• 제목/요약/키워드: 0.9 V to 5 V

검색결과 2,861건 처리시간 0.039초

노인복지용구의 품목 및 서비스의 만족도와 요구도에 대한 연구:노인장기요양보험 등급 인정자를 중심으로 (Study on Needs and Satisfaction of Service Related to Assistive Device and Assistive Device for Long-Term Care Elderly : Focused on Beneficiary Older Adults People in Long-term Care Insurance)

  • 우지희
    • 한국콘텐츠학회논문지
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    • 제19권9호
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    • pp.348-356
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    • 2019
  • 본 연구는 노인 장기요양보험 등급 인정자들의 노인복지용구 품목과 서비스에 대한 만족도와 요구도를 조사함으로써 복지용구의 개선방안을 제시하고자 한다. 자료수집은 D광역시와 I시에 위치한 재가복지서비스 시설을 이용하는 노인 장기요양보험 등급자 184명 대상으로 실시하였다. 수집된 자료는 SPSS 20.0을 이용하여 기술통계 분석을 하였다. 연구결과, 인지지원 등급자를 제외한 대상자들은 복지용구 품목과 서비스에는 보통에서 만족하는 경향을 보였다. 1등급과 2등급 인정자들은 자조관리를 돕는 품목, 3등급에서 5등급 및 인지지원 등급자들은 건강관리 및 안전에 관련된 품목에 대한 요구도를 보였다. 복지용구 서비스에서는 모든 장기요양보험 등급 인정자들이 주기적인 추후관리 서비스, 복지용구 전문가 및 전문 인력 교육훈련 그리고 체계적인 평가를 필요로 하였다. 본 연구는 기존의 복지용구관련 선행연구와 달리 장기요양보험등급별 복지용구 품목에 대한 요구도를 세부적으로 제시했다는 점에서 의의가 있다고 할 수 있다. 추후 본 연구결과가 복지용구 품목 및 서비스와 관련한 제도개선에 기초적인 자료로 활용되기를 기대해본다.

제7차 과학 교육과정에 대한 지구과학 교사들의 관심도와 활용도 분석 (An Analysis of Teachers' Level of Usage and Concern Over the 7th Science Curriculum)

  • 이용섭;안현희;김상달;김종희
    • 한국지구과학회지
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    • 제24권5호
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    • pp.378-392
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    • 2003
  • 본 연구는 제7차 과학 교육과정에 대한 지구과학 교사들의 관심도와 활용도에 대한 조사연구로서 과학교육과정에 대한 관심도에 대한 고등학교 지구과학 교사들은 단계 0의 지각적 관심이 상대적 강도 98%로 가장 높은 정점을 이루고 있어 대부분의 선행연구의 결과와 같이 교사들이 교육과정에 대해 무관심한 것으로 나타났다. 과학교육과정에 대한 활용도에 대한 고등학교 지구과학 교사들의 과학 교육과정에 대한 영역별 활용도를 분석한 결과는 교사들이 교육과정을 거의 활용하지 않는 수준(I수준)이 1.69%, 지구과학 교육과정에 대한 정보를 갖고 활용하려는 준비가 되어 있는 수준(II수준)이 17.80%, 지구과학 교육과정을 반성적 사고없이 교사중심적으로 활용하는 수준(III수준)이 43.97%이었으며, 교육과정을 완전히 이해하고 수용하여 안정적으로 활용하는 교사수준(IV수준)이 31.86%, 장기적 결과를 생각하며 동료들과 협력하여 더 나은 방안을 탐색하는 수준(V수준)이 4.69%로 나타났다. 전체적인 활용수준은 기계적 활용수준(3단계)으로 나타났고 수업목표 영역(평균 3.28)과 내용 영역(평균 3.28)의 활용도가 비교적 높게 나타났으며, 성격 및 이념 영역(평균 3.24), 수업자료 영역(3.18), 평가 영역(3.18), 수업방법 영역(평균 3.12)의 순으로 나타났다. 경력에 따른 지구과학 교사들의 과학 교육과정에 대한 관심도는 0${\sim}$4년, 15${\sim}$19년, 20년 이상, 5${\sim}$9년 경력의 교사 집단 순이며 10${\sim}$14년 경력의 교사 집단이 교육과정에 대한 관심도가 가장 낮은 것으로 나타났다.

