• The Journal of Korean Society for Radiation Therapy
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• v.20 no.1
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• pp.17-23
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• 2008

Purpose: Cone-beam CT using linear accelerator attached to on-board imager is a image guided therapy equipment. Because it is to check the patient's set-up error, correction, organ and target movement. but imaging dose should be cause of the secondary cancer when taking a image. The aim of this study is investigation of appropriate cone beam CT scan mode to compare and estimate the image quality and skin dose. Materials and Methods: Measurement by Thermoluminescence dosimeter (TLD-100, Harshaw) with using the Rando phantom are placed on each eight sites in seperately H&N, thoracic, abdominal section. each 4 methods of scan modes of are measured the for skin dose in three time. Subsequently, obtained average value. Following image quality QA protocol of equipment manufacturers using the catphan 504 phantom, image quality of each scan mode is compared and analyzed. Results: The results of the measured skin dose are described in here. The skin dose of Head & Neck are measured mode A: 8.96 cGy, mode B: 4.59 cGy, mode C: 3.46 cGy mode D: 1.76 cGy and thoracic mode A: 9.42 cGy, mode B: 4.58 cGy, mode C: 3.65 cGy, mode D: 1.85 cGy, and abdominal mode A: 9.97 cGy, mode B: 5.12 cGy, mode C: 4.03 cGy, mode D: 2.21 cGy. Approximately, dose of mode B are reduced 50%, mode C are reduced 60%, mode D are reduced 80% a point of reference dose of mode A. the results of analyzed HU reproducibility, low contrast resolution, spatial resolution (high contrast resolution), HU uniformity in evaluation item of image quality are within the tolerance value by recommended equipment manufacturer in all scan mode. Conclusion: Maintaining the image quality as well as reducing the image dose are very important in cone beam CT. In the result of this study, we are considered when to take mode A when interested in soft tissue. And we are considered to take mode D when interested in bone scan and we are considered to take mode B, C when standard scan. Increasing secondary cancer risk due to cone beam CT scan should be reduced by low mAs technique.

• The Journal of Korean Society for Radiation Therapy
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• v.30 no.1_2
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• pp.153-160
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• 2018

Purpose : We retrospectively analyzed doses of each radiation therapy technique used in the treatment for left breast cancer patients after partial mastectomy through dose results for normalorgans and tumor volume to use this as a clinical reference for radiation therapy of domestic left breast cancer patients. Materials and Methods : 40 patients who underwent partial mastectomy on left breast cancer were classified in 3 treatment methods. The treatment plan was evaluated by HI(homogeneity index), $D_{95%}$, and CI(conformity index), and the $V_{hot}$ for gross tumor volume and clinical target volume of each treatment method. In Cyberknife treatment, tumor volume was the same as high dose volume in the other techniques, so no consideration was given to clinical target volume. Treatment plan evaluation for normal organs were evaluated by mean dose on ipsilateral lung, heart, left anterior descending artery, opposite breast and lung, and non-target tissue. Result : Treatment with volumetric arc radiotherapy(VMAT) showed $95.84{\pm}0.75%$ of $D_{95%}$ on the clinical target volume, significantly higher than that of 3D-CRT. The $D_{95%}$ value of the total tumor volume was slightly higher than the other treatments. In Cyberknife treatment, the dose to the normal organs was significantly lower than other treatments. Overall, the maximum dose and mean dose to the heart were $26.2{\pm}6.12Gy$ and $1.88{\pm}0.2Gy$ in VMAT treatment and $20.25{\pm}9.35Gy$ and $1.04{\pm}0.19Gy$ in 3D-CRT therapy, respectively. Conclusion : In comparison on 3D-CRT and VMAT, most of the dosimetric parameters for the evaluation of the treatment plan showed similar values, so that there is no significant difference in treatment plan evaluation. It is possible to select the treatment method according to the patient's anatomical structure or possibility of breath control. Cyberknife treatment is very useful treatment for normal organs because of its accurate dose exposure to the tumor volume However, it has restrictions to treat the local area, to have relatively long treatment time and to involve invasive procedure.

