• Title/Summary/Keyword: 시 치료

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3-D Conformal Radiotherapy for CNS Using CT Simulation (입체조준장치를 이용한 중추신경계의 방사선 입체조형치료 계획)

  • 추성실;조광환;이창걸
    • Progress in Medical Physics
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    • v.14 no.2
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    • pp.90-98
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    • 2003
  • Purpose : A new virtual simulation technique for craniospinal irradiation (CSI) that uses a CT-simulator was developed to improve the accuracy of field and shielding placement as well as patient positioning. Materials and Methods : A CT simulator (CT-SIM) and a 3-D conformal radiation treatment planning system (3D-CRT) were used to develop CSI. The head and neck were immobilized with a thermoplastic mask while the rest of the body was immobilized with a Vac-Loc. A volumetric image was then obtained with the CT simulator. In order to improve the reproducibility of the setup, datum lines and points were marked on the head and body. Virtual fluoroscopy was performed with the removal of visual obstacles, such as the treatment table or immobilization devices. After virtual simulation, the treatment isocenters of each field were marked on the body and on the immobilization devices at the conventional simulation room. Each treatment fields was confirmed by comparing the fluoroscopy images with the digitally reconstructed radiography (DRR) and digitally composited radiography (DCR) images from virtual simulation. Port verification films from the first treatment were also compared with the DRR/DCR images for geometric verification. Results : We successfully performed virtual simulations on 11 CSI patients by CT-SIM. It took less than 20 minutes to affix the immobilization devices and to obtain the volumetric images of the entire body. In the absence of the patient, virtual simulation of all fields took 20 min. The DRRs were in agreement with simulation films to within 5 mm. This not only reducee inconveniences to the patients, but also eliminated position-shift variables attendant during the long conventional simulation process. In addition, by obtaining CT volumetric image, critical organs, such as the eyes and the spinal cord, were better defined, and the accuracy of the port designs and shielding was improved. Differences between the DRRs and the portal films were less than 3 m in the vertebral contour. Conclusion : Our analysis showed that CT simulation of craniospinal fields was accurate. In addition, CT simulation reduced the duration of the patient's immobility. During the planning process. This technique can improve accuracy in field placement and shielding by using three-dimensional CT-aided localization of critical and target structures. Overall, it has improved staff efficiency and resource utilization by standard protocol for craniospinal irradiation.

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Effect of Occlusal Stabilizing Splint for Osteoarthritis of Temporomandibular Joint (측두하악관절의 골관절염에 대한 교합안정장치의 치료효과)

  • Kim, Ji-Hyun;Jeon, Hye-Mi;Ok, Soo-Min;Heo, Jun-Young;Jeong, Jung-Hee;Ahn, Young-Woo;Ko, Myung-Yun
    • Journal of Oral Medicine and Pain
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    • v.37 no.2
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    • pp.113-123
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    • 2012
  • To evaluate the treatment outcome of occlusal stabilizing splint in patients with TMJ osteoarthritis, the 76 subjects were chosen among the patients who presented to the Department of Oral medicine of Pusan National University Hospital, diagnosed as TMJ osteoarthritis by cone beam computed tomography, x-ray and clinical exam, and treated with occlusal stabilizing splint from 2009 to 2011. They were treated with physical therapy and medication before occlusal stabilizing splint delivery and checked monthly after occlusal stabilizing splint delivery. Subjective symptoms and clinical findings were investigated to evaluate and compare the subjects' status at the first visit, splint delivery visit and the last visit. The results were as follows; 1. Pain, noise, LOM and MCO were significantly improved between the first visit and occlusal stabilizing splint delivery visit, and between occlusal stabilizing splint delivery and the last visit. 2. In the acute group, pain and noise were significantly improved between the first visit and occlusal stabilizing splint delivery visit. Pain, LOM and MCO were significantly improved between splint delivery visit and the last visit 3. In the chronic group, pain, noise and LOM were significantly improved between occlusal stabilizing splint delivery visit and the last visit.

Rehabilitation after operation

  • 최창혁
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2003.11a
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    • pp.84-90
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    • 2003
  • 최근 견관절 질환 치료의 발전에 힘입어 술 후의 유병율을 줄이고, 보다 견고한 조직 복원이 가능해 짐으로써 운동사슬(kinetic chain)의 생리적이고 생 역학적인 복원을 위한 재활치료를 조기에 시행할 수 있게 되었다. 이러한 조기재활 치료는 술 전 적절한 준비, 해부학적인 수술적 치료, 술 중 적절한 운동범위의 회복, 술 후 조기 보조 및 능동 보조운동, closed chain-axial loading rehabilitation protocol, 재활치료 중 기능적 관절위치 유지 및 기능회복에 따른 생리적 호전 등의 원칙을 통해 견관절의 여러 질환의 재활치료에 적용할 수 있다. 견관절의 조기 재활치료 시 통증은 근육의 조화운동을 저해하게 되며 관절의 안정적인 운동과 기능을 방해하게 된다. 따라서 시각 측정표를 이용한 4이하의 통증범위에서, 관절의 위치와 팔 및 몸의 운동 그리고 근육의 작용을 잘 관찰하는 가운데 운동을 함으로써 통증으로 인한 근억제 효과를 줄이며, 보다 조기에 안전하게 일상생활 및 운동복귀를 할 수 있다.

