• Title/Summary/Keyword: 수술 계획

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Active Inferential Processing During Comprehension in Poor Readers (미숙 독자들에 있어 이해 도중의 능동적 추리의 처리)

  • Zoh Myeong-Han;Ahn Jeung-Chan
    • Korean Journal of Cognitive Science
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    • v.17 no.2
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    • pp.75-102
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    • 2006
  • Three experiments were conducted using a verification task to examine good and poor readers' generation of causal inferences(with because sentences) and contrastive inferences(with although sentences). The unfamiliar, critical verification statement was either explicitly mentioned or was implied. In Experiment 1, both good and poor readers responded accurately to the critical statement, suggesting that both groups had the linguistic knowledge necessary to the required inferences. Differences were found, however, in the groups' verification latencies. Poor, but not good, readers responded faster to explicit than to implicit verification statements for both because and although sentences. In Experiment 2, poor readers were induced to generate causal inferences for the because experimental sentences by including fillers that were apparently counterfactual unless a causal inference was made. In Experiment 3, poor readers were induced to generate contrastive inferences for the although sentences by including fillers that could only be resolved by making a contrastive inference. Verification latencies for the critical statements showed that poor readers made causal inferences in Experiment 2 and contrastive inferences in Experiment 3 doting comprehension. These results were discussed in terms of context effect: Specific encoding operations performed on anomaly backgrounded in another passage would form part of the context that guides the ongoing activity in processing potentially relevant subsequent text.

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Reconstruction of Stereo MR Angiography Optimized to View Position and Distance using MIP (최대강도투사를 이용한 관찰 위치와 거리에 최적화 된 입체 자기공명 뇌 혈관영상 재구성)

  • Shin, Seok-Hyun;Hwang, Do-Sik
    • Investigative Magnetic Resonance Imaging
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    • v.16 no.1
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    • pp.67-75
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    • 2012
  • Purpose : We studied enhanced method to view the vessels in the brain using Magnetic Resonance Angiography (MRA). Noticing that Maximum Intensity Projection (MIP) image is often used to evaluate the arteries of the neck and brain, we propose a new method for view brain vessels to stereo image in 3D space with more superior and more correct compared with conventional method. Materials and Methods: We use 3T Siemens Tim Trio MRI scanner with 4 channel head coil and get a 3D MRA brain data by fixing volunteers head and radiating Phase Contrast pulse sequence. MRA brain data is 3D rotated according to the view angle of each eyes. Optimal view angle (projection angle) is determined by the distance between eye and center of the data. Newly acquired MRA data are projected along with the projection line and display only the highest values. Each left and right view MIP image is integrated through anaglyph imaging method and optimal stereoscopic MIP image is acquired. Results: Result image shows that proposed method let enable to view MIP image at any direction of MRA data that is impossible to the conventional method. Moreover, considering disparity and distance from viewer to center of MRA data at spherical coordinates, we can get more realistic stereo image. In conclusion, we can get optimal stereoscopic images according to the position that viewers want to see and distance between viewer and MRA data. Conclusion: Proposed method overcome problems of conventional method that shows only specific projected image (z-axis projection) and give optimal depth information by converting mono MIP image to stereoscopic image considering viewers position. And can display any view of MRA data at spherical coordinates. If the optimization algorithm and parallel processing is applied, it may give useful medical information for diagnosis and treatment planning in real-time.

Radiosensitization of Cis-Platimum in the Treatment of Advanced Head and Neck Squamous Cell Carcinoma (국소 진행된 두경부편평 상피암에 대한 CIS-PLATINUM과 방사선치료의 동시 병행요법)