• Tuberculosis and Respiratory Diseases
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• v.44 no.6
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• pp.1326-1331
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• 1997

Background : Weaning is the process of switching a patient from mechanical ventilator to spontaneous breathing. A number of different weaning techniques can be employed. At recent study, conventional spontaneous breathing trial was superior to other techniques, such as intermittent mandatory ventilation(IMV) or pressure support ventilation(PSV). But adequate observation time of the spontaneous breathing trial was not determined. We reported the effectiveness of weaning and extubation following a 60 minutes spontaneous breathing trial with simple oxygen supply through the endotrachial tube. In this study, we tried to shorten the spontaneous breathing time from 60 minutes to 30 minutes. If weaning success was predicted after 30 minutes spontaneous breathing, extubation was done without reconnection with ventilator. Methodes : Subjects consisted of 42 mechanically ventilated patients from August 1994 to July 1995. The weaning trial was done when the patients recovered sufficiently from respiratory failure that originally required ventilatory assistance, the patients became alert and showed stable vital sign, and arterial $O_2$ tension was adequated($PaO_2$ > 55 mmHg) with less than 40% of inspired oxygen fraction. We conducted a careful physical examination when the patients was breathing spontaneously through the endobronchial tube for 30 minutes. We terminated the trial if a patients was any of following signs of distress; cyanosis, diaphoresis, tachypnea(above 30 breaths per minute), and extreme tachycardia. Patients who had none of this features during spontaneous breathing for 30 minutes were extubated promptly. Result : 17 weaning trials of 15 patients were done in 42 mechanically ventilated patients. Successful weaning and extubation was possible in 14 trials of total 17 trials. In this 14 patients, 8 patients were extubated after 30 minutes spontaneous breathing, 3 patients were extubated after 60 minutes spontaneous breathing, and 3 patients needed over 3 hours for extubation from weaning. We found similar overall success rate compared with weaning following a 60 minutes spontaneous breathing trial. Conclusion : From the result of present study, we believe that weaning and extubation from mechanical ventilation following a 30 minutes spontaneous breathing with $O_2$ supply through the endotracheal tube is a simple and effective method.

• The Korean Journal of Nuclear Medicine
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• v.31 no.1
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• pp.73-82
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• 1997

Regional myocardial blood flow (rMBF) can be noninvasively quantified using N-13 ammonia and dynamic positron emission tomography (PET). The quantitative accuracy of the rMBF values, however, is affected by the distortion of myocardial PET images caused by finite PET image resolution and cardiac motion. Although different methods have been developed to correct the distortion typically classified as partial volume effect and spillover, the methods are too complex to employ in a routine clinical environment. We have developed a refined method incorporating a geometric model of the volume representation of a region-of-interest (ROI) into the two-compartment N-13 ammonia model. In the refined model, partial volume effect and spillover are conveniently corrected by an additional parameter in the mathematical model. To examine the accuracy of this approach, studies were performed in 9 coronary artery disease patients. Dynamic transaxial images (16 frames) were acquired with a GE $Advance^{TM}$ PET scanner simultaneous with intravenous injection of 20 mCi N-13 ammonia. rMBF was examined at rest and during pharmacologically (dipyridamole) induced coronary hyperemia. Three sectorial myocardium (septum, anterior wall and lateral wall) and blood pool time-activity curves were generated using dynamic images from manually drawn ROIs. The accuracy of rMBF values estimated by the refined method was examined by comparing to the values estimated using the conventional two-compartment model without partial volume effect correction rMBF values obtained by the refined method linearly correlated with rMBF values obtained by the conventional method (108 myocardial segments, correlation coefficient (r)=0.88). Additionally, underestimated rMBF values by the conventional method due to partial volume effect were corrected by theoretically predicted amount in the refined method (slope(m)=1.57). Spillover fraction estimated by the two methods agreed well (r=1.00, m=0.98). In conclusion, accurate rMBF values can be efficiently quantified by the refined method incorporating myocardium geometric information into the two-compartment model using N-13 ammonia and PET.

