• Title/Summary/Keyword: Prone Position

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The 3-Dimensional Analysis of the Efficacy of a Belly-Board Device for the Displacement of Small Bowel During Pelvic Irradiation (골반강 방사선치료 중 소장의 이동을 위한 벨리보드의 효과에 대한 3차원적 분석)

  • Lee, Kyung-Ja
    • Radiation Oncology Journal
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    • v.26 no.4
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    • pp.271-279
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    • 2008
  • Purpose: To evaluate the efficacy of a belly-board device (BBD) in reducing the volume of small bowel during four-field pelvic irradiation. Materials and Methods: Twenty-two cancer patients (14 uterine cervical cancer, 6 rectal cancer, and 2 endometrial cancer) scheduled to receive pelvic irradiation were selected for this study. Two sets of CT images were taken with and without the belly-board device using the Siemens 16 channel CT scanner. All patients were set in the prone position. The CT images were transferred to a treatment planning system for dose calculation and volume measurements. The external surfaces of small bowel and the bladder were contoured on all CT scans and the 4-pelvic fields were added. The dose-volume-histogram of the bladder and small bowel, with and without the BBD, were plotted and analyzed. Results: In all patients, the total small bowel volume included in the irradiated fields was reduced when the BBD was used. The mean volume reduction was 35% (range, $1{\sim}79%$) and was statistically significant (p<0.001). The reduction in small bowel volume receiving $10{\sim}100%$ of the prescribed dose was statistically significant when the BBD was used in all cases. Almost no change in the total bladder volume involved was observed in the field (<8 cc, p=0.762). However, the bladder volume receiving 90% of the prescribed dose was 100% in 15/22 patients (68%) and $90{\sim}99%$ in 7/22 patients (32%) with the BBD. In comparison, the bladder volume receiving 90% of the prescribed dose was 100% in 10/22 patients (45%), $90{\sim}99%$ in 7/22 patients (32%), and $80{\sim}89%$ in 5/22 patients (23%) without the BBD. When the BBD was used, an increase in the bladder volume receiving a high dose range was observed Conclusion: This study shows that the use of a BBD for the treatment of cancer in the pelvic area significantly improves small bowel sparing. However, since the BBD pushed the bladder into the treatment field, the bladder volume receiving the high dose could increase. Therefore it is recommended to be considerate in using the BBD when bladder damage is of concern.

Micro Feeding Site Preference of Wintering Cranes by Topography and Vegetation in Cheorwon Basin, Korea (철원지역에서 월동하는 두루미류의 지형과 식생에 의한 미소 취식지 선호성)

  • Yoo, Seung-Hwa;Kim, In-Kyu;Lee, Han-Soo;Lee, Ki-Sup
    • Korean Journal of Environment and Ecology
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    • v.23 no.5
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    • pp.418-430
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    • 2009
  • The main purpose of this study is to investigate the relationship between the topography of land and vegetation and the preferred habitat of wintering cranes. Investigations were conducted twelve times in Cheorwon basin, South Korea, during two wintering seasons (12/2005 - 2/2006; 1/2007 - 2/2007). The density of rice grain in the middle of rice paddies was higher than that of the areas along the edge of rice paddies. However it was observed that red-naped cranes preferred to feed along the edges of rice paddies rather than to feed in the middle of the paddies. White-naped cranes, on the other hand, Preferred to feed in the middle of paddies. To be more specific, red-crowned cranes preferred feeding sites such as levees of the paddies or the areas where the level of the rice beds was comparatively more elevated. But the preference of the white-naped cranes turned out to be just the opposite. Another finding was that both red-naped cranes and white-naped cranes preferred concealed areas for their feeding site, and the frequency rate of their feeding in concealed areas has little to do with weather factors. This finding contradicts a widely accepted view that cranes prefer open spaces for their feeding site. Besides, red-crowned cranes, compared with white-naped cranes, preferred to feed in more concealed areas. The frequency rate of feeding in both concealed areas and non-concealed areas had little to do with the size of feeding flocks. There was no difference between a flock of fewer than five cranes and a flock of more than five cranes in terms of frequency rate of their feeding. In conclusion, the result of these investigations indicate that red-naped cranes comparatively prefer concealed areas for their feeding site, and white-naped cranes are less prone to them, and there is no direct connection between their preference of feeding site or frequency and the size of their flock. This is presumed to be the characteristics unique to their individual species.

