• Title/Summary/Keyword: 시 치료

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Comparison and evaluation of treatment plans using Abdominal compression and Continuous Positive Air Pressure for lung cancer SABR (폐암의 SABR(Stereotactic Ablative Radiotherapy)시 복부압박(Abdominal compression)과 CPAP(Continuous Positive Air Pressure)를 이용한 치료계획의 비교 및 평가)

  • Kim, Dae Ho;Son, Sang Jun;Mun, Jun Ki;Park, Jang Pil;Lee, Je Hee
    • The Journal of Korean Society for Radiation Therapy
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    • v.33
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    • pp.35-46
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    • 2021
  • Purpose : By comparing and analyzing treatment plans using abdominal compression and The Continuous Positive Air Pressure(CPAP) during SABR of lung cancer, we try to contribute to the improvement of radiotherapy effect. Materials & Methods : In two of the lung SABR patients(A, B patient), we developed a SABR plan using abdominal compression device(the Body Pro-Lok, BPL) and CPAP and analyze the treatment plan through homogeneity, conformity and the parameters proposed in RTOG 0813. Furthermore, for each phase, the X, Y, and Z axis movements centered on PTV are analyzed in all 4D CTs and compared by obtaining the volume and average dose of PTV and OAR. Four cone beam computed tomography(CBCT) were used to measure the directions from the center of the PTV to the intrathoracic contacts in three directions out of 0°, 90°, 180° and 270°, and compare the differences from the average distance values in each direction. Result : Both treatment plans obtained using BPL and CPAP followed recommendations from RTOG, and there was no significant difference in homogeneity and conformity. The X-axis, Y-axis, and Z-axis movements centered on PTV in patient A were 0.49 cm, 0.37 cm, 1.66 cm with BPL and 0.16 cm, 0.12 cm, and 0.19 cm with CPAP, in patient B were 0.22 cm, 0.18 cm, 1.03 cm with BPL and 0.14 cm, 0.11 cm, and 0.4 cm with CPAP. In A patient, when using CPAP compared to BPL, ITV decreased by 46.27% and left lung volume increased by 41.94%, and average dose decreased by 52.81% in the heart. In B patient, volume increased by 106.89% in the left lung and 87.32% in the right lung, with an average dose decreased by 44.30% in the stomach. The maximum difference of A patient between the straight distance value and the mean distance value in each direction was 0.05 cm in the a-direction, 0.05 cm in the b-direction, and 0.41 cm in the c-direction. In B patient, there was a difference of 0.19 cm in the d-direction, 0.49 cm in the e-direction, and 0.06 cm in the f-direction. Conclusion : We confirm that increased lung volume with CPAP can reduce doses of OAR near the target more effectively than with BPL, and also contribute more effectively to restriction of tumor movement with respiration. It is considered that radiation therapy effects can be improved through the application of various sites of CPAP and the combination with CPAP and other treatment machines.

Accuracy of Dose Estimation in High Dose Rate Intracavitary Radiotherapy of Carcinoma of the Uterine Cervix (자궁경부암 고선량율 강내치료의 치료선량 정확도에 관한 연구)

  • Huh, Seung-Jae;Ha, Sung-Whan;Chai, Kyu-Young
    • Radiation Oncology Journal
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    • v.5 no.2
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    • pp.137-140
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    • 1987
  • In brachytherapy of uterine conical cancer using a high dose rate remote afterloading system, it is of prime importance to deliver a accurate dose in each fractionated treatment by minimizing the difference between the pre-treatment planned and post-treatment calculated doses. The post-treatment calculated point A dose was not much different from the pretreatment planned dose (500 cGy). The $average{\pm}standard$ deviation was $500\pm18cGy$ and 84 percent of 82 intracavitary radiotherapy was within the range of $500\pm25cGy$.

