• Title/Summary/Keyword: 장기 치료

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폐암 세기변조방사선치료 시 최적화된 조사계획 설정과 가상 장기 설정에 관한 연구

  • Lee, Seok;Lee, Chang-Geol;Cho, Sam-Ju;Chu, Sung-Sil;Lee, Sang-Hoon;Choi, Myung-Sun;Kim, Chul-Yong
    • Proceedings of the Korean Society of Medical Physics Conference
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    • 2003.09a
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    • pp.34-34
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    • 2003
  • 목적 : 폐암 환자 세기변조방사선치료 과정을 소개하고, 방사선치료계획의 최적화를 위한 빔 수와 방향, 가상장기 설정 (virtual organ delineation, VOD) 및 선량 제한 인자들의 이용에 대해 평가함으로써 폐, 심장 등에 조사되는 선량을 최소화하는데 사용하는 세기변조방사선치료 (intensity modulated radiotherapy, IMRT) 기술의 유용성을 평가하고자한다. 대상 및 방법 : 종양이 종격동을 침범하여 상대적으로 장기움직임에 의한 오차가 적은 폐암환자 5 명을 대상으로 하였다. 환자고정장치는 상반신을 편안하게 유지함과 동시에 팔의 위치를 고정시킴으로써 기대할 수 있는 환자고정효과와 벨트를 이용하여 환자 상복부를 압박해줌으로써 호흡운동에 의한 장기 움직임을 감소시킬 수 있는 형태로 고안하였다. 치료계획시 빔 수와 방향은 5,7,9 문 (from 200 to 160, equispaced field, arbitrary field), 4 문 (anterior, posterior, bilateral posterior oblique field) 과 비등방 7, 9 문 (non-equispaced field, arbitrary field) 등을 사용하였다. 선량제한 ($V_{20}V_{25}$)은 문헌에 기초하여 설정하였으며, 가상장기를 적절히 사용하여 최적화된 치료계획 결과를 얻었다. 방사선치료계획 평가는 선량-체적간 히스토그람 (DVH), 등선량곡선 및 선량통계 등을 이용하여 수행하였다. 특히 가상장기 설정 전, 후의 결과 값을 분석함으로써 그 유용성을 확인하였다. 결과 : 9문 등방-IMRT와 7문 비등방-IMRT 방법이 치료계획용적의 선량균질성 (PTV dose homogeneity), 평균 폐선량 (mean lung dose) 및 $V_{20}V_{25}$ 모두에서 20% 이내의 좋은 결과를 얻을 수 있었고, 가상 장기를 설정함으로써 같은 결과를 가져옴을 알 수 있었다. 또한 폐암 세기변조방사선치료 프로토콜을 작성하여 임상에 사용함으로써 치료과정 중 발생할 수 있는 오류를 보완할 수 있음을 알 수 있었다. 결론 : 폐암 세기변조방사선치료 시 사용할 수 있는 프로토콜을 작성하였고, 적절한 가상 장기 및 조사계획 설정으로 치료계획의 최적화를 얻을 수 있음을 알 수 있었다.

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Nonsubmerged Implant의 임상적 우위성

  • Kim, Hong-Gi
    • The Journal of the Korean dental association
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    • v.33 no.4 s.311
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    • pp.264-273
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    • 1995
  • 2000년대에 있어서 세계의학계는 인공심장의 완성과 인공신장, 인공 간, 인공수족과 인공골, 관절, 혈관 등의 인공장기이식의 눈부신 연구, 발전에 의하여 인간의 수명은 더욱 연장될 것이며 사망률을 낮추는 치료의학은 한없이 발전하게 될 것이다. 치과의학의 과제는 상실된 치아와 악골, 구강내외 장기의 수복을 위한 인공치아 및 장기이식의 치료요법의 발전이 될 것이다. 인공치아 치료요법의 한가지인 nonsubmerged and one stage operation type인 I.T.I. 임프란트 시스템은 골성접착과 결합이 이루어지는 인공치아 이식술로서 그 단순한 시술과 높은 성공률에 의해 전세계에 각광을 받는 치료방법의 하나이다.

