• The Journal of Korean Society for Radiation Therapy
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• v.27 no.2
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• pp.145-156
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• 2015

Purpose : The purpose of this study is to evaluate the efficiency of Split VMAT planning(Contouring rectum divided into an upper and a lower for reduce rectum dose) compare to Conventional VMAT planning(Contouring whole rectum) for prostate cancer radiotherapy involving pelvic lymph nodes. Materials and Methods : A total of 9 cases were enrolled. Each case received radiotherapy with Split VMAT planning to the prostate involving pelvic lymph nodes. Treatment was delivered using TrueBeam STX(Varian Medical Systems, USA) and planned on Eclipse(Ver. 10.0.42, Varian, USA), PRO3(Progressive Resolution Optimizer 10.0.28), AAA(Anisotropic Analytic Algorithm Ver. 10.0.28). Lower rectum contour was defined as starting 1cm superior and ending 1cm inferior to the prostate PTV, upper rectum is a part, except lower rectum from the whole rectum. Split VMAT plan parameters consisted of 10MV coplanar $360^{\circ}$ arcs. Each arc had $30^{\circ}$ and $30^{\circ}$ collimator angle, respectively. An SIB(Simultaneous Integrated Boost) treatment prescription was employed delivering 50.4Gy to pelvic lymph nodes and 63~70Gy to the prostate in 28 fractions. $D_{mean}$ of whole rectum on Split VMAT plan was applied for DVC(Dose Volume Constraint) of the whole rectum for Conventional VMAT plan. In addition, all parameters were set to be the same of existing treatment plans. To minimize the dose difference that shows up randomly on optimizing, all plans were optimized and calculated twice respectively using a 0.2cm grid. All plans were normalized to the prostate $PTV_{100%}$ = 90% or 95%. A comparison of $D_{mean}$ of whole rectum, upperr ectum, lower rectum, and bladder, $V_{50%}$ of upper rectum, total MU and H.I.(Homogeneity Index) and C.I.(Conformity Index) of the PTV was used for technique evaluation. All Split VMAT plans were verified by gamma test with portal dosimetry using EPID. Results : Using DVH analysis, a difference between the Conventional and the Split VMAT plans was demonstrated. The Split VMAT plan demonstrated better in the $D_{mean}$ of whole rectum, Up to 134.4 cGy, at least 43.5 cGy, the average difference was 75.6 cGy and in the $D_{mean}$ of upper rectum, Up to 1113.5 cGy, at least 87.2 cGy, the average difference was 550.5 cGy and in the $D_{mean}$ of lower rectum, Up to 100.5 cGy, at least -34.6 cGy, the average difference was 34.3 cGy and in the $D_{mean}$ of bladder, Up to 271 cGy, at least -55.5 cGy, the average difference was 117.8 cGy and in $V_{50%}$ of upper rectum, Up to 63.4%, at least 3.2%, the average difference was 23.2%. There was no significant difference on H.I., and C.I. of the PTV among two plans. The Split VMAT plan is average 77 MU more than another. All IMRT verification gamma test results for the Split VMAT plan passed over 90.0% at 2 mm / 2%. Conclusion : As a result, the Split VMAT plan appeared to be more favorable in most cases than the Conventional VMAT plan for prostate cancer radiotherapy involving pelvic lymph nodes. By using the split VMAT planning technique it was possible to reduce the upper rectum dose, thus reducing whole rectal dose when compared to conventional VMAT planning. Also using the split VMAT planning technique increase the treatment efficiency.

• The korean journal of orthodontics
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• v.30 no.1 s.78
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• pp.33-41
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• 2000

Although it is well known that the chincup, used to correct a skeletal class III malocclusion in growing children, reduce the mandibular prognathism by arresting the growth of the mandibular length and rotating the mandible posteroinferiorly, the majority of the studies about chincup is focused on condylar head that plays an Important role in mandibular growth. The aim of this study was to evaluate the morphologic change of the mandibular symphysis where extraoral force is applied directly during chincup treatment. The data lot this study were obtained from lateral cephalometric radiographs of 62 growing children(chincup group:32, control group:30) with mixed dentition who had been accepted lot the orthodontic treatment at Chonbuk National University Dental Hospital. The results were as follows : 1. Symphysis height was increased both in chincup therapy group and control group during treatment. Symphysis depth was decreased or maintained the initial values in chin cup therapy group, whereas increased in control group. Posterior symphysis depth was decreased both in chin cup therapy group and control group, but anterior svmphysis detph was increased in control group, whereas decreased in chincup therapy group. 2. Chin depth and chin curvature were increased in control group, whereas maintained or decreased in chincup therapy group during treatment. Chin angle, menton ang1e and symphysis angle were decreased in control group, whereas increased in chincup therapy group. It suggested that bone deposition in pogonion area that occur normally with mandibular growth was supressed by direct contact of chincup. 3. When growing children wear chincup, symphysis morphology was maintained due to inhibition of forward growth at mandibular symphysis. It may be due to the suppression of bone deposition in anterior part of symphysis.