Ecosysteme de I′Etang de Berre (Mediterranee nord-occidentale) : Caracteres Generales Physiques, Chimiques et Biologiques

  • Kim, Ki-Tai
    • 환경생물
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    • 제22권2호
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    • pp.247-258
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    • 2004
  • Climatological, hydrological and planktonical research studies, measurements of primary production and photosynthetic efficiency from December 1976 to December 1978 have been carried out in two brackish lakes: Lake Etang de Berre and Lake Etang de Vaine located in the French Mediterranean coast, in the region of Carry-le-Rouet located on the north-west Mediterranean near Marseilles, and in fresh water inflows from 4 Rivers (Touloubre, Durance, Arc, Durancole) to Lake Etang de Berre. Physico-chemical parameters were measured for this study: water temperature, salinity, density, pH, alcalinity, dissolved oxygen (% saturation), phosphate, nitrate, nitrite, silicate etc. Diverse biological parameters were also studied: photosynthetic pigments, phaeopigments, specific composition and biomass of phytoplankton, primary pelagic production etc. Climatical factors were studied: air-temperature, solar-radiation, evaporation, direction (including strength) of winds, precipitation and freshwater volume of the four rivers. The changes in Lake ‘Etang de Berre’ ecosystem depend on the quality of the water in the Durance River, and on the effects of seawater near the entrance of the Caronte Canal. The water quality of the lake varies horizontally and vertically as a result of atmospheric phenomena, maritime currents and tides. The distribution of water temperatures is generally heterogeneous. Southeasterly winds and the Northeasterly Mistral wind are important in the origins of circulated and mixed water masses. These winds are both frequent and strong. They have, as a result, a great effect on the water environment of Lake Etang de Berre. In theory, the annual precipitation in this region is well over eight times the water mass of the lake. The water of the Durance River flows into Lake Etang de Berre through the EDF Canal, amounting to 90% of the precipitation. However, reduction of rainfall in dry seasons has a serious effect on the hydrological characteristics of the lake. The temperature in the winter is partially caused by the low temperature of fresh water, particularly that of the Durance River. The hydrological season of fresh and brackish water is about one month ahead of the hydrological season of sea water in its vicinity. The salinity of Lake Etang de Berre runs approximately 3$\textperthousand$, except at lower levels and near the entrance to the Caronte Canal. However, when the volume of the Durance River water is reduced in the summer and fall, the salinity rises to 15$\textperthousand$. In the lake, the ratio of fresh water to sea water is six to one (6:1). The large quantities of seston conveyed by rivers, particularly the Durance diversion, strongly reduce the transparency in the brackish waters. Although the amount of sunshine is also notable, transparency is slight because of the large amount of seston, carried chiefly by Tripton in the fresh water of the Durance River. Therefore, photosynthesis generally occurs only in the surface layer. The transparency progressively increases from freshwater to open seawater, as mineral particles sink to the bottom (about 1.7kg $m^{-2}a^{-1}$ on the average in brackish lakes). The concentration of dissolved oxygen and the rate of oxygen saturation in seawater (Carry-le-Rouet) ranged from 5.0 to 6.0 $m\ell$ㆍ.$1^{-1}$, and from 95 to 105%, respectively. The amount of dissolved oxygen in Etang de Berre oscillated between 2.9 and 268.3%. The monographs of phosphate, nitrate, nitrite and silicate were published as a part of a study on the ecology of phytoplankton in these environments. Horizontal and vertical distributions of these nutriments were studied in detail. The recent diversion of the Durance River into Lake Etang de Berre has effected a fundamental change in this formerly marine environment, which has had a great impact in its plankton populations. A total of 182 taxa were identified, including 111 Bacillariophyceae, 44 Chlorophyceae, and 15 Cyanophyceae. The most abundant species are small freshwater algae, mainly Chlorophyceae. The average density is about $10^{8}$ cells $1^{-1}$ in Lake Etang de Berre, and about double that amount in Lake Etang de Vaine. Differences in phytoplankton abundance and composition at the various stations or at various depths are slight. Cell biovolume V (equivalent to true biomass), plasma volume VP (‘useful’ biomass) and, simultaneously. the cell surface area S and S/V ratio through the measurement of cell dimensions were computed as the parameters of phytoplankton productivity and metabolism. Pigment concentrations are generally very high on account of phytoplankton blooms by Cyanophyceae, Chlorophyceae and Cryptophyceae. On the other hand, in freshwaters and marine waters, pigment concentrations are comparatively low and stable, showing slight annual variation. The variations of ATP concentration were closely related to those of chlorophyll a and phytoplankton blooms only in marine waters. The carbon uptake rates ranged between 38 and 1091 mg$Cm^{-2}d^{-1}$, with an average surface value of 256 mg; water-column carbon-uptake rates ranged between 240 and 2310 mg$Cm^{-2}d^{-1}$, with an average of 810, representing 290 mg$Cm^{-2}$, per year 45 000 tons per year of photosynthetized carbon for the whole lake. Gross photosynthetic production measured by the method of Ryther was studied over a 2-year period. The values obtained from marine water(Carry-le-Rouet) ranged from 23 to 2 337 mg$Cm^{-2}d^{-1}$, with a weighted average of 319, representing about 110 gCm$^{-2}$ per year. The values in brakish water (Etang de Berre) ranged from 14 to 1778 mg$Cm^{-2}d^{-1}$, with a weighted average of 682, representing 250 mg$Cm^{-2}$ per year and 38 400 tons per year of photosynthesized carbon for the whole lake.

