• Radiation Oncology Journal
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• v.19 no.3
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• pp.275-286
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• 2001

Purpose : To setup procedures of quality assurance (OA) for implementing intensity modulated radiation therapy (IMRT) clinically, report OA procedures peformed for one patient with prostate cancer. Materials and methods : $P^3IMRT$ (ADAC) and linear accelerator (Siemens) with multileaf collimator are used to implement IMRT. At first, the positional accuracy, reproducibility of MLC, and leaf transmission factor were evaluated. RTP commissioning was peformed again to consider small field effect. After RTP recommissioning, a test plan of a C-shaped PTV was made using 9 intensity modulated beams, and the calculated isocenter dose was compared with the measured one in solid water phantom. As a patient-specific IMRT QA, one patient with prostate cancer was planned using 6 beams of total 74 segmented fields. The same beams were used to recalculate dose in a solid water phantom. Dose of these beams were measured with a 0.015 cc micro-ionization chamber, a diode detector, films, and an array detector and compared with calculated one. Results : The positioning accuracy of MLC was about 1 mm, and the reproducibility was around 0.5 mm. For leaf transmission factor for 10 MV photon beams, interleaf leakage was measured $1.9\%$ and midleaf leakage $0.9\%$ relative to $10\times\;cm^2$ open filed. Penumbra measured with film, diode detector, microionization chamber, and conventional 0.125 cc chamber showed that $80\~20\%$ penumbra width measured with a 0.125 cc chamber was 2 mm larger than that of film, which means a 0.125 cc ionization chamber was unacceptable for measuring small field such like 0.5 cm beamlet. After RTP recommissioning, the discrepancy between the measured and calculated dose profile for a small field of $1\times1\;cm^2$ size was less than $2\%$. The isocenter dose of the test plan of C-shaped PTV was measured two times with micro-ionization chamber in solid phantom showed that the errors upto $12\%$ for individual beam, but total dose delivered were agreed with the calculated within $2\%$. The transverse dose distribution measured with EC-L film was agreed with the calculated one in general. The isocenter dose for the patient measured in solid phantom was agreed within $1.5\%$. On-axis dose profiles of each individual beam at the position of the central leaf measured with film and array detector were found that at out-of-the-field region, the calculated dose underestimates about $2\%$, at inside-the-field the measured one was agreed within $3\%$, except some position. Conclusion : It is necessary more tight quality control of MLC for IMRT relative to conventional large field treatment and to develop QA procedures to check intensity pattern more efficiently. At the conclusion, we did setup an appropriate QA procedures for IMRT by a series of verifications including the measurement of absolute dose at the isocenter with a micro-ionization chamber, film dosimetry for verifying intensity pattern, and another measurement with an array detector for comparing off-axis dose profile.

• Journal of Chest Surgery
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• v.36 no.12
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• pp.929-936
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• 2003

We analysed the surgical outcomes of immediate reoperations after mitral valve repair. Material and Method: Eighteen patients who underwent immediate reoperation for failed mitral valve repair from April 1995 through July 2001 were reviewed retrospectively. There were 13 female patients. The mitral valve disease was regurgitation (MR) in 12 patients, stenosis (MS) in 3, and mixed lesion in 3. The etiologies of the valve disease were rheumatic in 9 patients, degenerative in 8, and endocarditis in 1. The causes of reoperation was residual MR in 13 patients, residual MS in 4, and rupture of left ventricle in 1. Fourteen patients had rerepair for residual mitral lesions (77.8%) and four underwent replacement. Result: There was no early death. After mean follow-vp of 33 months, there was one late death. Echocardiography revealed no or grade 1 of MR (64.3%) in 9 patients and no or mild MS in 11 patients (78,6%). Reoperation was done in one patient. The cumulative survival and freedom from valve-related reoperation at 6 years were 94% and 90%, respectively. The cumulative freedom from recurrent MR and MS at 4 years were 56% and 44%, respectively. Conclusion: This study suggests that immediate reoperation for failed mitral valve repair offers good early and intermediate survival, and mitral valve rerepair can be successfully performed in most of patients. However, because mitral rerepair have high failure rate, especially in rheumatic valve disease, adequate selections of valvuloplasty technique and indication are important to reduce the failure rate of mitral rerepair.

