• Journal of Korean Neurosurgical Society
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• v.30 no.5
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• pp.561-566
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• 2001

Objective : The purpose of this study are to evaluate the effectiveness of Gamma Knife radiosurgery(GKS) as a treatment of craniopharyngioma and to investigate the proper dose planning technique in GKS for craniopharyngioma. Method : Between May 1992 and March 1999, seven Gamma Knife radiosurgical procedures were done for residual tumor mass of 6 patients with craniopharyngioma after microsurgical resection. Conventional radiation therapy was not performed. In this study, their clinical, radiological and radiosurgical data were analyzed and the radiation dosage to the optic pathway, hypothalamus, pituitary stalk, and cavernous sinus were calculated and correlation with clinical outcome was evaluated. The mean follow-up period was 33.5 months(12.3-55.2 months). Result : The mean tumor volume was 4.4cc(0.4-18.0cc) and the maximum radiation dose ranged from 14 to 32 Gy(mean 20.9Gy). The radiation was given with isodose curve, 50-90% and the marginal dose varied within 8-22.4Gy(mean 12.7Gy). The mean number of isocenter was 4.3(1-12). The tumor was well controlled in all cases. In 5 of 7 cases, the size of tumor decreased to 10-50% of pre-GKS volume and remaining two showed no volume change. The mean dose to optic pathway was 5.7Gy(5.1-11.2Gy) and there were no complications. Conclusion : GKS seems to be effective for control of craniopharyngioma as an adjuvant treatment after microsurgical resection and even suboptimal dose for tumor margin is considered to be enough for tumor control. It is safe with careful dose planning to protect surrounding important structures, especially optic pathway. We believe conventional radiation therapy should be avoided because it has limitation for dose planning of additional treatments such as radiosurgery or intracystic instillation of radioisotope in case of recurrence.

• Radiation Oncology Journal
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• v.33 no.2
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• pp.117-125
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• 2015

Purpose: To investigate the relationship between early treatment response to definitive chemoradiotherapy (CRT) and survival outcome in patients with limited stage small cell lung cancer (LS-SCLC). Materials and Methods: We retrospectively reviewed 47 patients with LS-SCLC who received definitive CRT between January 2009 and December 2012. Patients were treated with systemic chemotherapy regimen of etoposide/carboplatin (n = 15) or etoposide/cisplatin (n = 32) and concurrent thoracic radiotherapy at a median dose of 54 Gy (range, 46 to 64 Gy). Early treatment volume reduction rate (ETVRR) was defined as the percentage change in gross tumor volume between diagnostic computed tomography (CT) and simulation CT for adaptive RT planning and was used as a parameter for early treatment response. The median dose at adaptive RT planning was 36 Gy (range, 30 to 43 Gy), and adaptive CT was performed in 30 patients (63.8%). Results: With a median follow-up of 27.7 months (range, 5.9 to 75.8 months), the 2-year locoregional progression-free survival (LRPFS) and overall survival (OS) rates were 74.2% and 56.5%, respectively. The mean diagnostic and adaptive gross tumor volumes were 117.9 mL (range, 5.9 to 447 mL) and 36.8 mL (range, 0.3 to 230.6 mL), respectively. The median ETVRR was 71.4% (range, 30 to 97.6%) and the ETVRR >45% group showed significantly better OS (p < 0.0001) and LRPFS (p = 0.009) than the other group. Conclusion: ETVRR as a parameter for early treatment response may be a useful prognostic factor to predict treatment outcome in LS-SCLC patients treated with CRT.

• Journal of Korean Society of Rural Planning
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• v.12 no.2 s.31
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• pp.57-64
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• 2006

