• The Journal of Korean Society for Radiation Therapy
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• v.30 no.1_2
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• pp.41-47
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• 2018

Purpose : The purpose of this study is to evaluate the usefulness of 6 Dimensional Skull Tracking(6DST) in Cyberknife Stereotactic Body Radiation Therapy(SBRT) for the first and second cervical vertebrae(C1 and C2) metastasis. Methode and material : The Computed Tomography (Lightspeed VCT 64, General Electric Co. Waukesha, WI, USA) was used to acquire the CT images of the 9 patients with cervical vertebrae(C1 and C2) metastasis. Treatment plans for Xsight spine tracking and 6 Dimensional skull tracking were established with planning system (Multiplan system Version 4.6, Accuray, US). The results of XST and 6DST for each patient were analyzed with Microsoft Excel 2010. Result : The Maximum offsets of XST for C1 were 0.9 mm in Y(supero-inferior), 0.9 mm in Z(antero-posterior), 0.7 mm in X(left-right) direction, and rotations were and 1.0 degrees roll, 1.0 degrees pitch and 1.2 degrees yaw. The Maximum offsets of 6DST for C1 were 0.7 mm, 0.7 mm, 0.9 mm and $1.0^{\circ}$, $1.0^{\circ}$, $1.2^{\circ}$ for Y, Z, X and Roll, Pitch, Yaw. The Maximum offsets of XST and 6DST for C2 were 0.7 mm, 0.7 mm, 0.8 mm and $0.9^{\circ}$, $1.0^{\circ}$, $1.8^{\circ}$, and 0.9 mm, 0.7 mm, 0.9 mm and $0.9^{\circ}$, $0.9^{\circ}$, $1.0^{\circ}$ for Y, Z, X and Roll, Pitch, Yaw, respectively. Conclusion : XST and 6DST showed identical results for translations and rotations within the tolerance. It is possible to simplify the treatment time and procedure by using the 6DST. Therefore, 6DST is very useful methode with XST among the various tracking methods in Cyberknife for the patients with C1, C2 vertebral metastasis.

• Journal of the Korean earth science society
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• v.43 no.1
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• pp.151-164
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• 2022

According to the records of historical and instrumental earthquakes, the southeastern part of the Korean Peninsula is considered the highest seismic activity area. Owing to recent reports of numerous Quaternary faults along the Yangsan and Ulsan fault zones, paleoseismological studies are being actively conducted in these areas. The study area is located in the central part of the Ulsan fault zone, where the largest number of active faults have been reported. Based on lineament and geomorphic analysis using LiDAR images and aerial photographs, fault-related landforms showing topographic relief were observed and a trench survey was conducted. The trench length 20 m, width 5 m, depth 5 m is located approximately 300 m away to the northeast from the previously reported Malbang fault. From the trench section, we interpreted the geometric and kinematic characteristics of the fault based on the deformed features of the Quaternary sedimentary layers. The attitude of the reverse fault, N26°W/33°NE, is similar to those of the reported faults distributed along the Ulsan fault zone. Although a single apparent displacement of approximately 40 cm has been observed, the true displacement could not be calculated due to the absence of the slickenline on the fault plane. Based on the geochronological results of the cryogenic structure proposed in a previous study, the most recent faulting event has been estimated as being earlier than the late Wurm glaciation. We interpreted the thrust fault system of the study area as an imbrication structure based on the previous studies and the fault geometry obtained in this additional trench. Although several previous investigations including many trench surveys have been conducted, they found limited success in obtaining the information on fault parameters, which could be due to complex characteristics of the reverse fault system. Additional paleoseismic studies will contribute to solving the mentioned problems and the comprehensive fault evolution.

