• The Journal of Korean Society for Radiation Therapy
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• v.29 no.1
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• pp.85-92
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• 2017

purpose: Image Guide System offers therapy precise, especially Intensity Modulated Radiation Therapy. However, organs at pelvis have variation and uncertainties each therapy. it brings IG system for verifying patient's position. In this study, analysis the variation at pelvis during rectal cancer radiation therapy. Moreover design the patient re-setup technique and apply to patients. Material and Method: 40 rectal cancer patient who have radiation therapy. The 530 image which acquired from IG system are analyzed. The bone structure, bladder, gas in the rectum, small bowel, soft tissue, weigh loss are evaluated by the criterion. The criterion are classified by best, good, bad and figure out the ratio with count. The re-setup proceed in case of one or over the two get the bad criterion and figure out the ratio of re-setup results: The ideal of therapy ratio is 19.2 % each criterion. And the good for therapy ratio is 54.9 %, the cases of bad for therapy is 25.8 %. The bad cases are have therapy after re-setup with post process. conclusion: Each pre-treatment image that acquired IG system has different results despite of same patients. The 25.8 % need to re-setup in order to unsuitable therapy. It is implies that the IG system is necessary establishing precise treatment plan like IMRT especially rectal cancer.

• Proceedings of the Korean Society for Food Science of Animal Resources Conference
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• 2006.05a
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• pp.146-150
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• 2006

도축 후 2일째 가열 감량은 시험구(골반골 현수)가 대조구(아킬레스건 현수)에 비하여 유의적으로 감량이 높았으나, 드립량에 있어서는 반대의 결과를 보였으며, 전체 감량은 두 처리구간 차이가 없었다. 연도의 지표인 전단력가는 대조구 $6.45kg/cm^2$로 시험구 $5.52kg/cm^2$에 비하여 유의적으로 높았으며, 골반골 현수를 통하여 도축 후 8일차의 대조구의 전단력 수준을 보여 숙성기간을 약 1주일 정도 단축이 가능하였다. 근절길이는 대조구 $1.93{\mu}m$, 시험구 $2.48{\mu}m$로 시험구가 유의적으로 길어 골반골 현수에 의한 단축 억제 효과로 볼 수 있다. 관능 평가 결과 도축후 2일차에는 대조구에 비하여 시험구가 다즙성, 연도, 향미, 기호성에서 유의적으로 높은 값을 보였으나, 도축 후 8일째에는 대조구와 시험구간에 차이를 보이지 않았다. 출하 연령과 현수방법에 따른 대퇴이두근의 물리적 특성을 비교한 결과로서 근절길이는 모든 월령에서 시험구가 대조구에 비하여 길었다. 전단력은 시험구가 대조구에 비하여 유의적으로 낮은 결과를 보였다. 골반골 현수에 의한 전단력가 감소 효과는 출하 월령이 많을수록 효과가 큰 것으로 나타났다. 드립 발생율은 대조구가 시험구에 비하여 유의적으로 높은 경향을 보였다. 가열 감량과 보수성은 처리구에 관계없이 유의적인 차이를 보이지 않았다. 관능 특성을 비교한 결과 30개월 미만의 경우에는 유의적인 차이를 보이지 않았으나, 30개월 이상에서는 처리구가 대조구에 비하여 다즙성 연도, 향미, 기호성 모두 우수한 것으로 나타났다. 특히 골반골 현수는 출하 월령이 증가됨에 따라 관능 특성의 개선율이 높은 것으로 나타났다. 수 있다.분별을 성공적으로 수행하였다.(p<0.05), 맛, 연도, 다즙성 및 전체적인 기호성은 유의한 차이가 없었다.자체를 악하다고 볼 수 없고 더구나 구원을 이 세상에서의 이탈로 볼 수 없다. 진정한 구원이란 원래 하나님이 보시기에 아름다웠던 그 세상으로의 회복을 포함한다. 이런 면에서 하나님 주권 신앙 하에서 구원이란 전 인격적인 구원, 전 우주적인 구원이 된다. 그렇기 때문에 성도는 세상의 삶과 학문, 예술, 정치, 경제, 사회를 포함한 모든 분야를 하나님의 뜻 가운데서 그 원래의 목적에 부합할 수 있도록 회복시키는 일에 적극 참여해야 한다.자체가 이를 주도하기는 사실 어려움이 있다. 그리고 대형유통점이 영업행위를 영업시간제한에서부터 출점제한에 이르기까지 규제하는 건은 심사숙고하여야 한다. 대형유통점이 국가경제 및 지역사회에 미치는 영향이 부정적인가 긍정적인가에 대해 국내외 학계와 업계에서 여전히 많은 논란이 있기 때문이다. 정부와 지자체에 의한 시장개입은 반드시 필요한 경우에 한해 합당한 방법에 의해 이루어져야 한다. 대형유통점에 대한 규제는 지역사회에 미치는 영향을 다면적으로 평가한 결과에 근거하여 이루어져야 할 것이다. 대부분의 지자체는 체계적인 평가시스템과 객관적인 통계 자료를 갖고 있지 못한 실정이다. 향후 가장 시급한 과제는 시장개방 이후 지난 10년간 대형유통점이 지역사회에 미친 영향에 관한 광범위한 통계자료를 수집하고 이를 체계적으로 분석하여 정책방향을 올바르게 설정하는 것이라 할 수 있다.i와 K. pneumoniae가 존재하며 확산 중임을 시사한다. 앞으로 CTX-M형 ESBL의 만연과 변종 CTX-M형 ESBL의 출연을 감시하기 위한 정기적인 연구와 조사가 필요한 것으로 생각한다., A2-1, B1-1, B2-1의 경우,