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장기적으로 안정된 예후를 위한 통합 치과치료의 원칙과 적용방법

  • Jang, Won-Geon
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.20 no.1
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    • pp.68-77
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    • 2011
  • 다양한 치과 전문분야의 협진 치료가 필요한 환자에서는 심미적인 만족뿐 아니라 기능적이며 장기적 안정을 가져올 수 있는 치료가 전제되어야 한다. 이를 위해서는 분명한 치료목표와 그 목표를 이루기 위한 치료계획을 세우는 것이 선행되어야 한다. 환자와 술자 모두가 만족하는 치료결과를 갖기 위하여 어떠한 치료목표가 필요하며 그 목표를 위하여 치료계획을 세우는 방법과 그 치료과정에 대해 실제 임상증례를 통하여 각 과정을 설명하였다.

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The Patient Specific QA of IMRT and VMAT Through the AAPM Task Group Report 119 (AAPM TG-119 보고서를 통한 세기조절방사선치료(IMRT)와 부피적세기조절회전치료(VMAT)의 치료 전 환자별 정도관리)

  • Kang, Dong-Jin;Jung, Jae-Yong;Kim, Jong-Ha;Park, Seung;Lee, Keun-Sub;Sohn, Seung-Chang;Shin, Young-Joo;Kim, Yon-Lae
    • Journal of radiological science and technology
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    • v.35 no.3
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    • pp.255-263
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    • 2012
  • The aim of this study was to evaluate the patient specific quality assurance (QA) results of intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) through the AAPM Task Group Report 119. Using the treatment planning system, both IMRT and VMAT treatment plans were established. The absolute dose and relative dose for the target and OAR were measured by using an ion chamber and the bi-planar diode array, respectively. The plan evaluation was used by the Dose volume histogram (DVH) and the dose verification was implemented by compare the measured value with the calculated value. For the evaluation of plan, in case of prostate, both IMRT and VMAT were closed the goal of target and OARs. In case of H&N and Multi-target, IMRT was not reached the goal of target, but VMAT was reached the goal of target and OARs. In case of C-shape(easy), both were reached the goal of target and OARs. In case of C-shape(hard), both were reached the goal of target but not reached the goal of OARs. For the evaluation of absolute dose, in case of IMRT, the mean of relative error (%) between measured and calculated value was $1.24{\pm}2.06%$ and $1.4{\pm}2.9%$ for target and OAR, respectively. The confidence limits were 3.65% and 4.39% for target and OAR, respectively. In case of VMAT the mean of relative error was $2.06{\pm}0.64%$ and $2.21{\pm}0.74%$ for target and OAR, respectively. The confidence limits were 4.09% and 3.04% for target and OAR, respectively. For the evaluation of relative dose, in case of IMRT, the average percentage of passing gamma criteria (3mm/3%) were $98.3{\pm}1.5%$ and the confidence limits were 3.78%. In case of VMAT, the average percentage were $98.2{\pm}1.1%$ and the confidence limits were 3.95%. We performed IMRT and VMAT patient specific QA using TG-119 based procedure, all analyzed results were satisfied with acceptance criteria based on TG-119. So, the IMRT and VMAT of our institution was confirmed the accuracy.

Assessment of Radiation Dose for Surrounding Organs and Persons Approaching Patients upon Brachytherapy of Cervical Cancer with $^{192}Ir$ ($^{192}Ir$를 사용한 자궁경부암 치료시 주변 장기 및 근접한 사람의 선량 평가)

  • Kang, Se-Sik
    • Journal of radiological science and technology
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    • v.33 no.3
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    • pp.283-288
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    • 2010
  • In order to evaluate radiation dose on the uterus and surrounding organs during brachytherapy for cervical cancer, of which the frequency of occurrence is high in Korean women, as well as radiation dose on medical staffs in proximity of patients receiving the therapy, a mathematical phantom based on reference Korean was established and the radiation dose was calculated accordingly. For simulation, $^{192}Ir$, which is useful in brachytherapy, was selected as radionuclide. Also, it was presumed that the intensity of initial radiation was 1 Ci. The result indicated the radiation of 4.92E-14 Gy/Ci in the uterus, the source organ. In addition, radiation on people around patient receiving the therapy was found to be 1.24E-07 Sv at a distance of 30 cm.

