• Title/Summary/Keyword: treatment planning

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Feasibility and response of helical tomotherapy in patients with metastatic colorectal cancer

  • Bae, Sun Hyun;Moon, Seong Kwon;Kim, Yong Ho;Cho, Kwang Hwan;Shin, Eung Jin;Lee, Moon Sung;Ryu, Chang Beom;Ko, Bong Min;Yun, Jina
    • Radiation Oncology Journal
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    • v.33 no.4
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    • pp.320-327
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    • 2015
  • Purpose: To investigate the treatment outcome and the toxicity of helical tomotherapy (HT) in patients with metastatic colorectal cancer (mCRC). Materials and Methods: We retrospectively reviewed 18 patients with 31 lesions from mCRC treated with HT between 2009 and 2013. The liver (9 lesions) and lymph nodes (9 lesions) were the most frequent sites. The planning target volume (PTV) ranged from 12 to 1,110 mL (median, 114 mL). The total doses ranged from 30 to 70 Gy in 10-30 fractions. When the ${\alpha}/{\beta}$ value for the tumor was assumed to be 10 Gy for the biologically equivalent dose (BED), the total doses ranged from 39 to $119Gy_{10}$ (median, $55Gy_{10}$). Nineteen lesions were treated with concurrent chemotherapy (CCRT). Results: With a median follow-up time of 16 months, the median overall survival for 18 patients was 33 months. Eight lesions (26%) achieved complete response. The 1- and 3-year local progression free survival (LPFS) rates for 31 lesions were 45% and 34%, respectively. On univariate analysis, significant parameters influencing LPFS rates were chemotherapy response before HT, aim of HT, CCRT, PTV, BED, and adjuvant chemotherapy. On multivariate analysis, $PTV{\leq}113mL$ and $BED>48Gy_{10}$ were associated with a statistically significant improvement in LFPS. During HT, four patients experienced grade 3 hematologic toxicities, each of whom had also received CCRT. Conclusion: The current study demonstrates the efficacy and tolerability of HT for mCRC. To define optimal RT dose according to tumor size of mCRC, further study should be needed.

A comparative study of soft tissue profile between Korean and Caucasian young adults under NHP (한국인 정상교합자의 natural head position시 안모의 연조직에 대한 측모두부방사선학적 분석)

  • Kang, Seung-Goo;Lee, Young-Jun;Park, Young-Guk
    • The korean journal of orthodontics
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    • v.33 no.5 s.100
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    • pp.323-337
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    • 2003
  • This study was performed to establish Korean soft tissue cephalometric norms, to compare the norms between sexes and between races, and then to suggest a guideline to execute orthodontic diagnosis and treatment planning for dentofacial deformities in Korean. Young Korean adults were selected. They were 27 males $(23.8{\pm}2.6-year-old)$ and 20 females $(22.5{\pm}1.7-year-old)$ who had harmonious facial balance. After taking lateral cephalograms under the natural head position which is widely known as a highly reliable and reproducible reference position, films were traced and analysing factors were measured as introduced by Arnett et at. Comparisons were done between male and female groups and between Korean and Caucasian groups using unpaired t-test. From the results it was concluded that Korean male had generally thicker lower facial soft tissue and smaller nasolabial angle, longer facial height, deeper facial depth, and more protrusive lower face than Korean female. From the comparison with Caucasian norms adopted from the research of Arnett et al., both Korean male and female showed longer facial lengths generally except less exposed maxillary incisor, and shorter facial depth than Caucasian counterparts. Also, both races showed similar horizontal position of maxillary structures from TVL (true vertical line), but there were more significant anteroposterior differences of marilla-mandible in Korean groups. These results mean Korean had relatively more retruded mandibular structures from the reference line, TVL. Individuals who had harmonious facial balance showed similar facial angle, more or less 170 degree, regardless of sexes or races.

