• The Journal of Korean Society for Radiation Therapy
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• v.25 no.2
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• pp.187-192
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• 2013

Purpose: We investigate the results of changed heart volume and heart dose in the left breast cancer patients while considering the movements of respiration. Materials and Methods: During the months of March and May in 2012, we designated the 10 patients who had tangential irradiation with left breast cancer in the department of radiation Oncology. With acquired images of free breathing pattern through 3D and 4D CT, we had planed enough treatment filed for covered up the whole left breast. It compares the results of the exposed dose and the volume of heart by DVH (Dose Volume histogram). Although total dose was 50.4 Gy (1.8 Gy/28 fraction), reirradiated 9 Gy (1.8 Gy/5 Fraction) with PTV (Planning Target Volume) if necessary. Results: It compares the results of heart volume and heart dose with the free breathing in 3D CT and 4D CT. It represents the maximum difference volume of heart is 40.5%. In addition, it indicated the difference volume of maximum and minimum, average are 8.8% and 27.9%, 37.4% in total absorbed dose of heart. Conclusion: In case of tangential irradiation (opposite beam) in left breast cancer patients, it is necessary to consider the changed heart volume by the respiration of patient and the heartbeat of patient.

• Journal of the KSME
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• v.27 no.2
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• pp.99-108
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• 1987

국내에서 개발중인 인공심장으로는 서울대학교 공과대학 기계설계학과와 서울대학교병원 의공학과에서 공동으로 개발중인 전기-기계식 인공심장이 있다. 모우터가 내장된 실린더가 모우터의 정.역전에 따라 통 안에서 좌.우로 움직이면서 좌.우심실을 교대로 압축한다. 모우터가 들어 있는 실린더의 위치가 통 안에서 고정되어 있지 않고 움직이므로, 한쪽 심실이 팽창할 때 실린더가 다른 한쪽 심실 공간을 차지하여 결국 전체 체적은 하나의 심실 공간과 모우터 공간만 있으면 되므로 모우터의 위치가 고정된 형식에 비해 체적 감소가 가능하다. 에너지 변환기를 구성하는 기계요소로는 2단의 유성기어열과 랙(rack)뿐으로서 비교적 구조가 간단하여 고장의 가능성이 낮다. 따라서 기존 모델들이 지니고 있는 단점들이 거의 극복 되었다. 현재 모의 순환실험에 성공하고 동물 실험을 준비 하고 있다.

• Transactions of the Korean Society of Mechanical Engineers
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• v.15 no.3
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• pp.855-868
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• 1991

본 연구에서는 위에서 언급한바와 같은 제반사항들에 대해 이론적인 해석을 행하고, 그 결과를 이용하여 설계된 모델이 생체내에 이식될 수 있는 가능성의 여부를 판단하며 생체내에 이식 되었을 때의 성능과 생체에 미치는 영향등을 예측하고자 한다.

• Journal of the Korean Society of Radiology
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• v.12 no.3
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• pp.313-319
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• 2018

In radiation treatment, it is unavoidable to block the influence of scattered ray on a skin and prevent internal normal organs from being exposed to radiation. It is fair to say that radiation therapy aims to reduce an absorbed dose of normal tissues. In particular, in radiation therapy of left-sided breast cancer, the internal neighboring organs are normal breast tissues, the heart, and the lung. The side effects on the heart include cardioplegy and myocardial infarction. This study tried to observe changes in the volume and dose of the heart in general radiation therapy plan and respiratory control based radiation therapy plan for patients with left-sided breast cancer, and to find the heart's volume and dose generated by respiration. According to the 4D computer tomography (CT), a volume of the heart had $12.8{\pm}8.7cc$ on average, and its dose had $17.3{\pm}12.1cGy$ on average. The differences in the volume and dose may cause side effects in radiation treatment. Therefore, it is necessary to apply respiratory control technique to establish the radiation treatment plan based on an accurate position of the heart.

• Proceeding of EDISON Challenge
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• 2017.03a
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• pp.662-664
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• 2017

심실 내부에 가해지는 수축력에 의해 심실 내부 벽에는 큰 무리가 될 수 있다. 이로 인해 다양한 심장질환인 부정맥, 심실 세동 등을 유발한다. 따라서 본 연구에서는 가상 심장모델을 구축하여 컴퓨터 시뮬레이션을 통한 수축이완시의 심장 상태를 살펴보고자 하였다. 이를 위해서 개 심장 모델을 활용하여 3차원으로 이뤄진 심장모델을 구현하였다. 심장모델의 전기생리학 기전에 기초한 전기전도 해석을 수행하고, 전기전도 해석 시 발생되는 칼슘이온의 농도변화를 활용하였다. 시간에 따른 칼슘 이온의 심장 수축 영향을 바탕으로 비선형 유한요소법을 이용, 3차원 심장의 수축역학을 해석하였다. 이러한 기전으로 심장 근육에 부하되는 응력(tension)를 계산하고, 이렇게 계산된 심근의 응력분포에 대해 관측 및 분석을 진행하였다.