Dosimetric Comparison of Radiation Treatment Techniques for Breast Cancer : 3D-CRT, IMRT and VMAT (유방암 방사선치료 기법에 따른 선량 비교 : 3차원 입체조형치료, 세기 변조 방사선치료, 입체세기조절회전 방사선치료)

  • Lee, Bo-Ram;Lee, Sun-Young;Yoon, Myong-Geun
    • Journal of radiological science and technology
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    • v.36 no.3
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    • pp.237-244
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    • 2013
  • The purpose of this study is to compare method in the treatment of breast cancer using dose index. And, it is to find the optimized treatment technique to the patient. The phantom filled with tissue-equivalent material were used simulation and treatment as techniques of 3D-CRT, IMRT, VMAT was planned using Eclipse v10. By using HI(homogeneity index), CI(Conformity index), OED(Organ equivalent dose), EAR(Excess Absolute Risk), were assessed for each treatment plans. HI and CI of 3D-CRT, IMRT, VMAT were calculated 16.89, 11.21, 9.55 and 0.59, 0.61, 0.83. The organ average doses of Lt lung, Rt lung, liver, heart, esophagus, cord, Lt breast, trachea and stomach were 0.01 ~ 2.02 Gy, 0.36 ~ 5.01 Gy, 0.25 ~ 2.49 Gy, 0.14 ~ 6.92 Gy, 0.03 ~ 2.02 Gy, 0.01 ~ 1.06 Gy, 0.25 ~ 6.08 Gy, 0.08 ~ 0.59 Gy, 0.01 ~ 1.34 Gy, respectively. The OED, EAR of the IMRT and VMAT show higher than 3D-CRT. As the result of this study, we could confirm being higher dose index(HI, CI) in IMRT and VMAT than 3D-CRT, but doses of around normal organs was higher IMRT, VMAT than 3D-CRT.

Radiation Dose Calculation in the Surrounding Organs during Brachytherapy of Prostate Cancer (전립선암 근접시료시 주변 장기 선량 평가)

  • Kim, Jung-Hoon;Lim, Chang-Seon;Whang, Joo-Ho
    • Progress in Medical Physics
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    • v.19 no.3
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    • pp.172-177
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    • 2008
  • As a part of estimating quantitative radiation treatment doses, we produced a mathematical phantom based on the standard Korean male. Then, with the prostate as the source organ, we calculated the absorbed dose in the prostate and surrounding organs forecasted to occur during brachytherapy for prostate cancer. To simulate the procedure, we selected $^{25}I$ and $^{103}Pd$ useful in brachytherapy of the prostate as the radionucleids and made an assumption that 1 Ci of initial radioactivity is administered. As a result, we found that the prostate, as the source organ, indicated 101 Gy/Ci and 7.24 Gy/Ci, respectively, in case of $^{125}I$ and $^{103}Pd$. With the exception of the prostate, organs with high absorbed doses were found to be in the order of the penis and scrotum, sigmoid colon, testicles and the urinary bladder, which are relatively close to the prostate.