• Journal of the Korean Orthopaedic Association
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• v.54 no.1
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• pp.1-8
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• 2019

Globally, the elderly population is increasing rapidly, which means that the number of deformity correction operations for elderly spine deformity patient has increased. On the other hand, for aged patients with deformity correction operation, preoperative considerations to reduce the complications and predict a good clinical outcome are not completely understood. First, medical comorbidity needs to be evaluated preoperatively with the Cumulative Illness Rating Scale for Geriatrics or the Charlson Comorbidity Index scores. Medical comorbidities are associated with the postoperative complication rate. Managing these comorbidities preoperatively decreases the complications after a spine deformity correction operation. Second, bone densitometry need to be checked for osteoporosis. Many surgical techniques have been introduced to prevent the complications associated with posterior instrumentation for osteoporosis patients. The preoperative use of an osteogenesis inducing agent - teriparatide was also reported to reduce the complication rate. Third, total body sagittal alignment need to be considered. Many elderly spine deformity patients accompanied degenerative changes and deformities at their lower extremities. In addition, a compensation mechanism induces the deformed posture of the lower extremities. Recently, some authors introduced a parameter including total body sagittal alignment, which can predict the clinical outcome better than previous parameters limited to the spine or pelvis. As a result, total body sagittal alignment needs to be considered for elderly spine deformity patients after a deformity correction operation. In conclusion, for elderly spine deformity patients, medical comorbidities and osteoporosis need to be evaluated and managed preoperatively to reduce the complication rate. In addition, total body sagittal alignment needs to be considered, which is associated with better clinical outcomes than the previous parameters limited to the spine or pelvis.

• Proceedings of the Korea Water Resources Association Conference
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• 2007.05a
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• pp.698-701
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• 2007