A Comparative Study on the Health Care System of South and North Korea (남북한 보건의료제도의 비교)

  • Lim Gyung Soon;Kim Chung Nam;Park Kyung Min
    • Journal of Korean Public Health Nursing
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    • v.15 no.1
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    • pp.182-201
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    • 2001
  • This Study has attemped to compare the health care systems of South and North Korea. There has been a wide difference in the health care System between the South and North of Korea. In this paper, I have also shown that each health care system has its own unique response to the social, political, and economic conditions of the country. Therefore the author analyzed and summarized the important difference of health care system between the South and the North of Korea as follows. 1. Compared with the Laissez-faire health care system of South Korea, North Korea has the state socialistic health care system which provide health care services to the people free of charge. And the North Korea is marking positive efforts toward the scientification and systemization of Oriental Medicine which is called Dongui-Hak in the North-on the basis of Ju-Che idea. 2. North Korea's health care system appears to be strongly geared toward extensive and preventive treatment and launched the massive sanitary propagation campaign. which have resulted in a great success. North Korea has a system of universal comprehensive care for its population. The government has a central role in planning and regulating health care. 3. The government also employs physicians, nurses, and other professionals to provide health care to patients at public expense. In North Korea, health professionals are government employees. They work for a salary and the system is funded through general taxation. 4. In the North Korea, health services area system of the cities and countre's unit is strictly conducted along with the doctor's area responsibility system. And so without referal card, patients can not use the upper-grade medical facilities. The health care delivery system of North Korea is made up of the fourth level procedue unlike South Korea. 5. General office of Oriental Medicine, Academy of Oriental Medical Science and Guidance Bureau of Oriental Medicine are established in the organization of the Department of Health in the North Korea. And nowadays much emphasis are equally placed on the Oriental Medicine as well as Western Medicine. Both South and North Korea have faced with a critical moment of developing a mutually agreeable and acceptable system of health care for the unified nation.

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Reproducibilities of cephalometric measurements of three-dimensional CT images reconstructed in the personal computer (개인용 컴퓨터에서 재구성한 3차원 전산화단층영상의 두부계측 재현성)

  • Jeon Kug-Jin;Park Hyok;Lee Hee-Cheol;Kim Kee-Deog;Park Chang-Seo
    • Imaging Science in Dentistry
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    • v.33 no.3
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    • pp.171-178
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    • 2003
  • Purpose: The purpose of this study was to report the reproducibility of intra-observer and inter-observer consistency of cephalometric measurements using three-dimensional (3D) computed tomography (CT), and the degree of difference of the cephalometric measurements. Materials and Methods: CT images of 16 adult patients with normal class I occlusion were sent to personal computer and reconstructed into 3D images using V-Works 3.5/sup TM/(Cybermed Inc., Seoul, Korea). With the internal program of V-Works 3.5/sup TM/, 12 landmarks on regular cephalograms were transformed into 21 analytic categories and measured by 2 observers and in addition, one of the observers repeated their measurements. Intra-observer difference was calculated using paired t-test, and inter-observer by two sample test. Results: There were significant differences in the intra-observer measurements (p < 0.05) in four of the categories which included ANS-Me, ANS-PNS, Cdl-Go (Lt), GoL-GoR, but with the exception of Cdl-Go (Lt), ZmL-ZmR, Zyo-Zyo, the average differences were within 2 mm of each other. The inter-observer observations also showed significant differences in the measurements of the ZmL-ZmR and Zyo-Zyo categories (p < 0.05). With the exception of the Cdl-Me (Rt), ZmL-ZmR, Zyo-Zyo categories, the average differences between the two observers were within 2 mm, but the ZmL-ZmR and Zyo-Zyo values differed greatly with values of 8.10 and 19.8 mm respectively. Conclusion: In general, 3D CT images showed greater accuracy and reproducibility, with the exception of suture areas such as Zm and Zyo, than regular cephalograms in orthodontic measurements, showing differences of less than 2 mm, therefore 3D CT images can be useful in cephalometric measurements and treatment planning.