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Characteristics of Physiological Variables(EDR, EMG) in Biofeedback Treatment (바이오피이드백 치료에서 나타나는 신체변수(EDR, EMG)의 특성)

  • Seo, Man-Kil;Han, Woo-Sang;Lee, Kyung-Kyu;Yu, Bum-Hee;Lee, Yu-Ri;Kim, E-Yong;Kim, Hyun-Woo
    • Sleep Medicine and Psychophysiology
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    • v.6 no.1
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    • pp.38-45
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    • 1999
  • Objectives: We explored the characteristics of physiological variables such as electrodermal response(EDR) and electromyography(EMG) in patients with insomnia, panic disorder, and other anxiety disorders. we aimed to decide the minimum sessions in biofeedback treatment to make the treatment effective and examine the effects of long-term biofeedback treatment by measuring the physiological variables. Methods: Thirty seven outpatients who received biofeedback treatment were divided into 3 groups according to the number of biofeedback sessions(patients who received 4-5 sessions, who received 6-9 sessions, and who received more than 10 sessions). We measured mean and delta values of EDR and EMG levels, and the Hamilton Anxiety Rating Scale(HARS), and Slef-Relaxation Inventory(SRI) in all patients. Data were analyzed by t-test and repeated measures analysis of variance. Results: The mean and delta values of EDR and EMG levels were not different among the 3 groups during the first 4 biofeedback sessions. However, patients who received more than 10 biofeedback sessions had higher baseline mean EDR value(F=2.233, p=0.036) in the first session, compared with other patients. In patients who received more than 10 biofeedback sessions, mean EDR was significantly reduced after $5^{th}$ session(F=10.41, p<0.01). They showed significant improvement in SRI scores at 12th biofeedback session(t=2.726, p<0.05) and in HARS scores at $6^{th}$(t=3.10, p<0.05) and $12^{th}$ biofeedback session(t=10.93, p<0.001). Conclusions: Wesuggest that patients should receive more than 5 biofeedback sessions to experience internal cues and get a good clinical response to biofeedback treatment.

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Occupational Therapy in Long-Term Care Insurance For the Elderly Using Text Mining (텍스트 마이닝을 활용한 노인장기요양보험에서의 작업치료: 2007-2018년)

  • Cho, Min Seok;Baek, Soon Hyung;Park, Eom-Ji;Park, Soo Hee
    • Journal of Society of Occupational Therapy for the Aged and Dementia
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    • v.12 no.2
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    • pp.67-74
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    • 2018
  • Objective : The purpose of this study is to quantitatively analyze the role of occupational therapy in long - term care insurance for the elderly using text mining, one of the big data analysis techniques. Method : For the analysis of newspaper articles, "Long - Term Care Insurance for the Elderly + Occupational Therapy for the Elderly" was collected after the period from 2007 to 208. Naver, which has a high share of the domestic search engine, utilized the database of Naver News by utilizing Textom, a web crawling tool. After collecting the article title and original text of 510 news data from the collection of the elderly long term care insurance + occupational therapy search, we analyzed the article frequency and key words by year. Result : In terms of the frequency of articles published by year, the number of articles published in 2015 and 2017 was the highest with 70 articles (13.7%), and the top 10 terms of the key word analysis showed the highest frequency of 'dementia' (344) In terms of key words, dementia, treatment, hospital, health, service, rehabilitation, facilities, institution, grade, elderly, professional, salary, industrial complex and people are related. Conclusion : In this study, it is meaningful that the textual mining technique was used to more objectively confirm the social needs and the role of the occupational therapist for the dementia and rehabilitation in the related key keywords based on the media reporting trend of the elderly long - term care insurance for 11 years. Based on the results of this study, future research should expand research field and period and supplement the research methodology through various analysis methods according to the year.

소통+섬기는 마음: 세계 속 건강 -세계 최고의 장기 기증률, 스페인에서 배우다

  • Kim, Won-Hak
    • 건강소식
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    • v.34 no.11
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    • pp.42-43
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    • 2010
  • 우리나라 장기기증자는 선진국에 비교해 크게 부족하다. 이로 인해 실낱같은 희망을 걸고 장기이식 순서를 기다리는 대기자는 매년 증가하고 있다. 장기기증은 간이나 신장질환자의 치료에 투입되는 엄청난 의료비용을 줄여준다. 생명나눔 차원뿐만 아니라 사회적 비용 감소에도 기여하는 것이다. 외국의 장기기증 현황을 알아봄으로써 국내 적용 가능성을 점쳐보고자 한다.

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