지하수 개발가능량 산정을 위한 함양량의 평가는 수문계의 물리적인 형태나 함수층의 수리성 분석 및 수직인 지질분포를 파악하여 어떤 조건하에서 물이 유입 유출되는가를 파악한 후에만 가능하다. 또한 지하수계의 물리적인 형태를 이해함으로써 조사지역의 지표수계나 지하수계의 양계를 통해서 흐르는 물의 양을 결정짓는 물수지 분석이 수행되어야 한다. 이에 따라 강수량, 증발산량, 지하수 유출량, 지표유출량 그리고 하천유출량 등을 수문학적으로 고려해야만 한다. 본 연구는 지표수-지하수 결합모형을 도입하여 분포형 지하수 함양량의 시공간적인 변동성을 파악하는 데 그 목적이 있다. 이를 위해 지표수-지하수 결합모형인 SWAT-K모형을 미호천 유역에 적용하였으며, 지표수의 총유출량과 지하수위의 공간분포자료를 이용하여 검정과 검증을 수행하였다. 전체유역에 대한 연평균 함양량은 수문총량의 약 19%인 것으로 나타났다. 1999년${\sim}$2004년까지의 소유역별 연간 함양량 결과를 월별로 나타냈으며, HRU(Hydrologic Response Unit)별 함양량의 공간분포를 통해 월별, 계절별 특성을 살펴볼 수 있었다. 소유역 모두 강수가 집중하는 7-9월에 걸쳐 많은 함양이 이루어지며 $1{\sim}3$월에는 상대적으로 함양이 적은 것을 볼 수 있다. 월함양량의 경우 최대 약200mm범위내에서 유역의 토지이용 및 토양특성, 경사등에 따라 매우 비균질하게 분포하는 것을 확인할 수 있었다. 이와같은 함양량의 시공간적 불균일성으로 인해 지하수 관리방안은 소유역별 함양특성을 반영해야 할 것으로 판단된다.의 종분산지수가 일반적인 자연대수층에 비해 9.1배 정도 높다는 것을 의미한다. 이는 시험대수층의 투수성이 매우 높아 염소이온의 용질이송이 매우 빠르게 발생되었기 때문이다. 본 연구에서 추정된 종분산지수를 Gelhar et al.(1992)의 연구 결과와 비교 분석한 결과에서도 시험규모에 비해 매우 높은 수리분산이 발생된 것으로 나타났다. 그리고 염소이온의 확산면적을 추정하기 위해, 수렴흐름 추적자시험에 의한 종분산지수와 시험대수층의 평균선형유속을 이용하여 종분산계수를 구하였다. 현장에서 수행된 양수시험에 의한 평균선형유속 22.44 m/day와 평균 종분산지수 0.4155 m를 적용하여 산정된 종분산계수는 $9.32\;m^2/day$이었다. 따라서, 시험부지 내 충적층에서 일정한 양수율$(2,500\;m^3/day)$로 지하수를 개발할 시에 양수정 주변지역으로 유입되는 염소이온의 확산면적은 1일 $9.32\;m^2$ 정도일 것으로 나타났다.적인 $OH{\cdot}$ 의 생성은 ascorbate가 조직손상에 관여할 가능성을 시사하였다.었다. 정확한 예측치를 얻기 위하여 불균질 조직이 조사야에 포함되는 경우 보정이 요구되며, 골반의 경우 골 조직의 보정이 중요한 요인임을 알 수 있었다. 이를 위하여 불균질 조직에 대한 정확한 정보가 요구되며, 이는 CT 영상을 이용하는 것이 크게 도움이 되리라 생각된다.전시 슬러지층과 상등액의 온도차를 측정하여 대사열량의 발생량을 측정하고 슬러지의 활성을 측정할 수 있는 방법을 개발하였다.enin과 Rhaponticin

• Radiation Oncology Journal
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• v.19 no.4
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• pp.335-344
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• 2001

Purpose : The aim of this study was to clarify the role of VEGF expression as an independent prognostic factor and to identify the patients at high risk for poor prognosis in stage IB cervical cancer. Materials and methods : A total of 118 patients with stage IB cervical cancer who had radical hysterectomy and pelvic lymph node dissection were included in the study. All known high risk factors of the patients were pathologically confirmed from the surgical specimen. Of the 118 patients, n patients were treated with postoperative radiotherapy and/or chemotherapy. VEGF expression was examined using immunohistochemistry in formalin-fixed, paraffin-embedded specimens of post-hysterectomy surgical materials. A semiquantitative analysis was made using a scoring system of 0, +, ++, and +++ for increasing intensity of stain. We classified the patients with scores from 0 to ++ as low VEGF expression and the patients with a score of +++ as high VEGF expression. Results : Of the 118 patients, 35 patients $(29.7\%)$ showed high VEGF expression. Strong correlations were found between the high VEGF expression and both deep stromal invasion (p=0.01) and the positive pelvic node (p=0.03). The 5-year overall and disease-free survival rates for all 118 patients were $95.5\%\;and\;93.8\%$. The 5-year overall (p=0.03) and disease-free survival (p<0.001) rates were $98.5\%\;and\;100%$ for low VEGF expression (0, +, and ++) and $85.5\%\;and\;79.7\%$ for high VEGF expression, respectively. Pelvic and distant failures for low versus high VEGF expression were $1.2\%$ versus $17.1\%$, (p=0.001) and $0\%$ versus $14.3\%$ (p<0.001), respectively. In a Cox multivariate analysis of survival, the high VEGF expression (p=0.02) and the bulky mass (p=0.02) were significant prognostic factors for overall survival. The high VEGF expression (p=0.002), and bulky mass (p=0.01) demonstrated as significant prognostic indicators for disease free survival. Conclusion : These results showed that VEGF expression was a highly significant predictor for pelvic and distant failure and the most significant prognostic factor of overall and disease free survival for the patients with stage IB cervix cancer treated with radical surgery. We strongly suggest that the immune-histochemistry for VEGF expression be performed in a routine clinical setting in order to identify the patients at high risk for poor prognosis in early stage cervical cancer. Furthermore, postoperative and/or chemotherapy did not reduce the pelvic failure and distant metastasis. To improve the cure rate for the patients with high VEGF expression in stage IB cervical cancer, antiangiogenic therapy including anti-VEGF Ab may be new treatment option.