The experiment was carried out to determine the distribution of total coliform the translocation of heavy metals and the salt accumulation in soils following the supply of ground water, the domestic wastewater and the ultraviolet treatment of domestic wastewater during the spinach and the chinese cabbage cultivation. There were not much changes in the Total-N, Total-P and cations in soils following the ultraviolet treatment of the domestic wastewater. However, the density of total coliform was dramatically reduced from 894MPN/100mL to 5MPN/100mL. The diagnosis of composition of soil after the harvest of chinese cabbages and spinach has shown that the concentration of Na$^+$ was 3-4 times higher in plot using domestic wastewater than in plot using ground water. When domestic wastewater and ground water were used in growing spinach md chinese cabbage at 50% each, the application of chemical fertilizers reduced about 25% to 50% compared to the criteria set down by the Rural Development Administration and there was not significant difference in terms of harvest. Using non-ultraviolet treatment of domestic wastewater directly on spinach and chinese cabbage has resulted in excessive density of total coliform at 25,000MPN/100mL. Even when ultraviolet treatment, the density was still high at 2,000MPN/100mL. The high density of total coliform even following ultraviolet treatment of domestic wastewater is considered to be caused by photo-reactivation of micro-organism. When reusing domestic wastewater, the application of sterilization such as ultraviolet, ultrasonic and electron-beam for public health and hygiene reasons may provide safe supply of agricultural water.

• Radiation Oncology Journal
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• v.37 no.1
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• pp.60-65
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• 2019

Purpose: The quality assurance (QA) chart rounds are multidisciplinary meetings to review radiation therapy (RT) treatment plans. This study focus on describing the changes in RT management based on QA round reviews in a single institution. Materials and Methods: After 9 full years of implementation, a retrospective review of all patients whose charts passed through departmental QA chart rounds from 2007 to 2015. The reviewed cases were presented for RT plan review; subcategorized based on decision in QA rounds into: approved, minor modifications or major modifications. Major modification defined as any substantial change which required patient re-simulation or re-planning prior to commencement of RT. Minor modification included treatment plan changes which didn't necessarily require RT re-planning. Results: Overall 7,149 RT treatment plans for different anatomical sites were reviewed at QA rounds. From these treatment plans, 6,654 (93%) were approved, 144 (2%) required minor modifications, while 351 (5%) required major modifications. Major modification included changes in: selected RT dose (96/351, 27%), target volume definition (127/351, 36%), organs-at-risk contouring (10/351, 3%), dose volume objectives/constraints criteria (90/351, 26%), and intent of treatment (28/351, 8%). The RT plans which required major modification according to the tumor subtype were as follows: head and neck (104/904, 12%), thoracic (12/199, 6%), gastrointestinal (33/687,5%), skin (5/106, 5%), genitourinary (16/359, 4%), breast (104/2387, 4%), central nervous system (36/846, 4%), sarcoma (11/277, 4%), pediatric (7/251, 3%), lymphoma (10/423, 2%), gynecological tumors (2/359, 1%), and others (11/351, 3%). Conclusion: Multi-disciplinary standardized QA chart rounds provide a comprehensive and an influential method on RT plans and/or treatment decisions.

• Progress in Medical Physics
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• v.20 no.3
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• pp.180-190
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• 2009

Depth of prostate volume from the skin can vary due to intra-fractional and inter-fractional movements, which may result in dose reduction to the target volume. Therefore we evaluated the feasibility of automated depth determination-based adaptive proton therapy to minimize the effect of inter-fractional movements of the prostate. Based on the center of mass method, using three fiducial gold markers in the prostate target volume, we determined the differences between the planning and treatment stages in prostate target location. Thirty-eight images from 10 patients were used to assess the automated depth determination method, which was also compared with manually determined depth values. The mean differences in prostate target location for the left to right (LR) and superior to inferior (SI) directions were 0.9 mm and 2.3 mm, respectively, while the maximum discrepancies in location in individual patients were 3.3 mm and 7.2 mm, respectively. In the bilateral beam configuration, the difference in the LR direction represents the target depth changes from 0.7 mm to 3.3 mm in this study. We found that 42.1%, 26.3% and 2.6% of thirty-eight inspections showed greater than 1 mm, 2 mm and 3 mm depth differences, respectively, between the planning and treatment stages. Adaptive planning based on automated depth determination may be a solution for inter-fractional movements of the prostate in proton therapy since small depth changes of the target can significantly reduce target dose during proton treatment of prostate cancer patients.

