• Title/Summary/Keyword: Complex Korean Medical treatment

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Experimental investigation of the photoneutron production out of the high-energy photon fields at linear accelerator (고에너지 방사선치료 시 치료변수에 따른 광중성자 선량 변화 연구)

  • Kim, Yeon Su;Yoon, In Ha;Bae, Sun Myeong;Kang, Tae Young;Baek, Geum Mun;Kim, Sung Hwan;Nam, Uk Won;Lee, Jae Jin;Park, Yeong Sik
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.2
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    • pp.257-264
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    • 2014
  • Purpose : Photoneutron dose in high-energy photon radiotherapy at linear accelerator increase the risk for secondary cancer. The purpose of this investigation is to evaluate the dose variation of photoneutron with different treatment method, flattening filter, dose rate and gantry angle in radiation therapy with high-energy photon beam ($E{\geq}8MeV$). Materials and Methods : TrueBeam $ST{\time}TM$(Ver1.5, Varian, USA) and Korea Tissue Equivalent Proportional Counter (KTEPC) were used to detect the photoneutron dose out of the high-energy photon field. Complex Patient plans using Eclipse planning system (Version 10.0, Varian, USA) was used to experiment with different treatment technique(IMRT, VMAT), condition of flattening filter and three different dose rate. Scattered photoneutron dose was measured at eight different gantry angles with open field (Field size : $5{\time}5cm$). Results : The mean values of the detected photoneutron dose from IMRT and VMAT were $449.7{\mu}Sv$, $2940.7{\mu}Sv$. The mean values of the detected photoneutron dose with Flattening Filter(FF) and Flattening Filter Free(FFF) were measured as $2940.7{\mu}Sv$, $232.0{\mu}Sv$. The mean values of the photoneutron dose for each test plan (case 1, case 2 and case 3) with FFF at the three different dose rate (400, 1200, 2400 MU/min) were $3242.5{\mu}Sv$, $3189.4{\mu}Sv$, $3191.2{\mu}Sv$ with case 1, $3493.2{\mu}Sv$, $3482.6{\mu}Sv$, $3477.2{\mu}Sv$ with case 2 and $4592.2{\mu}Sv$, $4580.0{\mu}Sv$, $4542.3{\mu}Sv$ with case 3, respectively. The mean values of the photoneutron dose at eight different gantry angles ($0^{\circ}$, $45^{\circ}$, $90^{\circ}$, $135^{\circ}$, $180^{\circ}$, $225^{\circ}$, $270^{\circ}$, $315^{\circ}$) were measured as $3.2{\mu}Sv$, $4.3{\mu}Sv$, $5.3{\mu}Sv$, $11.3{\mu}Sv$, $14.7{\mu}Sv$, $11.2{\mu}Sv$, $3.7{\mu}Sv$, $3.0{\mu}Sv$ at 10MV and as $373.7{\mu}Sv$, $369.6{\mu}Sv$, $384.4{\mu}Sv$, $423.6{\mu}Sv$, $447.1{\mu}Sv$, $448.0{\mu}Sv$, $384.5{\mu}Sv$, $377.3{\mu}Sv$ at 15MV. Conclusion : As a result, it is possible to reduce photoneutron dose using FFF mode and VMAT method with TrueBeam $ST{\time}TM$. The risk for secondary cancer of the patients will be decreased with continuous evaluation of the photoneutron dose.

Monte Carlo Study Using GEANT4 of Cyberknife Stereotactic Radiosurgery System (GEANT4를 이용한 정위적 사이버나이프 선량분포의 계산과 측정에 관한 연구)

