• The Journal of Korean Society for Radiation Therapy
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• v.31 no.1
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• pp.75-81
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• 2019

Purpose: Helmet type bolus for 3D printer is being manufactured because of the disadvantages of Bolus materials when photon beam is used for the treatment of scalp malignancy. However, PLA, which is a used material, has a higher density than a tissue equivalent material and inconveniences occur when the patient wears PLA. In this study, we try to treat malignant scalp tumors by using M3 wax helmet with 3D printer. Methods and materials: For the modeling of the helmet type M3 wax, the head phantom was photographed by CT, which was acquired with a DICOM file. The part for helmet on the scalp was made with Helmet contour. The M3 Wax helmet was made by dissolving paraffin wax, mixing magnesium oxide and calcium carbonate, solidifying it in a PLA 3D helmet, and then eliminated PLA 3D Helmet of the surface. The treatment plan was based on Intensity-Modulated Radiation Therapy (IMRT) of 10 Portals, and the therapeutic dose was 200 cGy, using Analytical Anisotropic Algorithm (AAA) of Eclipse. Then, the dose was verified by using EBT3 film and Mosfet (Metal Oxide Semiconductor Field Effect Transistor: USA), and the IMRT plan was measured 3 times in 3 parts by reproducing the phantom of the head human model under the same condition with the CT simulation room. Results: The Hounsfield unit (HU) of the bolus measured by CT was $52{\pm}37.1$. The dose of TPS was 186.6 cGy, 193.2 cGy and 190.6 cGy at the M3 Wax bolus measurement points of A, B and C, and the dose measured three times at Mostet was $179.66{\pm}2.62cGy$, $184.33{\pm}1.24cGy$ and $195.33{\pm}1.69cGy$. And the error rates were -3.71 %, -4.59 %, and 2.48 %. The dose measured with EBT3 film was $182.00{\pm}1.63cGy$, $193.66{\pm}2.05cGy$ and $196{\pm}2.16cGy$. The error rates were -2.46 %, 0.23 % and 2.83 %. Conclusions: The thickness of the M3 wax bolus was 2 cm, which could help the treatment plan to be established by easily lowering the dose of the brain part. The maximum error rate of the scalp surface dose was measured within 5 % and generally within 3 %, even in the A, B, C measurements of dosimeters of EBT3 film and Mosfet in the treatment dose verification. The making period of M3 wax bolus is shorter, cheaper than that of 3D printer, can be reused and is very useful for the treatment of scalp malignancies as human tissue equivalent material. Therefore, we think that the use of casting type M3 wax bolus, which will complement the making period and cost of high capacity Bolus and Compensator in 3D printer, will increase later.

• The Journal of the Korean bone and joint tumor society
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• v.16 no.1
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• pp.21-26
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• 2010

Purpose: To analyze clinical, radiological and pathological features as well as clinical outcome after surgical treatment of patients with secondary chondrosarcoma arising from osteochondroma(tosis). Materials and Methods: We retrospectively reviewed clinical records, radiographs, pathologic slides of 14 patients. Nine patients were male and fi ve were female. The mean age was 34 years. The mean follow-up period was 54 months. Results: All patients had a history of previous mass since childhood or puberty. Preexisted osteochondroma was single in 3 patients and multiple in 10. Remaining 1 patient had multiple osteochondromatosis with enchondromatosis. MRI clearly provided thickness of cartilage cap, which was over 2 cm except in 2 cases. Chondrosarcoma was grade 1 in all except 1 case, which was grade 2. Wide excision was performed in 10 patients, marginal excision in 3 and amputation in 1. Twelve patients were doing very well without evidence of disease. Among 3 patients with marginal excision, 1 patient had local recurrence and 1 patient died of disease. Conclusion: Comprehensive understanding of clinical, radiological and pathological features of secondary chondro sarcoma is warranted for accurate diagnosis. The best result can be expected with early recognition of malignant change of osteohcondroma(tosis) and wide excision.

• The Journal of Korean Society for Radiation Therapy
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• v.24 no.2
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• pp.189-196
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• 2012