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Study about the relationship between the amount of posterior impaction and the change of occlusal plane angle and incisor inclination in Le Fort I osteotomy (Le Fort I 골절단술에서 posterior impaction의 양과 occlusal plane angle, incisor inclination의 변화 관계에 관한 연구)

  • Kim, Bok-Joo;Kim, Min-Gu;Kim, Jung-Han;Kim, Chul-Hoon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.5
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    • pp.375-379
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    • 2010
  • Introduction: In the management of dentofacial deformities, variable movement of the maxilla can be made possible by a Le Fort I osteotomy. Posterior impaction of the maxilla necessary for rotation of the maxillomandibular complex enhances the functions and esthetic results. In cases of posterior impaction of the maxilla, an increase in the figure of the occlusal plane angle and incisor inclination can occur. This study reports the relationship between the amount of posterior impaction and the change in the occlusal plane angle and incisor inclination in a Le Fort I osteotomy by preoperative and postoperative lateral cephalograms. Materials and Methods: Twenty patients who had undergone orthognathic surgery in Dong-A University Medical Center participated in this study. Lateral cephalometrics, within 3 weeks prior to surgery and 3 days after surgery, were used for analysis. Pre and postoperative measurements of the occlusal plane angle and incisal inclination based on the Frankfort horizontal (FH) plane were performed. X and Y were defined as the amount of vertical change in the upper incisor tip and the amount of vertical change in the upper first molar mesial cup tip through the operation. The amount of final posterior maxillary impaction was determined by subtracting Y from X, which is the difference in vertical height. According to the amount of posterior maxillary impaction, the change in the occlusal plane angle and incisal inclination was measured. Results: The average posterior maxillary impaction was 2.91 mm and the average change in the occlusal plane angle and incisal inclination was $6.54^{\circ}$after surgery. As a result, each mm of posterior maxillary impaction changed the occlusal plane angle and incisal inclination by $2.25^{\circ}$. Statistically, there was high significance. Two cases were observed: one with the same amount of posterior maxillary impaction performed on both the right and left showing $2.20^{\circ}$, and the other with a different amount of posterior maxillary impaction performed showing $2.35^{\circ}$. In this case, there was no significance difference between the two cases. Conclusion: Each mm of posterior maxillary impaction changes the occlusal plane angle and incisal inclination by an average of $2.25^{\circ}$. In posterior maxillary impaction, there was no significant difference in the amount of change in the occlusal plane angle and incisal inclination regardless of whether there was an equal amount of posterior maxillary impaction on both sides. This study is expected to help in the presurgical orthodontic preparation and presurgical treatment planning.

The Effect of Parent Education Program Based on Sensory Integration Approach on the Parent's Understanding of Sensory Processing Ability of Children With Developmental Delays (감각통합접근 부모교육이 발달지체 아동의 감각처리능력에 대한 부모의 이해도에 미치는 효과)

  • Park, Hae-Seong;Kim, Kyeong-Mi;Chang, Moonyoung
    • The Journal of Korean Academy of Sensory Integration
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    • v.13 no.1
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    • pp.33-43
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    • 2015
  • Objective : The purpose of this study is to investigate the effect of parent education program with sensory integration approach on the parent's understanding of sensory processing ability of their own children with developmental delays. Methods : The period of this study is from March 15, 2015 to May 10, 2015. The participants of this study were thirty of parents who have children with developmental delays. The participants were randomly divided as experimental group (15 parents) and control group (15 parents) and an educational program was provided to those parents in the experimental group. The education program was developed based on sensory integration approach and 1:1 intensive individual counseling education. Short Sensory Profile (SSP) & a specially designed questionnaire were used to evaluate the parent's understanding of sensory processing ability of their children with developmental delays. The effect of between the groups was analyzed using an independent two samples t-test, and the effect of the intervention within a group was measured using the paired t-test. Results : After the intervention of parent education program, the total score of SSP was significantly decreased and the score of the parent questionnaire was significantly increased (p<.05). Conclusion : The results of this study show that parent education program with sensory integration approach is effective to improve the parent's understanding of sensory processing ability of their children with developmental delays. This study can be used as a good resource for therapists who is planning to provide sensory integration treatment for children with disabilities.