  • Lee, Chung-Il;Shin, Jae-Won;Shin, Hun-Joo;Jung, Jae-Yong;Kim, Yon-Lae;Min, Jeong-Hwan;Hong, Seung-Woo;Chung, Su-Mi;Jung, Won-Gyun;Suh, Tae-Suk
    • Progress in Medical Physics
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    • v.21 no.2
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    • pp.192-200
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    • 2010
  • Cyberknife with small field size is more difficult and complex for dosimetry compared with conventional radiotherapy due to electronic disequilibrium, steep dose gradients and spectrum change of photons and electrons. The purpose of this study demonstrate the usefulness of Geant4 as verification tool of measurement dose for delivering accurate dose by comparing measurement data using the diode detector with results by Geant4 simulation. The development of Monte Carlo Model for Cyberknife was done through the two-step process. In the first step, the treatment head was simulated and Bremsstrahlung spectrum was calculated. Secondly, percent depth dose (PDD) was calculated for six cones with different size, i.e., 5 mm, 10 mm, 20 mm, 30 mm, 50 mm and 60 mm in the model of water phantom. The relative output factor was calculated about 12 fields from 5 mm to 60 mm and then it compared with measurement data by the diode detector. The beam profiles and depth profiles were calculated about different six cones and about each depth of 1.5 cm, 10 cm and 20 cm, respectively. The results about PDD were shown the error the less than 2% which means acceptable in clinical setting. For comparison of relative output factors, the difference was less than 3% in the cones lager than 7.5 mm. However, there was the difference of 6.91% in the 5 mm cone. Although beam profiles were shown the difference less than 2% in the cones larger than 20 mm, there was the error less than 3.5% in the cones smaller than 20 mm. From results, we could demonstrate the usefulness of Geant4 as dose verification tool.

Morphologic Alterations in Amygdala Subregions of Adult Patients with Bipolar Disorder

  • Lee, Hyun-Jae;Han, Kyu-Man;Kim, Aram;Kang, Wooyoung;Kang, Youbin;Kang, June;Won, Eunsoo;Tae, Woo-Suk;Ham, Byung-Joo
    • Korean Journal of Biological Psychiatry
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    • v.26 no.1
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    • pp.22-31
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    • 2019
  • Objectives Previous studies have revealed inconsistent results on amygdala volume in adult bipolar disorder (BD) patients compared to healthy controls (HC). Since the amygdala encompasses multiple subregions, the subtle volume changes in each amygdala nucleus might have not been fully reflected in the measure of the total amygdala volume, causing discrepant results. Thus, we aimed to investigate volume changes in each amygdala subregion and their association with subtypes of BD, lithium use and clinical status of BD. Methods Fifty-five BD patients and 55 HC underwent T1-weighted structural magnetic resonance imaging. We analyzed volumes of the whole amygdala and each amygdala subregion, including the anterior amygdaloid area, cortico-amygdaloid transition area, basal, lateral, accessory basal, central, cortical, medial and paralaminar nuclei using the atlas in the FreeSurfer. The volume difference was analyzed using a one-way analysis of covariance with individual volumes as dependent variables, and age, sex, and total intracranial volume as covariates. Results The volumes of whole right amygdala and subregions including basal nucleus, accessory basal nucleus, anterior amygdaloid area, and cortico-amygdaloid transition area in the right amygdala of BD patients were significantly smaller for the HC group. No significant volume difference between bipolar I disorder and bipolar II disorder was found after the Bonferroni correction. The trend of larger volume in medial nucleus with lithium treatment was not significant after the Bonferroni correction. No significant correlation between illness duration and amygdala volume, and insignificant negative correlation were found between right central nucleus volume and depression severity. Conclusions Significant volume decrements of the whole amygdala, basal nucleus, accessory basal nucleus, anterior amygdaloid area, and cortico-amygdaloid transition area were found in the right hemisphere in adult BD patients, compared to HC group. We postulate that such volume changes are associated with altered functional activity and connectivity of amygdala nuclei in BD.

Tracing Per Ankh as a Prototype of Ancient Egytian Libraries (고대 이집트 도서관의 원형, 페르 앙크(Per Ankh) 추적)

  • Hee-Yoon Yoon
    • Journal of the Korean Society for Library and Information Science
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    • v.57 no.4
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    • pp.5-24
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    • 2023
  • In ancient Egypt, temples were not only religious sanctuaries but also community centers. One of the core spaces created in the temple is the facility where priests and scribes copied and preserved texts on papyrus and other media. Its common designation was 'pr-mḏȝ'(House of Books) and the 'per-(nw)-seshw'(House of Scrolls). The general term used during that time was 'Per Ankh', and the modern term for it is 'temple library'. Therefore, this study first identified the character and identity of the Per Ankh attached to the temple, and then traced whether it is appropriate to designate 'healing place of the souls' depicted on the hypostyle hall(Per Ankh) in the Ramesseum(mortuary temple) built by Ramses II of the New Kingdom as a library. As a result, Per Ankh, a hieroglyph combining the Per(house) and Ankh(life), was revealed to be a multi-purpose complex facility consisting of a learning and research center, a treatment and healing center with medical facilities and sanatoriums, a religious ceremony and a center for the celebration of eternal life, a scriptorium and a library. Therefore, the traditional argument that Per Ankh refers to a library cannot be justified. In the same context, the inscription 'Ψυχῆς ἰατρεῖον' on the doorplate of the hypostyle hall of the Ramesseum, which was first introduced by Greek historian Hecataeus of Miletus in the 4th century BC, was translated into Latin as 'Psychēs Iatreion' by Diodorus Siculus in the 1st century BC and described as the motto of the sacred library. However, Psyche is the goddess of Greek and Roman mythology, and Iatreion means hospital(clinic, healing center) and pharmacy, so Per Ankh in the Ramesseum is a space to heal the soul of the pharaoh (Ka). Therefore, 'Psychēs Iatreion = library' is a distortion and a mistranslation. It is not the motto of the library, but a metaphor for the Per Ankh.

