• Title/Summary/Keyword: 보완의학

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The Clinical Implementation of 2D Dose Distribution QA System for the Patient Specific Respiratory-gated Radiotherapy (호흡동조 방사선치료의 2차원 선량 분포 정도관리를 위한 4D 정도관리 시스템 개발)

  • Kim, Jin-Sung;Shin, Eun-Hyuk;Shin, Jung-Suk;Ju, Sang-Gyu;Han, Young-Yih;Park, Hee-Chul;Choi, Doo-Ho
    • Progress in Medical Physics
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    • v.21 no.2
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    • pp.127-136
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    • 2010
  • Emerging technologies such as four-dimensional computed tomography (4D CT) is expected to allow clinicians to accurately model interfractional motion and to quantitatively estimate internal target volumes (ITVs) for radiation therapy involving moving targets. A need exists for a 4D radiation therapy quality assurance (QA) device that can incorporate and analyze the patient specific intrafractional motion as it relate to dose delivery and respiratory gating. We built a 4D RT prototype device and analyzed the patient-specific 4D radiation therapy QA for 2D dose distributions successfully. With more improvements, the 4D RT QA prototype device could be an integral part of a 4D RT decision process to confirm the dose delivery.

A study on the dose distribution for total-body & hemibody irradiation using clinical photon beams (광자선을 이용한 전신 및 반신조사의 선량분포에 관한 고찰)

  • 김진기;권형철;김정수;오영기;김기환;신교철;김정홍;박충기;정동혁
    • Progress in Medical Physics
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    • v.12 no.2
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    • pp.147-153
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    • 2001
  • We have discussed that the total body irradiation(TBI) dose distribution of 6 and 10 MV photon beams, also differences between calculation dose use of compensator sheet and measurements in humanoid phantom. Total body irradiation and hemi-body irradiation(HBI) can be effectively performed when uniformity of dose distribution is estabilished. The method of TBI and HBI dosimatry requires special considerations related to technique, long distance and very large field, machine parameter, patient positioning. TBI and HBI with megavoltage photon beams requires basic dosimatric data which have to be measured directly or derived from the standard beam data. The semiconductor detector and ion chamber were positioned at a dmax depth, mid depth, and its specific ratio was determined using a scanning data by RFA-7 3-dimensional water phantom and solid phantom. The effective source axis distance 380 cm, the field size from 120 cm to 152 cm, isodose distributions were analyzed as a function of the thickness in phantom. Also, have discussed that the measurement of basic data for clinical photon beams for dosage calculations, data calculation sheet and the use of tissue compensation to improve dose uniformity. We have improved a dose uniformity in the TBI and HBI method.

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Characteristics of dose distribution for virtual wedge (가변형 쐐기필터의 선량분포에 관한 특성)

  • 김부길;김진기
    • Progress in Medical Physics
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    • v.12 no.2
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    • pp.125-131
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    • 2001
  • We was investigate the dosimetric characteristics of the virtual wedge and it compared to the conventional fixed wedge. Also we was evaluate the quality factor of the experimental multi-channel dosimetry system for virtual wedge. Recently virtual wedge technique and wedge fraction methods are available through the computer controlled asymmetric collimator or the independent jaw in medical linear accelerator for radiation therapy. The dosimetric characteristics are interpreted by radiation field analyzer RFA-7 system and PTW-UNIDOS system. Experimental multi-channel dosimetry system for virtual wedge was consists of the electrometer, the solid detector and array phantom. The solid detectors were constructed using commercially diodes for the assessment of quality assurance in radiotherapy. And it was used for the point dose measuring and field size scanning. The semiconductor detector and ion chamber were positioned at a dmax, 5 cm, 10 cm, 20 cm depth and its specific ratio was determined using a scanning data. Wedge angles in fixed and virtual type are compared with measurements in water phantom and it is shown that the wedge angle 15$^{\circ}$, 30$^{\circ}$, 45$^{\circ}$were agree within 1$^{\circ}$ degree in 6, 10 MV photon beams. In PDD and beam flatness, experimental multi-channel disimetry system was capable of reproduceing the measured values usually to within $\pm$2.1% the statistical uncertainties of the data. It was used to describe dosimetric characteristics of virtual wedge in clinical photon beams. Also we was evaluate optimal use of the virtual wedge and improve the quality factor of the experimental multi-channel dosimetry system for virtual wedge.