Purpose: The sufficiency of skin dose and the reemergence of patient set-up position to the success of skin cancer radiation treatment is a very important element. But the conventional methods to increase the skin dose were used to vacuum cushion, bolus and water tank have several weak points. For this reason, we producted Foxtail Millet Vacuum Cushion and evaluated the efficiency of the Foxtail Millet Vacuum Cushion in skin cancer Radiation treatment. Materials and Methods: We measured absolute dose for 3 materials (Foxtail Millet Vacuum Cushion, bolus and solid water phantom) and compared each dose distribution. We irradiated 6 MV 100 MU photon radiation to every material of 1 cm, 2 cm, 3 cm thickness at three times. We measured absolute dose and compared dose distribution. Finally we inspected the CT simulation and radiation therapy planing using the Foxtail Millet Vacuum Cushion. Results: Absolute dose of Foxtail Millet Vacuum Cushion was similar to absolute dose of bolus and solid water phantom's result in each thickness. it Showed only the difference of 0.1~0.2% between each material. Also the same result in dose distribution comparison. About 97% of the dose distribution was within the margin of error in the prescribed ranges ($100{\pm}3%$), and achieved the enough skin dose (Gross Tumor Volume dose : $100{\pm}5%$) in radiation therapy planing. Conclusion: We evaluated important fact that Foxtail Millet Vacuum Cushion is no shortage of time to replace the soft tissue equivalent material and normal vacuum cushion at the low energy radiation transmittance. Foxtail Millet Vacuum Cushion can simultaneously achieve the enough skin dose in radiation therapy planing with maintaining normal vacuum cushion' function. Therefore as above We think that Foxtail Millet Vacuum Cushion is very useful in skin cancer radiation treatment.

• Journal of the Korean Society of Radiology
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• v.15 no.7
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• pp.965-973
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• 2021

Since radiation therapy is irradiated with high-energy X-rays in a variety of at least 20 Gy to 80 Gy, a high dose is administered to the local area where the tumor is located, and various side effects of some normal tissues are expected. Currently, in clinical practice, lead, a representative material, is used as an effort to shield normal tissues, but lead is classified as a heavy metal harmful to the human body, and a large amount of skin contact can cause poisoning. Therefore, this study intends to manufacture a measurement sheet that can compensate for the limitations of lead using the materials Tungsten, Brass, and Copper of the 3D printer of the FDM (Fused Deposition Modeling) method and to investigate the penetration performance. Tungsten mixed filament transmission measurement sheet size was 70 × 70 mm and thickness 1, 2, 4 mm using a 3D printer, and a linear accelerator (TrueBeam STx, S/N: 1187) was measured by irradiating 100 MU at SSD 100 cm and 5 cm in water using a water phantom, an ion chamber (FC-65G), and an elcetrometer (PTW UNIDOSE), and the permeability was evaluated. As a result of increasing the measurement sheet of each material by 1 mm, in the case of Tungsten sheet at 3.8 to 3.9 cm in 6 MV, the thickness of the lead shielding body was thinner than 6.5 cm, and in case of Tungsten sheet at 4.5 to 4.6 cm in 15 MV. The sheet was thinner than the existing lead shielding body thickness of 7 cm, and equivalent performance was confirmed. Through this study, the transmittance measurement sheet produced using Tungsten alloy filaments confirmed the possibility of transmission shielding in the high energy region. It has been confirmed that the usability as a substitute is also excellent. It is thought that it can be provided as basic data for the production of shielding agents with 3D printing technology in the future.

• Radiation Oncology Journal
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• v.10 no.1
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• pp.107-113
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• 1992

Increasing frequency of skin cancer, mycosis fungoides, Kaposi's sarcoma etc, it need to treatment dose planning for total skin electron beam (TSEB) therapy. Appropriate treatment planning for TSEB therapy is needed to give homogeneous dose distribution throughout the entire skin surface. The energy of 6 MeV electron from the 18 MeV medical linear accelerator was adapted for superficial total skin electron beam therapy. The energy of the electron beam was reduced to 4.2 MeV by a $0.5\;cm\times90\;cm{\times}180\;cm$ acryl screen placed in a feet front of the patient. Six dual field beam was adapted for total skin irradiation to encompass the entire body surface from head to toe simultaneously. The patients were treated behind the acryl screen plate acted as a beam scatterer and contained a parallel-plate shallow ion chamber for dosimetry and beam monitoring. During treatment, the patient was placed in six different positions due to be homogeneous dose distribution for whole skin around the body. One treatment session delivered 400 cGy to the entire skin surface and patients were treated twice a week for eight consecutive weeks, which is equivalent to TDF value 57. instrumentation and techniques developed in determining the depth dose, dose distribution and bremsstrahlung dose are discussed.

• Journal of Oral Medicine and Pain
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• v.38 no.3
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• pp.247-253
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• 2013

Renal osteodystrophy(RO) is characterized by skeletal changes in patients with renal disease and developed as a result of alterations in the metabolism of calcium, phosphate and secondary hyperparathyroidism. Bony changes in the craniofacial region include decreased bone density, radiolucent lesions(brown tumors), depletion of cortical bone and loss of lamina dura, but such changes rarely occur in the temporomandibular joint(TMJ). We report an uncommon case of bony changes and pain of both TMJs in a patient with RO. A 41-year-old man with RO came to our clinic due to TMJ pain and sounds. Occlusal change was also reported. Radiographs revealed degenerative changes of the both condyles. The patient had medical history of renal cancer therapy and hemodialysis. The patient was diagnosed with TMJ arthritis of RO and referred for systemic management through medication of calcium and vitamin D and parathyroidectomy. At 15-month follow-up, most of TMD symptoms disappeared and second radiographs revealed that bone density and cortical thickness of the mandible increased and the skeletal outline of the both condyles became relatively clear. As bony changes may begin in the early stage of the renal disease, dentists should be alert to detect the sign of the disease. In addition, it is important to differentiate TMJ arthritis of systemic cause because the treatment protocol is quite different.

