• Title/Summary/Keyword: 근접 치료

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Verification of skin dose according to the location of tumor in Tomotherapy (토모테라피 시 종양의 위치에 따른 피부선량 검증)

  • Yoon, Bo Reum;Park, Su Yeon;Park, Byoung Suk;Kim, Jong Sik;Song, Ki Won
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.2
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    • pp.273-280
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    • 2014
  • Purpose : To verify the skin dose in Tomotherapy-based radiation treatment according to the change in tumor locations, skin dose was measured by using Gafchromic EBT3 film and compared with the planned doses to find out the gap between them. Materials and Methods : In this study, to measure the skin dose, I'm RT Phantom(IBA Dosimetry, Germany) was utilized. After obtaining the 2.5mm CT images, tumor locations and skin dose measuring points were set by using Pinnacle(ver 9.2, Philips Medical System, USA). The tumor location was decided to be 5mm and 10mm away from surface of the phantom and center. Considering the attenuation of a Tomo-couch, we ensured a symmetric placement between the ceiling and floor directions of the phantom. The measuring point of skin doses was set to have 3mm and 5mm thickness from the surface. Measurement was done 3 times. By employing TomoHD(TomoHD treatment system, Tomotherapy Inc., Madison, Wisconsin, USA), we devised Tomotherapy plans, measured 3 times by inserting Gafchromic EBT3 film into the phantom and compared the measurement with the skin dose treatment plans. Results : The skin doses in the upper part of the phantom, when the tumor was located in the center, were found to be 7.53 cGy and 7.25 cGy in 5mm and 3mm respectively. If placed 5mm away from the skin in the ceiling direction, doses were 18.06 cGy and 16.89 cGy; if 10mm away, 20.37 cGy and 18.27 cGy, respectively. The skin doses in the lower part of the phantom, when the tumor was located in the center, recorded 8.82 cGy and 8.29 cGy in 5mm and 3mm, each; if located 5mm away from the lower part skin, 21.69 cGy and 19.78 cGy were respectively recorded; and if 10mm away, 20.48 cGy and 19.57 cGy were recorded. If the tumor was placed in the center, skin doses were found to increase by 3.2~17.1% whereas if the tumor is 5mm away from the ceiling part, the figure decreased to 2.8~9.0%. To the Tomo-couch direction, skin doses showed an average increase of 11% or over, compared to the planned treatment. Conclusion : This study found gaps between planned skin doses and actual doses in the Tomotherapy treatment planning. Especially to the Tomo-cocuh direction, skin doses were found to be larger than the planned doses. Thus, during the treatment of tumors near the Tomo-couch, doses will need to be more accurately calculated and more efforts to verify skin doses will be required as well.

The Results of Radiation Therapy Alone vs Radiation Plus Chemotherapy of Uterine Cervix Cancer (자궁경부암에서 방사선 단독요법 및 항암화학과 방사선 병용요법의 치료성적)

