• Title/Summary/Keyword: 근접 치료

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Discourses on Mental Health Act Revision and Critical Analysis on Mental Health Promotion and Welfare Service Support Act (정신보건법 개정 담론에 근거한 정신건강증진 및 정신질환자 복지서비스 지원에 관한 법률 주요 쟁점 분석)

  • Kim, Moon Geun
    • Korean Journal of Social Welfare Studies
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    • v.47 no.3
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    • pp.85-111
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    • 2016
  • This study aims to analyse major changes of Mental Health Promotion and Welfare Service Support Act(MHPWSSA) and critically discuss these changes based on the major discourses on Mental Health Act revision. For this purposes this study reviewed literatures and government reports to understand human rights discourses, welfare discourses, and prevention discourses. Secondly, the major changes of MHPWSSA were analysed and discussed based on those discourses. This study found that MHPWSSA defined the concept of people with mental disorders narrowly, tightened the involuntary admission procedures, introduced welfare service support provisions and mental health promotion provisions. But this study shows that the new legislation may well be criticised due to neglect of the concept of disability and people with psychiatric disability, involuntary admission without mental capacity assessment, neglect of the basic values and principles of self determination and independent living common in welfare of the persons with disability. And the new legislation may be criticised due to overuse of the concept of mental health promotion as encompassing promotion, prevention, treatment and rehabilitation.

A Study on deduction of important factors for new infectious diseases through big data analysis (빅데이터 분석을 통한 신종감염병 중요 요인 도출)

  • Suh, Kyung-Do
    • Journal of Industrial Convergence
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    • v.19 no.3
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    • pp.35-40
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    • 2021
  • This study attempted to derive important factors of emerging infectious diseases by collecting and analyzing text data onto emerging infectious diseases. For this purpose, articles in the Naver News database were directly crawled, pre-processed, and used for data analysis. In addition, additional analysis was performed using Big Kinds. As a result of the priority analysis, the importance was shown in the order of corona, infectious disease, quarantine, vaccine, outbreak, virus, infection, and development. As a result of the proximity centrality analysis, the importance was shown in the order of government, death, and plan, and the analysis result of Big Kinds showed that Covid-19 and the Korea Centers for Disease Control and Prevention were important. Based on the results of this study, it can be said that the government's policy support is needed to raise public awareness of new infectious diseases, prevent disease, and develop vaccines and treatments.

Clinical Risk Evaluation Using Dose Verification Program of Brachytherapy for Cervical Cancer (자궁경부암 근접치료 시 선량 검증 프로그램을 통한 임상적 위험성 평가)

  • Dong‑Jin, Kang;Young‑Joo, Shin;Jin-Kyu, Kang;Jae‑Yong, Jung;Woo-jin, Lee;Tae-Seong, Baek;Boram, Lee
    • Journal of radiological science and technology
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    • v.45 no.6
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    • pp.553-560
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    • 2022
  • The purpose of this study is to evaluate the clinical risk according to the applicator heterogeneity, mislocation, and tissue heterogeneity correction through a dose verification program during brachytherapy of cervical cancer. We performed image processing with MATLAB on images acquired with CT simulator. The source was modeled and stochiometric calibration and Monte-Carlo algorithm were applied based on dwell time and location to calculate the dose, and the secondary cancer risk was evaluated in the dose verification program. The result calculated by correcting for applicator and tissue heterogeneity showed a maximum dose of about 25% higher. In the bladder, the difference in excess absolute risk according to the heterogeneity correction was not significant. In the rectum, the difference in excess absolute risk was lower than that calculated by correcting applicator and tissue heterogeneity compared to the water-based calculation. In the femur, the water-based calculation result was the lowest, and the result calculated by correcting the applicator and tissue heterogeneity was 10% higher. A maximum of 14% dose difference occurred when the applicator mislocation was 20 mm in the Z-axis. In a future study, it is expected that a system that can independently verify the treatment plan can be developed by automating the interface between the treatment planning system and the dose verification program.

