• The Journal of Korean Society for Radiation Therapy
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• v.31 no.1
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• pp.33-41
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• 2019

Purpose : To evaluate the effectiveness of Jaw-tracking(JT) technique in Intensity-modulated radiation therapy(IMRT) and Volumetric-modulated arc therapy(VMAT) for radiation therapy of esophageal cancer by analyzing volume dose of perimetrical normal organs along with the low-dose volume regions. Materials and Method: A total of 27 patients were selected who received radiation therapy for esophageal cancer with using $VitalBeam^{TM}$(Varian Medical System, U.S.A) in our hospital. Using Eclipse system(Ver. 13.6 Varian, U.S.A), radiation treatment planning was set up with Jaw-tracking technique(JT) and Non-Jaw-tracking technique(NJT), and was conducted for the patients with T-shaped Planning target volume(PTV), including Supraclavicular lymph nodes(SCL). PTV was classified into whether celiac area was included or not to identify the influence on the radiation field. To compare the treatment plans, Organ at risk(OAR) was defined to bilateral lung, heart, and spinal cord and evaluated for Conformity index(CI) and Homogeneity index(HI). Portal dosimetry was performed to verify a clinical application using Electronic portal imaging device(EPID) and Gamma analysis was performed with establishing thresholds of radiation field as a parameter, with various range of 0 %, 5 %, and 10 %. Results: All treatment plans were established on gamma pass rates of 95 % with 3 mm/3 % criteria. For a threshold of 10 %, both JT and NJT passed with rate of more than 95 % and both gamma passing rate decreased more than 1 % in IMRT as the low dose threshold decreased to 5 % and 0 %. For the case of JT in IMRT on PTV without celiac area, $V_5$ and $V_{10}$ of both lung showed a decrease by respectively 8.5 % and 5.3 % in average and up to 14.7 %. A $D_{mean}$ decreased by $72.3{\pm}51cGy$, while there was an increase in radiation dose reduction in PTV including celiac area. A $D_{mean}$ of heart decreased by $68.9{\pm}38.5cGy$ and that of spinal cord decreased by $39.7{\pm}30cGy$. For the case of JT in VMAT, $V_5$ decreased by 2.5 % in average in lungs, and also a little amount in heart and spinal cord. Radiation dose reduction of JT showed an increase when PTV includes celiac area in VMAT. Conclusion: In the radiation treatment planning for esophageal cancer, IMRT showed a significant decrease in $V_5$, and $V_{10}$ of both lungs when applying JT, and dose reduction was greater when the irradiated area in low-dose field is larger. Therefore, IMRT is more advantageous in applying JT than VMAT for radiation therapy of esophageal cancer and can protect the normal organs from MLC leakage and transmitted doses in low-dose field.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.20
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• pp.9033-9038
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• 2014

Background: The purpose of this study was to assess the feasibility of deep inspiration breath-hold (DIBH) based volumetric modulated arc therapy (VMAT) for locally advanced left sided breast cancer patients undergoing radical mastectomy. DIBH immobilizes the tumor bed providing dosimetric benefits over free breathing (FB). Materials and Methods: Ten left sided post mastectomy patients were immobilized in a supine position with both the arms lifted above the head on a hemi-body vaclock. Two thermoplastic masks were prepared for each patient, one for normal free breathing and a second made with breath-hold to maintain reproducibility. DIBH CT scans were performed in the prospective mode of the Varian real time position management (RPM) system. The planning target volume (PTV) included the left chest wall and supraclavicular nodes and PTV prescription dose was 5000cGy in 25 fractions. DIBH-3DCRT planning was performed with the single iso-centre technique using a 6MV photon beam and the field-in-field technique. VMAT plans for FB and DIBH contained two partial arcs ($179^{\circ}-300^{\circ}CCW/CW$). Dose volume histograms of PTV and OAR's were analyzed for DIBH-VMAT, FB-VMAT and DIBH-3DCRT. In DIBH mode daily orthogonal ($0^{\circ}$ and $90^{\circ}$) KV images were taken to determine the setup variability and weekly twice CBCT to verify gating threshold level reproducibility. Results: DIBH-VMAT reduced the lung and heart dose compared to FB-VMAT, while maintaining similar PTV coverage. The mean heart $V_{30Gy}$ was $2.3%{\pm}2.7$, $5.1%{\pm}3.2$ and $3.3%{\pm}7.2$ and for left lung $V_{20Gy}$ was $18.57%{\pm}2.9$, $21.7%{\pm}3.9$ and $23.5%{\pm}5.1$ for DIBH-VMAT, FB-VMAT and DIBH-3DCRT respectively. Conclusions: DIBH-VMAT significantly reduced the heart and lung dose for left side chest wall patients compared to FB-VMAT. PTV conformity index, homogeneity index, ipsilateral lung dose and heart dose were better for DIBH-VMAT compared to DIBH-3DCRT. However, contralateral lung and breast volumes exposed to low doses were increased with DIBH-VMAT.