Measurement uncertainty analysis of radiophotoluminescent glass dosimeter reader system based on GD-352M for estimation of protection quantity

  • Kim, Jae Seok;Park, Byeong Ryong;Yoo, Jaeryong;Ha, Wi-Ho;Jang, Seongjae;Jang, Won Il;Cho, Gyu Seok;Kim, Hyun;Chang, Insu;Kim, Yong Kyun
    • Nuclear Engineering and Technology
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    • 제54권2호
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    • pp.479-485
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    • 2022
  • At the Korea Institute of Radiological and Medical Sciences, physical human phantoms were developed to evaluate various radiation protection quantities, based on the mesh-type reference computational phantoms of the International Commission on Radiological Protection. The physical human phantoms were fabricated such that a radiophotoluminescent glass dosimeter (RPLGD) with a Tin filter, namely GD-352M, could be inserted into them. A Tin filter is used to eliminate the overestimated signals in low-energy photons below 100 keV. The measurement uncertainty of the RPLGD reader system based on GD-352M should be analyzed for obtaining reliable protection quantities before using it for practical applications. Generally, the measurement uncertainty of RPLGD systems without Tin filters is analyzed for quality assurance of radiotherapy units using a high-energy photon beam. However, in this study, the measurement uncertainty of GD-352M was analyzed for evaluating the protection quantities. The measurement uncertainty factors in the RPLGD include the reference irradiation, regression curve, reproducibility, uniformity, energy dependence, and angular dependence, as described by the International Organization for Standardization (ISO). These factors were calculated using the Guide to the Expression of Uncertainty in Measurement method, applying ISO/ASTM standards 51261(2013), 51707(2015), and SS-ISO 22127(2019). The measurement uncertainties of the RPLGD reader system with a coverage factor of k = 2 were calculated to be 9.26% from 0.005 to 1 Gy and 8.16% from 1 to 10 Gy. A blind test was conducted to validate the RPLGD reader system, which demonstrated that the readout doses included blind doses of 0.1, 1, 2, and 5 Gy. Overall, the En values were considered satisfactory.

고로슬래그미분말을 사용한 콘크리트의 염화물이온에 의한 철근부식 저항성 연구 (A Study on Corrosion Resistance of the Reinforement in Concrete Using Blast-Furnace Slag Powder)

