• 한국호스피스협회지
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• s.39
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• pp.3-3
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• 2001

• Journal of Chest Surgery
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• v.36 no.7
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• pp.527-530
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• 2003

Reexpansion pulmonary edema is a rare complication of the treatment of lung collapse secondary to pneumothorax, pleural effusion, or atelectasis. But occasionally, severe morbidity and death may result. Reexpansion pulmonary edema occurs when chronically collapsed lung is rapidly reexpanded by evacuation of large amounts of air or fluid. In the treatment of the chronically collapsed lung, physicians must remember the possible events and prevent the complications. When the difference in airway resistance or lung compliance between the two lungs is exaggerated, conventional mechanical ventilation might lead to preferential ventilation with hyperexpansion of one lung and gradual collapse of the other. Differential ventilation has been advocated to avert this problem. By differential lung ventilation, we successfully treated a severe reexpansion pulmonary edema in two patients. Therefore we suggest that differential lung ventilation is the treatment of choice for severe reexpansion pulmonary edema.

• The Journal of Korean Society for Radiation Therapy
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• v.33
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• pp.145-153
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• 2021

Purpose: The purpose of this study is to evaluate the ovarian dose during radiation therapy for breast cancer in women of childbearing age through an experiment. The ovarian dose is evaluated by comparing and analyzing between the calculated dose in the treatment planning system according to the treatment technique and the measured dose using a thermoluminescence dosimeter (TLD). The clinical usefulness of lead (Pb) apron is investigated through dose analysis according to whether or not it is used. Materials and Methods: Rando humanoid phantom was used for measurement, and wedge filter radiation therapy, 3D conformal radiation therapy, and intensity modulated radiation therapy were used as treatment techniques. A treatment plan was established so that 95% of the prescribed dose could be delivered to the right breast of the Rando humanoid phantom 3D image obtained using the CT simulator. TLD was inserted into the surface and depth of the virtual ovary of the Rando hunmanoid phantom and irradiated with radiation. The measurement location was the center of treatment and the point moved 2 cm to the opposite breast from the center of the Rando hunmanoid phantom, 5cm, 10cm, 12.5cm, 15cm, 17.5cm, 20cm from the boundary of the right breast to the center of treatment and downward, and the surface and depth of the right ovary. Measurements were made at a total of 9 central points. In the dose comparison of treatment planning systems, two wedge filter treatment techniques, three-dimensional conformal radiotherapy, and intensity-modulated radiation therapy were established and compared. Treatments were compared, and dose measurements according to the use of lead apron were compared and analyzed in intensity-modulated radiation therapy. The measured value was calculated by averaging three TLD values for each point and converting using the TLD calibration value, which was calculated as the point dose mean value. In order to compare the treatment plan value with the actual measured value, the absolute dose value was measured and compared at each point (%Diff). Results: At Point A, the center of treatment, a maximum of 201.7cGy was obtained in the treatment planning system, and a maximum of 200.6cGy was obtained in the TLD. In all treatment planning systems, 0cGy was calculated from Point G, which is a point 17.5cm downward from the breast interface. As a result of TLD, a maximum of 2.6cGy was obtained at Point G, and a maximum of 0.9cGy was obtained at Point J, which is the ovarian dose, and the absolute dose was 0.3%~1.3%. The difference in dose according to the use of lead aprons was from a maximum of 2.1cGy to a minimum of 0.1cGy, and the %Diff value was 0.1%~1.1%. Conclusion: In the treatment planning system, the difference in dose according to the three treatment plans did not show a significant difference from 0.85% to 2.45%. In the ovary, the difference between the Rando humanoid phantom's treatment planning system and the actual measured dose was within 0.9%, and the actual measured dose was slightly higher. This did not accurately reflect the effect of scattered radiation in the treatment planning system, and it is thought that the dose of scattered radiation and the dose taken by CBCT with TLD inserted were reflected in the actual measurement. In dosimetry according to the with or without a lead apron, when a lead apron was used, the closer the distance from the treatment range, the more effective the shielding was. Although it is not clinically appropriate for pregnancy or artificial insemination during radiotherapy, the dose irradiated to the ovaries during treatment is not expected to significantly affect the reproductive function of women of childbearing age after radiotherapy. However, since women of childbearing age have constant anxiety, it is thought that psychological stability can be promoted by presenting the data from this study.