Maxillofacial Trauma Trends at a Tertiary Care Hospital: A Retrospective Study

  • Jeon, Eun-Gyu;Jung, Dong-Young;Lee, Jong-Sung;Seol, Guk-Jin;Choi, So-Young;Paeng, Jung-Young;Kim, Jin-Wook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.36 no.6
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    • pp.253-258
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    • 2014
  • Purpose: Maxillofacial fractures are rapidly increasing from car accidents, industrial accidents, teenaged criminal activity, and sports injuries. Accurate assessment, appropriate diagnosis, and preparing individual treatment plans are necessary to reduce surgical complications. We investigated recent trends of facial bone fracture by period, cause, and type, with the objective of reducing surgical complications. Methods: To investigate time trends of maxillofacial fractures, we reviewed medical records from 2,196 patients with maxillofacial fractures in 1981~1987 (Group A), 1995~1999 (Group B), and 2008~2012 (Group C). We analyzed each group, comparing the number of patients, sex ratio, age, fracture site, and etiology. Results: The number of patients in each period was 418, 516, and 1,262 in Groups A to C. Of note is the increase in the number of patients from Group A to C. The sex ratios were 5.6:1, 3.5:1, and 3.8:1 in Groups A, B, and C. The most affected age group for fracture is 20~29 in all three groups. Traffic accidents are the most common cause in Groups A and B, while there were somewhat different causes of fracture in Group C. Sports-induced facial trauma was twice as high in Group C compared with Group A and B. Mandible fracture accounts for a large portion of facial bone fractures overall. Conclusion: We observed an increase in facial bone fracture patients at Kyungpook National University Dental Hospital over the years. Although facial injury caused by traffic accidents was still a major cause of facial bone fracture in all periods, the percentage decreased. In recent years, isolated mandible fracture increased but mandible and mid-facial complex fracture decreased, possibly because of a reduction in traffic accidents.

A History of Visualization for Biomedical Information of Meridian (경락경혈 의학정보의 시각화 방법에 대한 역사적 고찰)

  • Lee, Soon-Ho;Lee, In-Seon;Jo, Hee-Jin;Jung, Won-Mo;Lee, Ah-Reum;Kim, Song-Yi;Park, Hi-Joon;Lee, Hye-Jung;Huang, Long-Xiang;Chae, Youn-Byoung
    • Korean Journal of Acupuncture
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    • v.29 no.3
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    • pp.371-384
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    • 2012
  • Objectives : The meridian system is a systematic complex of empirical knowledge, which functions as a basis of acupuncture treatment. In this article, we reviewed the visualization methods of meridian and acupuncture points through the investigation of the characteristics of Diagram of Meridians, Mingtang Diagram, Diagram of Meridians and Collaterals, Bronze Statues and Diagram of Bronze Statue. Methods : We investigated the characteristics of Diagram of Meridians, Mingtang Diagram, Diagram of Meridians and Collaterals, and Bronze Statues. We reviewed the visualization methods of meridian and acupuncture points in those classical Diagrams and analyzed their relationships among them. Results : In order to explain the meridian and acupuncture points easily, ancient people usually used drawings which are named Mingtang Diagram, Diagram of Meridians and Collaterals, by their own characteristics. Owing to their limitations of drawings on the 2 dimensional plane, Chinese people designed the Bronze Statue for Acu-moxibustion and its first invention was invented in Tiansheng age of Song dynasty. For several decades and centuries, these models and drawings were inherited, also reflecting variations of meridian system. As the Bronze Statue has a deficiency in the educational use because of its limitations of mass production, Diagram of Bronze Statue drawn on the 2 dimensional plane was invented. At the beginning of Mingtang Diagram, Diagram of Meridians and Collaterals, Diagram of Bronze Statue and Bronze Statue, their own characteristics were significantly differed with other diagrams and statues. We found that both diagrams and statues were gradually combined with description of the relationship between internal organs and the skeletal structure and the meridian system. Conclusions : Our findings suggest that Diagram of Meridians, Mingtang Diagram, Diagram of Meridians and Collaterals, and Bronze Statues are the basic form of data visualization, one of the infographics. We suggest that ancient Chinese people intend to explain the empirical knowledge using the ancient infographics of meridian system, but have limitations on reflecting theorical or abstractional meaning.