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Development of A Fractionated Stereotactic Radiotherapy System (분할 정위방사선 치료 시스템 개발 연구)

  • 이동한;지영훈;이동훈;조철구;김미숙;유형준;류성렬
    • Progress in Medical Physics
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    • v.13 no.1
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    • pp.9-14
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    • 2002
  • We invented the newly developed Fractionated Stereotactic Radiotherapy(F.S.R.T) system using combined techniques of couch mounting and pedestal mounting system. Head fixation frame consists of a milled alluminium alloy(duralumin) and is placed to the couch. This frame immobilized patient head using the dental bite, 3.2 mm frontal and occipital thermoplastic mask. To evaluate the coordinate of target isocenter, Brown-Revert-Walls C.T localizer can be attached to this frame. And also, we developed the frame mounting system by developing the modification of pedestal mounting system. This system is fixed to couch floor and can be used to evaluate the isocenteric accuracy of gantry, couch and collimator in Q.A procedure. In order to measure the relocation accuracy, the acrylic phantom and the accurate pointers have been made. The repositioning of the targets in the phantom were estimated by comparing C.T coordinates and E.C.L portal films taken with anterior-posterior and right-left direction. From the results of experiments, the average distance errors between the target isocenter and its mean position were 0.71$\pm$0.19 for lateral, 0.45$\pm$0.15 for inferior-superior, 0.63$\pm$0.18 for anterior-posterior. And the maximum distance error was less than 1.3 mm. The new head fixation frame and frame mounting system were non-invasive, accurately relocatable, easy to use, very light and well tolerable by the results of phantom tests. The major advantage of using this frame mounting system is complete access to any point in the Patients cranium especially posterior direction

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A Feasibility study on the Simplified Two Source Model for Relative Electron Output Factor of Irregular Block Shape (단순화 이선원 모델을 이용한 전자선 선량율 계산 알고리듬에 관한 예비적 연구)

  • 고영은;이병용;조병철;안승도;김종훈;이상욱;최은경
    • Progress in Medical Physics
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    • v.13 no.1
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    • pp.21-26
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    • 2002
  • A practical calculation algorithm which calculates the relative output factor(ROF) for irregular shaped electron field has been developed and evaluated the accuracy of the algorithm. The algorithm adapted two-source model, which assumes that the electron dose can be express as sum of the primary source component and the scattered component from the shielding block. Original two-source model has been modified in order to make the algorithm simpler and to reduce the number of parameters needed in the calculation, while the calculation error remains within clinical tolerance range. The primary source is assumed to have Gaussian distribution, while the scattered component follows the inverse square law. Depth and angular dependency of the primary and the scattered are ignored ROF can be calculated with three parameters such as, the effective source distance, the variance of primary source, and the scattering power of the block. The coefficients are obtained from the square shaped-block measurements and the algorithm is confirmed from the rectangular or irregular shaped-fields used in the clinic. The results showed less than 1.0 % difference between the calculation and measurements for most cases. None of cases which have bigger than 2.1 % have been found. By improving the algorithm for the aperture region which shows the largest error, the algorithm could be practically used in the clinic, since one can acquire the 1011 parameter's with minimum measurements(5∼6 measurements per cones) and generates accurate results within the clinically acceptable range.