The Role of Air-Vacuum Cushion Device in Patients with Rectal Cancer in Radiation Therapy (직장암 환자에서 방사선치료시 Air-vacuum Cushion의 유용성)

  • Kim Ki-Hwan;Cho Moon-June;Kang No-Hyun;Kim Dong-Wuk;Kim Jun-Sang;Jang Ji-Young;Kim Jae-Sung
    • Radiation Oncology Journal
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    • v.19 no.3
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    • pp.287-292
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    • 2001
  • Prupose : We analyzed setup errors induced by using air-vacuum cushion as immobilization device in patients with rectal cancer. Materials and methods : We had treated the twenty patients with rectal cancer by 6 MV, 10 MV X-ray from Aug. 1998 to Aug. 1999 at Chungnam National University Hospital. All patients were treated at prone position. They were separated to two groups, control group, 10 patients using styrofoam, and test group, 10 patients using styrofoam and air-vacuum cushion. We measured errors of posterior field for x, y axis and lateral field for z, y axis with simulation film and EPID image using a matching technique. Results : In control group, the mean displacement values of pelvic bone landmark for x axis and y axis were 0.02 mm. 0.78 mm, respectively and the standard deviations of systematic error were 2.13 mm, 2.40 mm, respectively and the standard deviation of random error were 1.46 mm. 1.51 mm, respectively. In test group, the mean displacement values of x axis and y axis were -0.33 mm. 0.81 mm, respectively and the standard deviations of systematic error were 1.71 mm, 3.08 mm, respectively and the standard deviations of random errors were 1.40 mm. 1.88 mm, respectively. The mean displacement values of z axis and y axis were 2.98 mm. 0.74 mm, respectively and the standard deviations of systematic error were 4.75 mm, 2.65 mm, respectively and standard deviations of random error were 2.69 mm. 1.86 mm, respectively. The statistical difference of field size by using air vacuum cushion between two groups in posterior direction and lateral direction was not shown. Conclusion : We think that use of air-vacuum cushion may not be an advantage for improving setup accuracy in rectal cancer patients.

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Suggested Protocol for Efficient Medical Image Information Exchange in Korea: Breast MRI (효율적 의료영상정보교류를 위한 프로토콜 제안: 유방자기공명영상)

  • Park, Ji Hee;Choi, Seon-Hyeong;Kim, Sungjun;Yong, Hwan Seok;Woo, Hyunsik;Jin, Kwang Nam;Jeong, Woo Kyoung;Shin, Na-Young;Choi, Moon Hyung;Jung, Seung Eun
    • Journal of the Korean Society of Radiology
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    • v.79 no.5
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    • pp.254-258
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    • 2018
  • Purpose: Establishment of an appropriate protocol for breast magnetic resonance imaging (MRI) in the study of image quality standards to enhance the effectiveness of medical image information exchange, which is part of the construction and activation of clinical information exchange for healthcare informatization. Materials and Methods: The recommended protocols of breast and MRI scans were reviewed and the questionnaire was prepared by a responsible researcher. Then, a panel of 9 breast dedicated radiologists was set up in Korea. The expert panel conducted a total of three Delphi agreements to draw up a consensus on the breast MRI protocol. Results: The agreed breast MRI recommendation protocol is a 1.5 Tesla or higher device that acquires images with prone position using a breast dedicated coil and includes T2-weighted and pre-contrast T1-weighted images. Contrast enhancement images are acquired at least two times, and include 60-120 seconds between images and after 4 minutes. The contrast enhancement T1-weighted image should be less than 3 mm in thickness, less than 120 seconds in temporal resolution, and less than $1.5mm^2$ in-plane pixel resolution. Conclusion: The Delphi agreement of the domestic breast imaging specialist group has established the recommendation protocol of the effective breast MRI.

Re-examining the Concept of 'Seeking Out the Original Root (原始返本)' as an Example of Religious Language (종교언어로서의 '원시반본(原始返本)' 개념 재검토)

  • Cha, Seon-keun
    • Journal of the Daesoon Academy of Sciences
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    • v.29
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    • pp.171-207
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    • 2017
  • The research regarding religious concepts used in Daesoon Jinrihoe are still incomplete. This study is a suggestion to critically review the existing research on 'seeking out the original root (原始返本)', one of the religious terms of Daesoon Jinrihoe. In addition, this concept will be seen from a new perspective. 'Seeking out the original root' plays a major role in Daesoon theology due to the cosmology established by Daesoon Jinrihoe. However, the existing research on this topic are prone to the perspective of 'returning' and assuming a 'cyclical view on the order of history'. Therefore, the cosmology that has been built by the religious language misleads readers to assume a retrospective process or that the process itself is realized on its own in accordance with the cosmic order. These kinds of studies do not specifically manifest the world view of Daesoon Jinrihoe. They fail to do so because Sangje's reordering works and its fruit, the earthly paradise of the Later World, have never existed before. The concept of 'seeking out the original root' should break away from the frame of a cyclical view of history and exert the uniqueness of Daesoon Jinrihoe. In this regard, this study can be summarized as follows: 'Seeking out the original root', one of the principles needed to achieve the re-creation of the Later World, endeavors to find a way to account for the origin of all things such as civilizations, cultures, and dharmas. If such a way is found, the facts between the root and the beginning should be acknowledged, as the root itself is what has been sustained, succeeded, used, resolved, revised, and rectified. The origin is usually dealt with from the position of rewarding. This was all achieved in Sangje's decisions and his reordering works. Its outcome will be utilized as a basis to establish an earthly paradise in the Later World. This concept, as defined above, excludes a cyclical view of history and implies that the concept of 'seeking out the original root' is a flexible frame within the context of dynamic structuralism. Given the style of this approach, this study provides a view which can be easily differentiated from existing research.