Design of Head Blood Pressure(HBP) Measurement System and Correlativity Extraction of Blood Pressure(BP) and HBP (두부혈압 측정 시스템의 설계 및 두부혈압과 상완혈압과의 상관성 추출)

  • 이용흠;정석준;장근중;정동영
    • Journal of Biomedical Engineering Research
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    • v.24 no.5
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    • pp.381-389
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    • 2003
  • Various adult diseases (cerebral apoplexy, athymiait, etc.) result from hypertension, blood circulation disturbance and increment of HBP. In early diagnosis of these diseases, MRI, X-ray and PET have been used rather aim for treatment than for a prevention of disease. Since. cerebral apoplexy and athymiait could appear to the regular/irregular persons, it is very important to measure HBP which has connection with cerebral blood flow state. HBP has more diagnosis elements than that of BP. So, we can diagnose accurate hypertension by measuring of HBP. But, existing sphygmomanometers and automatic BP monitors can not measure HBP, and can not execute complex function(measuring of BP/HBP, blood flow improvement). Purpose of this paper is to develop a system and algorithm which can measure BP/HBP for accurate diagnosis. Also, we extracted diagnosis factors by correlativity analysis of BP/HBP. Maximum pressure of HBP corresponds to 62% that of BP, Minimum pressure of HBP corresponds to 46% that of BP. Therefore, we developed the multi-function automatic blood pressure monitor which can measure BP/HBP and improve cerebral blood flow state.

Antioxidant and Anti-obesity Effects of Herbal Complex Extract (한방복합추출물의 항산화 및 항비만 효과)

  • Shim, Jae-Won;Lee, Seung-Ju;Kim, Hye Kyung;Choi, Yun-Sik;Jang, Young-Ah
    • Journal of Life Science
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    • v.32 no.7
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    • pp.523-531
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    • 2022
  • The purpose of this study was to evaluate the effect of antioxidant and anti-adipogenic activities in ethanol extracts from herb mixture (Ephedra sinica, Atractylodes lance, Gypsum fibrosum, and Theobroma cacao). DPPH, ABTS+ radical and xanthine oxidase scavenging activities were measured for antioxidant activity. Extracts of the herb mixture had 75.0, 100.8, and 79.5% scavenging activities at 1,000 ㎍/ml concentration, respectively. We investigated the inhibition of adipogenesis and adipocyte differentiation with an extract of an herb mixture in 3T3-L1 preadipocytes. An extract from the herb mixture at concentrations between 0 and 50 ㎍/ml did not affect 3T3-L1 cell viability. Treatment with herb mixture extracts of 25, 50, and 75 ㎍/ml in 3T3-L1 preadipocytes inhibited lipid accumulation in a dose-dependent manner. As a result of a Western blot experiment, it was shown that the herb mixture inhibited the differentiation transcription factors, PPARγ and C/EBPa, by 44.2 and 77.6%, respectively, at a concentration of 75 ㎍/ml in MDI-induced differentiated 3T3-L1 cells. As a result of RT-PCR, the gene expression of C/EBPa, SREBP-1c, and PPARγ was significantly inhibited by 43.4%, 59.6%, and 55.3%, respectively, at the concentration of 75 ㎍/ml of the herb mixture compared with the MDI-treated group. In addition, the expression of fatty acid synthase (FAS), a fatty acid synthesis regulator, was suppressed. These results can be applied to develop a functional food for anti-obesity with a herb mixture.