• Therapeutic Science for Rehabilitation
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• v.13 no.1
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• pp.9-21
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• 2024

Objective : The purpose of this study was to confirm the characteristics and quality of a single-subject research that conducted interventions to improve activities of daily living (ADL) in stroke patients. Methods : 'Stroke,' 'activities of daily living,' and 'single-subject studies' were searched as keywords among papers published in the last 15 years between 2009 and 2023 among Research Information Sharing Service, DBpia, and e-articles. A total of nine papers were examined for the characteristics and quality before analysis. Results : The independent variables applied to improve ADL included constraint-induced therapy, mental practice for performing functional activities, virtual reality-based task training, subjective postural vertical training without visual feedback, bilateral upper limb movement, core stability training program, traditional occupational therapy and neurocognitive rehabilitation, smooth pursuit eye movement, neck muscle vibration, and occupation-based community rehabilitation. Assessment of Motor and Process Skills was the most common evaluation tool for measuring dependent variables, with four articles, and Modified Barthel Index and Canadian Occupational Performance Measure were two articles each. As a result of confirming the qualitative level of the analyzed papers, out of a total of nine studies, seven studies were at a high level, two at a moderate level, and none were at a low level. Conclusion : Various types of rehabilitation treatments have been actively applied as intervention methods to improve the daily life activities of stroke patients; the quality level of single-subject studies applying ADL interventions was reliable.

• Radiation Oncology Journal
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• v.23 no.3
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• pp.143-156
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• 2005

Background: The best dose-fractionation regimen of the definitive radiotherapy for cervix cancer remains to be clearly determined. It seems to be partially attributed to the complexity of the affecting factors and the lack of detailed information on external and intra-cavitary fractionation. To find optimal practice guidelines, our experiences of the combination of external beam radiotherapy (EBRT) and high-dose-rate intracavitary brachytherapy (HDR-ICBT) were reviewed with detailed information of the various treatment parameters obtained from a large cohort of women treated homogeneously at a single institute. Materials and Methods: The subjects were 743 cervical cancer patients (Stage IB 198, IIA 77, IIB 364, IIIA 7, IIIB 89 and IVA 8) treated by radiotherapy alone, between 1990 and 1996. A total external beam radiotherapy (EBRT) dose of $23.4\~59.4$ Gy (Median 45.0) was delivered to the whole pelvis. High-dose-rate intracavitary brachytherapy (HDR-IBT) was also peformed using various fractionation schemes. A Midline block (MLB) was initiated after the delivery of $14.4\~43.2$ Gy (Median 36.0) of EBRT in 495 patients, while In the other 248 patients EBRT could not be used due to slow tumor regression or the huge initial bulk of tumor. The point A, actual bladder & rectal doses were individually assessed in all patients. The biologically effective dose (BED) to the tumor ($\alpha/\beta$=10) and late-responding tissues ($\alpha/\beta$=3) for both EBRT and HDR-ICBT were calculated. The total BED values to point A, the actual bladder and rectal reference points were the summation of the EBRT and HDR-ICBT. In addition to all the details on dose-fractionation, the other factors (i.e. the overall treatment time, physicians preference) that can affect the schedule of the definitive radiotherapy were also thoroughly analyzed. The association between MD-BED $Gy_3$ and the risk of complication was assessed using serial multiple logistic regression models. The associations between R-BED $Gy_3$ and rectal complications and between V-BED $Gy_3$ and bladder complications were assessed using multiple logistic regression models after adjustment for age, stage, tumor size and treatment duration. Serial Coxs proportional hazard regression models were used to estimate the relative risks of recurrence due to MD-BED $Gy_{10}$, and the treatment duration. Results: The overall complication rate for RTOG Grades $1\~4$ toxicities was $33.1\%$. The 5-year actuarial pelvic control rate for ail 743 patients was $83\%$. The midline cumulative BED dose, which is the sum of external midline BED and HDR-ICBT point A BED, ranged from 62.0 to 121.9 $Gy_{10}$ (median 93.0) for tumors and from 93.6 to 187.3 $Gy_3$ (median 137.6) for late responding tissues. The median cumulative values of actual rectal (R-BED $Gy_3$) and bladder Point BED (V-BED $Gy_3$) were 118.7 $Gy_3$ (range $48.8\~265.2$) and 126.1 $Gy_3$ (range: $54.9\~267.5$), respectively. MD-BED $Gy_3$ showed a good correlation with rectal (p=0.003), but not with bladder complications (p=0.095). R-BED $Gy_3$ had a very strong association (p=<0.0001), and was more predictive of rectal complications than A-BED $Gy_3$. B-BED $Gy_3$ also showed significance in the prediction of bladder complications in a trend test (p=0.0298). No statistically significant dose-response relationship for pelvic control was observed. The Sandwich and Continuous techniques, which differ according to when the ICR was inserted during the EBRT and due to the physicians preference, showed no differences in the local control and complication rates; there were also no differences in the 3 vs. 5 Gy fraction size of HDR-ICBT. Conclusion: The main reasons optimal dose-fractionation guidelines are not easily established is due to the absence of a dose-response relationship for tumor control as a result of the high-dose gradient of HDR-ICBT, individual differences In tumor responses to radiation therapy and the complexity of affecting factors. Therefore, in our opinion, there is a necessity for individualized tailored therapy, along with general guidelines, in the definitive radiation treatment for cervix cancer. This study also demonstrated the strong predictive value of actual rectal and bladder reference dosing therefore, vaginal gauze packing might be very Important. To maintain the BED dose to less than the threshold resulting in complication, early midline shielding, the HDR-ICBT total dose and fractional dose reduction should be considered.

