer patients compared with 1.8 Gy in 59% of the patients with supraglottic cancers. The mean total dose delivered to primary lesions were 65.98 Gy and 70.15 Gy in glottic and supraglottic patients treated, respectively, with radiation alone. Based on the collected data, 12 modules with 90 items were developed for the study of the patterns of care in laryngeal cancer. CONCLUSION: The study items for laryngeal cancer were developed. In the near future, a web system will be established based on the items investigated, and then a nation-wide analysis on laryngeal cancer will be processed for the standardization and optimization of radiotherapy.
Subject(s)
Humans , Male , Age Distribution , Carcinoma, Squamous Cell , Diagnosis , Drug Therapy , Glottis , Hoarseness , Joints , Korea , Laryngeal Diseases , Laryngeal Neoplasms , Laryngoscopy , Larynx , Radiation Oncology , RadiotherapyABSTRACT
PURPOSE: In order to obtain basic data for treatment plan in radiosurgery, we measured small fields of 6 MV X-rays and compared the measured data with our Monte Carlo simulations for the small fields. MATERIALS AND METHODS: The small fields of 1.0, 2.0 and 3.0 cm in diameter were used in this study. Percentage depth dose (PDD) and beam profiles of those fields were measured and calculated. A small semiconductor detector, water phantoms, and a remote control system were used for the measurement. Monte Carlo simulations were performed using the EGS4 code with the input data prepared for the energy distribution of 6 MV X-rays, beam divergence, circular fields and the geometry of the water phantoms. RESULTS: In the case of PDD values, the calculated values were lower than the measured values for all fields and depths, with the differences being 0.3 to 5.7% at the depths of 2.0 to 20.0 cm and 0.0 to 8.9% at the surface regions. As a result of the analysis of beam profiles for all field sizes at a depth of 10cm in water phantom, the measured 90% dose widths were in good agreement with the calculated values, however, the calculated penumbra radii were 0.1 cm shorter than measured values. CONCLUSION: The measured PDDs and beam profiles agreement with the Monte Carlo calculations approximately. However, it is different when it comes to calculations in the area of phantom surface and penumbra because the Monte Carlo calculations were performed under the simplified geometries. Therefore, we have to study how to include the actual geometries and more precise data for the field area in Monte Carlo calculations. The Monte Carlo calculations will be used as a useful tool for the very complicated conditions in measurement and verification.
Subject(s)
Radiosurgery , Semiconductors , WaterABSTRACT
PURPOSE: The dose calculation program for the Buchler type remote afterloading system was developed. This program also can be used to calculate dose for various sealed sources. METHODS AND MATERIALS: We determined the source length and distribution by dividing the program disk to 72 points. The dose rate for the each program disk and source was calculated. The dose rate table for the xy coordinate was established. The dose rate for the interesting points of the patient were calculated by using this table. We also made isodose curve from this calculations. RESULTS: The storage size for the dose rate table were increased.But the calculation of the dose rate for the patient were carried out rapidly. So we could get real time calculation. CONCLUSION: By using this program, we could calculate the dose rate for the various oints of the patient quickly and accurately. This program will be useful for the treatment with various linear sources.
Subject(s)
Humans , BrachytherapyABSTRACT
PURPOSE: To analyse clinical outcome and prognostic factors according to treatment modality, this paper report our experience of retrospective study of patients with esophageal cancer. MATERIALS AND METHODS: One hundred and ten patients with primary esophageal cancer who were treated in Presbyterian Medical Center from May 1985 to December 1992. We analysed these patients retrospectively with median follow up time of 28 months, one hundred and four patients(95%) were followed up from 15 to 69 months. In methods, twenty-eight patients were treated with median radiation dose irradiated 54.3Gy only. Fifty-six patients were treated with combined chemoradiotherapy. Sixteen cases of these patients were treated with concurrent chemoradiation and the other patients(forty cases) were treated sequential chemoradiotherapy. In concurrent chemoradiotherapy group, patients received 5-FU continuous IV infusion for 4 days. Cisplatin IV bolus, and concurrent esophageal irradiation to 30 Gy. After that patients received 5-Fu continuous IV, Cisplatin bolus injection and Mitomycin-C bolus IV, Bleomycin continuous IV, and irradiation to 20 Gy. In sequential chemoradiotherapy group, the chemotherapy consisted of 5-FU 1,000 mg/m2 administered as a continuous 24 hour intravenous infusion during five days and Cisplatin 80-100 mg/m2 bolus injected, or Bleomycin, Vinblastine, Cisplatin, Methotrexate were used of 1 or 2 cycles. After preoperative concurrent chemoradiation, twenty-six patients underwent radical esophagectomy. RESULTS: ninety-three patients could be examined for response assessment. By treatment modality, response rates were 85.1% for radiation alone group and 86.3% for combined chemoradiation group. But in operation group, after one cycle of concurrent chemoradiation treatment, response rate was 61.9%. Ther pathologic complete response were 15.4% in operation group. Overall median survival was 11 months and actuarial 5-year survival rate was 8%. The median survival interval was 6 months for radiation alone group, 11 months for combined chemoradiation group and 19 months for operation group. And also median survival was 19 months for complete responder group that 8 months for noncomplete responder group. In univariative analysis, statistically significant prognositc factors were tumor size, clinical stage, tumor response, and operation. In multivariative analysis, siginificantly better survival was associated with clinical stage, tumor response, radiation dose, and peration. CONCLUSION: Compared with radiotherapy alone, combined mulimodlity may improve the median survival in patients with localized carcinoma of the esophagus and toxicity is acceptable.