• The korean journal of orthodontics
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• v.30 no.5 s.82
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• pp.509-519
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• 2000

Enlow's counterpart analysis explains the complex with anatomic and developmental characteristics where craniofacial aspect of individuals has been developed. The analysis does not compare individual measurement with the normal value from the average of majority but analyzes by comparison of values that each individual has. This study was to clarify the Korean craniofacial skeletal pattern using Enlow's counterpart analysis considering the fact that the craniofacial skeletal pattern has racial and regional variations. This research will be helpful in the future for growth research and research of the orthognathic surgery. For this study, the samples were consisted of 100 Korean adult subjects(50 males and 50 females) who had normal occlusion and pleasing face. Measurement points and lines were established using Enlow's counterpart analysis and they were statistically evaluated. The results indicated that : 1. The average angle between PCF and PMV was $38.54^{\circ}$ in males and $38.43^{\circ}$ in females, and the average Wits' appraisal was -2.51 in males and -2.3 in females. The ramus alignment(R4) was 1.89 in males and 2.36 in females. 2. It shows that females have a longer ramus than the PCF compared to the males, because there was a significant difference in Ramus/PCF horizontal dimensions (Skeletal A3-B3) between female and male subjects 3. It shows that males have a longer mandibular corpus than the maxilla compared to the females, because there was a significant difference in Maxillary/Mandibular arches(Skeletal A4-B4) between male and female subjects 4. In cranial floor+maxilla/ramus+corpus at A and B points(Al-Bl), which represents difference in total horizontal length between the maxilla and mandible, there was no significant difference between males and females. In conclusions, compared to Caucasian, Korean have more depressed midface, prognathic mandible, and ramus that rotates inferioposterior. Also, we observe that Korean women have target ramus posterior cranial base, as compared with Korean men. Consequently, the total length of maxilla and mandible does not show any difference, because man's mandible is longer than maxilla in comparison with woman's one.

• The korean journal of orthodontics
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• v.29 no.2 s.73
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• pp.239-249
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• 1999

In orthognathic surgery to obtain proper functional and esthetic form after skeletal discrepancy treatment, precise diagnosis and treatment plan are essential. Especially in two jaw surgeries that have serious upper and lower jaw problems, maxilla and mandible are arranged in three dimensions. Based on the maxillary rearrangement, mandibular sagittal and transverse positions are determined, and thus new occlusal plane is established. The object of this study is to evaluate the stability of the indiviual ideal occlusal plane based on the architectural and structural craniofacial analysis of Delaires. The subjects of this study were 48 patients who underwent two jaw surgeries, and they were equally divided into two groups, A and B. A group was operated with ideal occlusal plane and B group was not. Two groups were compared at the preoperative, immediate postoperative (average 4.3days), and long-term postoperative (average 1.3years) lateral cephalometric radiographs. The following results were obtained: 1. ANS was lower than that of PNS for both A and B after the surgery. That is, maxilla and mandible are rotated in posterior and superior direction. 2. Significances were found between $T_2$ and $T_3$ for both A and B are HRP-Me at vortical measurements, articular angle(p<0.01), gonial angle(p<0.01), and Mn. plane angle(p<0.05) at angular measurement. Mn. plane angle is increased at HRP-Me is decreased for both A and B. 3. There is no significance in skeletal stability aster the surgery between group A and B. 4. Horizontal movements of B and Pog by surgery have statistically significant inverse correlations with horizontal relapse of B and Pog, and vertical relapse of PNS, as well as Mn. Plane angle, and gonial angle after the surgery.