The Optimum of Respiratory Phase Using the Motion Range of the Diaphragm: Focus on Respiratory Gated Radiotherapy of Lung Cancer (횡격막의 움직임을 이용한 최적화된 호흡 위상의 선택: 폐암의 호흡 동기 방사선치료 중심)

  • Kim, Myoungju;Im, Inchul;Lee, Jaeseung;Kang, Suman
    • Journal of the Korean Society of Radiology
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    • v.7 no.2
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    • pp.157-163
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    • 2013
  • This study was to analyze quantitatively movement of planning target volume (PTV) and change of PTV volume through movement of diaphragm according to breathing phase. The purpose of present study was to investigate optimized respiration phase for radiation therapy of lung cancer. Simulated breathing training was performed in order to minimize systematic errors which is caused non-specific or irregular breathing. We performed 4-dimensional computed tomography (4DCTi) in accordance with each respiratory phase in the normalized respiratory gated radiation therapy procedures, then not only defined PTVi in 0 ~ 90%, 30 ~ 70% and 40 ~ 60% in the reconstructed 4DCTi images but analyzed quantitatively movement and changes of volume in PTVi. As a results, average respiratory cycle was $3.4{\pm}0.5$ seconds by simulated breathing training. R2-value which is expressed as concordance between clinically induced expected value and actual measured value, was almost 1. There was a statistically significant. And also movement of PTVi according to each respiration phase 0 ~ 90%, 30 ~ 70% and 40 ~ 60% were $13.4{\pm}6.4mm$, $6.1{\pm}2.9mm$ and $4.0{\pm}2.1mm$ respectively. Change of volume in PTVi of respiration phase 30 ~ 70% was decreased by $32.6{\pm}8.7%$ and 40 ~ 60% was decreased by $41.6{\pm}6.2%$. In conclusion, PTVi movement and volume change was reduced, when we apply a short breathing phase (40 ~ 60%: 30% duty cycle) range. Furthermore, PTVi margin considered respiration was not only within 4mm but able to get uniformity of dose.

Influence of Total Laryngectomy on Spinal Cord Dose in Advanced Laryngeal Cancers (진행된 후두암 환자에서 후두전절제술에 의한 척수선량 변화)

  • Kim, Jae-Cheol;Kim, Sung-Hwan;Park, In-Kyu
    • Radiation Oncology Journal
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    • v.14 no.2
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    • pp.167-173
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    • 1996
  • Purpose : This analysis was to evaluate the radiation dose around a tracheostoma and spinal cord in the case of advanced laryngeal cancers in which a total laryngectomy was done before radiotherapy. Materials and Methods : The radiation dose around a tracheostoma and spinal cord was measured by thermoluminescence and film dosimetry in the phantom, Radiotherapy treatment planning was done in 12 cases of advanced laryngeal cancer and compared with the measured dose in the phantom. Results : Mean spinal cord doses in the phantom by thermoluminescence dosimetry were $86.4\%$ (with a tracheostoma), $80.1\%$ (without a tracheostoma), and the difference was $6.3\%$. Mean spinal cord doses in the phantom by film dosimetry were $84.7\%$ (with a tracheostoma), $79.0\%$ (without a tracheostoma). and the difference were $5.7\%$. Calculated spinal cord doses in the phantom were $84.0\%$ (with a tracheostoma), $78.0\%$ (without a tracheostoma), and the difference was $6.0\%$. Mean calculated spinal cord doses in 12 patients were $83.1\%$ (with a tracheostoma), $76.9\%$ (without a tracheostoma). and the difference was $6.2\%$. Measured dose of lateral and posterior wall of the tracheostoma by film was low (depth of maximum dose = 12 mm). Conclusion : In the treatment planning of the advanced laryngeal cancers, the radiation dose of the tracheostoma and spinal cord should be evaluated and be followed by an appropriate management such as a bouls or a brachytherapy boost if the dose around the tracheostoma is low.

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The Variation of Surface Dose by Beam Spoiler in 10 MV Photon Beam from Linear Accelerator (선형가속기 10 MV 광자선에서 산란판(Beam Spoiler) 사용 시 표면선량 변화)

  • Bae, Seong-Cheol;Kim, Jun-Ho;Lee, Choul-Soo
    • The Journal of Korean Society for Radiation Therapy
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    • v.18 no.1
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    • pp.21-28
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    • 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.