• Proceedings of the Korean Information Science Society Conference
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• 2002.04a
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• pp.751-753
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• 2002

본 논문에서는 여러 시간대에 걸쳐 획득한 영상 데이터 집합에 대하여 동적 모델을 이용한 데이터들의 동시 가시화를 수행하고, 각 모델들 간의 변이를 분석하여 객관적인 영상 분석결과를 가시화해주는 연구를 수행하였다. 먼저 동적 모델의 동시 가시화를 위하여 동적 모델 데이터의 저장 및 로딩 모듈을 설계하였고, 동적 모델들간의 변이 분석은 체적, 속도를 비교 가시화함으로써 이루어졌다. 이를 한 환자에대하여 치료기간 중 일정 시간대별로 획득된 심장영상 집합들에 적용함으로써 기존의 영상분석의 한계점을 극복하고 심장 질환의 진단을 효율적으로 도울 수 있도록 하였다.

• Journal of Chest Surgery
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• v.32 no.5
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• pp.422-427
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• 1999

Background: Tachycardia induced heart failure model would be the model of choice for the dilated cardiomyopathy. This more closely resembles the clinical syndrome and does not require major surgical trauma, myocardial ischemia and pharmacological or toxic depression of cardiac function. When heart failure is progressive, application of new surgical procedures to the faling heart is highly risky. It has been shown that recovery trajectory from heart failure is a new method in decreasing animal mortality. The purpose is to establish the control datas for recovery trajectory in the canine heart failure model. Material and Method: 21 mongrel dogs were studied at 4 stages(baseline, at the heart failure, 4 and 8 weeks after recovery). Heart failure was induced during 4 weeks of continuous rapid pacing using a pacemaker. Eight weeks of trajectory of recovery period was allowed. Indices of left ventricular function and dimension were measured every 2 weeks and the hemodynamics were measured by use of Swan-Ganz catheterization and thermodilution method every 4 weeks. Values were expressed as mean${\pm}$standard deviation. Result: 4(20%) dogs died due to heart failure. Left ventricular end-diastolic volume at the 4 stages were 40.8${\pm}$7.4, 82.1${\pm}$21.1, 59.9${\pm}$7.7 and 46.5${\pm}$6.5ml. Left ventricular end-systolic volume showed the same trend. Ejection fractions were 50.6${\pm}$4.1, 17.5${\pm}$5.8, 36.3${\pm}$7.3, and 41.5${\pm}$2.4%. Blood pressure and heart rate showed no significant changes. Pressures of central vein, right ventricle, pulmonary artery, and pulmonary capillary wedge showed significant increase during the heart failure period, normalizing at the end of recovery period. Stroke volumes were 21.5${\pm}$8.2, 12.3${\pm}$3.5, 17.9${\pm}$4.6, and 15.5${\pm}$3.4ml. Blood norepinephrine level was 133.3${\pm}$60.0pg/dL at the baseline and 479.4${\pm}$327.3pg/dL at the heart failure stage(p=0.008). Conclusion: Development of tachycardia induced heart failure model is of high priority due to ready availability and reasonable amenability to measurements. Recovery trajectory after cessation of tachycardia showed reduction of cardiac dilatation and heart function. Application of new surgical procedures during the recovery period could decrease animal mortality.

• Proceedings of the KOSOMBE Conference
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• v.1994 no.05
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• pp.19-22
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• 1994

심장과 혈관의 고해상도 영상을 얻어 심질환에 관한 정보를 얻는데는 혈관조영기(Angiograph)가 가장 유용하게 사용되고 있다. 본 연구는 혈관조영기의 정량분석을 위한 영상 알고리즘을 구현하였다. 심장의 수축 이완에 따른 심벽의 부위별 움직임과 심장 체적 변화를 측정 수치화하고 혈관을 따라가면서 혈관의 두께를 기록하는 프로그램을 작성하였다. 영상획득과정에서 생기는 잡음과 위치오차를 없애는 전처리를 거친 후에 구조적 형태 인식법(Structural Pattern Recognition)으로 인식 알고리즘을 구현하였다. 14장의 심장의 수축이완 연속사진과 2장의 관상동맥 혈관조영사진을 분석한 결과 비교적 정확한 측정을 해내는 것을 관찰할 수 있었다.