  • 김은겸;김진근;이동혁;김영웅;김용철
    • 콘크리트학회논문집
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    • 제16권1호
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    • pp.1-9
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    • 2004
  • 본 논문은 고로슬래그미분말을 혼화한 콘크리트의 염화물 침투 및 철관 발청 성능을 평가한 것이다. 실험에는 1종 보통포틀랜드시멘트와 5종 내황산염시멘트 사용하였으며, 고로슬래그는 이들 시멘트 대신에 각각 $25\%$, $40\%$$55\%$를 치환하였다. 촉진 염화물 침투 시험결과에 대한 평가는 ASTM C 1202에 규정에 따랐으며, 철근 발청은 건습반복에 의한 촉진 시험에 의해 수행되었다. 시험체는 콘크리트로 제작하였으며, 각각 수중양생 28일, 56일 및 91일간 실시하였다. 모든 콘크리트 시험체는 3일간 염수 침지한 후 4일간 건조로에서 건조시키는 것을 1 cycle로 정하여 30 cycle에서 시험을 종료하는 것으로 하였다. 염수 침지 조건은 수온 $40^{\circ}C$, NaCl $3^{\circ}C$로 하였으며, 시험체의 건조는 건조로를 사용하여 $60^{\circ}C$에서 건조시키는 것으로 하였다. 시험결과, 고로슬래그미분말을 혼화한 1종 시멘트를 사용한 콘크리트 시험체의 염소이온 확산계수는 무치환의 경우에 비해 상당히 감소하였으며, 5종 시멘트를 사용한 경우에 있어서는 1종 시멘트를 사용한 시험체에 비해 염소이온의 확산계수는 증가하는 것으로 나타났다. 촉진시험에 의한 철근 발청은 고로슬래그미분말의 사용에 의해 상당한 저항성을 갖고 있으며, 5종 시멘트를 사용한 경우에는 철근 발청이 증가하는 현상을 나타내었다.

Status Report of the NISS and SPHEREx Missions

  • Jeong, Woong-Seob;Park, Sung-Joon;Moon, Bongkon;Lee, Dae-Hee;Park, Won-Kee;Lee, Duk-Hang;Ko, Kyeongyeon;Pyo, Jeonghyun;Kim, Il-Joong;Park, Youngsik;Nam, Ukwon;Kim, Minjin;Ko, Jongwan;Im, Myungshin;Lee, Hyung Mok;Lee, Jeong-Eun;Shin, Goo-Hwan;Chae, Jangsoo;Matsumoto, Toshio
    • 천문학회보
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    • 제41권1호
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    • pp.58.2-58.2
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    • 2016
  • The NISS (Near-infrared Imaging Spectrometer for Star formation history) onboard NEXTSat-1 is the near-infrared instrument optimized to the first small satellite of NEXTSat series. The capability of both imaging and low spectral resolution spectroscopy with the Field of View of $2{\times}2deg.$ in the near-infrared range from 0.9 to $3.8{\mu}m$ is a unique function of the NISS. The major scientific mission is to study the cosmic star formation history in local and distant universe. The Flight Model of the NISS is being developed and tested. After an integration into NEXTSat-1, it will be tested under the space environment. The NISS will be launched in 2017 and it will be operated during 2 years. As an extension of the NISS, SPEHREx (Spectro-Photometer for the History of the Universe Epoch of Reionization, and Ices Explorer) is the NASA SMEX (SMall EXploration) mission proposed together with KASI (PI Institute: Caltech). It will perform an all-sky near-infrared spectral survey to probe the origin of our Universe; explore the origin and evolution of galaxies, and explore whether planets around other stars could harbor life. The SPHEREx is designed to have wider FoV of $3.5{\times}7deg.$ as well as wider spectral range from 0.7 to $4.8{\mu}m$. After passing the first selection process, SPHEREx is under the Phase-A study. The final selection will be made in the end of 2016. Here, we report the current status of the NISS and SPHEREx missions.

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심한 만성기류폐쇄 환자의 Impairment/Disability 측정에 있어 폐기능검사 및 운동부하검사의 역할 (The role of the pulmonary function test and the exercise test for assessing impairment/disability in patients with chronic airflow obstruction)