  • Lee, Myung-Za;Choi, Seog-Young;Chun, Ha-Chung
    • Radiation Oncology Journal
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    • v.13 no.2
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    • pp.181-189
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    • 1995
  • Pupose: Radiation therapy(RT) is conventionally standard treatment for locally advanced stage for uterine cervix cancer. Recently to improve treatment results, combined chemotherapy and radiation therapy was tried We retrospectively analysed our experience of 122 patients. Comparision of the results in 45 patients treated with RT alone and 77 patients treated with RT plus chemotherapy was made Materials and Mathods: From January 1985 to December 1991 122 patients with cervix cancer were treated with whole pelvic external RT and ICR(34 1 ICR, 77 2 ICR, 11 high dose rate ICR) in our department. Forty five patients were treated with RT alone, and 77 patients were treated with combined RT plus chemotherapy Mean age was 58 years(range:29-81). Histologic types were 111 squamous cell carcinoma, 5 large cell carcinoma, 3 adenocarcinoma, and 2 adenosquamous cell carcinoma. According to the FIGO stage 6 had stage $IA(4.9\%),$ 11 had $IIA(9.0\%),$ 37 had $IIB(30.3\%),$ 3 had $IIIA(2.5\%),$ 63 had $IIIB(51.6\%).$ and 2 had stage $IV(1.6\%).$ In 77 patients with RT Plus chemotherapy, 36 patients were treated with VBP(vinblastin, bleomycin, cisplatinum) , 39 patients with cisplatinum plus 5-FU and 2 patients with 5-FU. Results: Complete response after external RT (3960cGy-5500cGy) was achieved in 61 patients$(50\%).$ The actuarial 5 year and 9 rear survival rate was $57.8\%\;and\;53.9\%,$ respectively. Five rear actuarial survival rate was $63.1\%$with RT alone(n=45) and $55.9\%$ with RT plus chemotherapy(n=77). The 5 rear survival rate was $35.5\%$ for 1 course of ICR and $67\%$ for 2 courses of ICR. There was statistically significant advantage of survival with RT alone group who were treated with 2 courses of ICR and dose to the A Point)=8000cGy (4/25 died). In RT plus chemotherapy group, dose response was not seen and there was no difference in 5 year survival between 1 course and 2 course of ICR $(50\%\;vs\;56.8\%),$ and dose to point A less than 8000 cGy and more than 8000 $cGy(55.6\%\;vs\;55.7\%).$ There was no significant difference in survival between RT alone and RT plus chemotherapy for patients with tumor size greater than 3cm in size. Five year survival rate for early stage (Stage IB and IIA) with RT alone group and with RT Plus chemotherapy group was $60\%\;and\;77.0\%,$ respectively In advanced stage (stage IIB, IIIA, IIIB, IVA) the 5 year actuarial survival rate were $62.6\%,$ for RT alone group vs $53.6\%$ for RT plus chemotherapy group. Conclusion: Present study demonstrates that there is no survival advantage with adding chemotherapy in advanced stage of uterine cervix cancer. RT alone is considered as treatment of choice for patients with locally advanced cervix cancer. There was increased survival in RT alone group treated with RT dose above 8000 cGy to point A and 2 course of ICR. but 2 course of ICR and RT dose above 8000 cGy to point A did not affect survival advantage in RT plus chemotherapy group.

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SURGICAL REPOSITIONING OF THE DISPLACED IMPACTED MAXILLARY CENTRAL INCISOR WITH DILACERATED ROOT : CASE REPORT (비정상 맹출로와 치근 만곡을 지닌 매복 상악영구전치의 자가치아이식 치험례)

  • Rhee, Ye-Ri;Choi, Sung-Chul;Park, Jae-Hong;Kim, Gwang-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.3
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    • pp.516-522
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    • 2008
  • In the case of the impacted teeth, the clinician has to consider development of tooth, site of impaction, eruption path, and cooperation of patient. If there are genetic or general factors to effect the eruption of tooth, the clinician treats these first and then takes the early treatment for eruption guidance. If there are physical factors to intercept eruption, the clinician put them off first. However, if there are no factors to effect eruption of tooth and enough space for eruption, the clinician can consider extraction of deciduous teeth, forced eruption and surgical reposition. In case of surgical repositioning, proper time for root development, proper socket formation, and minimal trauma are important for success. This case presents displaced impacted maxillary central incisor with dilacerated root. The development of root is Nolla's stage 7, and the tooth was treated by surgical repositioning. We can observe no root resorption and good healing pattern.

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The Relationship between Radiation Dose and Late Complication of Bladder in Carcinoma of the Uterine Cervix (자궁경부암에서 방사선량과 방광합병증의 관계)

  • Ha, Sung-Whan;Chung, Woong-Ki;Kim, Jong-Hoon
    • Radiation Oncology Journal
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    • v.11 no.2
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    • pp.377-385
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    • 1993
  • Five hundred and fifty patients treated for carcinoma of the uterine cervix at the Department of Therapeutic Radiology, Seoul National University Hospital from 1979 to 1986, were analyzed retrospectively for late bladder complications. Of them,468 patients received primary radiotherapy for the cervix cancer in intact uterus, and the other 82 patients were treated postoperatively. The cumulative incidence of radiation induced bladder complication of grade 2 or 3 was $2.5\%$ at five years. The mean bladder dose for the group of patients with complication was higher than that of the group without complication, and the difference was statistically significant (p<0.01). But relationship between mean bladder dose and severity of complication was not found. The frequency of complication (grade I, II, III) increased as a function of radiation dose to bladder from $5.0\%$ for patients with bladder dose less than 6,500 cGy to $27.7\%$ for patients with bladder dose higher than 8,000 cGy. Among various factors, the age of patient and the distance between ovoids turned out to have significant effect on the complication.

