• Title/Summary/Keyword: 방법론 평가

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Usefulness of Customized Cervical Spine Immobilizer in Head & Neck Image-Guided Radiation Therapy with Tomotherapy® (토모테라피를 이용한 두경부암 영상유도 방사선 치료 시 개인별 경추고정용구의 유용성 평가)

  • Jin, Sung Eun;Chang, Se Wuk;Choi, Jung Hoan;Kim, Min Joo;Ahn, Seung Kwon;Lee, Sang Kyu;Cho, Jung Heui
    • The Journal of Korean Society for Radiation Therapy
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    • v.30 no.1_2
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    • pp.65-71
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    • 2018
  • Purpose : Standardized pillow may not support patient's individual cervical spine thoroughly when head and neck radiation therapy with $Tomotherapy^{(R)}$. Therefore, the purpose of this study was to make a comparative analysis for the difference of using standardized pillow only and using customized cervical spine immobilizer with standardized pillow. Materials and Methos : The head and neck cancer patients who are treated image-guided radiation therapy(IGRT) with $Tomotherapy^{(R)}$ were divided into two groups, 20 patients using standardized pillow only, and 20 patients using customized cervical spine immobilizer with standardized pillow. We achieved 20 mega-voltage computed tomography(MVCT) image per patient, compared curvature of the cervical spine in MVCT with curvature of the cervical spine in CT-simulation. Results : Results of comparative analysis were curvature consistency 95.9 %, maximum error of distance 41.9 mm, average distance error per fractionation 19.4 mm, average standard deviation 1.34 mm in case of using standardized pillow only, curvature consistency 98.9 %, maximum error of distance 12.9 mm, average distance error per fractionation 5.8 mm, average standard deviation 0.59 mm in case of using customized cervical spine immobilizer with standardized pillow. Conclusion : Using customized cervical spine immobilizer shows higher reproducibility and low distance error, therefore customized cervical spine immobilizer could be useful for head and neck cancer patients who need radiation therapy.

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Improvement of patient's quality of life by improving patient's set-up line in radiotherapy (방사선 치료 시 환자 Set-up Line 개선을 통한 암환자 삶의 질 만족도 향상)

  • Choi, Jin Hyuk;Ahn, Woo Sang;Lee, Woo Seok;Kim, Dae Yong
    • The Journal of Korean Society for Radiation Therapy
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    • v.30 no.1_2
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    • pp.185-189
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    • 2018
  • Purpose : We evaluated the quality of life satisfaction of patients with radiation therapy while maintaining the set-up line. Materials and Methods : We retrospectively reviewed 60 patients who visited our clinic in January, 2018. The most common complaint was the inconvenience of not being able to wash during treatment (64 %), and a surgical tape was placed on the Set-up Line to help patients wash during the treatment period. A total of 50 patients who underwent surgical tape were evaluated on a 5-point scale (1 point was very unsatisfactory, 2 points were unsatisfactory, 3 points were average, 4 points were satisfied, 5 points were very satisfied). Forty patients out of 50 responded to the first treatment, and 10 patients underwent treatment. Results : In the first survey, 68 % of the patients and 32 % of the males were aged 34 %, 50~60 % and 38 %, respectively. Treatment areas were breast (57 %), chest (13 %), pelvis (10 %). The results of the second questionnaire after applying the surgical tape showed that 25 of the 40 patients and 15 of the male patients were treated. The treatment area was 22 breast and 18 pelvic areas. In the satisfaction of the 5-point scale, 5 to 15 points were satisfied with 1-3 points, and 4-5 points with 35 points (1 point 2 points, 2 points 2 points, 3 point 1 points, 4 point points 17 point points, % And 43 %, respectively. The results of the questionnaire survey of patients who were applied during the treatment showed that 9 out of 10 women and 1 male were treated. The treatment area was 8 breast and 2 pelvic areas. One point was satisfied with one point, and five points with nine points were satisfied with 90 %. Conclusions : The importance of improving the quality of life of patients with cancer is also important. After applying the surgical tape, 88 % of the patients who started the treatment and 90 % of the patients who applied during the treatment were satisfied. Particularly, patients who applied during treatment showed higher satisfaction. If this is not possible for all patients, selective application to patients with discomfort will be helpful in improving the quality of life of cancer patients.