  • 천선희
    • Tuberculosis and Respiratory Diseases
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    • 제43권3호
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    • pp.377-387
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    • 1996
  • 연구배경 : 폐기능의 경한 저하는 운동능력이나 작업능력을 제한 시키지 않지만 심한 폐기능 저하는 중요한 제한 요인이 된다. 1980년 세계보건기구(WHO)에서는 폐기능의 감소를 impairment, 운동기능의 감소를 disability로 구분하였으며, 1986년 ATS에서 FVC가 50% 이하로 감소, FEV1이 40% 이하로 감소, FEV1/FVC가 40% 이하로 감소, 혹은 DLCO가 40% 이하로 감소된 경우, 또는 운동부하 검사에서 VO2max가 15 ml/Kg/min 이하이면 거의 모든 작업기능을 수행할 수 없는 심한 장애상태로 평가하였다. 이에 심한 기류폐쇄환자를 대상으로 impairment/disability를 평가하는데 있어 안정시 폐기능 검사와 운동부하검사의 역할 및 상관관계를 살펴보고자 하였다. 방법 : 성한 만성기류폐쇄(CAO; chronic airflow obstruction) 환자 19예를 대상으로 안정시 spirometry와 body plethysmograph를 시행하였으며, cycle ergometer를 이용하여 증상제한적 최대 운동검사(symptom limited maximal exercise test)를 분당 5 - 10 watt 씩 증가시키면서 시행하였다. 환자를 안정시 폐기능검사 결과에 따라 FEV1이 40% 이하인 경우 severe impairment군, 이상인 경우 non-severe impairment 군으로 구분하여 비교하였다. 결과 : 1. Severe impairment 군은 non-severe impairment 군에 비하여 기도폐쇄 및 저산소증이 유의하게 심하였고, VO2max가 유의하게 감소되어 운동수행상태가 현저하게 감소되어 있었다. 2. Severe impairment 군은 운동부하검사에서 환기제한장애(ventilatory limitation)를 보였으며, 운동제한 증상은 10예중 9예가 호흡곤란이었다. 3. 만성기류폐쇄 환자중에서 결핵 파괴성 폐질환 환자의 장애가 가장 심하였다. 4. 안정시 폐기능검사 결과 중에서 FEV1이 심한 장애를 결정하는 가장 유용한 지표였으며, VO2max와의 상관관계도 가장 컷다(r = 0.81, p < 0.001). 5. 안정시 폐기능검사에 의한 심한 폐기능장애(impairment by WHO)는 sensitivity 80%, specificity 89%로 심한 운동장애(disability by WHO)를 예측할 수 있었다. 결론 : 심한 기류폐쇄환자에서는 안정시 폐기능검사 특히 FEV1으로 운동수행상태를 잘 예측할 수 있어, 운동부하검사를 시행하지 않고서도 안정시 폐기능검사인 폐기능 장애(impairment by WHO)에 따라 운동기능 장애(disability by WHO)를 충분히 판단할 수 있을 것으로 생각된다.

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치조골 폭경과 임플랜트 고정체의 직경에 따른 지지조직의 응력분포 (STRESS ANALYSIS OF SUPPORTING TISSUES ACCORDING TO IMPLANT FIXTURE DIAMETER AND RESIDUAL ALVEOLAR BONE WIDTH)

  • 한상운;방몽숙;양홍서;박상원;박하옥;임현필
    • 대한치과보철학회지
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    • 제45권4호
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    • pp.506-521
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    • 2007
  • Statement of problem: The cumulative success rate of wide implant is still controversial. Some previous reports have shown high success rate, and some other reports shown high failure rate. Purpose: The aim of this study was to analyze, and compare the biomechanics in wide implant system embeded in different width of crestal bone under different occlusal forces by finite element approach. Material and methods: Three-dimensional finite element models were created based on tracing of CT image of second premolar section of mandible with one implant embedded. One standard model (6mm-crestal bone width, 4.0mm implant diameter central position) was created. Varied crestal dimension(4, 6, 8 mm), different diameter of implants(3.3, 4.0, 5.5, 6.0mm), and buccal position implant models were generated. A 100-N vertical(L1) and 30 degree oblique load from lingual(L2) and buccal(L3) direction were applied to the occlusal surface of the crown. The analysis was performed for each load by means of the ANSYS V.9.0 program. Conclusion: 1. In all cases, maximum equivalent stress that applied $30^{\circ}$ oblique load around the alveolar bone crest was larger than that of the vertical load. Especially the equivalent stress that loaded obliquely in buccal side was larger. 2. In study of implant fixture diameter, stress around alveolar bone was decreased with the increase of implant diameter. In the vertical load, as the diameter of implant increased the equivalent stress decreased, but equivalent stress increased in case of the wide implant that have a little cortical bone in the buccal side. In the lateral oblique loading condition, the diameter of implant increased the equivalent stress decreased, but in the buccal oblique load, there was not significant difference between the 5.5mm and 6.0mm as the wide diameter implant. 3. In study of alveolar bone width, equivalent stress was decreased with the increase of alveolar bone width. In the vertical and oblique loading condition, the width of alveolar bone increased 6.0mm the equivalent stress decreased. But in the oblique loading condition, there was not a difference equivalent stress at more than 6.0mm of alveolar bone width. 4. In study of insertion position of implant fixture, even though the insertion position of implant fixture move there was not a difference equivalent stress, but in the case of little cortical bone in the buccal side, value of the equivalent stress was most unfavorable. 5. In all cases, it showed high stress around the top of fixture that contact cortical bone, but there was not a portion on the bottom of fixture that concentrate highly stress and play the role of stress dispersion. These results demonstrated that obtaining the more contact from the bucco-lingual cortical bone by installing wide diameter implant plays an important role in biomechanics.

