• Title/Summary/Keyword: medical direction methods

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Evaluation of Set-up Accuracy for Frame-based and Frameless Lung Stereotactic Body Radiation Therapy (폐암 정위체부방사선치료 시 고정기구(frame) 사용 유무에 따른 셋업 정확성 평가)

  • Ji, Yunseo;Chang, Kyung Hwan;Cho, Byungchul;Kwak, Jungwon;Song, Si Yeol;Choi, Eun Kyung;Lee, Sang-wook
    • Progress in Medical Physics
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    • v.26 no.4
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    • pp.286-293
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    • 2015
  • The purpose of this study was to evaluate the set up accuracy using stereotactic body frame and frameless immobilizer for lung stereotactic body radiation therapy (SBRT). For total 40 lung cancer patients treated by SBRT, 20 patients using stereotactic body frame and other 20 patients using frameless immobilizer were separately enrolled in each group. The setup errors of each group depending on the immobilization methods were compared and analyzed. All patients received the dose of 48~60 Gy for 4 or 5 fractions. Before each treatment, a patient was first localized to the treatment isocenter using room lasers, and further aligned with a series of image guidance procedures; orthogonal kV radiographs, cone-beam CT, orthogonal fluoroscopy. The couch shifts during these procedures were recorded and analyzed for systematic and random errors of each group. Student t-test was performed to evaluate significant difference depending on the immobilization methods. The setup reproducibility was further analyzed using F-test with the random errors excluding the systematic setup errors. In addition, the ITV-PTV margin for each group was calculated. The setup errors for SBF were $0.05{\pm}0.25cm$ in vertical direction, $0.20{\pm}0.38cm$ in longitudinal direction, and $0.02{\pm}0.30cm$ in lateral direction, respectively. However the setup errors for frameless immobilizer showed a significant increase of $-0.24{\pm}0.25cm$ in vertical direction while similar results of $0.06{\pm}0.34cm$, $-0.02{\pm}0.25cm$ in longitudinal and lateral directions. ITV-PTV margins for SBF were 0.67 cm (vertical), 0.99 cm (longitudinal), and 0.83 cm (lateral), respectively. On the other hand, ITV-PTV margins for Frameless immobilizer were 0.75 cm (vertical), 0.96 cm (longitudinal), and 0.72 cm (lateral), indicating less than 1 mm difference for all directions. In conclusion, stereotactic body frame improves reproducibility of patient setup, resulted in 0.1~0.2 cm in both vertical and longitudinal directions. However the improvements are not substantial in clinic considering the effort and time consumption required for SBF setup.

The Effect of Acupuncture by Needle Manipulation at SP3.HT7 on the Blood Pressure in Hypertensive Rats Induced by Two Kidney One Clip (2K1C) (태백(太白).신문(神門) 염전(捻轉) 및 영수(迎隨) 보사수기법(補瀉手技法)이 2K1C에 의하여 유발(誘發)된 신혈관성(腎血管性) 고혈압(高血壓) 백서(白鼠)에 미치는 영향(影響))

  • Youn, Dae-Hwan;Han, Jeong-Hee;Kim, Suhn-Hee
    • Korean Journal of Acupuncture
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    • v.28 no.2
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    • pp.1-11
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    • 2011
  • Objectives : The aim of this study was to examine the effect acupuncture by needle manipulation at acupoints, SP3 HT7, on the blood pressure and renin and atrial natriuretic peptide(ANP) in plasma, cardiac hypertrophy in hypertensive rats induced by two kidney one clip (2K1C). Materials and Methods : The experiments were performed on twenty-five Sprague Dawley rats, 2K1C hypertension model was prepared by constricting the left renal artery with a sliver clip. Animals were divided into five groups, control, AC-1a and AC-2a(acupuncture at SP3 HT7 bilaterally and the needle was twirled and rotated forward with the thumb and forefinger of the right hand 6 times), AC-3a(acupuncture at SP3 HT7 bilaterally and the needle was inserted in the opposite direction(body direction) as the channel runs), AC-4a(acupuncture at SP3 HT7 bilaterally and the needle was inserted in the opposite direction(body direction) as the channel runs and the needle was twirled and rotated forward with the forefinger of the right hand 6 times). The treatments were started on the 4 week after inducing 2K1C, and they were performed two times a week for 3 weeks in rats. Results : The results are that The blood pressure was significantly decreased at 4 times in Acu-1a, The cardiac hypertrophy was significantly decrease in Acu-2a and Acu-3a. The activity of plasma renin was decreased in all groups without control and Acu-1a, and that of plasma ANP was decrease in Acu-2a and Acu-3a than control group. Conclusions : These results suggest that acupuncture on SP3 HT7 mostly cause significant changes on controlling renal hypertension induced by 2K1C in the rats.