• Progress in Medical Physics
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• v.25 no.4
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• pp.199-204
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• 2014

The purpose of this study is to evaluate the dosimetric outcome of the field-in-field (FIF) plans compared with tangential wedged beams (TWB) plans for whole breast irradiation of breast cancer patients. Twenty patients with right-sided breast cancer and 10 patients with left-sided breast cancer were retrospectively enrolled in this study. We generated a FIF plan and a TWB plan for each patient to compare dosimetric outcomes. The dose the homogeneity index (HI), the conformity index (CI) and the uniformity index (UI) were defined and used for comparison of the dosimetric outcome of the planning target volume (PTV). To compare the dosimetric outcome of the organs at risk, the mean dose ($D_{mean}$) and the percentage of volumes receiving more than 10, 20 and 30 Gy of the ipsilateral lung and heart were used. The FIF plans had significantly lower HI (p=0.002), higher UI (p=0.000) and CI (p=0.000) than those of the TWB plans, which means that the FIF plans were better than the TWB plans in the dosimetric comparisons of the PTV. The $V10_{lung}$ ($17.1{\pm}7.1$ vs. $18.6{\pm}6.6%$, p=0.020) and $V30_{lung}$ ($10.3{\pm}5.1%$ vs. $10.7{\pm}5.2%$, p=0.000) were lower with the FIF plans compared with those of the TWB plans, with statistical significance. For the left-sided breast cancer patients, $D_{mean}$ of the heart ($2.6{\pm}1.3$ vs. $3.2{\pm}1.4$ Gy, p=0.000), $V20_{heart}$ ($3.4{\pm}2.6$ vs. $3.6{\pm}2.8%$, p=0.005) and $V30_{heart}$ ($2.6{\pm}2.3%$ vs. $2.9{\pm}2.4%$, p=0.004) were significantly lower for the FIF plans in comparison with those of the TWB plans. The FIF plans increased the dose homogeneity, conformity and uniformity of the target volume for the whole-breast irradiation compared with the TWB plans. Moreover, FIF plans reduced the doses to the ipsilateral lung and heart.

• Radiation Oncology Journal
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• v.21 no.1
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• pp.82-93
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• 2003

Purpose : To reduce the Irradiation dose to the lungs and heart in the case of chest wail irradiation using an oppositional electron beam, we used an Individualized custom bolus, which was precisely designed to compensate for the differences In chest wall thickness. The benefits were evaluated by comparing the normal tissue complication probablilties (NTCPS) and dose statistics both with and without boluses. Materials and Methods : Boluses were made, and their effects evaluated in ten patients treated using the reverse hockey-stick technique. The electron beam energy was determined so as to administer 80% of the irradiation prescription dose to the deepest lung-chest wall border, which was usually located at the internal mammary lymph node chain. An individualized custom bolus was prepared to compensate for a chest wall thinner than the prescription depth by meticulously measuring the chest wall thickness at 1 emf intervals on the planning CT Images. A second planning CT was obtained overlying the individuailzed custom bolus for each patient's chest wall. 3-D treatment planning was peformed using ADAC-Pinnacle$^{3}$ for all patients with and without bolus. NTCPS based on 'the Lyman-Kutcher' model were analyzed and the mean, maximum, minimum doses, V$_{50}$ and V$_{95}$ for 4he heari and lungs were computed. Results .The average NTCPS in the ipsliateral lung showed a statistically significant reduction (p<0.01), from 80.2${\pm}$3.43% to 47.7${\pm}$4.61%, with the use of the individualized custom boluses. The mean lung irradiation dose to the ipsilateral iung was also significantly reduced by about 430 cGy, Trom 2757 cGy to 2,327 cGy (p<0.01). The V$_{50}$ and V$_{95}$ in the ipsilateral lung markedly decreased from the averages of 54.5 and 17.4% to 45.3 and 11.0%, respectively. The V$_{50}$ and V$_{95}$ In the heart also decreased from the averages of 16.8 and 6.1% to 9.8% and 2.2%, respectively. The NTCP In the contralateral lung and the heart were 0%, even for the cases with no bolus because of the small effective mean radiation volume values of 4.4 and 7.1%, respectively Conclusion : The use of an Individualized custom bolus in the radiotherapy of postrnastectorny chest wall reduced the NTCP of the ipsilateral lung by about 24.5 to 40.5%, which can improve the complication free cure probability of breast cancer patients.