In proton therapy, the analysis of secondary particles is important due to delivered dose outside the target volume and thus increased potential risk for the development of secondary cancer. The purpose of this study is to analyze the influence of secondary particles from proton beams on fluence and energy deposition in the presence of inhomogeneous material by using Geant4 simulation toolkit. The inhomogeneity was modeled with the condition that the adipose tissue, bone and lung equivalent slab with thickness of 2 cm were inserted at 30% (Plateau region) and 80% (Bragg peak region) dose points of maximum dose in Bragg curve. The energy of proton was varied with 100, 130, 160 and 190 MeV for energy dependency. The results for secondary particles were presented for the fluence and deposited energy of secondary particles at inhomogeneous condition. Our study demonstrates that the fluence of secondary particles is neither influenced insertion of inhomogeneties nor the energy of initial proton, while there is a little effect by material density. The deposited energy of secondary particles has a difference in the position placed inhomogeneous materials. In the Plateau region, deposited energy of secondary particles mostly depends on the density of inserted materials. Deposited energy in the Bragg region, in otherwise, is influenced by both density of inserted material and initial energy of proton beams. Our results suggest a possibility of prediction about the distribution of secondary particles within complex heterogeneity.
Adipose Tissue ; Dependency (Psychology) ; Lung ; Population Characteristics ; Proton Therapy ; Protons

Geant4 (GEometry ANd Tracking) provides various packages specialized in modeling electromagnetic interactions. The validation of Geant4 physics models is a significant issue for the applications of Geant4 based simulation in medical physics. The purpose of this study is to evaluate accuracy of Geant4 electromagnetic physics for proton therapy. The validation was performed both the Continuous slowing down approximation (CSDA) range and the stopping power. In each test, the reliability of the electromagnetic models in a selected group of materials was evaluated such as water, bone, adipose tissue and various atomic elements. Results of Geant4 simulation were compared with the National Institute of Standards and Technology (NIST) reference data. As results of comparison about water, bone and adipose tissue, average percent difference of CSDA range were presented 1.0%, 1.4% and 1.4%, respectively. Average percent difference of stopping power were presented 0.7%, 1.0% and 1.3%, respectively. The data were analyzed through the kolmogorov-smirnov Goodness-of-Fit statistical analysis test. All the results from electromagnetic models showed a good agreement with the reference data, where all the corresponding p-values are higher than the confidence level alpha=0.05 set.
Adipose Tissue ; Magnets ; Proton Therapy ; Protons ; Water

PURPOSE: The purpose of this study was to analyze and assess the current situation of Korea's school health education program and to establish measures to efficiently carry out school health education in Korea. METHOD: The survey was conducted through the internet with the health educators of elementary, middle, and high schools nationwide to assess the current condition of school health education programs, and 2,459 samples were collected which accounted for 23.4% of the total respondents. RESULTS: According to school health educators on the enforcement of health education, the higher the education became, the less the health education was enforced. The enforcement rate was 96.9% in elementary schools, 76.7% in middle schools, and 67.3% in high schools. The major reasons were found as difficulty in securing class time (54.5%) and other excessive workloads (20.9%). As a result of the health education awareness survey, over 99% answered that health education is needed, over 80% answered that the education requires independent health textbooks, and over 95% answered that health educators are suitable for the person in charge of the education. CONCLUSION: This study will be a useful in establishing a detailed policy on enhancing school health education in the future.
Adolescent ; Adult ; Aged ; Child ; Health Education/organization & administration/*trends ; Humans ; Korea ; Male ; Middle Aged ; Questionnaires ; School Health Services/*trends

Absorbed dose to water based protocols recommended that plane-parallel chambers be calibrated against calibrated cylindrical chambers in a high energy electron beam with R50>7 g/cm2 (E> or =16 MeV). However, such high-energy electron beams are not available at all radiotherapy centers. In this study, we are compared the absorbed dose to water determined according to cross-calibration method in a high energy electron beam of 16 MeV and in electron beam energies of 12 MeV below the cross-calibration quality remark. Absorbed dose were performed for PTW 30013, Wellhofer FC65G Farmer type cylindrical chamber and for PTW 34001, Wellhofer PPC40 Roos type plane-parallel chamber. The cylindrical and the plane-parallel chamber to be calibrated are compared by alternately positioning each at reference depth, zref=0.6R50-0.1 in water phantom. The DW of plane-parallel chamber are derived using across-calibration method at high-energy electron beams of 16, 20 MeV. Then a good agreement is obtained the DW of plane-parallel chamber in 12 MeV. The agreement between 20 MeV and 12 MeV are within 0.2% for IAEA TRS-398.
Electrons ; Water