• Journal of the Korean Society of Radiology
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• v.15 no.7
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• pp.975-982
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• 2021

The purpose of this study is to evaluate the effect on the phantom for magnetic resonance imaging located nearby by partially shielding RF with a mesh made thinner than hair composed of copper, black metal, and polyester using metallic materials of titanium, which are commonly used for esophageal stents and implants in the body. Magnetic resonance images according to field of view (FOV) were analyzed in the Spin Echo T1 weighted images of TR 500 ms, TE 20 ms, NEX 1, and slice thickness 5mm using a Cardiac coil of 3T Achieva X-series. Aliasing artifact did not occur in FOV 304 mm × 304 mm, but it occurred in 250 mm × 250 mm and 170 mm × 170 mm. In FOV 170 mm × 170 mm, when a mesh was not used, the SNR was measured with 78.23, and when separated by standing a mesh in the middle, it was 215.05, and when completely shielded with a mesh, the SNR was 366.44. In addition, when completely shielded with a mesh, the aliasing artifact was also removed, and signal intensities on the left, middle and right of the image were also able to obtain homogeneous images compared to the previous two cases. In conclusion, if RF is partially shielded with a mesh, aliasing artifact can be removed, and magnetic resonance images with excellent image resolution and homogeneity can be obtained using a small FOV.

• The Journal of Korean Society for Radiation Therapy
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• v.28 no.2
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• pp.171-178
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• 2016

Purpose : In order to minimize the dose of femoral head as an appropriate treatment plan for rectal cancer radiation therapy, we compare and evaluate the usefulness of 3-field 3D conformal radiation therapy(below 3fCRT), which is a universal treatment method, and 5-field 3D conformal radiation therapy(below 5fCRT), and Volumetric Modulated Arc Therapy (VMAT). Materials and Methods : The 10 cases of rectal cancer that treated with 21EX were enrolled. Those cases were planned by Eclipse(Ver. 10.0.42, Varian, USA), PRO3(Progressive Resolution Optimizer 10.0.28) and AAA(Anisotropic Analytic Algorithm Ver. 10.0.28). 3fCRT and 5fCRT plan has $0^{\circ}$, $270^{\circ}$, $90^{\circ}$ and $0^{\circ}$, $95^{\circ}$, $45^{\circ}$, $315^{\circ}$, $265^{\circ}$ gantry angle, respectively. VMAT plan parameters consisted of 15MV coplanar $360^{\circ}$ 1 arac. Treatment prescription was employed delivering 54Gy to recum in 30 fractions. To minimize the dose difference that shows up randomly on optimizing, VMAT plans were optimized and calculated twice, and normalized to the target V100%=95%. The indexes of evaluation are D of Both femoral head and aceta fossa, total MU, H.I.(Homogeneity index) and C.I.(Conformity index) of the PTV. All VMAT plans were verified by gamma test with portal dosimetry using EPID. Results : D of Rt. femoral head was 53.08 Gy, 50.27 Gy, and 30.92 Gy, respectively, in the order of 3fCRT, 5fCRT, and VMAT treatment plan. Likewise, Lt. Femoral head showed average 53.68 Gy, 51.01 Gy and 29.23 Gy in the same order. D of Rt. aceta fossa was 54.86 Gy, 52.40 Gy, 30.37 Gy, respectively, in the order of 3fCRT, 5fCRT, and VMAT treatment plan. Likewise, Lt. Femoral head showed average 53.68 Gy, 51.01 Gy and 29.23 Gy in the same order. The maximum dose of both femoral head and aceta fossa was higher in the order of 3fCRT, 5fCRT, and VMAT treatment plan. C.I. showed the lowest VMAT treatment plan with an average of 1.64, 1.48, and 0.99 in the order of 3fCRT, 5fCRT, and VMAT treatment plan. There was no significant difference on H.I. of the PTV among three plans. Total MU showed that the VMAT treatment plan used 124.4MU and 299MU more than the 3fCRT and 5fCRT treatment plan, respectively. IMRT verification gamma test results for the VMAT plan passed over 90.0% at 2mm/2%. Conclusion : In rectal cancer treatment, the VMAT plan was shown to be advantageous in most of the evaluation indexes compared to the 3D plan, and the dose of the femoral head was greatly reduced. However, because of practical limitations there may be a case where it is difficult to select a VMAT treatment plan. 5fCRT has the advantage of reducing the dose of the femoral head as compared to the existing 3fCRT, without regard to additional problems. Therefore, not only would it extend survival time but the quality of life in general, if hospitals improved radiation therapy efficiency by selecting the treatment plan in accordance with the hospital's situation.