• The Journal of Korean Society for Radiation Therapy
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• v.26 no.2
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• pp.225-232
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• 2014

Purpose : The purpose of this study was to evaluate the surface and superficial dose for patients requiring postmastectomy radiation therapy(PMRT) with different treatment techniques. Materials and Methods : Computed tomography images were acquired for the phantom(I'mRT, IBA) consisting of tissue equivalent material. Hypothetical chestwall and lung were outlined and modified. Five treatment techniques(Wedged Tangential; WT, 4-field IMRT, 7-field IMRT, TOMO DIRECT, TOMO HELICAL) were evaluated using only 6MV photon beam. GafChromic EBT3 film was used for dose measurements at the surface and superficial dose. Surface dose profiles around the phantom were obtained for each treatment technique. For superficial dose measurements, film were used inside the phantom and analyzed superficial region for depth from 1-6mm. Results : TOMO DIRECT showed the highest surface dose by 47~70% of prescribed dose, while 7-field IMRT showed the lowest by 35~46% of prescribed dose. For the WT, 4-field IMRT and 7-field IMRT, superficial dose were measured over 60%, 70%, and 80% for 1mm, 2mm, and 5mm depth, respectively. In case of TOMO DIRECT and TOMO HELICAL, over 75%, 80%, and 90% of prescribed dose was measured, respectively. Surface and superficial dose range were uniform in overall chestwall for the 7-field IMRT and TOMO HELICAL. In contrast, Because of the dose enhancement effect with oblique incidence, The dose was gradually increased toward the obliquely tangential angle for the WT and TOMO DIRECT. Conclusion : For PMRT, TOMO DIRECT and TOMO HELICAL deliver the higher surface and superficial doses than treatment techniques based linear accelerator. It showed adequate dose(over 75% of prescribed dose) at 1mm depth in skin region.

• Progress in Medical Physics
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• v.24 no.3
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• pp.145-153
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• 2013

Stereotactic body radiation therapy (SBRT) is increasingly used to treat spinal metastases. To achieve the highest steep dose gradients and conformal dose distributions of target tumors, intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) techniques are essential to spine radiosurgery. The purpose of the study was to qualitatively compare IMRT and VMAT techniques with International Spine Radiosurgery Consortium (ISRC) contoured consensus guidelines for target volume definition. Planning target volume (PTV) was categorized as TB, $T_{BPT}$ and $T_{ST}$ depending on sectors involved; $T_B$ (vertebral body only), $T_{BPT}$ (vertebral body+pedicle+transverse process), and $T_{ST}$ (spinous process+transverse process). Three patients treated for spinal tumor in the cervical, thoracic, and lumbar region were selected. Eacg tumor was contoured by the definition from the ISRC guideline. Maximum spinal cord dose were 12.46 Gy, 12.17 Gy and 11.36 Gy for $T_B$, $T_{BPT}$ and $T_{ST}$ sites, and 11.81 Gy, 12.19 Gy and 11.99 Gy for the IMRT, RA1 and RA2 techniques, respectively. Average fall-off dose distance from 90% to 50% isodose line for $T_B$, $T_{BPT}$, and $T_{ST}$ sites were 3.5 mm, 3.3 mm and 3.9 mm and 3.7 mm, 3.7 mm and 3.3 mm for the IMRT, RA1 and RA2 techniques, respectively. For the most complicated target $T_{BPT}$ sites in the cervical, thoracic and lumbar regions, the conformity index of the IMRT, RA1 and RA2 is 0.621, 0.761 and 0.817 and 0.755, 0.796 and 0.824 for rDHI. Both IMRT and VMAT techniques delivered high conformal dose distributions in spine stereotactic radiosurgery. However, if the target volume includes the vertebral body, pedicle, and transverse process, IMRT planning resulted in insufficient conformity index, compared to VMAT planning. Nevertheless, IMRT technique was more effective in reducing the maximum spinal cord dose compared to RA1 and RA2 techniques at most sites.