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A Study on the Skin Dose Measurement of Glass Dosimeter Use During Rectal Cancer 3field Technic and Cervical Cancer 4field Technic Radiation Therapy (직장암 3문조사와 자궁경부암 4문조사 방사선 치료 시 유리선량계를 이용한 피부선량 측정에 관한 연구)

  • Shin, Seong-Soo;Choi, Won-Sik;Park, Cheol-Soo;Lee, Sun-Yeb;Cho, Jae-Hwan;Seo, Jeong-Min;Shim, Jae-Koo;Kim, Chan-Hyeong;Goo, Eun-Hoe;Kim, Eng-Chan
    • Journal of radiological science and technology
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    • v.34 no.2
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    • pp.157-163
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    • 2011
  • Recently a variety of high technologies for radiation therapy (IMRT, SRS,. 3D-RT, etc.) has been developed. For the cervical and rectal cancer, 3field or 4field radiotherapy have been applied to the patients. In the case of two-dimensional treatment, one of the most typical side-effects is skin burn due to the radiation irradiation. In general the skin dose is evaluated by only a single measurement during the whole treatment period. In this study, however, skin dose was measured in each radiation treatment and the total skin dose was accumulated in a glass dosimeter through all the cases. After simulating the skin dose from treatment planning system, the results were compared with the actual skin doses. The results showed a good agreement between two data sets. Even though there are certain amount of errors caused by the patient movement along the treatment, the difference between actual dose and simulated dose was within the accepted range of error.

Effects of a Digital Pegboard Training Program With Visual and Auditory Feedback on Hand Function and Visual Perception in Patients With Stroke (시각, 청각 피드백을 이용한 디지털 페그보드 훈련 작업치료 프로그램이 뇌졸중 환자의 손 기능 및 시·지각에 미치는 영향)

  • Hong, Jang-Woo;Yoo, Chan-Uk;Gang, Mi-Yeong;Chang, Ki-Yeon
    • Therapeutic Science for Rehabilitation
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    • v.11 no.4
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    • pp.85-97
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    • 2022
  • Purpose : This study aimed to investigate the effects of a digital pegboard training program with visual and auditory feedback on hand function and visual perception in stroke patients. Methods : Twenty two participants were randomly assigned to an experimental or control group. The experimental group received training using a digital pegboard training program with visual and auditory feedback (n=11), while traditional occupational therapy was administered to the control group (n=11). Hand function was assessed before and after the intervention using the Nine-Hole Peg Test and manual function test (MFT), while visual perception was assessed using the Motor-Free Visual Perception Test-3rd edition (MVPT-3). Results : Following the intervention, both the experimental and control groups showed significant improvements in performance in the Nine-Hole Peg Test and MVPT-3 (p<.05). The improvement on both tests was significantly greater in the experimental group than in the control group (p<.05). Conclusion : The results suggest that digital pegboard training with visual and auditory feedback may improve hand function and visual perception in stroke patients. Therefore, this intervention can be effective in occupational therapy to aid the recovery of stroke patients.

Factors Affecting Final Adult Height in Patients with Turner Syndrome (터너증후군 환자에서 최종 성인키에 영향을 미치는 인자들에 대한 연구)