Preoperative Concurrent Radio-chemotherapy for Rectal Cancer: Report of Early Results (직장암에 대한 수술 전 동시병용 방사선-항암 화학요법: 초기 치료결과 보고)

  • Shin, Seong-Soo;Ahn, Yong-Chan;Chun, Ho-Kyung;Lee, Woo-Yong;Kang, Won-Ki;Park, Young-Suk;Park, Joon-Oh;Song, Sang-Yong;Lim-Do-Hoon;Park, Won;Lee, Jung, Eun;Kang, Min-Kyu;Park, Yung-Je
    • Radiation Oncology Journal
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    • v.21 no.2
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    • pp.125-134
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    • 2003
  • Purpose: To report the early results of preopeartive concurrent radio-chemotherapy (CRCT) for treating rectal cancer. Materials and Methods: From June 1999 to April 2002, 40 rectal cancer patients who either had lesions with a questionable resectability or were candidates for sphincter-sacrificing surgery received preoperative CRCT. Thirty-seven patients completed the planned CRCT course. 45 Gy by 1.8 Gy daily fraction over 5 weeks was delivered to the whole pelvis in the prone position. The chemotherapy regimens were oral UFT plus oral leucovorin (LV) in 12 patients, intravenous bolus 5-FU plus LV in 10 patients, and intravenous 5-FU alone in 15 patients (bolus infusion in 10, continuous infusion in 5). Surgery was planned in 4$\~$6 weeks of the completion of the preoperative CRCT course, and surgery was attempted in 35 patients. Results: The compliance to the current preoperative CRCT protocol was excellent, where 92.5$\%$ (37/40) completed the planned treatment. Among 35 patients, in whom surgery was attempted after excluding two patients with new metastatic lesions in the liver and the lung, sphincter-preservation was achieved in 22 patients (62.9$\%$), while resection was abandoned during laparotomy in two patients (5.7$\%$). Gross complete resection was peformed in 30 patients, gross incomplete resection was peformed in one patient, and no detailed information on the extent of surgery was available in two patients. Based on the surgical and pathological findings, the down-staging rate was 45.5$\%$ (15/33), and the complete resection rate with the negative resection margin 78.8$\%$ (26/33). During the CRCT course, grade 3 $\~$4 neutropenia developed in four patients (10.8$\%$). Local recurrence after surgical resection developed in 12.1$\%$ (4/33), and distant metastases after the preoperative CRCT start developed in 21.6$\%$ (8/37). The overall 3-years survival rate was 87$\%$. Conclusion: Preoperative CRCT in locally advanced rectal cancer is well tolerated and can lead to high resection rate, down-staging rate, sphincter preservation rate, however, longer term follow-up will be necessary to confirm these results.

An Analysis of the Psychiatric Characteristics of the Alopecia Areata in Female (여성 탈모증의 정신의학적 특성 분석)