The Effects of Acupuncture by Needle Manipulation at $LR1{\cdot}KI1$ on the Blood Pressure in Hypertensive Rat induced by Two Kidney One Clip (2K1C). (대돈(大敦)${\cdot}$용천(湧泉) 염전(捻轉) 및 영수(迎隨) 보사수기법(補瀉手技法)이 2K1C에 의하여 유발(誘發)된 고혈압(高血壓) 백서(白鼠)에 미치는 영향(影響))

  • Youn, Dae-Hwan;Han, Jeong-Hee;Kim, Suhn-Hee;Na, Chang-Su
    • Korean Journal of Acupuncture
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    • v.24 no.3
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    • pp.165-177
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    • 2007
  • Objectives : The purpose of this study was to examine effects of acupuncture by needle manipulation at $LR1{\cdot}Kl1$ on the blood pressure, plasma levels of ANP(atrial natriuretic peptide), renin and cardiomegalic index in hypertensive rat Induced by two kidney one clip(2K1C). Material and methods : The groups divided into 7 groups; Control, no treatment. Acu-1,acupuncture at $LR1{\cdot}Kl1$ bilaterally and the needle was twirled and rotated forward with the thumb of the right hand 6 times. Acu-2, acupuncture at $LR1{\cdot}Kl1$ bilaterally and the needle was twirled and rotated forward with the forefinger of the right hand 6 times. Acu-3, acupuncture at $LR1{\cdot}Kl1$ bilaterally and the needle was inserted in the opposite direction(body direction) as the channel runs, Acu-4, acupuncture at $LR1{\cdot}Kl1$ bilaterally, the needle was inserted in the opposite direction(body direction) as the channel runs and the needle was twirled and rotated forward with the forefinger of the right hand 6 times. The acupuncture executed 5times for 2 weeks. Results : Systolic blood pressure was decreased significantly in Acu-2, Acu-3 and Acu-4. Plasma renin was decreased significantly in Acu-2 and Acu-4. Plasma ANP was increased significantly in Acu-2, however was decreased significantly in Acu-4. Cardiac hypertrophy index was decreased significantly in Acu-1, Acu-2, Acu-3 and Acu-4. Conclusions : These results suggest that acupuncture by needle manipulation at $LR1{\cdot}Kl1$ is effective in hypertension by renal blood problem.

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The Relief Effect of Copayment Decreasing Policy on Unmet Needs in Targeted Diseases (산정특례제도가 미충족 의료경험에 미치는 영향: 2·4차 한국의료패널자료를 이용하여)

  • Choi, Jae-Woo;Kim, Jae-Hyun;Park, Eun-Cheol
    • Health Policy and Management
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    • v.24 no.1
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    • pp.24-34
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    • 2014
  • Background: Bankrupted households have recently been increased due to excessive medical expenditure in Korea. They have not been protected from economic risk when household's member has severe diseases that need a lot of money for treatment. Purpose of this study examines policy effect by comparing unmet needs' change of policy object households and non-object groups. Methods: We used Korea Health panel 2nd 4th data collected by Korea Institute for Health and Social Affairs and National Health Insurance Service. Analysis subjects were 381 households (pre-policy) and 393 households (post-policy) that had cancer and cardiovascular and cerebrovascular diseases. Since it was major concern that estimates benefit strengthening policy started by certain time, we setup comparing households which had diabetes, hypertension disease. Comparison subjects were 393,247 households, respectively and we evaluated policy effect using difference in difference (DID) model. Results: Although unmet needs of policy object households were higher than non-object groups, policy execution variable affected negative direction. But interaction-term which shows pure effect of policy was not statistically significant. We utilized multi-DID model to examine factors affecting unmet needs causes. Copayment assistance policy did not significantly affect households that responded to 'economic reason,' and 'no have time to visit' for unmet needs causes. Conclusion: The second copayment assistance policy did not significantly give positive effect to beneficiary households than non-beneficiary groups. When we consider that primary purpose of public insurance guarantee high medical expenditure occurred by unexpected events, it needs to deliberate on switch of benefit strengthening policy that can assist vulnerable people. Also, we suggest that government forward a policy covering non-reimbursable medical expenses as well as switch of benefit strengthening direction because benefit policy do not affect non-covered medical cost which accounts for quarter of total health expenditure.