Needs Assessment of Nurses and Educators toward Gerontological Nursing Curriculum Development (노인간호학 교과개발을 위한 요구 사정 연구)

  • Bae Young-Sook;Lee Kap-Soon
    • The Journal of Korean Academic Society of Nursing Education
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    • v.3 no.2
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    • pp.163-192
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    • 1997
  • As the population over the age of 65 increases, the demand for nurses who care for this group also continues to grow. Well-prepared nurses who are knowledgeable and skilled for the elderly can be prepared through systematic gerontological nursing curricula. This study was carried out to identify the needs for gerontological nursing curricular contents. The subjects for this study were two participant groups the educators who teach gerontological nursing in three-year and four-year baccalaureate nursing programs, and the nurses who are working with the elderly in hospitals, community health centers, social welfare agencies, and community health practioner's posts. The major findings of the study are as follows : 1. The differences between actual contents and essential contents of the educators : Concerning the actual contents that is actually taught, the educators showed the highest scores on the demographics of older adults and the lowest scores on the cultural variations affecting health care. Regarding the essential contents, the educators showed the highest scores on the demographics and the lowest scores on the economics of aging. Aside from the demographics, all of the items were found to have significant differences between essential and actual contents. This implies that all the content areas except demographics should be emphasized. 2. The differences between actual knowledge and essential knowledge of the nurses : Concerning the nurses' actual knowledge, the nurses showed the highest scores on the common health problems and their treatment and the lowest scores on the politics of aging. Regarding the essential knowledge, nurses showed the highest scores on the chronic illness and common health problems and the lowest scores on their roles and functions. However, they thought all the items to be essential. All of the items were found to have significant differences between actual and essential knowledge. The nurses who studied gerontological nursing in their school years and after graduating had more knowledge. However, they felt more knowledge was needed. This implies that the nurses need more education in all content areas of gerontological nursing. 3. The differences between educators and nurses : Concerning the essential contents, the educators showed higher scores on the demographics and growth and development than the nurses. Whereas, the nurses showed higher scores on the cultural variations, long-term care, economics of aging, politics of aging, legal and ethical issues, and common health problems than the educators. 4. Activities of nursing care for the elderly : Most common activities were related to direct nursing care such as giving physical care, counseling/teaching clients, and assessing and planning care for the clients. Nurses thought that all the items were critical, but they showed relatively low scores on the following :'serve on multidisciplinary committee', 'preparing reports', 'evaluation of outcomes of care', 'determine policy for nursing service', 'set patient care standards', and 'participate in nursing research' The constraints in providing better nursing service were time constraints, administrative restraints, social restraints, and inadequate knowledge.

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A study on horizontal reference planes in lateral cephalogram in Korean adults (한국 성인의 측모두부 수평기준선에 관한 연구)

  • Kim, Kyung-Ho;Baik, Hyoung-Seon;Kim, Gin-Kap
    • The korean journal of orthodontics
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    • v.28 no.5 s.70
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    • pp.865-875
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    • 1998
  • The purpose of this study was to investigate the angle formed by the Sella-Nasion(SN) plane and Frankfort-Horizontal(FH) plane and evaluate the correlation and difference of the FH plane to other horizontal reference planes. Through this study we hope to present a basis for selecting a horizontal reference plae which can be implemented in cephalometric studies and in surgical orthodontic treatment planning. 600 subjects were chosen following a clinical examination md lateral cephlometric X-rays were taken. According to cephalometric analysis the subjects were classified into 3 groups , Skeletal Class I malocclusion or normal occlusion group(male 50, female 50), Skeletal Class II malocclusion group(male 50, female 65) and Skeletal Class III malocclusion group(male 50, female 50). The results were as follows. 1. The angle formed by the SN plane and FH plane showed no difference among the malocclusion groups, but there was a significant sex difference. For males the angle measured was $7.47^{\circ}{\pm}2.40^{\circ}$ whereas for females it was $8.93^{\circ}{\pm}2.72^{\circ}$. 2. The angle formed by the SN plane or FH plane and Mandibular plane was higher in females for all malocclusion groups. This angle in the Skeletal Class I malocclusion group was lower than in the other two groups. 3. There was no difference among the sexes or malocclusion groups considering the angle formed by the FH plane and Palatal plane. 4. The genial angle in the Skeletal Class III malocclusion group was higher than in the Skeletal Class I and Class II malocclusion groups in both sexes.