• Progress in Medical Physics
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• v.23 no.3
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• pp.177-187
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• 2012

Magnetic resonance angiography (MRA) techniques are widely used in diagnosis of vascular disorders such as hemadostenosis and aneurism. Especially, phase contrast (PC) MRA technique, which is a typical non contrast-enhanced MRA technique, provides not only the anatomy of blood vessels but also flow velocity. In this study, we developed the 2- and 3-dimensional PC MRA pulse sequences for a low magnetic field MRI system. Vessel images were acquired using 2D and 3D PC MRA and the velocities of the blood flow were measured in the superior sagittal sinus, straight sinus and the confluence of the two. The 2D PC MRA provided the good quality of vascular images for large vessels but the poor quality for small ones. Although 3D PC MRA gave more improved visualization of small vessels than 2D PC MRA, the image quality was not enough to be used for diagnosis of the small vessels due to the low SNR and field homogeneity of the low field MRI system. The measured blood velocities were $25.46{\pm}0.73cm/sec$, $24.02{\pm}0.34cm/sec$ and $26.15{\pm}1.50cm/sec$ in the superior sagittal sinus, straight sinus and the confluence of the two, respectively, which showed good agreement with the previous experimental values. Thus, the developed PC MRA technique for low field MRI system is expected to provide the useful velocity information to diagnose the large brain vessels.

• Proceedings of the Korean DIstribution Association Conference
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• 2003.02a
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• pp.123-166
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• 2003

Marketing channel is recognized as one of the society systems which have the character of functional organization. These organizations are related to each other for specialized and cooperative work. Channel members in distribution channel are striving to accomplish exchange through reciprocal action. Thus channel members exercise their power to take better position in exchange. There will be struggling between members about satisfaction and conflict during this power exercise. Now a days, buyers use more harsh power as large retail firms are increasing. This phenomenon is occurring in the distribution channel. However, there will be different phenomenon in case of agricultural products. Not like industrial product suppliers, agricultural product suppliers have various supply channels and many agricultural products are seasonal. It has also unstable amount supplies. There should be differentiated marketing in agricultural products. Relatively weaker powered suppliers have to strengthen comparative factors and also have to be technically specialized through assessed experience in order to establish strong product sales chain. Making a brand of agricultural product would be also a good idea to increase the product comparability. Channel members need to be recognized their specialized functions in order to make balanced distribution channel. There have to be conversion of concept of relation between suppliers and buyers from subordinate relationship to cooperative relationship.

• Korean Journal of Remote Sensing
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• v.26 no.5
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• pp.477-487
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• 2010

In North Korea, forests were intensively degraded by forest land reclamation for food production and firewood collection since the mid-1970s. These degraded forests have to be certainly recovered for economic support, environmental protection and disaster prevention. In order to provide detailed land cover information of forest recovery project (A/R CDM), this study was focused to develop an improved classification method for degraded forest using 2.5m SPOT-5 pan-sharpened image. The degraded forest of North Korea shows various different types of texture. This study used GLCM texture bands of segmented image with spectral bands during forest cover classification. When scale factor 40/shape factor 0.3 was used as a parameter set to generate segment image, segment image was generated on suitable segment scale that could classify types of degraded forest. Forest land cover types were classified with an optimum band combination of Band1, Band2, band3, GLCM dissimilarity (band2), GLCM homogeneity (band2) and GLCM standard deviation (band3). Segment-based classification method using spectral bands and texture bands reached an 80.4% overall accuracy, but the method using only spectral bands yielded an 70.3% overall accuracy. As using spectral and texture bands, a classification accuracy of stocked forest and unstocked forest showed an increase of 23~25%. In this research, SPOT-5 pan-sharpened high-resolution satellite image could provide a very useful information for classifying the forest cover of North Korea in which field data collection was not available for ground truth data and verification directly. And segment-based classification method using texture information improved classification accuracy of degraded forest.