A study on the definition and development direction of manual therapy (도수치료의 정의에 대한 고찰 및 발전 방향에 관한 연구)

  • Park, Jong Hang;Park, Hyun Sik;Shin, Young Il;Lee, Ho Jong
    • Journal of Korean Physical Therapy Science
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    • v.29 no.1
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    • pp.1-14
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    • 2022
  • Background: The legal and academic definitions of manual therapy in domestic and foreign countries are reviewed, and problems and improvement plan of manual therapy are established through comparative analysis of the current status and system of manual therapy in Korea and abroad. Design: Review. Methods: In this study, the development direction of manual therapy in Korea was derived by analyzing the definition, application status, and service system of domestic and foreign manual therapy. Results: Firstly, it lays the foundation for a more comprehensive national health promotion by solving problems arising from the current unclear definition of manual therapy. Secondly, the subject of manual therapy is a physiotherapist but the subject of claiming non-benefit costs is a doctor, moreover illegal manual therapy by an unqualified or non-professional who is not a physiotherapist is being carried out in the medical field. Thirdly, in order to provide quality physiotherapy services (manual therapy) under a cooperative relationship between medical staff and physiotherapists, it is appropriate that physiotherapist have a clear "prescription" or "request" by a doctor. Fourth, there is no provision for the preparation of medical records in the current Medical Technicians Act, and this causes safety accidents of patients during manual treatment. Conclusion: As described above, the current manual therapy in Korea is being performed indiscriminately without a clear interpretation, resulting in various problems. I think it is necessary to lay the foundation for institutional and legal re-establishment of manual therapy through additional research on manual therapy in the future.

Walking Will Recognition Algorithm for Walking Aids Based on Torque Estimation (모터 토크 추정을 통한 보행보조기의 의지파악 알고리즘)

  • Kong, Jung-Shik
    • Journal of Biomedical Engineering Research
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    • v.31 no.2
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    • pp.162-169
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    • 2010
  • This paper deals with the recognition algorithm of walking will based on torque estimation. Recently, concern about walking assistant aids is increasing according to the increase in population of elder and handicapped person. However, most of walking aids don't have any actuators for its movement. So, general walking aids have weakness for its movement to upward/download direction of slope. To overcome the weakness of the general walking aids, many researches for active type walking aids are being progressed. Unfortunately it is difficult to control aids during its movement, because it is not easy to recognize user's walking will. Many kinds of methods are proposed to recognize of user's walking will. In this paper, we propose walking will recognition algorithm by using torque estimation from wheels. First, we measure wheel velocity and voltage at the walking aids. From these data, external forces are extracted. And then walking will that is included by walking velocity and direction is estimated. Here, all the processes are verified by simulation and experiment in the real world.

Detection of Gastric Contraction by Vector Analysis in Electrogastrography (위전도신호의 벡터분석에 의한 위수축 측정)

  • Han, Wan-Tack;Kim, In-Young;Kim, Won-Ky
    • Proceedings of the KOSOMBE Conference
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    • v.1997 no.05
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    • pp.387-390
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    • 1997
  • Electrogastrography(EGG), the cutaneous recording of the myoelectrical activity of the stomach using surface electrodes, is attractive due to its non-invasiveness. We propose feasible methods to detect tile gastric contraction by vector analysis of the surface EGG signals obtained from three paired electrodes. The amplitude and direction of the calculated EGG vector were analyzed and compared with the gastric contraction signals such as the strain gauge signal from the gastric serosa in dog. From the vector analysis of the EGG signal, we found a typical change of the amplitude and direction of the EGG vector, which can indicate occurrences of the gastric contraction.