• Journal of the Korean earth science society
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• v.25 no.7
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• pp.615-628
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• 2004

In order to elucidate seasonal sedimentary characteristics and depositional environment after construction of seawall on macrotidal flat, a seasonal observations of surface sediments (total 450) and sedimentation rates on 4 transects have been investigated for 2 years. The eastern area of Iwon tidal flat, has been changed from semi-closed coast to open coast by construction of seawall, shows general seasonal changes similar to characteristics of open coast type, which represented both fining and bad sorted distribution due to deposition of fine sediments under low energy condition in the summer, and relatively coarser and better sorted distribution because of erosion of fine sediments in the winter. In considering angles of transects, distribution patterns of surface sediments, the northern and southern parts of eastern tidal flat are dominantly influenced by wave and tidal effects, respectively. As time goes by, the eastern tidal flat shows coarsening-trend of surface sediments caused by direct effect of tidal current, were and typhoon. Meanwhile the western area of seawall, which has been re-formed by construction seawall, is sheltered from northwesterly seasonal wind. The seasonal change pattern of western area of seawall is slightly different from that of eastern tidal flat. Mean grain size and sorting of surface sediments during spring is finer and worse than those during summer. This seasonal change pattern maybe influenced by topographic effects caused from the construction of seawall. In consideration of all result, the transport of fine sediments in the study area, which is supplied to limited sediments, shows clockwise circulation pattern that fine sediments are transported from the eastern tidal flat to the western area of seawall because of blocking of seawall in the winter and are transported reversed direction the summer. As a result, many changes have been observed in the study area after construction of seawall; however, this change is still in progress and is expected to need continuous monitoring.

• The korean journal of orthodontics
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• v.28 no.1 s.66
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• pp.99-111
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• 1998

The purpose of this study was to evaluate the positioning errors according to the method of bonding lingual brackets. Dental models of twenty orthodontic patients with malocclusion were selected for this study. The positioning errors were measured on each model that brackets were bonded to. Three different bonding methods were used. For the first method the bracket was bonded intimately to the lingual surface of the model. For the second method, the bracket was bonded intimately to the lingual surface after setting up using articulator. The passive bracketing, bonding the bracket ligated first to ideal archwire, was used after setting up as the last method. The results were as follows: 1. The brackets bonded without setting up showed greater angulation errors in the upper 1st premolar and the lower canine than those in other bonding methods. The brackets bonded without passive bracketing showed greater positioning errors in upper central incisor, lower 1st and End premolars. 2. The brackets bonded without setting up showed greater torque error in lower 2nd premolar than those in other bonding methods. The brackets bonded without passive bracketing showed greater torque errors in all upper teeth, lower 1st and 2nd premolars. 3. The brackets bonded without passive bracketing showed greater rotation errors between upper central incisors, lower central incisors, lower lateral and central incisor, lower canine and lateral incisor. 4. The brackets bonded without setting up showed greater in-out errors between upper canine and lateral incisor than those in other bonding methods. The brackets bonded without passive bracketing showed greater in-out errors between upper central incisors, upper central and lateral incisors, upper 1st and 2nd premolars, lower lateral and central incisors, lower canine and lateral incisor. These results suggest that there is a large amount of positioning error in lingual brackets even by an indirect bonding technique, and it may be reduced by passive bracketing.

• The korean journal of orthodontics
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• v.29 no.6 s.77
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• pp.649-661
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• 1999

The goals of this study were 1) to present pre-surgical naso-alveolar molding (PNAM) appliance for bilateral cleft lip and palate treatment and 2) to evaluate the effects of the PNAM appliance on the alveolar molding of the premaxilla and the lateral segments. Subjects consisted of 8 bilateral cleft lip and palate infants (7 males and 1 female, mean age at first visit = 61.6 days after birth) who were treated with PNAM appliances in Department of Orthodontics, Seoul National University Dental Hospital. Average alveolar cleft gap between the premaxilla and the lateral segment was $8.09{\pm}5.03mm$ and average duration of alveolar molding treatment was $8.8{\pm}3.1$ weeks. These patients' models were obtained at initial visit (T0) and after alveolar molding (T1). 20 linear and 14 angular variables were measured by using photometry and digital caliper, All statistical analyses were performed by Microsoft Excel 97 program. Paired t-test was used to discriminate the effect of alveolar molding by PNAM appliance. 1. Closure of the alveolar cleft gap in bilateral cleft cases by molding therapy was completed successfully, 2. Alveolar molding inhibited outward growth of lateral segments and produced inward bending of lateral segments. 3. By bending the anterior part of the vomer, the premaxilla could be rotated and moved. posteriorly via alveolar molding. Conclusion This appliance can be applied to bilateral cleft lip and palate infants with satisfactory results before cheiloplasty.