  • Chang, Hye-Sook
    • Radiation Oncology Journal
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    • v.10 no.1
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    • pp.27-34
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    • 1992
  • Cis-Platinum (DDP) was utilized as a radiosensitizer in a pilot study for stage III and IV squamous cell carcinoma between 1984-1987, and DDP 20 $mg/M^2$/day was administered for 4 days at 3 week interval with concurrent radiotherapy. This study consisted of three phases: cytoreduction phase, eradicative treatment phase and adjuvant phase. Total 59 patients were subjected to evaluate a tumor response and its toxicity. During the eradicative phase,27 patients underwent surgery (group I ), 29 patients were treated with radiotherapy only (group II) and 3 patients did not complete the second phase of therapy. At the cytoreduction phase, $95\%$ response rate with complete response (CR) $47.5\%$ and partial response (PR) $47.5\%$ was observed. Complete tumor clearance (CTC) rate following 2nd phase of therapy was $84\%$ (47/56) with 26/27($96\%$) in group I achieved CTC with surgery and 21/29 ($72\%$) patients In group II achieved CTC following 2nd phase. $67\%$ of primary lesions and $70\%$ of nodal diseases in group I showed no tumor in the surgical specimen. $34\%$ of patiets who achieved CTC at 2nd phase developed recurrence and median time to recur was 8 months. Actuarial disease free survival at 4 years was $59\%$ and $51\%$(24/27) of patients who achieved CTC at 2nd phase were alive without any evidence of disease at median follow-up 31 months (range, 10-48 months). There was no significant difference in overall and disease free survival between group I and II between CR and PR group following 1st Phase. Only significant Prognostic factor in this study was the complete tumor clearance following 2nd phase theapy. In general, toxicity was not excessive. Author concludes that this study confirmed the significant radiosensitizing effect of DDP with the acceptable toxicity and warrant the prospective study to determine optimum scheduling for DDP and radiotherapy which maximizes the therapeutic gain.

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Pretreatment prognostic Factors in Early Stage Caricinoma of the Uterine Cervix (초기 자궁 경부암에서 치료전 예후 인자)

  • Kim, Mi-Sook;Hua, Sung-Whan
    • Radiation Oncology Journal
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    • v.10 no.1
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    • pp.59-67
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    • 1992
  • From March 1979 through December 1986, 124 patients with early stage carcinoma of the uterine cervix received curative radiation therapy. According to FIGO classification, 35 patients were stage IB and 89 were stge II A. In stage IB, five year locoregional control, five year disease free survival, and five year overall survival was $79.0\%$, $76.4\%$ and $81.8\%$, respectively. In stage II A, five year locoregional control, five year disease free survival, and five year overall survival were $78.0\%$, $66.8\%$, and $72.1\%$, respectively. To identify prognostic factors, pretreatment parameters including age, ECOG performance status, number of pregnancies, history of diabetes mellitus and hypertension, histology, size and shape of primary tumor, CT findings and blood parameters were retrospectively analyzed in terms of locoregional control, disease free survival and overall survival using univariate analysis and multivariate analysis. In univariate analysis, tumor size on physicai examination and rectal invasion on CT significantly affected locoregional control, disease free survival and overall survival. Parametrial involvement on CT was a significant prognostic factor on locoregional control and disease free survival. Hemoglobin level affected disease free survival and overall survival. Histology and age were significant prognostic factors on locoregional control. In multivariate analysis excluding CT finding, tumor size on physical examination was a significant factor in terms of locoregioal control and overall survival. Hemoglobin level was significant in terms of disease free survival. In multivariate analysis including CT, histology was a prognostic factor on locoregional control and disease free survival. Hemoglobin level and rectal invasion on CT were significant factors on locoregional control.

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Development of the Whole Body 3-Dimensional Topographic Radiotherapy System (3차원 전신 정위 방사선 치료 장치의 개발)