비만(肥滿) CLINIC 내원환자(來院患者) 453 CASES에 대(對)한 임상적(臨床的) 고찰(考察)

  • 안경순;성낙기
    • 혜화의학회지
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    • 제2권2호
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    • pp.219-246
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    • 1993
  • In 1991, Obesity rate of South Korea has reached to 18.7%. Because of economical development, the pattern of diet is exchanged from carbohydrate to rich protein and fat. The more problem is not only obesity of adult but also one of little child. Obesity is induced to diabetes mellitus, hypertension, artherosclerosis, hyperlipoidemia. heart and C.V.A disease, etc. In Woman, special important ploblem is the complex of beauty about Woman's figure. In Oriental Medicine, the factor of obesity is mainly regarded as dampness. And there are many treatments and methods to body weight loss, but obesity patients dislike to use them because of their side effects and inconvenience, intolerance. Now ear acupuncture is applied on so many disease because of its easy handly, non-side effect and high efficiency in clinics. Here obesity acupuncture is used to ear and whole body acupuncture. Because they react eachother for lack point. Therefore, in order to investigate the effect of obesity acupuncture and develop non-drug, non-starvation etc, we analyzed 453 the cases of body weight loss patients treated with ear and whole body acupuncture in Oriental Medicine Hospital of Jeon-Ju Woo-Sug University from April.1.1992. to March.17. 1993. The results were summarized as follows. 1. Distribution of sex ; male (4.4%), Female(95.6%) 2. Distribution of age in descending order ; 30s, 20s, 40s, 10s, 50s, below 10s, abowe 60s. The 20s-30s are group made up 60.7% of the group. 3. Distribution of occupation in descending order; housewife, student, service, salaried, merchant, teacher, farmer, inoccupation. 4. Distribution of human coporal constitution in descending order : Tae-Eum-In, So-Eum-In, So-Yang-In. 5. Distribution of body height and weight, 155-164cm ; 71.1%, 60-70kg, 74.6% are majority. 6. Distribution of weight variation, 2-6kg(71.0%) is majority, also 13-14kg(0.4%). 7. Distribution of duration in descending order ; 1-3 years, 3-6 years, 1-12months, above 10 years but in success, 1-12 months, 1-3 years, 3-6 years, above 10 years. Therefore, we know that the shorter duration of obesity is, the more loss of body weight. 8. Past experiences to body weight loss; Yes(69.5%), No(30.5%). The success rate accordant with the past temporary experiences shows that the cases without experience is higher than the ones with experience. 9. In distribution of times(treatments), 10 times is top. The rate of body weight loss is the highest in 14 times. Therefore, I think that one would need at least 10 times. in order lose body weight 10. Distribution of body weight variation in treatments times is at 2 times(3-4kg loss), and surprisingly is 14kg loss at above 15 times. 11. Distribution of symptoms improvement, in descending order ; heavy sense in body, dec. of appetite, inc.of exercise, lumbago, edema, knee pain, inc.of urine, inc. of fullness sense, thirsty, disease of gynecology, white tung, chest burning, heart burning, dec.of tobacco, drink taste. motion sickness, allergy, water eczema, arthma, belching. 12. Distribution of snack; Yes(87.4%), No(78.6%) 13. Distribution of exercise; Yes(21.4%), No(78.6%) 14. Distribution of sleeping times, above 7 hours(79.0%) 15. Distribution of the reason to body loss, the complex of beauty(68.7%) is top. 16. Distribution of side effect in obesity acupuncture, constipation (17.4%) is top. 17. Distribution of method in body weight loss ; dietary treatment (31.1%), sauna(26.7%), exercise(19.7%), the center of body weight loss (15.0%) herb-med and starvation treatments (5.1%), hand-finger acupuncture (hand-foot acupuncture) is 1.6%, diet pill(0.3%), etc(0.6%).