• The Korean Journal of Nuclear Medicine
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• v.32 no.5
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• pp.414-424
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• 1998

Purpose: Cross-modality coregistration of positron emission tomography (PET) and magnetic resonance imaging (MR) could enhance the clinical information. In this study we propose a refined technique to improve the robustness of registration, and to implement more realistic visualization of the coregistered images. Materials and Methods: Using the sinogram of PET emission scan, we extracted the robust head boundary and used boundary-enhanced PET to coregister PET with MR. The pixels having 10% of maximum pixel value were considered as the boundary of sinogram. Boundary pixel values were exchanged with maximum value of sinogram. One hundred eighty boundary points were extracted at intervals of about 2 degree using simple threshold method from each slice of MR images. Best affined transformation between the two point sets was performed using least square fitting which should minimize the sum of Euclidean distance between the point sets. We reduced calculation time using pre-defined distance map. Finally we developed an automatic coregistration program using this boundary detection and surface matching technique. We designed a new weighted normalization technique to display the coregistered PET and MR images simultaneously. Results: Using our newly developed method, robust extraction of head boundary was possible and spatial registration was successfully performed. Mean displacement error was less than 2.0 mm. In visualization of coregistered images using weighted normalization method, structures shown in MR image could be realistically represented. Conclusion: Our refined technique could practically enhance the performance of automated three dimensional coregistration.

• Investigative Magnetic Resonance Imaging
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• v.10 no.2
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• pp.108-116
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• 2006

Purpose : High-resolution spiral-scan imaging is performed at 3 Tesla MRI system. Since the gradient waveforms for the spiral-scan imaging have lower slopes than those for the Echo Planar Imaging (EPI), they can be implemented with the gradient systems having lower slew rates. The spiral-scan imaging also involves less eddy currents due to the smooth gradient waveforms. The spiral-scan imaging method does not suffer from high specific absorption rate (SAR), which is one of the main obstacles in high field imaging for rf echo-based fast imaging methods such as fast spin echo techniques. Thus, the spiral-scan imaging has a great potential for the high-speed imaging in high magnetic fields. In this paper, we presented various high-resolution images obtained by the spiral-scan methods at 3T MRI system for various applications. Materials and Methods : High-resolution spiral-scan imaging technique is implemented at 3T whole body MRI system. An efficient and fast higher-order shimming technique is developed to reduce the inhomogeneity, and the single-shot and interleaved spiral-scan imaging methods are developed. Spin-echo and gradient-echo based spiral-scan imaging methods are implemented, and image contrast and signal-tonoise ratio are controlled by the echo time, repetition time, and the rf flip angles. Results : Spiral-scan images having various resolutions are obtained at 3T MRI system. Since the absolute magnitude of the inhomogeneity is increasing in higher magnetic fields, higher order shimming to reduce the inhomogeneity becomes more important. A fast shimming technique in which axial, sagittal, and coronal sectional inhomogeneity maps are obtained in one scan is developed, and the shimming method based on the analysis of spherical harmonics of the inhomogeneity map is applied. For phantom and invivo head imaging, image matrix size of about $100{\times}100$ is obtained by a single-shot spiral-scan imaging, and a matrix size of $256{\times}256$ is obtained by the interleaved spiral-scan imaging with the number of interleaves of from 6 to 12. Conclusion : High field imaging becomes increasingly important due to the improved signal-to-noise ratio, larger spectral separation, and the higher BOLD-based contrast. The increasing SAR is, however, a limiting factor in high field imaging. Since the spiral-scan imaging has a very low SAR, and lower hardware requirements for the implementation of the technique compared to EPI, it is suitable for a rapid imaging in high fields. In this paper, the spiral-scan imaging with various resolutions from $100{\times}100$ to $256{\times}256$ by controlling the number of interleaves are developed for the high-speed imaging in high magnetic fields.

• Journal of the Korean Arthroscopy Society
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• v.8 no.1
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• pp.14-18
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• 2004

Purpose: To compare the mid-term follow-up results of anterior cruciate ligament(ACL) reconstruction with the bone-patellar tendon- bone(BTB) autograft to those with the BTB allograft. Materials and Methods: Retrospective study was performed in 59 cases with BTB autograft and 42 cases with BTB allograft. Evaluations include Lysholm score, 2000 IKDC subjective knee score, Shelbourne patello-femoral pain score , Lachman test, pivot shift test, KT-1000 arthrometer test and 2000 IKDC knee examination. Results: There were no significant statistic differences between two groups in Lysholm score and 2000 IKDC subjective knee score of more than 70 (p<0.05). Five cases(8.5%) showed the patello-femoral pain score less than 80 according to Shelboume with autograft group and two cases(4.8%) with allograft group (p<0.05). Lachman test, pivot shift test and KT-1000 arthrometer test showed no significant statistic differences between two groups(P<0.05). Fifty-four cases(91.5%) were normal or nearly normal according to the 2000 IKDC knee examination with autograft group and thirty-eight cases(90.4%) with allograft group(p<0.05).Conclusion: BTB allograft as well as BTB autograft is considered to be an acceptable choice for ACL reconstruction.