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Bedside Estimation of the Length of Nares-Vocal Cord in Children (소아에서의 비공 - 성대간 거리에 관한 예측공식의 유도)

  • Lee, Young-Eun;Shin, Teo-Jeon;Kim, Chong-Chul;Lee, Sang-Hoon;Jang, Ki-Taeg;Kim, Jung-Wook;Kim, Youmg-Jae;Hyun, Hong-Keun;Han, Hyo-Jo;Kim, Hyun-Jeong;Seo, Kwang-Suk
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.11 no.2
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    • pp.141-145
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    • 2011
  • 배경: 협조가 불가능하거나 진정법 하 치과치료가 여의치 않을 경우 전신마취 하 치료를 계획하게 된다. 하지만 전신마취 하 치료시 기관내 삽관이 여의치 않은 경우를 종종 경험하게 된다. 이와같은 경우 기관지경을 이용한 기관내 삽관을 시행한다. 기관지 내시경을 환자의 성문에 근접하게 전진시킬 경우 기관지 내시경 하 시야확보가 용이한 점을 감안 시 비공 - 성대간 거리를 예측하는 것은 매우 유용할 것으로 생각된다. 또한 비공 - 성대간 거리를 추정하게 되면 맹목적 비강내 기관내 삽관을 하는데도 도움이 된다. 방법: 본 연구는 전신마취하 치과치료가 예정되어 있는 62명의 소아환자들을 대상으로 하여 신체변수와 비공 - 성대거리와의 관계를 확인해보고자 하였다. 선형회귀분석을 시행하여 다음과 같은 결론을 도출하였다. 결과: 소아환자들에 있어 비공 - 성대간 거리는 환아의 신장, 체중, 연령 등과 상관관계를 나타내었다. 비공 - 성대간 거리와 상관관계를 보인 변수들 중 에서 신장과의 상관계수가 가장 높았다. 선형회귀분석을 통해 비공 - 성대간 거리를 예측하는 다음과 같은 회귀식을 구하였다. 비공 - 성대간 거리 = (4.8 + 신장(cm)) ${\times}$ 0.07 고찰: 본 연구에서 구해진 회귀식을 이용하여 기도유지가 어려운 소아의 기도유지 하는데 큰 도움이 될 것으로 생각된다.

Implant assisted removable partial denture using bilateral single implant-supported surveyed crown: a case report (양측성 단일 임플란트 지지 서베이드 크라운을 이용한 하악 임플 란트 보조 국소의치 수복 증례)

  • Seojune Choi;Hong Seok Moon;Jaeyoung Kim
    • The Journal of Korean Academy of Prosthodontics
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    • v.62 no.2
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    • pp.146-156
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    • 2024
  • Implant assisted removable partial denture (IARPD) has been practiced in various forms for a long time, and among them, implant surveyed crown RPD is gaining predictability as well as being considered as a treatment option for patients with anatomical and financial disadvantages. The position of implant could be divided as posterior placement or anterior placement according to the purpose of the treatment and should be planned in consider to the alveolar ridge of patient, anticipated prognosis of remaining teeth, and opposing dentition. This case report describes a treatment for mandibular Kennedy class I partial edentulous patient with two implant-supported surveyed crown and implant assisted removable partial denture. Given the difficulty of posterior placement in this patient and the prognosis of the residual teeth, the plan was to place two implants in close proximity to the residual teeth, which were placed in the planned position, angle, and depth using guided surgery. The process of fabricating the fixed prosthesis was carried out in parallel with the maxillary edentulous tooth arrangement process to increase predictability, and when fabricating the localized tooth, the implant was designed in a form that allows the patient to perform functional movements by preventing excessive loading as the last supporting tooth, and was fabricated through a secondary impression process. Each treatment procedure was proceeded as planned, with aesthetically and functionally satisfactory results for both patient and operator.