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Analysis of Body Mass Index on Set Up Errors Rectal Cancer in Radiotherapy (체질량지수(BMI)와 방사선 치료 시 직장암 환자의 자세 오차 분석)

  • Shim, Jae-Goo;Jung, Hong-Ryang;Seo, Jung-Min;Park, Byoung Suk;Jang, Joon-Young
    • Proceedings of the Korea Contents Association Conference
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    • 2013.05a
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    • pp.211-212
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    • 2013
  • 방사선 치료를 받는 모든 환자의 경우 먼저 모의 치료를 시행한 후에 동일한 자세로 방사선 치료를 실시한다. 이 때 무엇보다도 중요한 사항은 정확한 자세의 재현성이다. 직장암 환자의 방사선 치료를 시행하는 경우에도 모의 치료와 동일한 자세 유지가 요구되어진다. 하지만 호흡 및 환자의 여러 가지 요소에 의해 자세의 오차가 발생할 수 있다. 이에 본 논문은 직장암 환자의 방사선 치료를 시행하는 경우 오차가 발생할 수 있는 요소 중에 환자의 체지량 지수 차이에 의한 자세 재현성에 대해 알아보고 향후 자세 오차를 줄일 수 있는 방법을 모색하고자 한다.

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Case Report of Radiotherapy to a Breast Cancer Patient with a Pacemaker (인공심장박동기가 이식된 유방암환자의 방사선 치료에 대한 사례 보고)

  • Chae, Seung-Hoon;Park, Jang-Pil;Lee, Yang-Hoon;Yoo, Suk-Hyun;Seong, Won-Mo;Kim, Kyu-Bo
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.2
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    • pp.197-203
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    • 2012
  • Purpose: In this study, we considerate our radiation therapy process for the breast cancer patient implanted a pacemaker applying the machine movement surgery, shielding, beam selection. Materials and Methods: We perform radiation therapy to a 54 years old, breast cancer patient implanted a pacemaker. The patient underwent a surgery to move the position of a pacemaker to right side breast after consultation with cardiology department. Prescribed dose was 5,040 cGy and daily dose 180 cGy for 28 fractions. The 10 MV photon energy, field size 0/$9.5{\times}20$ cm, half beam and opposing portal irradiation are used. To find out appropriate thickness of shielding board, we carried out an experiment using a solid water phantom ($30{\times}30{\times}7$ cm), a Farmer-type chamber (TN30013, PTW, Germany) and a shielding board (Pb $28{\times}27{\times}0.1$ cm). We calculated expected absorbed dose to te pacemaker with absorb ratio and shielding ratio. In the PTP system (Eclipse, Varian, USA), we figured out how much radiation would be absorbed to the machine with and without shielding. First day of the radiation therapy, we measured head scatter to the pacemaker with MOSFET Dose Verification System (TN-RD-70-W, Medical Canada Ltd., Canada). Results: In the phantom measurement, we found out appropriate thickness was 2 mm of shielding board. In the RTP, when using 2 mm shielding the pacemaker will be absorbed 11.5~38.2 cGy and DVH is 77.3 cGy. In the first day of the therapy, 4.3 cGy was measured so 120.4 cGy was calculated during total therapy. The patient was free from any side effects, and the machine also normally functioned. Conclusion: As the report of association which have public confidence became superannuated, there is lack of data about new machine. We believe that radiation therapy to thiese kind of patients could be done successfully with co-operation, patient-suitable planning, accurate QA, frequent in-vivo dosimetry and monitoring.

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A Study on the Skeletal and Profile Change after Using the Activator in Class II Malocclusion (II급 부정 교합자의 Activator 치료 후 골격 및 안모 변화에 관한 연구)

  • Moon, Eun-Young;Lee, Jin-Woo
    • Journal of Oral Medicine and Pain
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    • v.33 no.2
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    • pp.121-132
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    • 2008
  • To establish the diagnosis and treatment plan for skeletal Class II malocclusion, patient's skeletal morphology, prognosis as well as the treatment effect is one of the important factor to consider. Therefore, the present study classified analyzed the difference between initial(T1) and after use of activator(T2), and after finish of direct multi-bonding system treatment(T3) for Class II malocclusion during growth period according to the treatment result(effective body length) and morphology of vertical skeletal type. The experimental group was classified into two groups(1 group, 2 group) according to the effective body length change between before and after use of activator, showed good treatment effect of activator for patient with small mandible and large differential between maxilla and mandible, and short anterior facial height. And the difference between 1 and 2 group in the experimental group before treatment(T1) disappeared in the finished treatment(T3). But in contrast, the initial difference of T1 stage between a and b group in the control group did not disappear in the finished treatment(T3). In short, experimental group's treatment effect was much better than contrast group and the treatment effect was maintained and got stable results at comparison experimental group with contrast group. Through this study, we can find activator's treatment effect and stable retention of that in growing Class II malocclusion patients. By estimate of activator treatment effect through these results, we can establish the correct diagnosis and treatment plan for adolescent Class II malocclusion estimate of activator treatment effect and lead the ideal facial growth pattern.