  • Jung, Won-Kyun;Lee, Byung-Yong;Choi, Eun-Kyung;Kim, Jong-Hoon;An, Seung-Do;Lee, Seok;Min, Chul-Ki;Park, Cham-Bok;Jang, Hye-Sook
    • Progress in Medical Physics
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    • v.10 no.2
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    • pp.63-71
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    • 1999
  • For the purpose of utilization in 3-D conformal radiotherapy and whole body radiosurgery, the Whole Body 3-Dimensional Topographic Radiation Therapy System has been developed. Whole body frame was constructed in order to be installed on the couch. Radiopaque catheters were engraved on it for the dedicated coordinate system and a MeV-Green immobilizer was used for the patient setup by the help of side panels and plastic rods. By designing and constructing the whole body frame in this way, geometrical limitation to the gantry rotation in 3-D conformal radiotherapy could be minimized and problem which radiation transmission may be altered in particular incident angles was solved. By analyzing CT images containing information of patient setup with respect to the whole body frame, localization and coordination of the target is performed so that patient setup error may be eliminated between simulation and treatment. For the verification of setup, the change of patient positioning is detected and adjusted in order to minimize the setup error by means of comparison of the body outlines using 3 CCTV cameras. To enhance efficiency of treatment procedure, this work can be done in real time by watching the change of patient setup through the monitor. The method of image subtraction in IDL (Interactive Data Language) was used to visualize the change of patient setup. Rotating X-ray system was constructed for detecting target movement due to internal organ motion. Landmark screws were implanted either on the bones around target or inside target, and variation of target location with respect to markers may be visualized in order to minimize internal setup error through the anterior and the lateral image information taken from rotating X-ray system. For CT simulation, simulation software was developed using IDL on GUI(Graphic User Interface) basis for PC and includes functions of graphic handling, editing and data acquisition of images of internal organs as well as target for the preparation of treatment planning.

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THE DISTRIBUTIONS AND TRENDS IN MALOCCLUSION PATIENTS - A 10 year study of 2155 patients from YDSH (연세대학교 영동세브란스병원 교정과에 내원한 부정교합 환자의 분포 및 경향에 관한 연구)

  • Baik, Hyoung-Seon;Kim, Kyung-Ho;Park, Yul
    • The korean journal of orthodontics
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    • v.25 no.1 s.48
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    • pp.87-100
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    • 1995
  • Distributions and trends were examined in 2155 malocclusion patients who had been examined and diagnosed at Deparment of Orthodontics in Youngdong Severance Hospital over a 10 year-period from 1984 to 1993. The results were as follows ; 1. The number of patients per you had nearly quadrupled during the 10 year-period, with females($58.3\%$) outnumbering males ($41.7\%$). 2. Age distribution had shown 7-12 year-old group being the largest($53.3\%$), but percentages of 7-12 year-old and 13-18 year-old groups had been decreasing while that of above-19 patients had gradually incresed. 3. Distributions in the types of malocclusion according to the Angle's Classification had shown $27.8\%$ for Class I, $22.6\%$ for Class II division 1, $7.9\%$ for Class II division 2, and $41.6\%$ for Class III. Percentages of Class I patients had decreased while percentages of Class II and III patients had increased. 4. Non-extraction cases ($75.4\%$) had outnumbered extraction cases ($24.6\%$), with a general trend toward fewer extraction cases over the 10 year period. 5. Patients who had orthognathic surgery had been increasing, with Class I, II, and III cases comprising $8.8\%,\;16.9\%\;and\;74.3\%$, respectively. There had been three times as newly 2-jaw operations as 1-jaw operations. 6. Nearly $4\%$ of the subjects had facial asymmetries, with Class III cases being the most frequent. 7. Patients with TMD symptoms comprised $4.6\%$, with an increasing trend. The symptoms had occurred more frequently in older patients and in females. 8. Geograpic distributions showed majority (3/4) of patients from the nearby areas, namely Gangnam-gu, Seocho-gu and Songpa-gu.