  • Kim, Jae Hyun;Lee, Sung Soo;Hong, Su Young;Chung, Hye Rim;Shin, Choong Ho;Yang, Sei Won
    • Clinical and Experimental Pediatrics
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    • v.48 no.2
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    • pp.191-196
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    • 2005
  • Purpose : Short stature is one of the characteristic features of Turner syndrome. We investigated the factors affecting final adult height(FAH) in patients with Turner syndrome. Methods : The study group was comprised of 60 patients who were diagnosed with Turner syndrome by chromosomal study and clinical phenotypes and attained FAH. Data were obtained from retrospective review of the medical records. We analyzed the factors influencing FAH in growth hormone(GH) treated and GH untreated groups. Results : Sixty patients were enrolled; 48 patients received GH treatment, and 12 patients did not. Mean duration of GH treatment was 35.8 months(range 4 to 120 months), and mean dosage of GH was $0.8{\pm}0.2IU/kg/wk$ in GH treated group. Mean growth velocity was $5.6{\pm}2.0cm/yr$, which was significantly higher than that during pretreatment period. In the GH treated group, mean chronological age, bone age, mean height, and height standard deviation(SD) score at GH treatment were $12.2{\pm}2.7yr$ $10.3{\pm}2.5yr$ $127.5{\pm}10.1cm$ and $-3.1{\pm}1.1$, respectively. In the GH treated group, the mean FAH and SD score of FAH were $146.9{\pm}5.8cm$ and $-2.7{\pm}1.2$, respectively, which showed significant differences compared with those of the GH untreated group. Analyzing the factors affecting FAH in GH-treated patients, only the SD score of height at the time of treatment was significantly related to FAH. Conclusion : GH treatment leads to an increment in FAH in patients with Turner syndrome. Average FAH gain was as much as 5.8 cm. SD score of height at the time of GH treatment was the only factor influencing FAH.

PULSE RATE AND OXYGEN SATURATION IN CHILDREN DURING ROUTINE RESTORATIVE DENTISTRY (소아 치과치료시 심박동과 동맥혈 산소포화도의 변화)

  • Kim, Ha-Na;Baik, Byeong-Ju;Kim, Jae-Gon;Yang, Yeon-Mi;Park, Jeong-Yeol
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.1
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    • pp.65-72
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    • 2008
  • Pulse oximeter to monitor oxygen saturation during pediatric dental sedations enables early detection of hypoxemia. The purpose of this study was to monitor the hemoglobin oxygen saturation level and pulse rate of nonmedicated pediatric patients during routine restorative procedures to study the effect of procedure and treated jaw. We obtained data from 53 children treated at the Department of Pediatric Dentistry, Chonbuk national university hospital. Pulse rate and oxygen saturation were measured and recorded using pulse oximetry at each step of treatment. The results are as follows: 1. In non-anesthesia group, steep increase of pulse rate was observed during rubber dam application in the maxilla and during cavity preparation in the mandible. 2. In anesthesia group, pulse rate started to decrease after the rubber dam application in the maxilla, while its decrease observed since cavity preparation step in the mandible. 3. In non-anesthesia group, oxygen saturation level was relatively constant during all steps in the maxilla, but in mandible, it was higher during operation compared to its pre and post operation baseline. 4. In anesthesia group, oxygen saturation level was observed at 99% level through all steps in both jaw groups, and there was no statistical significance between the maxilla and the mandible groups(p>0.05). The purpose of this study was to evaluate the effect of routine dental treatment on the pulse rate and oxygen saturation level in nonmedicated pediatric patients during routine restorative procedures in the maxilla and mandible.

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Effect of maxillary premolar extraction on transverse arch dimension in Class III surgical-orthodontic treatment (III급 부정교합의 수술-교정 치료시 상악 소구치 발치가 치열궁 폭경 변화에 미치는 영향)

  • Lee, Shin-Jae;Hong, Sung-Joon;Kim, Young-Ho;Baek, Seung-Hak;Suhr, Cheong-Hoon
    • The korean journal of orthodontics
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    • v.35 no.1 s.108
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    • pp.23-34
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    • 2005
  • Collective changes caused by orthodontic tooth movement evaluated in a specific treatment modality could give suggestive information on the specific treatment strategy. The aim of this study was to investigate retrospectively the characteristics of the orthodontic tooth movement during surgical-orthodontic treatment in order to provide an effective presurgical orthodontic treatment planning for the maxillary premolar extraction modality In the skeletal Class III malocclusion patient. Pre- and post-treatment dental casts of skeletal Class III malocclusion patients with nonextraction (N=:24) and the maxillary premolar extraction (N=31) were collected. The angulation and inclination measuring gauge(Invisitech Co. Seoul, Korea) was used to evaluate the orthodontic tooth movement. The changes in the maxillary and mandibular dental arch widths were also measured from the canines to the second molars. As a result, more palatal inclination change in the maxillary dentition was found with the premolar extraction modality than with the nonextraction modality. Linear regression analysis showed that the inter-arch width coordination was mainly due to the inclination changes of maxillary posterior teeth We conclude that the indications and proper treatment planning for surgical-orthodontic treatment in skeletal Class III malocclusion with maxillary premolar extraction could depend partly on the magnitude of the transverse inter-arch coordination especially in the maxillary dentition.