The Study of Shielding Effect on Ovoids of Three Different Gynecological Applicator Sets in microSelectron-HDR System (microSelectron-HDR System에서 부인암 강내조사에 쓰이는 세 가지 Applicator Set들의 Ovoids에 대한 차폐효과 연구)

  • Cho, Young-K.;Park, Sung-Y.;Choi, Jin-H.;Kim, Hung-J.;Kim, Woo-C.;Loh, John-J.K.;Kim, Joo-Y.
    • Journal of Radiation Protection and Research
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    • v.23 no.4
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    • pp.259-266
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    • 1998
  • There are three different types of gynecological applicator sets available in microSelectron-high dose-rate(HDR) System by Nucletron; standard applicator set(SAS), standard shielded applicator set(SSAS), and Fletcher-Williamson applicator set(FWAS). Shielding effect of a SAS without shielding material was compared with that of a SSAS with shielding material made of stainless steel(density ${\varrho}=8,000kg/m^3$) at the top and bottom of each ovoid, and of a FWAS with shielding material made of tungsten alloy(density ${\varrho}=14,000kg/m^3$ at the top and bottom of each ovoid. The shielding effects to the rectum and bladder of these two shielded applicator sets were to be measured at reference points with an ion chamber and specially designed supporting system for applicator ovoids inside of the computerized 3-dimensional water phantom. To determine the middle point of two ovoids the measurement was performed with the reference tip of ion chamber placed at the same level and at the middle point from the two ovoids, while scanning the dose with the ion chamber on each side of ovoids. The doses to the reference points of rectum were measured at 20(Rl), 25(R2), 30(R3), 40(R4), 50(R5), and 60(R6) mm located posteriorly on the vertical line drawn from M5(the middle dwell position of ovoid), and the doses to the bladder were measured at 20(Bl), 30(B2), 40(B3), 50(B4), and 60(B5) mm located anteriorly on the vertical line drawn from M5. The same technique was employed to measure the doses on each reference point of both SSAS and FWAS. The differences of measured rectal doses at 25 mm(R2) and 30 mm(R3) between SAS and SSAS were 8.0 % and 6.0 %: 25.0% and 23.0 % between SAS and FWAS. The differences of measured bladder doses at 20 mm(Bl) and 30 mm(B2) between SAS and SSAS were 8.0 % and 3.0 %: 23.0 % and 17.0 % between SAS and FWAS. The maximum shielding effects to the rectum and bladder of SSAS were 8.0 % and 8.0 %, whereas those of FWAS were 26.0 % and 23.0 %, respectively. These results led to the conclusion that FWAS has much better shielding effect than SSAS does, and when SSAS and FWAS were used for gynecological intracavitary brachytherapy in microSelectron-HDR system, the dose to the rectum and bladder was significantly reduced to optimize the treatment outcome and to lower the complication rates in the rectum and bladder.

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CONSTRUCTION PROCEDURE OF TOOTH POSITIONER (Tooth Positioner의 제작에 관해서)