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Gender Differences of Direct and Relational Aggression in Children and Adolescents (국내 초등학생 및 중학생의 성별에 따른 직접적 공격성과 관계적 공격성의 차이)

  • Jeong, Da-un;Kim, Ji-Woong;Hong, Hyun-ju;Kim, Seung-Jun;Lee, Na-Hyun;Yang, Ji-sun;Ahn, Song-ii;Im, Woo-Young;Jhung, Kyungun
    • Korean Journal of Psychosomatic Medicine
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    • v.23 no.2
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    • pp.86-92
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    • 2015
  • Objectives : The aim of this study was to investigate the gender differences of direct aggression and relational aggression in Korean elementary and middle school students. Methods : Parents of 946 elementary school students(age $9.54{\pm}1.72$ years, 485 boys, 461 girls) completed the Child Behavior Checklist(CBCL). Six-hundred-and-three middle school students(age $13.98{\pm}0.93$ years, 301 boys, 302 girls) completed the Youth Self-Report(YSR). Independent t-test, chi-square test, and Fisher's exact test were used. Results : Boys had significantly higher direct aggression scores than girls in elementary school students(p<0.001). There was no significance gender difference of relational aggression in elementary school students(p=0.235). In middle school students, boys had significantly higher direct aggression than girls(p=0.017), and girls had significantly higher relational aggression compared to the boys(p<0.001). Conclusions : Our results suggest the presence of gender differences in manifestation of aggression subtypes in Korean elementary and middle school students. These gender differences should be taken into account in prevention and intervention approaches of aggression in children and adolescents.

Electroencephalographic Changes Induced by a Neurofeedback Training : A Preliminary Study in Primary Insomniac Patients (뉴로피드백 훈련에 의한 뇌파 변화 연구 : 일차성 불면증 환자에 대한 예비 연구)

  • Lee, Jin Han;Shin, Hong-Beom;Kim, Jong Won;Suh, Ho-Suk;Lee, Young Jin
    • Sleep Medicine and Psychophysiology
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    • v.26 no.1
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    • pp.44-48
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    • 2019
  • Objectives: Insomnia is one of the most prevalent sleep disorders. Recent studies suggest that cognitive and physical arousal play an important role in the generation of primary insomnia. Studies have also shown that information processing disorders due to cortical hyperactivity might interfere with normal sleep onset and sleep continuity. Therefore, focusing on central nervous system arousal and normalizing the information process have become current topics of interest. It has been well known that neurofeedback can reduce the brain hyperarousal by modulating patients' brain waves during a sequence of behavior therapy. The purpose of this study was to investigate effects of neurofeedback therapy on electroencephalography (EEG) characteristics in patients with primary insomnia. Methods: Thirteen subjects who met the criteria for an insomnia diagnosis and 14 control subjects who were matched on sex and age were included. Neurofeedback and sham treatments were performed in a random order for 30 minutes, respectively. EEG spectral power analyses were performed to quantify effects of the neurofeedback therapy on brain wave forms. Results: In patients with primary insomnia, relative spectral theta and sigma power during a therapeutic neurofeedback session were significantly lower than during a sham session ($13.9{\pm}2.6$ vs. $12.2{\pm}3.8$ and $3.6{\pm}0.9$ vs. $3.2{\pm}1.0$ in %, respectively; p < 0.05). There were no statistically significant changes in other EEG spectral bands. Conclusion: For the first time in Korea, EEG spectral power in the theta band was found to increase when a neurofeedback session was applied to patients with insomnia. This outcome might provide some insight into new interventions for improving sleep onset. However, the treatment response of insomniacs was not precisely evaluated due to limitations of the current pilot study, which requires follow-up studies with larger samples in the future.