• Radiation Oncology Journal
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• v.31 no.2
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• pp.104-110
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• 2013

Purpose: Intensity modulated arc therapy (IMAT) is a form of intensity modulated radiation therapy (IMRT) that delivers dose in single or multiple arcs. We compared IMRT plans versus single-arc field (1ARC) and multi-arc fields (3ARC) IMAT plans in high-risk prostate cancer. Materials and Methods: Sixteen patients were studied. Prostate ($PTV_P$), right pelvic ($PTV_{RtLN}$) and left pelvic lymph nodes ($PTV_{LtLN}$), and organs at risk were contoured. $PTV_P$, $PTV_{RtLN}$, and $PTV_{LtLN}$ received 50.40 Gy followed by a boost to $PTV_B$ of 28.80 Gy. Three plans were per patient generated: IMRT, 1ARC, and 3ARC. We recorded the dose to the PTV, the mean dose ($D_{MEAN}$) to the organs at risk, and volume covered by the 50% isodose. Efficiency was evaluated by monitor units (MU) and beam on time (BOT). Conformity index (CI), Paddick gradient index, and homogeneity index (HI) were also calculated. Results: Average Radiation Therapy Oncology Group CI was 1.17, 1.20, and 1.15 for IMRT, 1ARC, and 3ARC, respectively. The plans' HI were within 1% of each other. The $D_{MEAN}$ of bladder was within 2% of each other. The rectum $D_{MEAN}$ in IMRT plans was 10% lower dose than the arc plans (p < 0.0001). The GI of the 3ARC was superior to IMRT by 27.4% (p = 0.006). The average MU was highest in the IMRT plans (1686) versus 1ARC (575) versus 3ARC (1079). The average BOT was 6 minutes for IMRT compared to 1.3 and 2.9 for 1ARC and 3ARC IMAT (p < 0.05). Conclusion: For high-risk prostate cancer, IMAT may offer a favorable dose gradient profile, conformity, MU and BOT compared to IMRT.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.12
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• pp.8176-8186
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• 2015

This research was conducted for the purpose of developing a high-fidelity simulation education program, applying it to clinical field and analyzing this program's effect on nursing college students in order to solve problems being caused from the gap between the adult nursing theoretical class and practical education. As the analysis method, this study developed a scenario including an algorithm for caring hyperkalemia patients, the evaluation check list, and debriefing according to the adult nursing theoretical class's learning goal and measured the high-fidelity simulation program's effect in using the non-equivalent control group pre-test and post-test design. As the results from the analysis, there secured the simulation education program's general properties and dependent variable's homogeneity in the experimental group and the control group. The nursing simulation practice program for hyperkalemia patients showed slight effect on the experimental group compared to the control group in fields such as nursing practice ability, problem solving ability, critical thinking skills, self-confidence of nursing, and knowledge. (t=-83.313, p<.001, t=-3.169, p=.003, t=-2.473, p=.017, t=-4.036, p<.001, t=-5.044, p<.001). High-Fidelity simulation programs in conjunction with an adult nursing theory classes of nursing students nursing practice ability, problem solving ability, critical thinking skills, self-confidence of nursing, and knowledge. This simulation program may be an effective educational method for nursing practice and also support improved quality of nursing education.

• Journal of the Korean Institute of Landscape Architecture
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• v.34 no.4 s.117
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• pp.69-83
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• 2006

Nature rehabilitation has become a major theme in river management in South Korea. An analysis and evaluation of the landscape is a crucial step to select the suitable tracts for developing or conserving land use in the process of landscape planning. The purpose of this paper is to establish a hierarchical procedure for the setting of the landscape units on the various scales at which field biologists performed their observations and to select the preserves through by a suitability model for synthesizing the ecological empirical, and biophysical data. An evaluation process needs to be performed according to the landscape scales: site, local, and regional scales, at which the environmental data were collected, analyzed, and synthesized. Introducing of three level scales was crucially necessary for evaluating the various multi level ecological data for zoning of preserves in river corridors. The evaluation level at different scales are hierarchically established into three phases. The first evaluation phase can be performed by the long length units defined by the ranges of stream widths at regional scale. Secondly, each of these long units can be divided into two or more segments according to its landscape homogeneity at local level. Finally the segments at the last phase can be designated according to the location of the reservoir weirs and bridges at site level. The conceptual model components are adopted for collecting, evaluating, and interpreting the biological and abiotic data at site level. Three preserves are selected, having high potentials for being intensely managed as the Ecological Education Areas in the river. Despite a lot of assumption the results are expected to facilitate discussion and decision making about which frameworks of evaluation are desirable and adaptable for integrating the ecological data into the rehabilitation design process in South Korea.