• The Journal of Korean Society for Radiation Therapy
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• v.27 no.2
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• pp.145-156
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• 2015

Purpose : The purpose of this study is to evaluate the efficiency of Split VMAT planning(Contouring rectum divided into an upper and a lower for reduce rectum dose) compare to Conventional VMAT planning(Contouring whole rectum) for prostate cancer radiotherapy involving pelvic lymph nodes. Materials and Methods : A total of 9 cases were enrolled. Each case received radiotherapy with Split VMAT planning to the prostate involving pelvic lymph nodes. Treatment was delivered using TrueBeam STX(Varian Medical Systems, USA) and planned on Eclipse(Ver. 10.0.42, Varian, USA), PRO3(Progressive Resolution Optimizer 10.0.28), AAA(Anisotropic Analytic Algorithm Ver. 10.0.28). Lower rectum contour was defined as starting 1cm superior and ending 1cm inferior to the prostate PTV, upper rectum is a part, except lower rectum from the whole rectum. Split VMAT plan parameters consisted of 10MV coplanar $360^{\circ}$ arcs. Each arc had $30^{\circ}$ and $30^{\circ}$ collimator angle, respectively. An SIB(Simultaneous Integrated Boost) treatment prescription was employed delivering 50.4Gy to pelvic lymph nodes and 63~70Gy to the prostate in 28 fractions. $D_{mean}$ of whole rectum on Split VMAT plan was applied for DVC(Dose Volume Constraint) of the whole rectum for Conventional VMAT plan. In addition, all parameters were set to be the same of existing treatment plans. To minimize the dose difference that shows up randomly on optimizing, all plans were optimized and calculated twice respectively using a 0.2cm grid. All plans were normalized to the prostate $PTV_{100%}$ = 90% or 95%. A comparison of $D_{mean}$ of whole rectum, upperr ectum, lower rectum, and bladder, $V_{50%}$ of upper rectum, total MU and H.I.(Homogeneity Index) and C.I.(Conformity Index) of the PTV was used for technique evaluation. All Split VMAT plans were verified by gamma test with portal dosimetry using EPID. Results : Using DVH analysis, a difference between the Conventional and the Split VMAT plans was demonstrated. The Split VMAT plan demonstrated better in the $D_{mean}$ of whole rectum, Up to 134.4 cGy, at least 43.5 cGy, the average difference was 75.6 cGy and in the $D_{mean}$ of upper rectum, Up to 1113.5 cGy, at least 87.2 cGy, the average difference was 550.5 cGy and in the $D_{mean}$ of lower rectum, Up to 100.5 cGy, at least -34.6 cGy, the average difference was 34.3 cGy and in the $D_{mean}$ of bladder, Up to 271 cGy, at least -55.5 cGy, the average difference was 117.8 cGy and in $V_{50%}$ of upper rectum, Up to 63.4%, at least 3.2%, the average difference was 23.2%. There was no significant difference on H.I., and C.I. of the PTV among two plans. The Split VMAT plan is average 77 MU more than another. All IMRT verification gamma test results for the Split VMAT plan passed over 90.0% at 2 mm / 2%. Conclusion : As a result, the Split VMAT plan appeared to be more favorable in most cases than the Conventional VMAT plan for prostate cancer radiotherapy involving pelvic lymph nodes. By using the split VMAT planning technique it was possible to reduce the upper rectum dose, thus reducing whole rectal dose when compared to conventional VMAT planning. Also using the split VMAT planning technique increase the treatment efficiency.

• Journal of radiological science and technology
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• v.30 no.4
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• pp.329-334
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• 2007

This paper is for investigation of the noise reduction effect all 20 filters by combining Low Pass Filter(LPF) 5 kinds, High Pass Filter(HPF) 4 kinds, Median Filter(MF) 11 kinds. Noise is added to reduce noise and minimize the quality degradation in medical imaging system. We also compared Peak Signal to Noise Ratio(PSNR), Mean Square Error(MSE) for all the combinations of different filters. As a result, noise decrease appeared in the LPF3*3#1 + HPF3*3#1 + Vertical3*1 of highest filter. We confirmed noise reduction effect by applying the proposed filter combination in many fields of medical imaging applications.