• Radiation Oncology Journal
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• v.21 no.2
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• pp.125-134
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• 2003

Purpose: To report the early results of preopeartive concurrent radio-chemotherapy (CRCT) for treating rectal cancer. Materials and Methods: From June 1999 to April 2002, 40 rectal cancer patients who either had lesions with a questionable resectability or were candidates for sphincter-sacrificing surgery received preoperative CRCT. Thirty-seven patients completed the planned CRCT course. 45 Gy by 1.8 Gy daily fraction over 5 weeks was delivered to the whole pelvis in the prone position. The chemotherapy regimens were oral UFT plus oral leucovorin (LV) in 12 patients, intravenous bolus 5-FU plus LV in 10 patients, and intravenous 5-FU alone in 15 patients (bolus infusion in 10, continuous infusion in 5). Surgery was planned in 4$\~$6 weeks of the completion of the preoperative CRCT course, and surgery was attempted in 35 patients. Results: The compliance to the current preoperative CRCT protocol was excellent, where 92.5$\%$ (37/40) completed the planned treatment. Among 35 patients, in whom surgery was attempted after excluding two patients with new metastatic lesions in the liver and the lung, sphincter-preservation was achieved in 22 patients (62.9$\%$), while resection was abandoned during laparotomy in two patients (5.7$\%$). Gross complete resection was peformed in 30 patients, gross incomplete resection was peformed in one patient, and no detailed information on the extent of surgery was available in two patients. Based on the surgical and pathological findings, the down-staging rate was 45.5$\%$ (15/33), and the complete resection rate with the negative resection margin 78.8$\%$ (26/33). During the CRCT course, grade 3 $\~$4 neutropenia developed in four patients (10.8$\%$). Local recurrence after surgical resection developed in 12.1$\%$ (4/33), and distant metastases after the preoperative CRCT start developed in 21.6$\%$ (8/37). The overall 3-years survival rate was 87$\%$. Conclusion: Preoperative CRCT in locally advanced rectal cancer is well tolerated and can lead to high resection rate, down-staging rate, sphincter preservation rate, however, longer term follow-up will be necessary to confirm these results.