• The Journal of Korean Society for Radiation Therapy
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• v.31 no.1
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• pp.51-56
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• 2019

Purpose: The usefulness of using single-electron radiation for secondary radiotherapy of breast cancer patients after surgery is assessed and the use of a combine of different energy. Methods and materials : In this study, 40 patients (group A) using energy 6 MeV and 9 MeV, and 19 patients (group B) using a combine of 9 MeV and 12 MeV were studied among 59 patients who performed secondary care using combine electronic radiation. Each patient in each group, 6 MeV, 9 MeV, Combine(6 MeV / 9 MeV) and 9 MeV, 12 MeV, Combine (9 MeV / 12 MeV) were developed in different ways, and the maximum doses delivered to the original hospital, D95, D5, and $V_3$, $V_5$, $V_{10}$ were compared. Result: The D95 mean value of Group A treatment plan was $785.33{\pm}225.37cGy$, $1121.79{\pm}87.02cGy$ at 9 MeV, and $1010.98{\pm}111.17cGy$ at 6 MeV / 9 MeV, and the mean value at 6 MeV / 9 MeV was most appropriate for the dose. The mean values of the low dose area $V_3$ and $V_5$ in the lung of the breast direction being treated were $3.24{\pm}3.49%$ and $0.72{\pm}1.55%$ at 6 MeV, the highest 9 MeV at $7.25{\pm}4.59%$, $3.07{\pm}2.64%$, the lowest at 6 MeV. Maximum and average lung dose was $727.78{\pm}137.27cGy$ at 6 MeV / 9 MeV, $49.16{\pm}24.44cGy$, highest 9 MeV at $998.97{\pm}114.35cGy$, $85.33{\pm}41.18cGy$, and lowest 6 MeV at $387.78{\pm}208.88cGy$, $9.27{\pm}6.60cGy$. The value of $V_{10}$ was all close to zero. Group B appeared in the pattern of Group A. Conclusion: Relative differences in low-dose areas of the lungs $V_3$ and $V_5$ were seen and were most effective in the dose transfer of tumor bed in the application of combined energy. It is thought that the method of using electronic energy in further radiation treatments for breast cancer is a more effective way to use the energy effect of limiting energy resources, and that if you think about it again, it could be a little more beneficial radiation treatment for patients.

• Radiation Oncology Journal
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• v.29 no.2
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• pp.71-82
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• 2011

Purpose: To evaluate the biochemical control rate and the rate of side effects after performing permanent brachytherapy of localized prostate cancer. Materials and Methods: 67 patients with localized prostate cancer were treated with brachytherapy between April 2007 and December 2008. Of these, 43 patients who were followed up and did not receive external radiotherapy were evaluated for the change in prostate specific antigen (PSA) level and the occurrence of side effects. In total, 18 patients were classified as low risk, 19 patients as intermediate risk, and 6 patients as high risk. The prescription dose was 145 Gy. Results: A PSA increase greater than 2 ng/mL occurred in 2 patients (4.7%). Radiation Therapy Oncology Group (RTOG) grade 1 and 2 acute urologic complications (UC) occurred in 40 and 3 patients, respectively. Further, 5 patients had RTOG grade 1 acute rectal complication (RC). The numbers of RTOG grade 1, 2, and 3 chronic UC were 1, 4, and 1, respectively. The numbers of RTOG grade 1, 2, and 4 chronic RC were 5, 10, and 3, respectively. The statistically significant risk factors (RF) of acute RC were the minimal dose in the most irradiated 0.1 cc volume ($D_{0.1cc}$, p=0.041) and absolute volume receiving 150% of the prescribed dose ($V_{150cc}$, p=0.038) in the entire rectum (ER). The percentage ($V_{100%}$, p=0.019) and absolute volume ($V_{100cc}$, p=0.047) in the involved rectum (IR) were also statistically significant. The RF of chronic RC were $V_{100%}$ (p=0.011) in the ER and the $D_{0.1cc}$ (p=0.049), $V_{100cc}$ (p=0.023) in the IR. The number of used seeds were related with acute UC (p=0.028). Conclusion: Permanent brachytherpy of localized prostate cancer showed a favorable short term biochemical control rate. As such, selective intermediate and high risk patients can be managed with permanent brachytherapy. The effort to reduce rectal complication is also necessary.