• Progress in Medical Physics
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• v.25 no.2
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• pp.100-109
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• 2014

In stereotactic body radiotherapy (SBRT), the accurate location of treatment sites should be guaranteed from the respiratory motions of patients. Lots of studies on this topic have been conducted. In this letter, a new verification method simulating the real respiratory motion of heterogenous treatment regions was proposed to investigate the accuracy of lung SBRT for Volumetric Modulated Arc Therapy. Based on the CT images of lung cancer patients, lung phantoms were fabricated to equip in $QUASAR^{TM}$ respiratory moving phantom using 3D printer. The phantom was bisected in order to measure 2D dose distributions by the insertion of EBT3 film. To ensure the dose calculation accuracy in heterogeneous condition, The homogeneous plastic phantom were also utilized. Two dose algorithms; Analytical Anisotropic Algorithm (AAA) and AcurosXB (AXB) were applied in plan dose calculation processes. In order to evaluate the accuracy of treatments under respiratory motion, we analyzed the gamma index between the plan dose and film dose measured under various moving conditions; static and moving target with or without gating. The CT number of GTV region was 78 HU for real patient and 92 HU for the homemade lung phantom. The gamma pass rates with 3%/3 mm criteria between the plan dose calculated by AAA algorithm and the film doses measured in heterogeneous lung phantom under gated and no gated beam delivery with respiratory motion were 88% and 78%. In static case, 95% of gamma pass rate was presented. In the all cases of homogeneous phantom, the gamma pass rates were more than 99%. Applied AcurosXB algorithm, for heterogeneous phantom, more than 98% and for homogeneous phantom, more than 99% of gamma pass rates were achieved. Since the respiratory amplitude was relatively small and the breath pattern had the longer exhale phase than inhale, the gamma pass rates in 3%/3 mm criteria didn't make any significant difference for various motion conditions. In this study, the new phantom model of 4D dose distribution verification using patient-specific lung phantoms moving in real breathing patterns was successfully implemented. It was also evaluated that the model provides the capability to verify dose distributions delivered in the more realistic condition and also the accuracy of dose calculation.

• Restorative Dentistry and Endodontics
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• v.33 no.1
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• pp.20-27
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• 2008

The purpose of this study was to evaluate the consistency of two electronic apex locators in vitro model. Materials consisted of fifty two extracted premolars and two electronic apex locators; Root ZX (J. Morita, Osaka, Japan) and E-Magic Finder Deluxe (S-Denti. Cheonan, Korea). After access preparation, the teeth were embedded in a saline-mixed alginate model. Canal lengths of each tooth were measured at "0.5" and "Apex" mark of the apex locators, respectively so that each tooth had two measurements from 0.5 and Apex points. The file was fixed at final measurement using a glass ionomer cement. The apical 4 mm from the apex was exposed to measure the distance from the file tip to the major apical foramen of each tooth. Average distances and standard deviations were used to evaluate the consistency. Results showed that all measurements of both Root ZX and E-Magic Finder located the major foramen the range of ${\pm}0.5\;mm$ level. Both apex locators showed better consistency at Apex mark than at 0.5 mark. The average distance of file tip-major foramen was - 0.18 mm at 0.5 mark and - 0.07 mm at Apex mark in Root ZX, - 0.25 mm at 0.5 mark and - 0.02 mm at Apex mark in E-Magic Finder. Standard deviation was 0.21 at 0.5 mark and 0.12 at Apex mark in Root ZX, 0.12 at 0.5 mark and 0.09 at Apex mark in E-Magic Finder.

• Archives of design research
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• v.19 no.1 s.63
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• pp.201-214
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• 2006

Modern society is an age of vagueness and confusion. In addition, vagueness, complexity and variety are seen throughout art including modern philosophy, literature, and environmental design. A phenomenon like this shows that modern society has integrated different components as an organic relationship frequently crossing the boundary of fields. This feature can be regarded as hybrid related with accepting contradictory components and binding them into one under relationship between part and whole. As new design concept, presented are attitude to accept the two instead of attitude to select one of the alternatives, abundance instead of dearness, and ambiguity instead of simplicity. This principle has a crucial influence on creative design providing opposing contradiction and several alternative plans as non-deterministic form not completed one and, above all, useful information in mutual dependence and mutual relationship. When it comes to hybrid, therefore, a strategy is needed to consider layer of several fields getting out of standardizing space into a single space. As an event of this situation and concept, space experience means behaving freely based on experience of users' body. It can be known that this experience brings about users' more dynamic experience in comparison with the experience of seeing environmental design from a viewpoint of visual ism on the existing simplicity. Such a practical experience is subjective, synesthetic, and non-observational one. Therefore, hybrid has brought active users to the stage, which is distinguished from synesthesia felt through body's experience, not through observational attitude and visual space which achieve former balance and harmony with non-determination. That's because hybrid creatures are turning to a product resulted from creative imagination instead of from reappearance which makes text visualized. Such experience performed by user's active participation collapses the boundary between special elite-centered art and daily life and it is the present progressive form showing creation process of future events and new esthetic experience.