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Analysis of Surface Dose Refer to Distance between Beam Spoiler and Patient in Total Body Irradiation (전신방사선조사(Total Body Irradiation) 시 Beam Spoiler와 환자 간의 거리에 관한 고찰)

  • Choi, Jong-Hwan;Kim, Jong-Sik;Choi, Ji-Min;Shin, Eun-Hyuk;Song, Ki-Won;Park, Young-Hwan
    • The Journal of Korean Society for Radiation Therapy
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    • v.19 no.1
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    • pp.51-54
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    • 2007
  • Purpose: Total body irradiation is used to kill the total malignant cell and for immunosuppression component of preparatory regimens for bone-marrow restitution of patients. Beam spoiler is used to increase the dose to the superficial tissues. This paper finds the property of the distance between beam spoiler and patient. Materials and Methods: Set-up conditions are 6 MV-Xray, 300 MU, SAD = 400 cm, field size = $40{\times}40cm^2$. The parallel plate chamber located in surface, midpoint and exit of solid water phantom. The surface dose is measured while the distance between beam spoiler and patient is altered. Because it should be found proper distance. The solid water phantom is fixer and beam spoiler is moving. Results: Central dose of phantom is 10.7 cGy and exit dose is 6.7 cGy. In case of distance of 50 cm to 60 cm between beam spoiler and solid water phantom, incidence dose is $14.58{\sim}14.92cGy$. Therefore, The surface dose was measured $99.4{\sim}101%$ with got near most to the prescription dose. Conclusion: In clinical case, distance between beam spoiler and patient affect surface dose. If once $50{\sim}60cm$ of distance between beam spoiler and patient, surface dose of patient got near prescription dose. It would be taken distance between beam spoiler and patient into account in clinical therapy.

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A Study for Reappearance Acording to the Scan Type, the CT Scanning by a Moving Phantom (팬톰을 이용한 전산화 단층촬영방법에 따른 재현성에 대한 고찰)

  • Choi, Jae-Hyock;Jeong, Do-Hyeong;Suk, Choi-Gye;Jang, Yo-Jong;Kim, Jae-Weon;Lee, Hui-Seok
    • The Journal of Korean Society for Radiation Therapy
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    • v.19 no.2
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    • pp.123-129
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    • 2007
  • Purpose: CT scan shows that significant tumor movement occurs in lesions located in the proximity of the heart, diaphragm, and lung hilus. There are differences concerning three kinds of type to get images following the Scan type called Axial, Helical, Cine (4D-CT) mode, when the scanning by CT. To know how each protocol describe accurately, this paper is going to give you reappearance using the moving phantom. Materials and Methods: To reconstruct the movement of superior-inferior and anterior-posterior, the manufactured moving phantom and the motor following breathing were used. To distinguish movement from captured images by CT scanning, a localizer adhered to the marker on the motor. The moving phantom fixed the movement of superior-inferior upon 1.3 cm /1 min. The motor following breathing fixed the movement of anterior-posterior upon 0.2 cm /1 min. After fixing each movement, CT scanning was taken by following the CT protocols. The movement of A localizer and volume-reappearance analyzed by RTP machine. Results: Total volume of a marker was 88.2 $cm^3$ considering movement of superior-inferior. Total volume was 184.3 $cm^3$. Total volume according to each CT scan protocol were 135 $cm^3$ by axial mode, 164.9 $cm^3$ by helical mode, 181.7 $cm^3$ by cine (4D-CT) mode. The most closely describable protocol about moving reappearance was cine mode, the marker attached localizer as well. Conclusion: CT scan should reappear concerning a exact organ-description and target, when the moving organ is being scanned by three kinds of CT protocols. The cine (4D-CT) mode has the advantage of the most highly reconstructible ability of the three protocols in reappearance of the marker using a moving phantom. The marker on the phantom has always regular motion but breathing patients don't move like a phantom. Breathing education and devices setting patients were needed so that images reconstruct breathing as exactly as possible. Users should also consider that an amount of radiation to patients is being bombed.