Association of Nutritional Status with Clinical Outcome of Stomach Cancer Patients (위암환자의 입원초기 영양상태와 치료효과와의 관련성)

  • Kim, Young-Ok;Han, Bu
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.29 no.6
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    • pp.1185-1189
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    • 2000
  • 본 연구는 입원한 위암환자를 대상으로 영양불량의 정도를 중심으로 영양위험의 정도를 추정하며, 이러한 환자들의 초기 영양상태와 치료결과와의 관련성을 규명하기 위해 시도되었다. 연구대상은 병원에 입원한 209명의 위암환자였다. 영양불량은 표준체중백분율, 혈청알부민, 총임파구(TLC)로 판정하였으며, 치료결과는 합병증유무, 퇴원시 상태, 사망 등 세가지 관점에서 측정하였다. 표준체중백분율, 혈청 알부민, 총임파구수를 기준으로 영양상태를 보았을 때 비위험군은 39.7%였고, 위험군 I은 41.6%, 영양불량이 심한 위험군 II는 18.7%로, 환자의 60.3%가 영양상태가 불량한 것으로 나타나 위암환자 입원초기의 영양불량 정도가 심한 것으로 나타났다. 치료 결괴 퇴원시 상태가 "좋은"이 95.7%, 나쁨이 "4.3%"였으며, 사망환자는 6.8%, 합병증은 20.1%발생하였다. 또한 초기영양상태와 합병증과의 관련성은 높은 변수군 분류의 적절성(p<0.03)을 보여주고 있으며, 초기영양상태와 퇴원시의 치료상태에서도 높은 변수군 분류의 적절성(p<0.001)이 있는 것으로 나타났다. 환자의 초기 영양상태와 사망과의 관련성 검토 결과 초기영양상태가 불량한 경우 사망확률이 높은 것으로 나타나높은 상관성이 있음을 보였다. 이상의 연구결과로 볼 때 위암 환자의 초기 영양상태는 환자의 치료결과와 높은 관련성이 있는 것으로 나타났다.높은 관련성이 있는 것으로 나타났다.

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Myofascial Pain, and the Spraying and Stretching Technique (근막동통과 분사신장요법)

  • Kim, Byung-Gook;Lim, Young-Gwan
    • Journal of Oral Medicine and Pain
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    • v.25 no.3
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    • pp.325-329
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    • 2000
  • 근막동통은 발통점과 중추흥분효과가 나타나는 국소적 근육성 동통이다. 발통점은 근육의 일부나 건 부착점에 나타나는 부위로서 단단한 띠로서 느껴지고 촉진시 통증을 유발한다. 통증은 관련된 발통점의 위치에 따라 연관된 부위에 나타난다. 이러한 근막 발통점에 따른 증상은 약한 기능이상부터 일상생활이 어렵게 되는 정도의 심한 통증까지 다양하다. 이의 발생에는 국소적 근육이상, 심부 동통, 심리적 스트레스의 증가, 수면장애와 전신적인 요인들도 관여한다. 일반적으로 치료는 보존적인 처치로써, fluoro-methane 같은 vapocoolant spray를 사용하는 사용하여 분사신장하는 방법이 있으며, 국소적인 주사, 마사지, 초음파, 온열요법등이 있다. 여러 환자에서 근막동통을 가지는 환자에 분사신장요법을 시행한 결과 대부분 환자에서 증상의 개선을 보였다. 근막동통의 치료시 분사신장요법은 매우 보존적인 처치로 임상가의 적용과 접근이 쉬우며, 환자로 하여금 치료에 따른 불안감을 줄이면서 만족을 느낄 수 있는 치료로 사료된다. 그러나 만성 환자의 경우 분사신장요법의 치료결과에 대한 만족도가 높지 않았다. 분사신장 용법은 근막동통을 가진 환자 모두에서 효과적이지는 않으나 치료의 도입으로, 근막동통을 진단시에 일차적으로 사용할 수 있는 안정한 보존적인 용법으로 사료된다.