The Effects of a Brief Intervention for Insomnia on Community Dwelling Older Adults (지역 사회 노인을 대상으로 한 불면증 단기 치료 프로그램의 효과)

  • Oh, Eui Sun;Park, Kyung Mee;An, Suk Kyoon;Namkoong, Kee;Shim, Da-hye;Lee, Eun
    • Sleep Medicine and Psychophysiology
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    • v.25 no.2
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    • pp.74-81
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    • 2018
  • Objectives: Insomnia is one of the major concerns in the elderly population. Cognitive behavioral treatment for insomnia is the first line treatment option, but there are some limitations including time and cost burdens and the requirement for sufficient cognitive resources to obtain a proper treatment effect. The Brief intervention for insomnia (BII) is a treatment that focuses on behavioral aspects of insomnia in primary care practices. The purpose of this study was to evaluate the effects of BII in community-dwelling older adults. Methods: A total of 47 older adults with insomnia were enrolled from community centers between May 2016 and January 2018. They participated in the BII program for three weeks. We gathered sleep-related participant information with using the Pittsburgh sleep quality index (PSQI), the Sleep hygiene index, and a sleep diary. Clinical efficacy was evaluated by comparing total sleep time (TST), sleep latency (SL), waking after sleep onset (WASO), and sleep efficiency (SE) before and after the treatment. Results: There was significant improvement in sleep-related features after BII. Global score and sleep quality from the PSQI, freshness, and WASO from the sleep diary showed statistically significant improvement. Conclusion: We found BII showed positive clinical efficacy in community dwelling older adults, especially from the perspective of subjective sleep quality and WASO. This finding implies that BII can be effectively applied for the managment of elderly insomnia patients in a community setting.

A Study on Superficial Dose of 6MV-FFF in HalcyonTM LINAC: Phantom Study (HalcyonTM 선형가속기 6MV-FFF 에너지의 표재 선량에 대한 고찰: Phantom Study)

  • Choi, Seong Hoon;Um, Ki Cheon;Yoo, Soon Mi;Park, Je Wan;Song, Heung Kwon;Yoon, In Ha
    • The Journal of Korean Society for Radiation Therapy
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    • v.32
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    • pp.31-39
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    • 2020
  • Purpose: The aims of this study were to compare the superficial dose with Optically Stimulated Luminescence Dosimeter(OSLD) measurement and Treatment Planning System(TPS) calculation for 6MV-Flattening Filter Free(FFF) energy using HalcyonTM and TrueBeamTM. Materials and methods: Phantom study was performed using the CT images of human phantom. In the treatment planning system, the Planning Target Volume(PTV) was contoured which is similar to Glottic cancer. Furthermore, Point(M), Point(R), and Point(L) were contoured at the iso-center of head and neck region and 5mm bolus was applied to the body contour. Each treatment plans using 6MV-FFF energy from HalcyonTM and TrueBeamTM with static Intensity Modulated Radiation Therapy(IMRT) and Volumetric Modulated Arc Therapy(VMAT) were established with eclipse. To reproduce the same position as the TPS, OSLDs were placed at the iso-center point and 5mm bolus was applied to compare the error rate after the dose delivery. Result: The results of the study using human phantom are as follows. In case of HalcyonTM, the mean absolute error rates of the point dose using the treatment planning system and the dose measured by OSLD were 1.7%±1.2% for VMAT and 4.0±2.8% for IMRT. Also TrueBeamTM was identified as 2.4±0.4% and 8.6±1.8% respectively for VMAT and IMRT. Conclusion: Through the results of this study, TrueBeamTM confirmed that the average error rate was 2.4 times higher for VMAT and 3.6 times higher for IMRT than HalcyonTM. Therefore, based on the results of this study, If we need a more accurate dose assessment for the superficial dose, It is expected that using HalcyonTM would be better than TrueBeamTM.