Subject(s)
Humans , Bleomycin , Chemoradiotherapy , Cisplatin , Drug Therapy , Esophageal Neoplasms , Esophagectomy , Esophagus , Fluorouracil , Follow-Up Studies , Infusions, Intravenous , Methotrexate , Mitomycin , Protestantism , Radiotherapy , Retrospective Studies , Survival Rate , VinblastineABSTRACT
Among the 63 patients with histopathologically proven primary squamous cell anal cancer who were managed in Presbyterian Medical Center and Yonsei University Cancer from Jan. 1971 to Dec. 1991, 34 patients, who were managed with surgery alone (abdominoperineal resection) or post-operative radiotherapy and concurrent chemoradiotherapy were analyzed. With mean follow up time of 81.3 months, 30 patients (88%) were followed up from 17 to 243 months. In methods, 10 patients were treated with surgery alone. 9 patients were treated with combined surgery and postoperative radiotherapy (59~60 Gy in 28~30 fractions). 15 patients were treated with concurrent chemoradiotherapy. Chemotherapy (Mitomycin C 15 mg/squ, bolus injection day 1;5-FU, 750 mg/squ, 24hr infusion, day 1 to 5) and radiotherapy started the same day. A dose of 30 Gy was given to the tumor and to the pelvis including inguinal nodes, in 15 fractions. After 2 weeks a boost of radiotherapy (20 Gy) to the ano-perineal area and second cycle of chemotherapy completed the treatment. The overall 50year survival rate was 56.2%. concurrent chemoradiotherapy group was 70% and surgery alone group was 16.7%. According to the cox proportional harzard model, there was significant different between survival with concurrent chemoradiotherapy and surgery alone (p=0.0129), but post-operative radiotherapy was 64.8%, which was not stastically significant (p=0.1412). In concurrent chemoradiotherapy group, the anal function preservation rate was 87% and the severe complication rate (grade 3 stenosis and incontinence) was 13.3%. In conclusion, we conclude that the concurrent chemoradiotherapy may be effective treatment modality in patients with anal cancer
Subject(s)
Humans , Anus Neoplasms , Chemoradiotherapy , Constriction, Pathologic , Drug Therapy , Follow-Up Studies , Pelvis , Protestantism , Radiotherapy , Survival RateABSTRACT
A total of 93 patients with rectal cancer treated with radiotherapy at department of Radiation Oncology, Yonsei University College of Medicine, Yonsei Cancer Center between January 1974 and December 1983 are retrospectively analysed. The patients are divided into three groups as follows: I. Postoperative radiotherapy, II. Pstoperative recurrent, III. Unresectable or Inoperable group. In postoperative radiotherapy group, overall 5 year survival rate is 34.8% and prognostic factors are presence of obstruction and degree of differentiation. In postoperative recurrent group, overall 5 year survival rate is 34.8% and prognostic factors are presence of obstruction and degree of differentiation. In postoperative recurrent group, overall 2 year survival rate is 7.4% with median survival of 13 months and prognostic factors are RT responsiveness and sex, and the local failure rate is 22.7%. In unresectable or inoperable group, overall 2 year survival rate is 19.8% with median survival of 12.6 months and prognostic factors are RT responsiveness and RT dose. The complications for RT are not significant and are acceptable in all patients.
Subject(s)
Humans , Radiation Oncology , Radiotherapy , Rectal Neoplasms , Retrospective Studies , Survival RateABSTRACT
From January 1970 through December 1984, 15 patients with sinonasal Non-Hodgkin's lymphoma combined to the head and neck were treated by external irradiation. 13 patients were stage IE and 2 were stage IIE by Ann Arbor Classification. However, when using TNM system, 7 were locally advanced T3, T4 lesions. All patients had follow up from 3.7 to 16 years with the median follow-up of 8.5 years. The overall actuarial 5-year survival rates were 25%, 28% for IE and 0% for IIE. Total tumor dose varied from 40 to 68 Gy. 100% complete response with a total tumor dose of more than 55 Gy and 73% complete response with less than 55 Gy. When the disease was staged using the TNM (AJC) system, the five-year disease free survival for T1 and T2 patients was 50% as compared with 14% for T3 and T4. Failure rate by stage was 33% (2/6) for T1 and T2, 86% (6/7) for T3 and T4, and 100% (2/2) for IIE. The results suggest that 1. Higher CR could be obtained with a total tumor dose of more than 55 Gy. 2. Use of TNM staging system is as important as Ann arbor in management of sinonasal NHL. 3. The addition of combination chemotherapy should be considered for T3, T4 and IIE the sinonasal Non-Hodgkin's lymphoma although the disease is limited to head and neck.