• Journal of the Korean Institute of Traditional Landscape Architecture
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• v.30 no.1
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• pp.46-56
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• 2012

The research results of tracing the Landscape Philosophy of Hageowon garden(何去園) in Musu-dong, Daejon of Youhwadang, Kwon, Iijin(權以鎭, 1668-1734) is as below. The ideological background of the protagonist reflected in Hageowon is the Hyoje Ideology(filial piety and brotherly love, 孝弟) of Sinjongchuwon(painstakingly caring for one's ancestors), Musil ideology(pursuing ethical diligence and truthful mind, 務實) based on sadistic tradition and ethical rationalism, Confucionist Eunil Ideology(ideology on seclusion, 隱逸) of Cheonghanjiyeon(quiet relaxation, 淸閒之燕), and the Pungryu ideology(appreciation for the arts, 風流) of Taoism in the Taoist style. Thus, by substituting these ideological values into a space called Hageowon, the Byulup gardens(別業) such as the Symbolic garden(象徵園), meaning gaeden(意園), and miniascape garden(縮景園) were able to be constructed. 2) The space organization system of Hageowon is generally classified into three phases considering the hierarchy. The first territory is the transitional space having residential features, which is an area to reach peach tree - road(Taoist world 桃經) from Youhwadang(有懷堂). The second territory is a monumental memorial space where the Yocheondae(繞千臺), Jangwoodam(丈藕潭), Hwagae(花階), and the ancestral graves take place, centering on the yards of Sumanheon(收漫軒), and the third territory is the secluded space in the eastern outer garden where the mountain stream flows from the north to south and which is the vein of the left-hand blue dragon(靑龍) of the guardian mountain of Hageowon. 3) Symbolically, the first phase has symbolized the space as a meaningful scenery by overlapping the Confucionist place of Youhwadang - Gosudae(孤秀臺) - Odeokdae(五德臺), and the mystic world of Jukcheondang(竹遷堂) - peach tree - road(桃徑). The second phase, which is the space of Sumanheon(收漫軒), Yocheondae, and Jangwoodam, the symbolical value of Sinjongchuwon(愼終追遠) and the remembrance and longing for one's parents are reflected. The third phase, which is the eastern outer garden of Hageowon and where the mountain stream flows from the north to south, is composed of the east valley(東溪) - Hwalsudam(活水潭) - Sumi Waterfall(修眉瀑布). More specifically, (1) Mongjeong symbolizes the life of gaining knowledge through studying to realize one's foolishness, (2) Hwalsudam symbolizes a transcending attitude in life refusing to pursue wealth and fame, and (3) Jangwoodam symbolizes the gateway to the fairyland to enter the world of mystic gods. 4) The rationale behind Hageowon is that the two algorithms of Confucionism and Taoist Theory appear repeatedly and in an overlapping way. The Napoji(納汚池) and Hwalsudam, which pertains to the prelude of space development, has symbolized Susimyangseong(修心養成, meditating one's mind and improving one's nature), which is based on ethical rationalism. Moreover, if the Monjeong sphere pertaining to the eastern outer garden of Hageowon takes the Confucionist value system as its theme, including moral training, studying, and researching, Jangwudam, Sumi Waterfalls, and Unwa can be understood as a taste of Cheokbyeon(滌煩, eliminating troubles) for the arts where the mystic world is substituted as a meaningful scenery. 5) The miniascape technique called artificial mountain was substituted to Hageowon to construct a mystic world like the 12 peaks of Mt. Mu(巫山). By borrowing the symbolic meaning expressed in old poems, it has been named 'Habang(1/何放), Hwabong(2, 3/和峯), Chulgun(4, 5, 6/出群), Sinwan(7/神浣), Chwhigyu(8, 9, 10/聚糾), Cheomyo(11/處杳), Giyung(12/氣融).' The representative poet reciting artificial mountain were Wangeui(汪醫), Nosamgang(魯三江), Dubo(杜甫), Hanyou(韓愈), Jeonheaseong(錢希聖), and Beomseokho(范石湖). They related themselves with literature by transcending time and space and attempted to sing about the richness of the mental world by putting the mystic world and culture of appreciating the arts they pursued in the vacation home called Hageowon.