Dosimetric Effect on Selectable Optimization Parameters of Volumatric Modulated Arc Therapy (선택적 최적화 변수(Selectable Optimization Parameters)에 따른 부피적조절회전방사선치료(VMAT)의 선량학적 영향)

  • Jung, Jae-Yong;Shin, Yong-Joo;Sohn, Seung-Chang;Kim, Yeon-Rae;Min, Jung-Wan;Suh, Tae-Suk
    • Progress in Medical Physics
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    • v.23 no.1
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    • pp.15-25
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    • 2012
  • The aim of this study is to evaluate plan quality and dose accuracy for Volumetric Modulated Arc Therapy (VMAT) on the TG-119 and is to investigate the effects on variation of the selectable optimization parameters of VMAT. VMAT treatment planning was implemented on a Varian iX linear accelerator with ARIA record and verify system (Varian Mecical System Palo Alto, CA) and Oncentra MasterPlan treatment planning system (Nucletron BV, Veenendaal, Netherlands). Plan quality and dosimetric accuracy were evaluated by effect of varying a number of arc, gantry spacing and delivery time for the test geometries provided in TG-119. Plan quality for the target and OAR was evaluated by the mean value and the standard deviation of the Dose Volume Histograms (DVHs). The ionization chamber and $Delta^{4PT}$ bi-planar diode array were used for the dose evaluation. For treatment planning evaluation, all structure sets closed to the goals in the case of single arc, except for the C-shape (hard), and all structure sets achieved the goals in the case of dual arc, except for C-shape (hard). For the variation of a number of arc, the simple structure such as a prostate did not have the difference between single arc and dual arc, whereas the complex structure such as a head and neck showed a superior result in the case of dual arc. The dose distribution with gantry spacing of $4^{\circ}$ was shown better plan quality than the gantry spacing of $6^{\circ}$, but was similar results compared with gantry spacing of $2^{\circ}$. For the verification of dose accuracy with single arc and dual arc, the mean value of a relative error between measured and calculated value were within 3% and 4% for point dose and confidence limit values, respectively. For the verification on dose accuracy with the gantry intervals of $2^{\circ}$, $4^{\circ}$ and $6^{\circ}$, the mean values of relative error were within 3% and 5% for point dose and confidence limit values, respectively. In the verification of dose distribution with $Delta^{4PT}$ bi-planar diode array, gamma passing rate was $98.72{\pm}1.52%$ and $98.3{\pm}1.5%$ for single arc and dual arc, respectively. The confidence limit values were within 4%. The smaller the gantry spacing, the more accuracy results were shown. In this study, we performed the VMAT QA based on TG-119 procedure, and demonstrated that all structure sets were satisfied with acceptance criteria. And also, the results for the selective optimization variables informed the importance of selection for the suitable variables according to the clinical cases.

Clinical Characteristics and Genetic Analysis of Prader-Willi Syndrome (Prader-Willi 증후군의 임상 양상 및 유전학적 진단에 관한 고찰)

  • Lee, Ji Eun;Moon, Kwang Bin;Hwang, Jong Hee;Kwon, Eun Kyung;Kim, Sun Hee;Kim, Jong Won;Jin, Dong Kyu
    • Clinical and Experimental Pediatrics
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    • v.45 no.9
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    • pp.1126-1133
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    • 2002
  • Purpose : Prader-Willi syndrome(PWS) is a complex disorder affecting multisystems with characteristic clinical features. Its genetic basis is an expression defect in the paternally derived chromosome 15q11-q13. We analyzed the clinical features and genetic basis of PWS patients for early detection and treatment. Methods : We retrospectively studied 24 patients with PWS in Department of Pediatrics, Samsung Medical Center, from September 1997 to September 2001. We performed cytogenetic and molecular genetic techniques using high resolution GTG banding techniques, fluorescent in situ hybridization and methylation-specific PCR for CpG island of SNRPN gene region. Results : The average birth weight of PWS patients was $2.67{\pm}0.47kg$ and median age at diagnosis was 1.3 years. The average height and weight of PWS patients under one year at diagnostic time were located in a 3-10 percentile relatively, and a rapid weight gain was seen between two and six years. Feeding problems in infancy and neonatal hypotonia were the two most consistently positive major criteria in over 95% of the patients. In 18 of the 24 cases(75%), deletion of chromosome 15q11-q13 was demonstrated and one case among 18 had an unbalanced 14;15 translocation. In four cases without any cytogenetic abnormality, it may be considered as maternal uniparental disomy and the rest showed another findings. Conclusion : We suggest diagnostic testing for PWS in all infants/neonates with unexplained feeding problems and hypotonia. It is necessary for clinically suspicious patients to undergo an early genetic test. As the genetic basis of PWS was heterogenous and complex, further study is required.