Evaluation of the usefulness of IGRT(Image Guided Radiation Therapy) for markerless patients using SGPS(Surface-Guided Patient Setup) (표면유도환자셋업(Surface-Guided Patient Setup, SGPS)을 활용한 Markerless환자의 영상유도방사선치료(Image Guided Radiation Therapy, IGRT)시 유용성 평가)

  • Lee, Kyeong-jae;Lee, Eung-man;Lee, Jeong-su;Kim, Da-yeon;Ko, Hyeon-jun;Choi, Shin-cheol
    • The Journal of Korean Society for Radiation Therapy
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    • v.33
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    • pp.109-116
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    • 2021
  • Purpose: The purpose of this study is to evaluate the usefulness of Surface-Guided Patient Setup by comparing the patient positioning accuracy when image-guided radiation therapy was used for Markerless patients(unmarked on the skin) using Surface-Guided Patient Setup and Marker patients(marked on the skin) using Laser-Based Patient Setup. Materials And Methods: The position error during IGRT was compared between a Markerless patient initially set up with SGPS using an optical surface scanning system using three cameras and a Marker patient initially set up with LBPS that aligns the laser with the marker drawn on the patient's skin. Both SGPS and LBPS were performed on 20 prostate cancer patients and 10 Stereotactic Radiation Surgery patients, respectively, and SGPS was performed on an additional 60 breast cancer patients. All were performed IGRT using CBCT or OBI. Position error of 6 degrees of freedom was obtained using Auto-Matching System, and comparison and analysis were performed using Offline-Review in the treatment planning system. Result: The difference between the root mean square (RMS) of SGPS and LBPS in prostate cancer patients was Vrt -0.02cm, Log -0.02cm, Lat 0.01cm, Pit -0.01°, Rol -0.01°, Rtn -0.01°, SRS patients was Vrt 0.02cm, Log -0.05cm, Lat 0.00cm, Pit -0.30°, Rol -0.15°, Rtn -0.33°. there was no significant difference between the two regions. According to the IGRT standard of breast cancer patients, RMS was Vrt 0.26, Log 0.21, Lat 0.15, Pit 0.81, Rol 0.49, Rtn 0.59. Conclusion:. As a result of this study, the position error value of SGPS compared to LBPS did not show a significant difference between prostate cancer patients and SRS patients. In the case of additionally performed SGPS breast cancer patients, the position error value was not large based on IGRT. Therefore, it is considered that it will be useful to replace LBPS with SGPS, which has the great advantage of not requiring patient skin marking..

A Study on Status of Landscape Architecture Industry with National Statistics (국가통계자료를 활용한 조경산업 현황 연구)

  • Choi, Ja-Ho;Yoon, Young-Kwan;Koo, Bon-Hak
    • Journal of the Korean Institute of Landscape Architecture
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    • v.50 no.5
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    • pp.40-53
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    • 2022
  • This study carried out to provide the methodology and basic status material of using Korean national statistics needed to find the actual state of the landscape architecture industry. The landscape architecture industry was classified into 'Design', 'Construction Management', 'construction', 'Maintenance & Management', 'Materials', 'Research', 'Education', and 'Administration' areas. In each field, business types were systemized and associated in accordance with Korean standard industrial classification and legislations pertinent to construction. Among them, the business types directly defined in the construction related legislations under the Ministry of Land, Infrastructure and Transport were focused on, and the establishment, association, integration, distribution, duplication, and omission of national statistics were analyzed. As a result, the business types of statistical analysis were selected. In order for commonality of statistical items and minimized error of interpretation, semantic analysis was conducted. Finally, the number of registered business types, the number of workers, and sales were selected. Based on them, the analysis framework applicable to fundamental analysis and evaluation of the actual state of the industry was proposed. Actual national statical data were applied for analysis and evaluation. In 2019, the number of registered business types related to the landscape architecture industry was 12,160, the number of workers by business type was 106,296, and the sales by business type were 8,308.5 billion KRW. The number of registered business types and the number of workers had been on the rise from 2017, whereas the sales had been on the decrease. It is required to come up with a plan for industrial development. This study was conducted with the national statistics established by multiple public institutions, so that there are limitations in securing consistency and reliability. Therefore, it is necessary to establish systematic and consistent national statistics in accordance with 「Landscaping Promotion Act」. In the future, it will planned to research application and development plans of national statistics according to subjects including park and green.