• KSCE Journal of Civil and Environmental Engineering Research
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• v.40 no.3
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• pp.273-283
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• 2020

Because of climate change, the occurrence of localized and heavy rainfall is increasing. It is important to predict floods in urban areas that have suffered inundation in the past. For flood prediction, not only numerical analysis models but also machine learning-based models can be applied. The LSTM (Long Short-Term Memory) neural network used in this study is appropriate for sequence data, but it demands a lot of data. However, rainfall that causes flooding does not appear every year in a single urban basin, meaning it is difficult to collect enough data for deep learning. Therefore, in addition to the rainfall observed in the study area, the observed rainfall in another urban basin was applied in the predictive model. The LSTM neural network was used for predicting the total overflow, and the result of the SWMM (Storm Water Management Model) was applied as target data. The prediction of the inundation map was performed by using logistic regression; the independent variable was the total overflow and the dependent variable was the presence or absence of flooding in each grid. The dependent variable of logistic regression was collected through the simulation results of a two-dimensional flood model. The input data of the two-dimensional flood model were the overflow at each manhole calculated by the SWMM. According to the LSTM neural network parameters, the prediction results of total overflow were compared. Four predictive models were used in this study depending on the parameter of the LSTM. The average RMSE (Root Mean Square Error) for verification and testing was 1.4279 ㎥/s, 1.0079 ㎥/s for the four LSTM models. The minimum RMSE of the verification and testing was calculated as 1.1655 ㎥/s and 0.8797 ㎥/s. It was confirmed that the total overflow can be predicted similarly to the SWMM simulation results. The prediction of inundation extent was performed by linking the logistic regression with the results of the LSTM neural network, and the maximum area fitness was 97.33 % when more than 0.5 m depth was considered. The methodology presented in this study would be helpful in improving urban flood response based on deep learning methodology.

• Clinical and Experimental Pediatrics
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• v.45 no.4
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• pp.489-497
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• 2002

Purpose : The objectives of this study were to investigate the causes of chronic cough and to establish the appropriate diagnostic approach to chronic cough in children. Methods : One hundred and thirty two cases of chronic cough were prospectively evaluated. They visitors to pediatric chronic cough clinics at Kang-nam saint Mary's Hospital of Catholic University from August 2000 to July 2001 for 12 months. Careful history taking by questionnaire, physical examination, radiologic studies of chest and sinus, hematologic and immunologic studies, allergic skin tests, and methacholine challenge tests were performed. Color doppler(CD) ultrasonography were performed and compared with simultaneous 24 Hr. esophageal pH monitoring to diagnose gastroesophageal reflux disease(GERD). Results : Age distributions were demonstrated that nine in infants, 82 in early childhood, 38 in late childhood, and three in adolescence. Common causes of chronic cough were bronchial asthma in 40 cases, chronic sinusitis in 22 cases, GERD in seven cases, bronchial asthma combined with sinusitis in 28 cases, bronchial asthma combined with GERD in 14 cases, psychogenic cough in two. cases, foreign body in one case, chronic bronchitis in one case, and bronchiolitis in one case. Comparing with 24 Hr. pH monitoring, sensitivity, specificity, positive predictive value and negative predictive values of CD ultrasonography were 88%, 69%, 85 %, and 73% respectively. Conclusion : The most common causes of chronic cough in children were bronchial asthma, sinusitis and GERD in order. We suggest that CD ultrasonography can be used as a good, convenient screening method for patients with suspected GERD in outpatient settings.