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Usefulness of MRI 3D Image Reconstruction Techniques for the Diagnosis and Treatment of Femoral Acetabular Impingement Syndrome(Cam type) (대퇴 골두 충돌 증후군(Cam type)의 진단과 치료를 위한 자기공명 3D 영상 재구성 기법의 유용성)

  • Kwak, Yeong-Gon;Kim, Chong-Yeal;Cho, Yeong-Gi
    • The Journal of the Korea Contents Association
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    • v.15 no.11
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    • pp.313-321
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    • 2015
  • To minimize CT examination for Hip FAI diagnosis and operation plan. also, whether the MRI 3D images can replace Hip Clock face image was evaluated when performing Hip FAI MRI by using additional 3D image. This study analyzed Hip MRI and 3D Hip CT images of 31 patients in this hospital. For the purpose of evaluating the images, one orthopedic surgeon and one radiology specialist reconstructed Clock face, at MR and CT modality, by superior 12 o'clock, labrum front 3 o'clock, and the other side 9 o'clock, centering on Hip joint articular transverse ligament 6 o'clock. Afterwards, by the Likert Scale 5 point scale (independent t-test p<0.005), this study evaluated the check-up of A. retinacular vessel, B. head neck junction at 11 o'clock, A. Epiphyseal line, B. Cam lesion at 12 o'clock, and Cam lesion, Posterior Cam lesion at 1,2,3 and 4 o'clock. As for the verification of reliability among observers, this study verified coincidence by Cohen's weighted Kappa verification. As a result of Likert scale for the purpose of qualitative evaluation about the image, 11 o'clock A. retinacular vessel MR average was $3.69{\pm}1.0$ and CT average was $2.8{\pm}0.78$. B. head neck juncton didn't have a difference between two observers (p <0.416). 12 o'clock A. Epiphyseal line MR average was $3.54{\pm}1.00$ and CT average was $4.5{\pm}0.62$(p<0.000). B. Cam lesion didn't have a difference between two observers (p <0.532). 1,2,3,4 Cam lesion and Posterior Cam lesion were not statistically significant (p <0.656, p <0.658). As a result of weighted Kappa verification, 11 o'clock A.retinacular vessel CT K value was 0.663 and the lowest conformity. As a result of coincidence evaluation on respective item, a very high result was drawn, and two observers showed high reliability.

Analysis of Set-up Errors during CT-scan, Simulation, and Treatment Process in Breast Cancer Patients (유방암 환자의 모의치료, CT 스캔 및 치료 과정에서 발생되는 준비 오차 분석)

  • Lee, Re-Na
    • Radiation Oncology Journal
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    • v.23 no.3
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    • pp.169-175
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    • 2005
  • Purpose: Although computed tomography (CT) simulators are commonly used in radiation therapy department, many Institution still use conventional CT for treatments. In this study the setup errors that occur during simulation, CT scan (diagnostic CT scanner), and treatment were evaluated for the twenty one breast cancer patients. Materials and Methods: Errors were determined by calculating the differences in isocenter location, SSD, CLD, and locations of surgical clips implanted during surgery. The anatomic structures on simulation film and DRR image were compared to determine the movement of isocenter between simulation and CT scan. The isocetner point determined from the radio-opaque wires placed on patient's surface during CT scan was moved to new position if there was anatomic mismatch between the two images Results: In 7/21 patients, anatomic structures on DRR Image were different from the simulation Image thus new isocenter points were placed for treatment planning. The standard deviations of the diagnostic CT setup errors relative to the simulator setup in lateral, longitudinal, and anterior-posterior directions were 2.3, 1.6, and 1.6 mm, respectively. The average variation and standard deviation of SSD from AP field were 1.9 mm and 2.3 mm and from tangential fields were 2.8 mm and 3.7 mm. The variation of the CLD for the 21 patients ranged from 0 to 6 mm between simulation and DRR and 0 to 5 mm between simulation and treatment. The group systematic errors analyzed based on clip locations were 1.7 mm in lateral direction, 2.1 mm in AP direction, and 1.7 mm in SI direction. Conclusion: These results represent that there was no significant differences when SSD, CLD, clips' locations and isocenter locations were considered. Therefore, it is concluded that when a diagnostic CT scanner is used to acquire an image, the set-up variation is acceptable compared to using CT simulator for the treatment of breast cancer. However, the patient has to be positioned with care during CT scan in order to reduce the setup error between simulation and CT scan.