  • Lee, Kil-Hong;Na, Chul;Lee, Young-Sik;Lee, Chang-Hoon;No, Byung-In;Hong, Chang-Kwon
    • Korean Journal of Psychosomatic Medicine
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    • v.8 no.1
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    • pp.31-45
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    • 2000
  • Objectives : The present study was performed to reveal differences between female and male cases of alopecia in their alopecia related variables such as patterns of hair loss, psychiatric characteristics, associate illnesses, and methods of treatment, and to use them as basic materials for proper management and early prevention of the alopecia prone cases. Methods : In order to analysis the gender difference in hair losses, the subjects were divided into two subgroups as the 51 cases of female alopecia and the 42 cases of male alopecia, who had visited to the department of psychiatry consulted from the department of dermatology, Yongsan hopital, ChungAng University, Seoul, Korea, from January 1998 to December 1998. In data analysis, the subjects were statistically assesed by chi-squre test and analysis of varaiance, through SPSS-$PC^+$ 9.0V. Results : 1) Female subjects were more likely showed lower socio-economical level including lower eonomical level, lower educational level, or lower occupational level in their parent's job, were more likely to have larger number of siblings and to have many sisters comparison to the male cases. 2) Female subjects were more likely visited to the department of dermatology, more history of alopecia in their female family members, lesser history of alopecia in their male family members, more loss of hairs in vertex or frontal region of scalp, lesser loss of hairs in occipital region, and lesser nail changes in comparison to the male cases. 3) Female subjects were more suffered from intra-familial conflicts and economical changes, or their introverted personality makeup, lesser likely suffered from changes of business and health changes, and showed lesser conflicts related with poorer adaptaion in their job life. 4) Female subjects were more likely diagnosed as depression or conversion disorders, more frequently complaint anxiety symptoms or depressive symptoms, higher level of anxiety index, lesser complaint somatization or obsessive compulsive symptoms, and lesser diagnosed as anxiety disorder in comparison to the male cases. 5) Female subjects were more likely tended to show personality makeup such as the introverted, the lie, the repressed, or the feminine trends than the male cases. 6) Female subjects were more significantly treated by antianxiety drug such as etizolam and dermatological therapies include tretinoin, and lesser treated by clotiazepam and prednicarbonate in comparison to the male cases. Conclusion : From the facts that The most important factors in developing hair loss in the female subjects in comparison to the male cases seems to be closely correlated with the serious psychopathology such as the presence of mental disorders including depression, the presence of complaining anxiety or depressive symptomatology, the presence of stressful life events such as intrafamilial life changes, and the presence of personality makeup such as the introverted, the lie, the repressed, or the feminine trends, the authors confirmed that dermatologists act as the primary care physician are in a unique position to recognize psychiatric comorbidity and execute meaningful intervention for female patients with the alopecia with psychiatrists.

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Postoperative Radiotherapy in the Rectal Cancers Patterns of Care Study for the Years of $1998\~1999$ (직장암의 방사선치료에 대한 Patterns of Care Study: $1998{\sim}1999$년도 수술 후 방사선치료 환자들의 특성 및 치료내용에 대한 분석결과)

  • Kim, Jong-Hoon;Oh, Do-Hoon;Kang, Ki-Moon;Kim, Woo-Cheol;Kim, Won-Dong;Kim, Jung, Soo;Kim, June-Sang;Kim, Jin-Hee;Kil, Hak-Jae;Suh, Chang-Ok;Sohn, Seung-Chang;Ahn, Yong-Chan;Yang, Dae-Sik
    • Radiation Oncology Journal
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    • v.23 no.1
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    • pp.22-31
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    • 2005
  • Purpose : To conduct a nationwide survey on the principals in radiotherapy for rectal cancer, and produce a database of Korean Patterns of Care Study. Materials and Methods : We developed web-based Patterns of Care Study system and a national survey was conducted using random sampling based on power allocation methods. Eligible patients were who had postoperative radiotherapy for rectal cancer without gross residual tumor after surgical resection and without previous history of other cancer and radiotherapy to pelvis. Data of patients were Inputted to the web based PCS system by each investigators in 19 institutions. Results : Informations on 309 patients with rectal cancer who received radiotherapy between 1998 and 1999 were collected. Male to female ratio was 59 : 41, and the most common location of tumor was lower rectum ($46\%$). Preoperative CEA was checked in $79\%$ of cases and its value was higher than 6 ng/ml in $32\%$. Pathologic stage were I in $1.5\%$, II in $32\%$, III in $53\%$, and IV in $1.6\%$. Low anterior resection was the most common type of surgery and complete resection was peformed in $95\%$ of cases. Distal resection margin was less than 2 cm in $30\%$, and number of lymph node dissected was less than 12 in $31\%$. Chemotherapy was peformed in $91\%$ and most common regimen was 5-FU and leucovorine ($59\%$). The most common type of field arrangement used for the initial pelvic field was the four field box (Posterior-Right-Left) technique ($65.0\%$), and there was no AP-PA parallel opposing field used. Patient position was prone in $81.2\%$, and the boost field was used in $61.8\%$. To displace bowel outward, pressure modulating devices or bladder filling was used in $40.1\%$. Radiation dose was prescribed to isocenter in $45.3\%$ and to isodose line in 123 cases ($39.8\%$). Percent delivered dose over $90\%$ was achieved in $92.9\%$. Conclusion : We could find the Patterns of Care for the radiotherapy in Korean rectal cancer patients was similar to that of US national survey. The type of surgery and the regimen of chemotherapy were variable according to institutions and the variations of radiation dose and field arrangement were within acceptable range.