• Journal of Korean Medicine Rehabilitation
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• v.20 no.4
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• pp.171-183
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• 2010

Objectives : The biomechanical relationship of leg length discrepancy(LLD), Lumbar lordosis, pelvic variance and degenerative scoliosis is one of the most important parameters when treat musculoskeletal disorders, however the reports are still controversial. The purpose of this study was to compare the relationships between the parameters and bothersomeness in subject with chronic ow back pain. Methods : Sixty female and eight male adults with non specific low back pain over 3 months were recruited. LLD was measured by tape measure method. Lumbar lordosis, lumbosacral angle and related pelvic parameters were measured using simple radiologic films of lumbosacral view. Results : Lumbar lordosis was significantly correlated to the lumbosacral angle, pelvic incidence and difference of the both iliac widths. Pelvic incidence had significant correlation with difference of the both iliac widths. And difference of both iliac widths was related with LLD by radiologic film. There was also significant correlation between the LLD by radiologic film and tape measurement. Visual analogue scale(chronic low back pain) of normal lordosis group was greater than hyperlordosis group. Conclusions : There were close biomechanical relationships between lumbar, pelvis, and lower extremity. But in order to determine the effect of structure on the chronic low back pain, global balance of musculoskeletal structure seems to be worth further researching.

• Journal of radiological science and technology
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• v.38 no.4
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• pp.383-387
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• 2015

This study investigated the size specific dose estimates of difference localizer on pediatric CT image. Seventy one cases of pediatric abdomen-pelvic CT (M:F=36:35) were included in this study. Anterior-posterior and lateral diameters were measured in axial CT images. Conversion factors from American Association of Physicists in Medicine (AAPM) report 204 were obtained for effective diameter to determine size specific dose estimate (SSDE) from the CT dose index volume (CTDIvol) recorded from the dose reports. For the localizer of mid-slice SSDE was 107.63% higher than CTDIvol and that of xiphoid-process slices SSDE was higher than 92.91%. The maximum error of iliac crest slices, xiphoid process slices and femur head slices between mid-slices were 7.48%, 17.81% and 14.04%. In conclusion, despite the SSDE of difference localizer has large number of errors, SSDE should be regarded as the primary evaluation tool of the patient radiation in pediatric CT for evaluation.

• Journal of radiological science and technology
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• v.36 no.1
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• pp.39-47
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• 2013

For radiotherapy in rectal cancer patients treated with small bowel displacement device (SBDD) and belly board, We will suggest new indication of using SBDD depending on obesity index by analyzing correlation between obesity and irradiated small bowel volume. In this study, We reviewed 29 rectal cancer patients who received pelvic radiation therapy with belly board and SBDD from January to April in 2012. We only analyzed those patients treated with three-field technique (PA and both LAT) on 45 Gy (1.8 Gy/fx). We measured patients' height, weight, body mass index (BMI), waist-hip ratio (WHR) and divided BMI into two groups.(${\geq}23$:BMI=group1, <23:BMI=group2) We performed a statistical analysis to evaluate correlation between total volume of bladder($TV_{bladder}$), obesity index and high dose volume of small bowel (small bowel volume irradiated at 90% of prescribed dose, $HDV_{sb}$), low dose volume of small bowel (small bowel volume irradiated at 33% of prescribed dose, $LDV_{sb}$). The result shows, gender, WHR and status of pre operative or post operative do not greatly affect $HDV_{sb}$ and $LDV_{sb}$. Statistical result shows, there are significant correlation between $HDV_{sb}$ and BMI (p<0.04), $HDV_{sb}$ and $TV_{bladder}$ (p<0.01), $LDV_{sb}$ and $TV_{bladder}$ (p<0.01). BMI seems to correlate with $HDV_{sb}$ but does not with $LDV_{sb}$ (p>0.05). There are negative correlation between $HDV_{sb}$ and BMI, $TV_{bladder}$ and $HDV_{sb}$, $TV_{bladder}$ and $LDV_{sb}$. Especially, BMI group1 has more effective and negative correlation with $HDV_{sb}$ (p=0.027) than in BMI group2. In the case of BMI group 1, $TV_{bladder}$ has significant negative correlation with $HDV_{sb}$ and $LDV_{sb}$ (p<0.04). In conclusions, we confirmed that Using SBDD with belly board in BMI group1 could more effectively reduce irradiated small bowel volume in radiation therapy for rectal cancer. Therefore, We suggest using belly board with SBDD in order to reduce the small bowel toxicity in rectal radiotherapy, if patients' BMI is above 23.