• Progress in Medical Physics
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• v.13 no.4
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• pp.181-186
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• 2002

The IMRT planning depends on the algorithm of each planning system and MLC performance of each Linac system. Yonsei Cancer Center introduced an IMRT System at the beginning of February, 2002. The system consists of CORVUS (Nomos, U.S.A.) treatment planning system, LANTIS, PRIMEVIEW and PRIMART (Siemens, U.S.A) linac system. The optimization of CORVUS planning system with PRIMART is an important task to make a desirable quality treatment plan. Our Step ＆ Shoot IMRT system uses Finite Size Pencil Beams (FSPB) dose model, simulated annealing optimization algorithm and IMFAST segmentation algorithm. We constructed treatment plans for four different patient cases with two basic beamlet sizes, 1.0$\times$1.0 $\textrm{cm}^2$ and 0.5$\times$1.0 $\textrm{cm}^2$, and four intensity steps, 5%, 10%, 20%, 33%. Each case's plan was evaluated with the dose volume histograms of target volumes and delivery efficiencies. The patient case of small target volume is sensitive at the change of intensity map's segmentation and it highlighted an effective treatment plan at marrow intensity step and small basic projection beamlet.

• Journal of Radiation Protection and Research
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• v.36 no.3
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• pp.160-167
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• 2011

This study conducts cross-comparison through verification of treatment planning of using beam spoiler and bolus, according to the dose variation of different tumor bed and metastatic lymph node cancers, against ionization and optically stimulated luminescence detectors(OSLDs), in head and neck radiotherapy. Verification of treatment planning examined the feasibility of inserting detectors through simulated solid dry water slabs under identical irradiated conditions from treatment planning system to measure beam spoiler and 0.5, 1 cm bolus. In addition, two detectors were cross-compared for verification of treatment planning accuracy and reliability within ${\pm}$2%. The study found that, given a beam spoiler thickness of 0.5 cm and beam spoiler-to-skin distance of 10 cm subjected to optimal dose distribution given for metastatic lymph node cancers, the bolus low-level skin dose was less, and the tumor bed dose reduced slightly. Additionally, two detectors were cross-compared for accuracy within ${\pm}$1%. Accordingly, The use of beam spoiler was determined that reduces skin side effects and can deliver an optimal dose distribution for tumor, and to apply to future clinical studies should be performed.

• Journal of The Korea Institute of Healthcare Architecture
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• v.14 no.2
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• pp.25-34
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• 2008

The purpose of this study was to spatial organization feature and area composition of the over 500beds general hospital that will be expected construct in Seoul, Gyeonggi-do area after 2000year. From this study, we can suggest architectural planning for the efficiency operating of emergency medical facilities that can be used as preliminary data. The Spatial organization of emergency medical facilities are categorize into 4 session as medical examination and treatment, diagonosticradiology, staff, public and the others. We can find spatial organization system and area composition that compare area composition of 6 hospital the subject of research in a emergency medical facilities. The result of this study were as follows : spatial distribution of its field, grasping of spatial organization factor and recognize its merits and demerits should be researched in advance. Through this kind of recognizing emergency system, realistic medical local and condition architectural planning for spatial organization will be operate.

• 제어로봇시스템학회:학술대회논문집
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• 2005.06a
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• pp.2448-2450
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• 2005

A robotic external fixation system for the surgery of bone deformity correction was developed to simulate the execution process of mal-unioned femur by the adjustment of the joints of the fixation system. An inverse kinematics analysis algorithm was developed to calculate the necessary rotations and translations at each joint of the robotic system. The computer graphic model was developed for validation of the analysis result and visualization of the surgical process. For given rotational and angular deformity case, the surgical execution process using the robotic system was well matched with the pre-operative planning. The final residual rotational deformities were within $1.0^{\circ}{\sim}1.6^{\circ}$ after surgical correction process. The presented robotic system with computer-aided planning can be useful for knowledge-based fracture treatment and bone deformity correction under external fixation.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2002.09a
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• pp.121-122
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• 2002

The main principle of radiation therapy is to deliver optimum dose to tumor to increase tumor cure probability while minimizing dose to critical normal structure to reduce complications. RTP system is required for proper dose plan in radiation therapy treatment. The main goal of this research is to develop dose model for photon, electron, and brachytherapy, and to display dose distribution on patient images with optimum process. The main items developed in this research includes: (l) user requirements and quality control; analysis of user requirement in RTP, networking between RTP and relevant equipment, quality control using phantom for clinical application (2) dose model in RTP; photon, electron, brachytherapy, modifying dose model (3) image processing and 3D visualization; 2D image processing, auto contouring, image reconstruction, 3D visualization (4) object modeling and graphic user interface; development of total software structure, step-by-step planning procedure, window design and user-interface. Our final product show strong capability for routine and advance RTP planning.