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Correlation between Self-evaluation Factor and Academic Achievement of Medical Students according to Introduction of Explanation Meeting in Cadaveric Dissection (해부설명회의 도입에 따른 의학전문대학원생들의 자기 평가 요인과 학업성취도 상관관계 분석)

  • Park, Jeong-Hyun;Kim, Jee-Hee;Kim, Kwang-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.7
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    • pp.2475-2482
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    • 2010
  • This study aimed to evaluate correlation between self-evaluation factors(satisfaction, linkage with major, suitability of management, verbal and non-verbal communication) and academic achievement of medical students according to introduction of explanation meeting in cadaveric dissection. The study was carried out that medical students(n=57) explained cadaveric structure to health allied sciences students and discussed with each other. Just after the meeting,, medical students filled out a questionnaire on impact of self-evaluation factors and communication. We analyzed these factors and their scores using frequency analysis, T-test and analysis of variance. Regardless of their gender, age, previous experience, the majority of the students gave high scores in all of self-evaluation factors. Among them, only verbal communication factor was closely related to their academic achievement(p<0.05). The verbal and non-verbal communication also had a high correlation of 0.673(p<0.01). The explanation meeting provided chance to learn further with positive attitude to medical students and motivated them academically. Additionally, they realized that communication skill played a key role in transmitting medical knowledge to others. Therefore, introduction of communication-based explanation meeting would be very useful tool in improving educational efficiency.

The Effect of Health Promotion Program on the Frailty of Rural Elderly Women Implemented at Primary Health Care Posts (일부 보건진료소에서 실시한 건강증진프로그램이 농촌여성노인의 노쇠에 미치는 효과)

  • Kim, Min-Kyung;Park, Ki-Soo
    • Journal of agricultural medicine and community health
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    • v.44 no.3
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    • pp.115-123
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    • 2019
  • Objective: This study was conducted to examine the effects of a health promotion program on the health condition of rural elderly women implemented at primary health care posts using Korean Frailty Index. Methods: The research was designed a nonequivalent control group pretest-posttest setting. The participants in this study were 50 residents (intervention group: 25, control group: 25) selected from 4 villages 2 primary health care posts in J city Gyeongsangnam-do. The health promotion program was conducted at the primary health care posts twice a week for 12 weeks. This program consisted of basic exercises(Gukseondo + Theraband muscle strength training) and additional activities(including modified Theraband activity, rubber ball exercise, ball massage, nutrition class, singing class). Collected data were analyzed by descriptive statistics, paired t-test, and repeated measures ANOVA with SPSS 21.0. Results: Results of the health promotion program showed that the health conditions(measured by perceived health status, frailty score, upper/lower flexibility, maximum grip strength, dynamic balance test Timed Up and Go) of the experimental group(25) all statistical significantly improved. Conclusion: Study findings indicate that the health promotion program implemented at primary health care posts on rural elderly women is effective and can contribute to a developed health promotion program for local residents in the future.

Convergence research on cytological diagnosis of gynecological diseases and genital HPV : Based on data from the Obstetrics and Gynecology Department of a general hospital located in Suwon-si (수원시 소재 일개 종합병원 산부인과에서 자궁경부 질환 검사의 실태조사 : HPV와 세포학적 검사의 융합연구)

  • Joung, You Hyun;Lee, Jun Min;Kim, Jong-Wan;Kim, Jae Kyung
    • Journal of the Korea Convergence Society
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    • v.13 no.1
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    • pp.119-129
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    • 2022
  • Cervical cytology has been widely used as a screening tool for cervical cancer. However, Human papillomavirus (HPV) detection and subtype testing are suggested to overcome the high false-negative rate associated with cytology. We aimed to investigate the clinical usefulness and infection rate in the HPV polymerase chain reaction (PCR) test performed in hospitals. HPV PCR data from 217 patients were analyzed. Analysis of variance revealed a significant difference in the infection rate among different age groups (P=0.015). The biopsy results showed that epithelial cell abnormalities and high HPV-positivity rate was observed in 1 (100%) subject aged <29 years, in 4 out of 5 (80%) patients in their 30s, and in 3 out of 4 (75%) patients aged ≥70 years. The prevalence of HPV infection was very high (46.1%). The highest prevalence (87.5%) was observed among patients in their <29, followed by those in their 30s (67.7%) and those in their 40s (31.9%).A high rate of epithelial cell abnormalities (≥ cervical intraepithelial neoplasia type 1, mild dysplasia) was observed in HPV-infected women aged<30 years. Therefore, extensive research and prevention activities are needed in this age group. HPV PCR testing is recommended to complement cervical cytology