• Journal of Korean Society of Coastal and Ocean Engineers
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• v.26 no.1
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• pp.49-64
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• 2014

Seabed beneath and near the coastal structures may undergo large excess pore water pressure composed of oscillatory and residual components in the case of long durations of high wave loading. This excess pore water pressure may reduce effective stress and, consequently, the seabed may liquefy. If the liquefaction occurs in the seabed, the structure may sink, overturn, and eventually fail. Especially, the seabed liquefaction behavior beneath a gravity-based structure under wave loading should be evaluated and considered for design purpose. In this study, to evaluate the liquefaction potential on the seabed, numerical analysis was conducted using 2-dimensional numerical wave tank. The 2-dimensional numerical wave tank was expanded to account for irregular wave fields, and to calculate the dynamic wave pressure and water particle velocity acting on the seabed and the surface boundary of the structure. The simulation results of the wave pressure and the shear stress induced by water particle velocity were used as inputs to a FLIP(Finite element analysis LIquefaction Program). Then, the FLIP evaluated the time and spatial variations in excess pore water pressure, effective stress and liquefaction potential in the seabed. Additionally, the deformation of the seabed and the displacement of the structure as a function of time were quantitatively evaluated. From the analysis, when the shear stress was considered, the liquefaction at the seabed in front of the structure was identified. Since the liquefied seabed particles have no resistance force, scour can possibly occur on the seabed. Therefore, the strength decrease of the seabed at the front of the structure due to high wave loading for the longer period of time such as a storm can increase the structural motion and consequently influence the stability of the structure.

• Analytical Science and Technology
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• v.31 no.2
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• pp.96-105
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• 2018

This study aimed to improve the method for detecting eight secondary aliphatic amines (SAAs), so as to measure their concentrations in fresh water and tap water samples. NaOH (8 mL, 10 M) and benzenesulfonyl chloride (2 mL) were added to a water sample (200 mL), and the mixture was stirred at $80^{\circ}C$ for 30 min. An additional NaOH solution (10 mL) was added and the stirring was continued for another 30 min. The pH of the cooled mixture was adjusted to 5.5-6.0 by adding HCl (35 %), and the SAAs were extracted using dichloromethane (50 mL). This extraction was repeated once. The extract was then washed with $NaHCO_3$ (15 mL, 0.05 M) and dried over $Na_2SO_4$ (4 g). The extract was finally concentrated to 0.1 mL, of which $1{\mu}L$ was analyzed for SAAs by GC-MS. The linearity of the spike calibration curves was high ($r^2=0.9969-0.9996$). The detection limits of the method ranged from 0.01 to $0.20{\mu}g/L$, and its repeatability and reproducibility (expressed as relative standard deviation) were both less than 10 % (6.6-9.4 %). Its accuracy (measured in percentage error) ranged between 2.4 % and 6.1 %. The established method was applied to the analysis of five surface water and 82 tap water samples. Dimethylamine was the only SAA detected in all the water samples, and its average concentration was $0.79{\mu}g/L$ (range: $0.20-2.54{\mu}g/L$). Therefore, this study improved the analytical method for SAAs in surface water and tap water, and the regional and seasonal concentration distributions were obtained.

• The Journal of Korean Society for Radiation Therapy
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• v.27 no.2
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• pp.175-181
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• 2015

Purpose : To evaluate Contralateral Breast Doses with Supine and Prone Positions for tangential Irradiation techniques for left-sided breast Cancer Materials and Methods : We performed measurements for contralateral doses using Human Phantom at each other three plans (conventional technique, Field-in-Field, IMRT, with prescription of 50 Gy/25fx). For the measurement of contralateral doses we used Glass dosimeters on the 4 points of Human Phantom surface (0 mm, 10 mm, 30 mm, 50 mm). For the position check at every measurements, we had taken portal images using EPID and denoted the incident points on the human phantom for checking the constancy of incident points. Results : The contralateral doses in supine position showed a little higher doses than those in prone position. In the planning study, contralateral doses in the prone position increased mean doses of 1.2% to 1.8% at each positions while those in the supine positions showed mean dose decreases of 0.8% to 0.9%. The measurements using glass dosimeters resulted in dose increases (mean: 2.7%, maximum: 4% of the prescribed dose) in the prone position. In addition, the delivery techniques of Field-in-field and IMRT showed mean doses of 3% higher than conventional technique. Conclusion : We evaluated contralateral breast doses depending on different positions of supine and prone for tangential irradiations. For the phantom simulation of set-up variation effects on contralateral dose evaluation, although we used humanoid phantom for planning and measurements comparisons, it would be more or less worse set-up constancy in a real patient. Therefore, more careful selection of determination of patient set-up for the breast tangential irradiation, especially in the left-sided breast, should be considered for unwanted dose increases to left lung and heart. In conclusion, intensive patient monitoring and improved patient set-up verification efforts should be necessary for the application of prone position for tangential irradiation of left-sided breast cancer.