• Progress in Medical Physics
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• v.17 no.1
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• pp.40-46
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• 2006

Hepatoma is one of 3 most common malignancies in Korea, the survival rate is not improved since last decades because of delayed diagnosis and limited treatment conditions. Radiation was one of treatment options but the impact on the survival is not remarkable. High dose exposure to target area was suggested for improved effect but low tolerance dose of normal liver tissue is the main limited factor. IMRT is the advanced form of 3DCRT, for focusing high dose on target with minimal dose to surrounding normal tissues. Motion of the tumor by respiration, cardiac pulsation and peristalsis is the main treatment harrier of IMRT for treatment of hepatoma patients. Development of QA technique for acceptable geometrical uncertainties and dose error on target volume is essential for IMRT in clinical treatment but proper QA technique is not yet developed. This study compared the verification film dosimetry with measured dose in phantom and calculated dose in planning computer on exactly same conditions of patient treatments. Within 3% dose differences between 3 groups were confirmed. We suggest that our verification QA technique is easy, economic, iterative and acceptable in clinical application for advanced hepatoma patients.

• Journal of Convergence Society for SMB
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• v.6 no.1
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• pp.33-38
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• 2016

Disease of patient who visited the hospital can cause different symptoms of the disease, depending on the environment and lifestyle. Recent medical services offered in patients has changed in the environment that can be selected for treatment by analyzing the patient according to the disease symptoms. In this paper, we propose an efficient method to manage disease control because the treatment method may change at any patients suffering from the disease according to the patient conditions by grouping the different treatments to patients for disease information. The proposed scheme has a feature that can be ingested by the patient big disease information, as well as to improve the treatment efficiency of the medical treatment the increase patient satisfaction. The proposed sheme can handle big data by clustering of disease information for patients suffering from diseases such as patient consent small groups. In addition, the proposed scheme has the advantage that can be conveniently accessed via a particular keyword, the treatment method according to patient disease information. The experimental results, the proposed method has been improved by 23% in terms of efficiency compared to conventional techniques, disease management time is gained 11.3% improved results. Medical service user satisfaction seen from the survey is to obtain a high 31.5% results.

• Journal of the Korea Institute of Information and Communication Engineering
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• v.20 no.2
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• pp.359-366
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• 2016

The normal tissue in radiation therapy, to minimize radiation, it is most important to maximize local tumor control rates in intensive research the exact dose to the tumor sites. Therefore, the initial, therapist accuracy of detecting movement of the patient fatigue therapist has been a problem that is weighted down directly. Also, by using a web camera, a difference value between the image to be updated to the reference image is calculated, if the result exceeds the reference value, using the system for determining the motion has occurred. However, this system, it is not possible to quantitatively analyze the movement of the patient, the background is changed when moving the treatment bed in the co-therapeutic device was not able to sift the patient. In this paper, using a alpah(${\alpha}$) filter index is an attempt to solve these limitations points, quantifies the movement of the patient, by separating a background image of the patient and treatment environment, and movement of the patient during treatment It senses only, it was possible to reduce the problems due to patient movement.