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Biologic rationale of cancer treatment with hyperthermia (고온온열치료장치를 사용한 종양치료의 생물학적 원리)

  • 김명세
    • Proceedings of the Korea Electromagnetic Engineering Society Conference
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    • 1999.07a
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    • pp.47-55
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    • 1999
  • 고온온열치료는 radiofrequency, ultrasound , microwave, 원적외선 등을 이용하여 신체의 부분 혹은 전신을 4$0^{\circ}C$ 이상으로 가열하여 암을 치료하는 방법이다. 우리나라에 도 입된 15기의 기계중 현재까지 사용되고 있는 것은 대부분이 radiofrequency를 사용하는 기 계이며 현재 고신의대, 동아의대, 부산메리놀병원, 여의도 성모병원, 영남의대, 전주예수병원 등에서 환자치료에 사용하고 있다. 고온 온열치료제(hyperthermia)는 직접 암세포를 죽이는 작용, 방사선치료나 항암제치료와 병행하여 그 효과를 증강시키는 작용으로 크게 나눌수 있 다. 직접 암세포를 죽이기 위하여는 43$^{\circ}C$이상의 고온을 사용하여야 하나 인체에서는 42.5$^{\circ}C$ 이상으로 가온하기가 쉽지않아 4$0^{\circ}C$~42$^{\circ}C$ 정도의 온도에서 방사선 치료나 항암제 치료효과 를 증진시키는 작용을 임상에서 주로 사용하고 있다. 특히 방사선 치료와 병합 사용시 그 효과가 뛰어나 간암, 난소암, 대장 직장암, 식도암, 위암, 자궁암, 전립선안, 췌장암, 폐암등, 거의 모든 암에서 부작용을 증가시키지 않으면서 그 효율을 1.1-6.14배나 증가시킨다고 보 고되고 있어 지난 10여 년간 제자리걸음을 하고 있는 암의 치료에 희망을 주고 있다. 방사 선 치료와 병합시 효과를 증대시키는 기전은 1)세포의 핵 합성기 (S-phase)는 방사선 치료 에는 매우 저항력이 강하여 잘 죽지 않으나 고온온열치료에는 예민함으로 암세포는 정상조 직에 비해 산소가 부족하여 염기성대사(anaerobic metabolism)를 많이 함으로 그 부산물인 유산 (lactic acid)이 많이 생성됨으로 정상조직보다 pH가 낮아 암 조직이 정상조직에 비해 고온온열치료에 더 잘 듣는 원인이 된다. 3) 영양이 부족한 상태의 세포는 고온온열치료에 훨씬 예민하다. 4) 암조직은 혈관상태가 정상조직에 비해 좋지 않음으로 정상조직보다 쉽게 가온이 되며, 일단 가온된 온도는 잘 식지 않음으로 정상조직에 비해 훨씬 효율적이다. 5)고 온온열치료는 4$0^{\circ}C$~43.5 $^{\circ}C$정도에서만 이 작용이 일어남으로 정상인체에서 43$^{\circ}C$이상의 가온 은 쉽지 않음으로 이 효과는 암조직에서 주고 일어나게 된다. 6)고온온열치료는 방사선치료 후에 생기는 손상의 재생을 억제함으로 방사선의 치료효과를 높인다. 7)38.5$^{\circ}C$~41.5$^{\circ}C$의 낮 은 온도에서도 암조직의 산소 상태를 호전시켜 방사선 치료효과를 증대시키는 역할을 한다.

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