• The Journal of Korean Society for Radiation Therapy
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• v.23 no.1
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• pp.1-6
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• 2011

Purpose: Immobilizations used in order to maintain the reproducibility of a patient set-up and the stable posture for a long period are important more than anything else for the accurate treatment when the stereotactic body radiotherapy is underway. So the purpose of this study is to adapt the optimum immobilizations for the stereotactic body radiotherapy by comparing two commercial immobilizations with the self-manufactured immobilizations. Materials and Methods: Five people were selected for the experiment and three different immobilizations (A: Wing-board, B: BodyFix system, C: Arm up holder with vac-lock) were used to each target. After deciding on the target's most stable respiratory cycles, the targets were asked to wear a goggle monitor and maintain their respiration regularly for thirty minutes to obtain the respiratory signals. To analyze the respiratory signal, the standard deviation and the variation value of the peak value and the valley value of the respiratory signal were separated by time zone with the self-developed program at the hospital and each tie-downs were compared for the estimation by calculating a comparative index using the above. Results: The stability of each immobilizations were measured in consideration of deviation changes studied in each respiratory time lapse. Comparative indexes of each immobilizations of each experimenter are shown to be A: 11.20, B: 4.87, C: 1.63 / A: 3.94, B: 0.67, C: 0.13 / A: 2.41, B: 0.29, C: 0.04 / A: 0.16, B: 0.19, C: 0.007 / A: 35.70, B: 2.37, C: 1.86. And when all five experimenters wore the immobilizations C, the test proved the most stable value while four people wearing A and one man wearing D expressed relatively the most unstable respiratory outcomes. Conclusion: The self-developed immobilizations, so called the arm up holder vac-lock for the stereotactic body radiotherapy is expected to improve the effect of the treatment by decreasing the intra-fraction organ motions because it keeps the respiration more stable than other two immobilizations. Particularly in case of the stereotactic body therapy which requires the maintenance of set-up state for a long time, the self-developed immobilizations is thought to more useful for stereotactic body radiotherapy rather than the rest two immobilizations with instable respiratory cycle as time passes.

• The Journal of Korean Society for Radiation Therapy
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• v.24 no.1
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• pp.39-43
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• 2012

Purpose: In hospital image-guided radiation therapy in patients with bladder cancer to enhance the reproducibility of the appropriate amount, depending on the patient's condition, and image-guided injection of saline system (On-Board Imager system, OBI, VARIAN, USA) three of the Cone-Beam CT dimensional matching (3D-3D matching) to be the treatment. In this study, the treatment of patients with bladder cancer at Cone-Beam CT image obtained through the analysis of the bones based matching and matching based on the bladder to learn about the differences, the bladder's volume change injected saline solution by looking at the bladder for the treatment of patients with a more appropriate image matching is to assess how the discussion. Materials and Methods: At our hospital from January 2009 to April 2010 admitted for radiation therapy patients, 7 patients with bladder cancer using a Folly catheter of residual urine in the bladder after removing the amount determined according to individual patient enough to inject saline CT-Sim was designed after the treatment plan. After that, using OBI before treatment to confirm position with Cone-Beam CT scan was physician in charge of matching was performed in all patients. CBCT images using a total of 45 bones, bladder, based on image matching and image matching based on the difference were analyzed. In addition, changes in bladder volume of Eclipse (version 8.0, VARIAN, USA) persuaded through. Results: Bones, one based image matching based on the bladder and re-matching the X axis is the difference between the average $3{\pm}2mm$, Y axis, $1.8{\pm}1.3mm$, Z-axis travel distance is $2.3{\pm}1.7mm$ and the overall $4.8{\pm}2.0mm$, respectively. The volume of the bladder compared to the baseline showed a difference of $4.03{\pm}3.97%$. Conclusion: Anatomical location and nature of the bladder due to internal movement of the bones, even after matching with the image of the bladder occurred in different locations. In addition, the volume of saline-filled bladder showed up the difference between the 4.03 percent, but matched in both images to be included in the planned volumes were able to confirm. Thus, after injection of saline into the bladder base by providing a more accurate image matching will be able to conduct therapy.