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Division of the N2 Stage According to the Multiplicity of the Involved Nodal Stations May be Necessary in the N2-NSCLC Patients Who are Treated with Postoperative Radiotherapy (비소세포성 폐암으로 수술 후 방사선치료가 시행된 N2병기 환자들에서 다발 부위 종격동 림프절 전이 여부에 따른 N2병기 구분의 임상적 의미)

  • Yoon, Hong-In;Kim, Yong-Bae;Lee, Chang-Geol;Lee, Ik-Jae;Kim, Song-Yih;Kim, Jun-Won;Kim, Joo-Hang;Cho, Byung-Chul;Lee, Jin-Gu;Chung, Kyung-Young
    • Radiation Oncology Journal
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    • v.27 no.3
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    • pp.126-132
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    • 2009
  • Purpose: We wanted to evaluate the prognostic factors for the pathologic N2 non-small cell lung cancer (NSCLC) patients who were treated by postoperative radiotherapy. Materials and Methods: We retrospectively reviewed 112 pN2 NSCLC patients who underwent surgery and postoperative radiotherapy (PORT) From January 1999 to February 2008. Seventy-five (67%) patients received segmentectomy or lobectomy and 37 (33%) patients received pneumonectomy. The resection margin was negative in 94 patients, and it was positive or close in 18 patients. Chemotherapy was administered to 103 (92%) patients. Nine (8%) patients received PORT alone. The median radiation dose was 54 Gy (range, 45 to 66), and the fraction size was 1.8~2 Gy. Results: The 2-year overall survival (OS) rate was 60.2% and the disease free survival (DFS) rate was 44.7% for all the patients. Univariate analysis showed that the patients with multiple-station N2 disease had significantly reduced OS and DFS (p=0.047, p=0.007) and the patients with an advanced T stage ($\geq$T3) had significantly reduced OS and DFS (p<0.001, p=0.025). A large tumor size ($\geq$5 cm) and positive lymphovascular invasion reduced the OS (p=0.035, 0.034). Using multivariate analysis, we found that multiple-station N2 disease and an advanced T stage ($\geq$T3) significantly reduced the OS and DFS. Seventy one patients (63.4%) had recurrence of disease. The patterns of failure were loco-regional in 23 (20.5%) patients, distant failure in 62 (55.4%) and combined loco-regional and distant failure in 14 (12.5%) patients. Conclusion: Multiple involvement of mediastinal nodal stations for the pN2 NSCLC patients with PORT was a poor prognostic factor in this study. A prospective study is necessary to evaluate the N2 subclassification and to optimize the adjuvant treatment.

Report of Present Status of Calibration for Domestic Radiation Measurements Instruments (국내 방사선 측정장비 보유 현황 및 교정 현황 조사)

  • Lim, Sangwook;Choi, Jinho;An, Sohyun;Cho, Kwang Hwan;Lee, Sang Hoon;Lee, Rena;Cho, Sam Ju
    • Progress in Medical Physics
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    • v.27 no.1
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    • pp.46-53
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    • 2016
  • Periodical calibrations of radiation detectors are important for accurate quality assurance of therapeutic linac. The measuring instruments such as ion-chamber, thermometer, barometer, and survey meter should be calibrated periodically. Period of calibration for these instruments is suggested 6 month to one year in Korea and two years in other countries nowadays. Therefore, the determination of reasonable period for calibration is needed. In this study, we plan to utilize the results of these survey; frequent in use, how to use and stability of instruments, to determine the optimized period of calibration for the instruments in the departments of radiation oncology in Korea based on the ILAC-G24. The SurveyMonkey web-based survey tool was used and the objects of survey were 18 department of radiation oncology in university hospitals, and 15 departments were answered. The 64 questionnaires which supposed to be answered in 50 minutes were classified as the information of candidates, the thermometer, the barometer, the surveymeter, and the ion-chamber. The thermometers and the barometers were not under periodical calibration for more than half of candidates. The periods of calibration of surveymeters were 6 month to 1 year. We expect that the calibration period can be determined based on these survey results.