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Influence of Aquaplastic Mask Immobilization on Patient Positioning in Head & Neck Radiotherapy (두경부암 방사선 치료 시 Aquaplastic Mask가 환자 고정에 미치는 영향)

  • Lee, Ho-Yeon;Bae, Sun-Myung;Kim, Jin-San;Kang, Tae-Young;Kwak, Jung-Won;Back, Geum-Mun
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.2
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    • pp.175-181
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    • 2012
  • Purpose: This study aimed to analyze the influence of aquaplastic mask which is used for the radiotherapy for patients with head and neck cancer on patient positioning by analyzing the results of 2D/2D matching with the use of Exactrac 6D couch system. Materials and Methods: 2D/2D matching-based Image guidance was performed with the use of Exactrac 6D couch system on a total of 14 patients with head and neck cancer who received radiotherapy at this hospital in a period from June 2010 to June 2011. The adjusted 6D values obtained after the image guidance were classified into values related with patients and values not related with patients as to the correlation between the results. Results: In the analysis of the relation of each adjusted value to patients, the coefficient of determination ($R^2$) of longitudinal and pitch direction was 0.76, of longitudinal and yaw direction was 0.48, and of pitch and yaw direction was 0.42 although the coefficient of determination for above factors was 0.03 or less when the dependency of patients was excluded. Conclusion: It was demonstrated that intrinsic factors of aquaplastic mask had influence on the immobilization of patients by aquaplastic mask although various factors related with patients had influence on the immobilization of patients. It is believed that if these factors are adjusted, the treatment of patients with head and neck cancer can be more accurate.

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The Effect of Intrinsic Foot Muscles Strengthening Exercise on the Balancing Ability and the Height of Navicular Bone in Adults with Flexible Flatfoot on Unstable Surface (불안정한 지면에서 발 내재근 강화운동이 유연성 편평발을 가진 성인의 균형능력과 발배뼈 높이에 미치는 효과)

  • Ju-Hyun Lee;Min-Seok Kim;Soo-Bin Shin;Chan-Young Lee;Seo-Yeon Chae;Yu-Jin Hong;Se-Jung Oh
    • Journal of the Korean Society of Physical Medicine
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    • v.18 no.2
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    • pp.61-70
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    • 2023
  • PURPOSE: This study evaluated an intrinsic foot strengthening exercise method for flat feet by comparing the effects of intrinsic exercises on a stable surface and intrinsic exercises on an unstable surface. METHODS: Twenty-four people with flat feet were divided into two groups. The control group performed short foot exercises and toe towel curl exercises on the stable support surface. The experimental group performed short foot exercises and toe towel curl exercises on an unstable support surface using Aerostep. The navicular drop test, and the static and dynamic balance were measured before and after the intervention. RESULTS: In the experimental and control groups, there was a significant difference in the navicular drop test and static balance before and after the intervention (p < .05). On the other hand, there was no significant difference between the two groups (p > .05). In the dynamic balance, the experimental group showed significant differences in all directions after the intervention (p < .05). The control group showed significant differences in the postero-lateral direction and posteromedial direction (p < .05). In particular, in the forward direction, the experimental group had a more significant change than the control group (p < .05). CONCLUSION: Intrinsic foot muscle strengthening exercises performed on unstable surfaces can be an effective clinical exercise method to improve the dynamic balance ability of people with flat feet.

Study on the Present Status and Developments of New Health Technologies of Traditional Korean Medicine (한의 신의료기술 행위 동향 분석)

  • Han, Chang-Hyun;Park, Hwang-Jin;Lee, Bong-Hyo;Lee, Young-Joon;Kwon, Oh-Min
    • Korean Journal of Acupuncture
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    • v.29 no.2
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    • pp.315-326
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    • 2012
  • Objectives : The new health technology assessment system was introduced in April 2007. The purpose of new health technology assessment is assessing safety and efficacy in deciding a behavior of new health technology according to the Health Insurance Act. This study aims to understand the present status of new health technologies of Korean medicine. Methods : This research introduces new health technologies and their present status, and searches for a development direction for the new health technology of Korean medicine in the future. Results : Thirty seven cases(3%) of Korean medicine doctors who utilized new health technologies application were found. In the status about new health technologies application by technologies assortment, diagnostic test techniques were used more often than treatment skills. New medical technology that included korean medicine doctor as actual user was only one item, i.e. HCV antibody test. Conclusions : In order for the new health technology of korean medicine to settle down well, continuous interest and efforts of both government and medical community are necessary.