• Journal of the Korean Institute of Traditional Landscape Architecture
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• v.36 no.4
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• pp.113-123
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• 2018

The purpose of this research is to develop evaluation indicators forperformance improvement of horticultural therapy garden. In order to achieve a therapeutic purpose, the gardening activity held by the trained horticultural therapist. Moreover, horticultural therapy is 'a medical model' for the treatment and basic premise of the research was set, as horticultural therapy garden is characterized area to support activities of patients and horticultural therapist functionally and efficiently. For this study, three times of Delphi and AHP techniques were proceeded to export panels who were recruited by purposive sampling. Through these techniques, it was possible to deduct the evaluation indicator which maximizes the performance of the horticultural therapy garden. The evaluation items were prioritized by typing and stratification of the indicator. The results and discussions were stated as followings. Firstly, a questionnaire of experts was conducted to horticultural therapists and civil servants who were in charge of horticultural therapy. As results(horticultural therapists: 87.8%, civil servants: 75.2%), It is possible to conclude that both positions have the high recognition and agreed on the necessity of horticultural therapy. Secondly, Delphi investigation was conducted three times in order to develop the evaluation indicator for performance evaluation. After Delphi analysis, total 34 of evaluation elements to improve the performance of the horticultural therapy garden by reliability and validity analysis results. Thirdly, AHP analysis of each evaluation indicator was conducted on the relative importance and weighting. Moreover, the results showed 'interaction between nature and human' as the most important element, and in order of 'plan of the program', 'social interaction', 'sustainable environmental', and 'universal design rule', respectively. On the other hand, the exports from the university and research institute evaluated the importance of 'interaction between nature and human', while horticultural therapists chose 'plan of the program' as the most important element. Fourthly, the total weight was used to develop weight applied evaluation indicator for the performance evaluation of the horticultural therapy garden. The weight applying to evaluation index is generally calculated multiply the evaluation scores and the total weight using AHP analysis. Finally, 'the evaluation indicator and evaluation score sheet for performance improvement of the horticultural therapy garden' was finally stated based on the relative order of priority between evaluation indicators and analyzing the weight. If it was deducted the improvement points for the efficiency of already established horticultural therapy garden using the 'weight applied evaluation sheet', it is possible to expand it by judging the importance with the decision of the priority because the item importance decided by experts was reflected. Moreover, in the condition of new garden establishment, it is expected to be helpful in suggesting ways for performance improvement and in setting the guidelines by understanding the major indicators of performance improvement in horticultural therapy activity.

• The Journal of Korean Society for Radiation Therapy
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• v.26 no.2
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• pp.297-303
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• 2014

Purpose : The purpose of this study is reproducibility evaluation of deep inspiration breath-hold(DIBH) technique by respiration data and heart position analysis in radiation therapy for Left Breast cancer patients. Materials and Methods : Free breathing(FB) Computed Tomography(CT) images and DIBH CT images of three left breast cancer patients were used to evaluate the heart volume and dose during treatment planing system( Eclipse version 10.0, Varian, USA ). The signal of RPM (Real-time Position Management) Respiratory Gating System (version 1.7.5, Varian, USA) was used to evaluate respiration stability of DIBH during breast radiation therapy. The images for measurement of heart position were acquired by the Electronic portal imaging device(EPID) cine acquisition mode. The distance of heart at the three measuring points(A, B, C) on each image was measured by Offline Review (ARIA 10, Varian, USA). Results : Significant differences were found between the FB and DIBH plans for mean heart dose (6.82 vs. 1.91 Gy), heart $V_{30}$ (68.57 vs. $8.26cm^3$), $V_{20}$ (76.43 vs. $11.34cm^3$). The standard deviation of DIBH signal of each patient was ${\pm}0.07cm$, ${\pm}0.04cm$, ${\pm}0.13cm$, respectively. The Maximum and Minimum heart distance on EPID images were measured as 0.32 cm and 0.00 cm. Conclusion : Consequently, using the DIBH technique with radiation therapy for left breast cancer patients is very useful to establish the treatment plan and to reduce the heart dose. In addition, it is beneficial to using the Cine acquisition mode of EPID for the reproducibility evaluation of DIBH.