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유방암의 방사선치료에서 Virtual Wedge와 Physical Wedge사용에 따른 유방선량 및 주변조직선량의 차이 (Comparison of Virtual Wedge versus Physical Wedge Affecting on Dose Distribution of Treated Breast and Adjacent Normal Tissue for Tangential Breast Irradiation)

  • 김연실;김성환;윤세철;이정석;손석현;최일봉
    • Radiation Oncology Journal
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    • 제22권3호
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    • pp.225-233
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    • 2004
  • 목적: 유방의 방사선조사 시 결손조직을 보상하고 방사선 균질선량 분포를 얻기 위해 통상적으로 physical wedge를 사용하여 왔다. Physical wedge 사용 시 주변의 폐, 심장, 반대편 유방, 피부에 조사되는 방사선량의 증가에 따른 급성, 만성 부작용의 증가가 문제시 된다. 본 연구에서는 일반적인 Physical wedge와 virtual wedge를 비교하여 동측 유방, 반대편 유방, 폐, 심장, 주변연부조직에 미치는 선량분포의 개선점을 알아보고자 하였다. 재료 및 방법: Solid water phantom을 이용하여 Dmax와 10 cm 깊이에서 physical wedge와 virtual wedge 사용시 조사야 주변선량을 비교하였다 Humanoid Phantom (Anderson Rando Phantom)을 사용하여 Lt. breast의 tangential Irradiation 시 physical wedge와 virtual wedge 사용에 따른 동측 유방선량과 피부선량, 반대편 유방선량과 반대편 유방의 피부선량, 주변 연부조직선량, 동측 폐선량 및 심장에 조사되는 선량을 TLD를 이용하여 비교하였으며 Helax 5.0 RTP system을 이용한 compute planning으로 선량분포 및 관심부의 DVH를 비교하였다. 이때 virtual wedge와 physical wedge의 사용에 따른 총조사 시간을 측정하였다 또한 7명의 유방암 환자에서 virtual wedge, physical wedge 사용에 따른 동측 유방 피부선량, 반대편 유방 피부선량, 조사야에서 1.5 cm 떨어진 주변 선량을 측정하여 비교하였다. 결과: Virtual wedge는 15$^{\circ}$, 30$^{\circ}C$, 45$^{\circ}C$, 50$^{\circ}C$ 모두에서 physical wedge에 비해 주변선량이 감소하였으며 방사선조사 시간을 53$\~$55$\%$ 감소시켜 유용한 결과를 나타냈다. 15$^{\circ}C$, 30$^{\circ}C$ wedge를 사용한 Humanoid Phantom의 TLD 측정에서도 virtual wedge에서 반대편 유방선량은 1.35$\%$, 2.55$\%$ 감소하였고, 반대편 유방 피부선량은 0.87$\%$, 1.9$\%$ 감소하였다 또한 동측 폐선량은 2.7$\%$, 5.0$\%$, 심장선량은 0.95$\%$, 2.5$\%$ 감소하였다. 또한 조사야 경계부위의 선량은 1.8$\%$, 2.33$\%$ 감소하였으며 동측 유방의 피부선량은 2.4$\%$, 4.58$\%$ 증가하였다. Helax 5.0 RTP system을 이용한 DVH analysis에서 동측 유방내 선량균질정도는 physical wedge와 virtual wedge에서 차이 없이 유사하였다 결론: 유방암치료에서 virtual wedge는 통상 사용하는 physical wedge에 비하여 주변 연부조직선량, 반대편 유방선량, 동측 페선량 및 심장선량을 감소시켜 급, 만성 방사선 부작용의 위험을 감소시킬 수 있는 임상적으로 매우 유용한 방법이며 또한 방사선조사시간을 단축시킴으로써 선형가속기의 부하를 줄일 수 있다.