CHARACTERISTICS OF CRANIOFACIAL STRUCTURES IN SEVERE ADULT CLASS III MALOCCLUSION (심한 골격성 III급 부정교합을 가진 성인 두개안면골격의 특성)

  • Park, Chang-Jin;Lee, Ki-Soo
    • The korean journal of orthodontics
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    • v.28 no.2 s.67
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    • pp.219-229
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    • 1998
  • The purpose of this study is to define the characteristics of the skeleton and soft tissues of severe adult class III malocclusion. The materials selected for this study were lateral cephalograms of 112 adult class III malocclusion patients with ANB difference below -2 degrees. and the mean age was 22.9 years old. The normal control sampler consisted of lateral cephalograms of 50 adults in normal occlusion and the mean age was 22.1 years old. The Horizontal reference line was FH line and the vertical reference line was nasion perpendicular to FH line. The skeletal and soft tissue characteristics of Class III malocclusion are as follows : 1. In the skeletal profile evaluated by vertical reference line (Nasion perpendicular to FH), the forehead and maxilla was similar to normal, but the mandible was protruded significantly. 2. The soft tissue profile is concave. The thickness of soft tissue covering forehead area and nose is within normal range. but the upper lip is thicker and the nasolabial angle is smaller than normal. The lower lip and inferior labial sulcus is thinner than normal. The degree of eversion of lower lip is lesser than normal. 3. The cranial base of class III malocclusion is shorter and saddle angle is smaller than normal. 4. The location of midface evaluated in relations to cranial base is within normal range but, the length of midface is shorter than normal when compared from the deep portion of the facial skeleton. 5. The location of maxilla in reference to cranial base is within normal range but the length of maxilla was shorter in class III malocclusion. 6. The mandible was protruded, ramus height and body length, gonial angle were greater than normal, and the chin angle was smaller. 7. Upper incisor was proclined, lower incisor was retroclined.

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Facial soft tissue measuring analysis of normal occlusion using three-dimensional CT imaging (3차원 CT 영상을 이용한 정상교합자의 안면 연조직 계측 분석)

  • Han, Soo-Yeon;Baik, Hyoung-Seon;Kim, Kee-Deog;Yu, Hyung-Seog
    • The korean journal of orthodontics
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    • v.35 no.6 s.113
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    • pp.409-419
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    • 2005
  • Studies for diagnostic analysis using three-dimensional (3D) CT images are recently in progress and needs for 3D craniofacial analysis are increasing in the fields of orthodontics. It is especially essential to analyze the facial soft tissue after orthodontic treatment and orthognathic surgery. In this study 3D CT images of adults with normal occlusion were taken to analyze the facial soft tissue. Norms were obtained from CT images of adults with normal occlusion (12 males, 11 females) using a computer program named V works 4.0 program. 3D coordinate planes were established using soft tissue Nasion as the reference point and a total of 20 reproducible landmarks of facial soft tissue were obtained using the multiple reconstructive sectional images (axial, sagittal and coronal images) of the V works 4.0 program: soft tissue Nasion, Pronasale, Subnasale, Upper lip center, Lower lip center, soft tissue B, soft tissue Pogonion, soft tissue Menton, Endocanthion (Rt/Lt), Alare lateralis (Rt/Lt), Cheilion (Rt/Lt), soft tissue Gonion (Rt/Lt), Tragus (Rt/Lt), and Zygomatic point (Rt/Lt). According to the established landmarks and measuring method, the 3D CT images of adults with normal occlusion were measured and the normal positional measurements and their Net (${\delta}=\sqrt{{X^2}+{Y^2}+{Z^2}}$) values were obtained using V surgery program, In the linear measurement between landmarks, there was a significant difference between males and females except Na' -Sn and En(Rt)-En(Lt). The normal ranges of Na'-Zy, Na'-Ch and Na'-Go' (facial depth) were obtained, which was difficult to measure by two-dimensional (2D) cephalometric analysis and facial photographs. These data may be used as references for 3D diagnosis and treatment planning for patients with malocclusion and dentofacial deformity.