• Journal of Wetlands Research
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• v.25 no.2
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• pp.99-110
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• 2023

Non-point source (NP) pollutants in an agricultural landuse are discharged from a large area compared to those in other land uses, and thus effective source control measures are needed. To develop appropriate control measures, it is necessary to quantify discharge load of each source and evaluate the degree of water quality improvement by implementing different options of the control measures. This study used Hydrological Simulation Program-FORTRAN (HSPF) to quantify pollutant discharge loads from different sources and effects of different control measures on water quality improvements, thereby supporting decision making in developing appropirate pollutant control strategies. The study area is the Gyeseong river watershed in Changnyeong county, Gyeongsangnam-do, with agricultural areas occupying the largest proportion (26.13%) of the total area except for the forest area. The main pollutant sources include chemical and liquid fertilizers for agricultural activities, and manure produced from small scale livestock facilities and applied to agriculture lands or stacked near the facilities. Source loads of chemical fertilizers, liquid fertilizers and livestock manure of small scale livestock facilities, and point sources such as municipal wastewater treatment plants (WWTPs), community WWTPs, private sewage treament plants were considered in the HSPF model setup. Especially, NITR and PHOS modules were used to simulate detailed fate and transport processes including vegitation uptake, nutrient deposition, adsorption/desorption, and loss by deep percolation. The HSPF model was calibrated and validated based on the observed data from 2015 to 2020 at the outlet of the watershed. The calibrated model showed reasonably good performance in simulating the flow and water quality. Five Pollutants control scenarios were established from three sectors: agriculture pollution management (drainge outlet control, and replacement of controlled release fertilizers), livestock pollution management (liquid fertilizer reduction, and 'manure management of small scale livestock facilities) and private STP management. Each pollutant control measure was further divided into short-term, mid-term, and long-term scenarios based on the potential achievement period. The simulation results showed that the most effective control measure is the replacement of controlled release fertilizers followed by the drainge outlet control and the manure management of small scale livestock facilities. Furthermore, the simulation showed that application of all the control measures in the entire watershed can decrease the annual TN and TP loads at the outlet by 40.6% and 41.1%, respectively, and the annual average concentrations of TN and TP at the outlet by 35.1% and 29.2%, respectively. This study supports decision makers in priotizing different pollutant control measures based on their predicted performance on the water quality improvements in an agriculturally dominated watershed.

• Korean Journal of Environmental Biology
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• v.34 no.4
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• pp.257-263
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• 2016

Objective of this study was to evaluate the carbon budget on 40 years old pear orchard at Naju. For carbon budget assessment, we measured the soil respiration, net ecosystem productivity of herbs, pear biomass and net ecosystem exchange. In 2015, pear orchard released about $25.6ton\;CO_2\;ha^{-1}$ by soil respiration. And $27.9ton\;CO_2\;ha^{-1}$ was sequestrated by biomass growth. Also about $12.6ton\;CO_2\;ha^{-1}$ was stored at pruning branches and about $5.2ton\;CO_2\;ha^{-1}$ for photosynthesis of herbs. As a result, 25.6 ton of $CO_2$ per ha is annually released to atmosphere. At the same time about 45.7 ton of $CO_2$ was sequestrated from atmosphere. When it sum up the amount of $CO_2$ release and sequestration, approximately $20.1ton\;CO_2\;ha^{-1}$ was sequestrated by pear orchard in 2015, and it showed no significant differences with net ecosystem exchanges ($17.8ton\;CO_2\;ha^{-1}\;yr^{-1}$) by eddy covariance method with the same period. Continuous research using various techniques will help the understanding of $CO_2$ dynamics in agroecosystem and it can be able to present a new methodology for assessment of carbon budget in woody crop field. Futhermore, it is expected that the this study can be used as the basic data to be recognized as a carbon sink.