OBJECTIVES: This study, as a preliminary one attempting to develop the Korean version of Integrated Therapy for the rehabilitation of schizophrenic patients, was designed to investigate the results of Integrated Psychological Therapy(IPT) and review the problems during the program application. METHODS: Cognitive Differentiation Scale, Problem-Solving Scale, and PANSS(Positive And Negative Syndrome Scale) were administered to schizophrenic inpatients before and after IPT incorporating cognitive differentiation, social perception, verbal communication, social skill and interpersonal problem-solving skill subprograms. The therapy groups were offered activities three times per week during the 12-week program. The control groups were attention-placebo groups for control ling factors such as group interaction and social attention, and were offered psychoeducation. RESULTS: The 12-week IPT groups, compared with the control groups, demonstrated significant improvements in the general psychopathology and the total symptoms of PANSS, but did not in cognitive functions and problem-solving skill. Significant improvements in cognitive functions were found only after cognitive differentiation subprogram and social skill subprogram had limited effects on social skills. But within 12-week IPT groups significant improvements in the positive symptoms, negative symptoms and general psychopathology were found. CONCLUSION: These findings support some effectiveness of IPT, but do not address the unique contribution by cognitive components. Applied to schizophrenic patients in this country, this modality had the problems such as differences in sociocultural and lingual background, duration of treatment, homogeneity in the level of the functioning among group members, management of emotions in activities, and the therapists' skill in the training of cognitive components. So the modification of this modality will be required.
Humans ; Inpatients ; Psychopathology ; Rehabilitation ; Schizophrenia ; Social Perception

The drug inducing tubulointerstitial nephritis is a crucial cause of acute kidney injury. Use of herbal plants in disease treatment is generally practiced in Korea. Although there are a small number of case reports, tubulointerstitial nephritis caused by taking Atractylodes macrocephala Koidzumi in human has never been reported. A 62-year-old man visited our hospital with symptoms of systemic edema accompanied by reduced urine volume and dyspnea after taking herbal plant 1 week ago. Chest radiographs showed both sided pleural effusion. Blood test results showed elevation of serum blood urea nitrogen and creatinine level and urine test results showed hematuria and proteinuria. Renal biopsy result showed evidence of tubulointerstitial nephritis by tubulitis and inflammatory cell expansion in the interstitium was observed. The patient's renal function recovered after administration of active renal replacement treatment and conservative therapy such as supplementation of fluid and electrolytes, and there was no disease recurrence for 1 year. Therefore, this case proved that Atractylodes macrocephala Koidzumi could cause acute kidney injury by the drug induced tubulointerstitial nephritis in human.
Acute Kidney Injury* ; Atractylodes* ; Biopsy ; Blood Urea Nitrogen ; Creatinine ; Dyspnea ; Edema ; Electrolytes ; Hematologic Tests ; Hematuria ; Herbal Medicine ; Humans ; Korea ; Middle Aged ; Nephritis ; Nephritis, Interstitial ; Plants ; Pleural Effusion ; Proteinuria ; Radiography, Thoracic ; Recurrence ; Renal Dialysis

Background: Tinnitus is a bothersome condition associated with various symptoms. However, the mechanisms of tinnitus are still uncertain, and a standardized assessment of the diagnostic criteria for tinnitus is required. We aimed to reach a consensus on diagnosing tinnitus with professional experts by conducting a Delphi study with systematic review of the literature. Methods: Twenty-six experts in managing tinnitus in Korea were recruited, and a two-round modified Delphi study was performed online. The experts evaluated the level of agreement of potential criteria for tinnitus using a scale of 1–9. After the survey, a consensus meeting was held to establish agreement on the results obtained from the Delphi process. Consensus was defined when over 70% of the participants scored 7–9 (agreement) and fewer than 15% scored 1–3 (disagreement). To analyze the responses of the Delphi survey, the content validity ratio and Kendall’s coefficient of concordance were evaluated. Results: Consensus was reached for 22 of the 38 statements. For the definition of tinnitus, 10 out of 17 statements reached consensus, with three statements achieving complete agreement including; 1) Tinnitus is a conscious perception of an auditory sensation in the absence of a corresponding external stimulus, 2) Tinnitus can affect one’s quality of life, and 3) Tinnitus can be associated with hearing disorders including sensorineural hearing loss, vestibular schwannoma, Meniere’s disease, otosclerosis, and others. For the classification of tinnitus, 11 out of 18 statements reached consensus. The participants highly agreed with statements such as; 1) Vascular origin is expected in pulse-synchronous tinnitus, and 2) Tinnitus can be divided into acute or chronic tinnitus. Among three statements on the diagnostic tests for tinnitus only Statement 3, “There are no reliable biomarkers for sensory or emotional factors of tinnitus.”reached consensus. All participants agreed to perform pure-tone audiometry and tinnitus questionnaires, including the Tinnitus Handicap Inventory and Tinnitus Questionnaire. Conclusion We used a modified Delphi method to establish a consensus-based definition, a classification, and diagnostic tests for tinnitus. The expert panel reached agreement for several statements, with a high level of consensus. This may provide practical information for clinicians in managing tinnitus.