  • Kyung, Hee Moon;Sung, Jae Hyun
    • The korean journal of orthodontics
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    • v.12 no.1
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    • pp.61-68
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    • 1982
  • Tooth Positioner는 band를 제거한 후 가능한 빨리 장착시켜야 susceptible하며 무엇보다도 환자의 생리학적 jaw movement를 설정해서 제작해야 하고 적어도 hingeaxis relation은 찾아서 제작해야한다. Positioner의 장착시간은 하루에 $3\~4$시간의 active biting exercise와 수안시간동안 사용하게 한다. 처음 장착시에 가장 tight하고 이 tightness 는 치아가 요망되는 위치로 근접함에 따라서 점차 감소되고 이 tightness의 감소가 작용효과의 가장 좋은 지침이 되며 자는 하루 하루 그 변화를 느껴야 한다. Positioner가 느슨하게 적합되고 좋은 교합관계를 보이면 장착을 수안시간동안으로 제한시키거나 혹은 깨어 있을 동안 한 두시간 장착하게 한아. 대개 $3\~4$주 후에 predetermined pattern과 유사하게 되며, 일반적으로 장착 후 $8\~10$주 후에 더 장착할 것인가를 결정하고 필요성이 없다면 conventional retainer로 바꾸어 준다. Tooth Positioner는 기능적인 구호흡, thumb sucking, snoring을 해소시켜 줄 수 있으며 jaw relationship이나 overbite문제를 해결할 수 있다. 그리고 chair time을 감소시켜 줄 수 있으며 tissue tone을 자극해서 치아위치를 증진시키는데 끊임없이 작용한다. 그러나 제작에 많은 시간이 걸리고 치아를 배열하는 술자의 능력에 따라 치료효과가 많이 좌우되며 너무 bulky하므로 이물감이 커서 유용하게 장착할 수 있는 시간이 제한적이고 natural muscle balance에 대해 간헐적인 교정력을 가함으로써 치아를 loosening 시킬 수 있다. 이 장치물은 다른 removable appliance와 같이 환자의 협조가 무엇보다 중요하므로 환자에게 장착동기를 유발시켜 주는 것이 좋으며 True Blocked Nasal Airway가 있는 환자에게는 금기증이 된다.

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Scientometric Analysis through Centrality Analysis of Graph for Linkage Relation of Keyword for Elder's Rehabilitation and Healthcare (노인 재활 헬스케어에 대한 키워드 연결 관계의 그래프 중심성 분석을 통한 계량 정보 분석)

  • Kim, Myung-Mi
    • The Journal of the Korea institute of electronic communication sciences
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    • v.14 no.2
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    • pp.447-452
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    • 2019
  • The elder problem is very serious stage in the age of present. This paper carries out scientometric analysis based on keyword that effort of global researcher for this research field as viewpoint of ICT and healthcare in order to settle physical exercise and rehabilitation of elder. First, this paper performs analysis of linkage relation of keyword. Second this paper carries out the analysis of degree distribution and centrality analysis of network based on betweenness centrality, closeness centrality and harmony centrality. Through this process, this paper reviews research trend of present and future through core keyword in the field of ICT and healthcare.

The Study of Dose Variation and Change of Heart Volume Using 4D-CT in Left Breast Radiation Therapy (좌측 유방 방사선치료 시 4D-CT를 이용한 심장의 체적 및 선량변화에 대한 연구)

  • Park, Seon Mi;Cheon, Geum Seong;Heo, Gyeong Hun;Shin, Sung Pil;Kim, Kwang Seok;Kim, Chang Uk;Kim, Hoi Nam
    • The Journal of Korean Society for Radiation Therapy
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    • v.25 no.2
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    • pp.187-192
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    • 2013
  • Purpose: We investigate the results of changed heart volume and heart dose in the left breast cancer patients while considering the movements of respiration. Materials and Methods: During the months of March and May in 2012, we designated the 10 patients who had tangential irradiation with left breast cancer in the department of radiation Oncology. With acquired images of free breathing pattern through 3D and 4D CT, we had planed enough treatment filed for covered up the whole left breast. It compares the results of the exposed dose and the volume of heart by DVH (Dose Volume histogram). Although total dose was 50.4 Gy (1.8 Gy/28 fraction), reirradiated 9 Gy (1.8 Gy/5 Fraction) with PTV (Planning Target Volume) if necessary. Results: It compares the results of heart volume and heart dose with the free breathing in 3D CT and 4D CT. It represents the maximum difference volume of heart is 40.5%. In addition, it indicated the difference volume of maximum and minimum, average are 8.8% and 27.9%, 37.4% in total absorbed dose of heart. Conclusion: In case of tangential irradiation (opposite beam) in left breast cancer patients, it is necessary to consider the changed heart volume by the respiration of patient and the heartbeat of patient.

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