Genetic Counseling in Korean Health Care System (한국 의료제도와 유전상담 서비스의 구축)

  • Kim, Hyon-J.
    • Journal of Genetic Medicine
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    • v.8 no.2
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    • pp.89-99
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    • 2011
  • Over the years Korean health care system has improved in delivery of quality care to the general population for many areas of the health problems. The system is now being recognized in the world as the most cost effective one. It is covered by the uniform national health insurance policy for which most people in Korea are mandatory policy holders. Genetic counseling service, however, which is well recognized as an integral part of clinical genetics service deals with diagnosis and management of genetic condition as well as genetic information presentation and family support, is yet to be delivered in comprehensive way for the patients and families in need. Two major obstacles in providing genetic counseling service in korean health care system are identified; One is the lack of recognition for the need for genetic counseling service as necessary service by the national health insurance. Genetic counseling consumes a significant time in delivery and the current very low-fee schedule for physician service makes it very difficult to provide meaningful service. Second is the critical shortage of qualified professionals in the field of medical genetics and genetic counseling who can provide the service of genetic counseling in clinical setting. However, recognition and understanding of the fact that the scope and role of genetic counseling is expanding in post genomic era of personalized medicine for delivery of quality health care, will lead to the efforts to overcome obstacles in providing genetic counseling service in korean health care system. Only concerted efforts from health care policy makers of government on clinical genetics service and genetic counseling for establishing adequate reimbursement coverage and professional communities for developing educational program and certification process for professional genetic counselors, are necessary for the delivery of much needed clinical genetic counseling service in Korea.

Development of JPEG2000 Viewer for Mobile Image System (이동형 의료영상 장치를 위한 JPEG2000 영상 뷰어 개발)

  • 김새롬;정해조;강원석;이재훈;이상호;신성범;유선국;김희중
    • Progress in Medical Physics
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    • v.14 no.2
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    • pp.124-130
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    • 2003
  • Currently, as a consequence of PACS (Picture Archiving Communication System) implementation many hospitals are replacing conventional film-type interpretations of diagnostic medical images with new digital-format interpretations that can also be saved, and retrieve However, the big limitation in PACS is considered to be the lack of mobility. The purpose of this study is to determine the optimal communication packet size. This was done by considering the terms occurred in the wireless communication. After encoding medical image using JPGE2000 image compression method, This method embodied auto-error correction technique preventing the loss of packets occurred during wireless communication. A PC class server, with capabilities to load, collect data, save images, and connect with other network, was installed. Image data were compressed using JPEG2000 algorithm which supports the capability of high energy density and compression ratio, to communicate through a wireless network. Image data were also transmitted in block units coeded by JPEG2000 to prevent the loss of the packets in a wireless network. When JPGE2000 image data were decoded in a PUA (Personal Digital Assistant), it was instantaneous for a MR (Magnetic Resonance) head image of 256${\times}$256 pixels, while it took approximately 5 seconds to decode a CR (Computed Radiography) chest image of 800${\times}$790 pixels. In the transmission of the image data using a CDMA 1X module (Code-Division Multiple Access 1st Generation), 256 byte/sec was considered a stable transmission rate, but packets were lost in the intervals at the transmission rate of 1Kbyte/sec. However, even with a transmission rate above 1 Kbyte/sec, packets were not lost in wireless LAN. Current PACS are not compatible with wireless networks. because it does not have an interface between wired and wireless. Thus, the mobile JPEG2000 image viewing system was developed in order to complement mobility-a limitation in PACS. Moreover, the weak-connections of the wireless network was enhanced by re-transmitting image data within a limitations The results of this study are expected to play an interface role between the current wired-networks PACS and the mobile devices.

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