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Fabrication of a Patient-Customized Helmet with a Three-Dimensional Printer for Radiation Therapy of Scalp

  • Oh, Se An;Lee, Chang Min;Lee, Min Woo;Lee, Yeong Seok;Lee, Gyu Hwan;Kim, Seong Hoon;Kim, Sung Kyu;Park, Jae Won;Yea, Ji Woon
    • Progress in Medical Physics
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    • v.28 no.3
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    • pp.100-105
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    • 2017
  • The purpose of the present study was to develop and evaluate patient-customized helmets with a three-dimensional (3D) printer for radiation therapy of malignant scalp tumors. Computed tomography was performed in a case an Alderson RANDO phantom without bolus (Non_Bolus), in a case with a dental wax bolus on the scalp (Wax_Bolus), and in a case with a patient-customized helmet fabricated using a 3D printer (3D Printing_Bolus); treatment plans for each of the 3 cases were compared. When wax bolus was used to fabricate a bolus, a drier was used to apply heat to the bolus to make the helmet. $3-matic^{(R)}$ (Materialise) was used for modeling and polyamide 12 (PA-12) was used as a material, 3D Printing bolus was fabricated using a HP JET Fusion 3D 4200. The average Hounsfield Unit (HU) for the Wax_Bolus was -100, and that of the 3D Printing_Bolus was -10. The average radiation doses to the normal brain with the Non_Bolus, Wax_Bolus, and 3D Printing_Bolus methods were 36.3%, 40.2%, and 36.9%, and the minimum radiation dose were 0.9%, 1.6%, 1.4%, respectively. The organs at risk dose were not significantly difference. However, the 95% radiation doses into the planning target volume (PTV) were 61.85%, 94.53%, and 97.82%, and the minimum doses were 0%, 77.1%, and 82.8%, respectively. The technique used to fabricate patient-customized helmets with a 3D printer for radiation therapy of malignant scalp tumors is highly useful, and is expected to accurately deliver doses by reducing the air gap between the patient and bolus.

Growth and Physiological Responses of Indeciduous Quercus L. in Container by Fertilizing Treatment (시비 처리에 따른 상록 참나무속 수목의 용기 내 생장 및 생리적 반응)

  • Kim, Jong Jin;Lee, Seung Hak;Song, Ki Seon;Jeon, Kwon Seok;Choi, Jin Young;Choi, Kyu Seong;Lee, Seok Noh;Sung, Hwan In
    • Korean Journal of Environmental Agriculture
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    • v.33 no.4
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    • pp.372-380
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    • 2014
  • BACKGROUND: This study was carried out in order to closely examine the influence of fertilization upon growth in container of seedling in indeciduous Quercus species (Q. mysinaefolia, Q. acuta and Q. glauca). METHODS AND RESULTS: Fertilizer level was made by adjusting water soluble compound fertilizer (N:P:K=19: 19:19, v/v) to 1000, 2000, $3000mg{\cdot}L^{-1}$ level along with non-fertilizing plot. Fertilization increased height, root collar diameter growth, and dry weight in these three species of trees. The more increase in fertilizer level led to the more rise even in growth of these species. H/D ratio and T/R ratio also showed tendency of getting bigger in the more rise in fertilizer level. Photosynthetic rate was shown to get higher in the higher fertilizer level according to fertilization in all the three species. In the analysis of root morphological traits, the total root length was surveyed to be longer in the more rise in fertilizer concentration. As even a case of root project area, surface area, and root volume is the similar tendency to characteristics in the total root length, a rise depending on fertilization was observed. CONCLUSION: In light of the results in this experiment, the fertilizer level is judged to be $2000mg{\cdot}L^{-1}$ level that is proper for production of 1-year-old container seedling in indeciduous Quercus species with excellent root development and high seedling quality index.