Evaluation of surface dose comparison by treatment equipment (치료 장비 별 표면 선량 비교평가)

  • Choi Eun Ha;Yoon Bo Reum;Park Byoung Suk;An Ye Chan;Park Myoung Hwan;Park Yong Chul
    • The Journal of Korean Society for Radiation Therapy
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    • v.34
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    • pp.31-42
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    • 2022
  • Purpose: This study measures and compares the surface dose values in the virtual target volume using Tomotherapy, Halcyon, and TrueBeam equipment using 6MV-Flattening Filter-Free(FFF) energy. Materials and Methods: CT scan was performed under three conditions of without bolus, 0.5 cm bolus, and 1 cm bolus using an IMRT phantom (IBA, Germany). The Planning Target Volume (PTV) was set at the virtual target depth, and the treatment plan was established at 200 cGy at a time. For surface dosimetry, the Gafchromic EBT3 film was placed in the same section as the treatment planning system and repeated measurements were performed 10 times and then analyzed. Result: As a result of measuring the surface dose for each equipment, without, 0.5 cm, 1 cm bolus is in this order, and the result of Tomotherapy is 115.2±2.0 cGy, 194.4±3.3 cGy, 200.7±2.9 cGy, The result in Halcyon was 104.7±3.0 cGy, 180.1±10.8 cGy, 187.0±10.1 cGy, and the result in TrueBeam was 92.4±3.2 cGy, 148.6±5.7 cGy, 155.8±6.1 cGy, In all three conditions, the same as the treatment planning system, Tomotherapy, Halcyon, TreuBeam was measured highly in that order. Conclusion: Higher surface doses were measured in Tomotherapy and Halcyon compared to TrueBeam equipment. If the characteristics of each equipment are considered according to the treatment site and treatment purpose, it is expected that the treatment efficiency of the patient will increase as well as the treatment satisfaction of the patient.

A Comparative Study on the Mental Health of Adolescents Residing in Child Care Institutions (Orphanages) and Youth Shelters (아동양육시설과 청소년 쉼터에 거주중인 청소년들의 정신건강 수준 비교)

  • Yeonwoo Joun;Cheolgyu Shin;Hyunjeong Kim;Keun Oh;Heeyoung Seo;Jonggook Lee;Je Jung Lee
    • Korean Journal of Psychosomatic Medicine
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    • v.31 no.2
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    • pp.125-133
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    • 2023
  • Objectives : This study aims to compare the mental health of adolescents living in child care institutions (orphanages) and youth shelters, to provide basic data for appropriate psychiatric interventions for each facilities. Methods : The sample consisted of 157 adolescents in child care institutions and 31 adolescents in Youth Shelters who completed the Korean version of the Youth Self Report (K-YSR). We compared the K-YSR scores between the two groups and also examined factors related to suicidality. Results : Adolescents in youth shelters were older and had higher rates of drinking (p<0.001), smoking (p<0.001), and "abnormal sleep" (p=0.007) than adolescents in child care institutions. They also showed higher 'suicidality' (p=0.004) and K-YSR scores. On the other hand, adolescents in child care institutions have lower 'suicidality', but they have higher 'suicidality' when they have 'abnormal sleep' (OR 4.194; p=0.006), 'abnormal diet' (OR 2.503; p=0.010), and 'concerns about weight gain' (OR 2.503; p=0.010). Additionally, 17.6% of participants in the study showed 'suicidality'. The 'suicidality' group had a higher overall K-YSR score than the non-suicidal group, and had higher 'abnormal sleep' (OR 3.766; p=0.014) and 'concern about weight gain' (OR 2.864; p=0.032). Conclusions : Adolescents in youth shelters appear to have more serious clinical difficulties than adolescents in child care institutions, so prompt psychiatric intervention is needed. Additionally, it is necessary to consider mental health assessments including suicidality when adolescents in child care institutions complain of sleep, eating, or weight gain problems.