• Progress in Medical Physics
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• v.25 no.1
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• pp.1-7
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• 2014

Hyperthermia is effective treatment modality when it combine with the radiotherapy treatment. It is important to verify the temperature distribution of (patient's) body for the safety and effective treatment during raising the temperature. In this study, we raised the temperature in agar phantom using radio frequency (RF) Hyperthermia and protocol that manufacture recommend. Temperature distribution measured 5 section of 5 cm thickness with agar phantom. When the temperature was raised according to the increase energy. Temperature distribution was elevated at similar domain regardless of energy. The temperature tend to be increased at up side then bottom side and also increase when A large electrode was used than small one.

• Journal of Korean Academy of Nursing
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• v.22 no.2
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• pp.248-259
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• 1992

질적 보장은 전문직 종사자에 의하여 수혜받는 대상자를 보호하기 위하여 전적으로 필요한 프로그램이다. 이러한 질적보장을 통하여 전문직의 자율성과 책임을 튼튼히 할 수 있는 의무는 전문직 종사자 모두의 관심사가 되어야 한다. 미국에 있어서 질적 간호에 대한 관심은 이제 새로운 이유가 아니다. Beyers(1988)는 건강체계 지도자 사이에 가장 중요한 문제로 강조하는 것이 수혜자의 이용의 용이성(Access), 숫가(Cost) 그리고 질적인 제공(Quality)이 라고 피력 하였다. 미국 건강사업 평가자와 조정자(Regulator)들은 질(Quality)을 위한 자율적인 프로그램에 많은 에너지를 투입하여 전반적인 건강사업 즉 의료계의 질보장, 더 나아가서는 간호의 질을 향상 시키기 위한 많은 프로그램을 분석 연구한다. 이 논문은 간호에 있어서 질적 보장을 위한 내용으로 주요점은 질적 보장에 사용되는 용어, 역사적 배경, 질적 보장을 강조하는 이유, 질적 보장제도의 개발, 질 사정(euali assessment)과 질적 보장에 있어서 간호 전문직 개입을 차례대로 설명하였다. 구미의 경우 1970년대부터 간호직에 있어서는 질적보장제도개발에 우선순위를 두게되어 미 간호협회에서는 Professional Standards Review Organizations (PSRO)에 근거하여 간호실무를 위한 표준을 내어놓았다. 질적보장을 위한 평가방법으로 구조, 과정, 결과 그리고 수혜자가 간호계획을 세우는데 사정에 참여하는 방법 등 4가지를 간략하게 설명하였다. 질적 보장을 향상시키기 위해서는 전문직과 공공의료기간이 서로 협동체가 되어 중추역할을 해야함을 강조하고 이렇게 서로 협력하므로써만이 비로서 우리의 목적을 성취할 수 있다고 생각된다.구 등이 이용된다. $^{166}$ Ho, $^{198}$ Au, $^{32}$P, $^{90}$ Y, $^{169}$ Er, $^{186}$ Rc, $^{131}$ I, $^{211}$ At 등 의 방사성 핵종의 교질, 미소구 또는 단세포군 항체표지 형태로 직접 종양내 또는 공동이나 체강에 투여하는 치료법이 있다. 류마치스 관절염의 슬관절에 $^{165}$ Dy colloid를 주사하는 $^{166}$ Ho-MAA도 활발히 이용되고 있다. and computed groundwater levels. 본 논문에서는 가파른 산사면에서 산사태의 발생을 예측하기 위한 수문학적 인 지하수 흐름 모델을 개발하였다. 이 모델은 물리적인 개념에 기본하였으며, Lumped-parameter를 이용하였다. 개발된 지하수 흐름 모델은 두 모델을 조합하여 구성되어 있으며, 비포화대 흐름을 위해서는 수정된 abcd 모델을, 포화대 흐름에 대해서는 시간 지체 효과를 고려할 수 있는 선형 저수지 모델을 이용하였다. 지하수 흐름 모델은 토층의 두께, 산사면의 경사각, 포화투수계수, 잠재 증발산 량과 같은 불확실한 상수들과 a, b, c, 그리고 K와 같은 자유모델변수들을 가진다. 자유모델변수들은 유입-유출 자료들로부터 평가할 수 있으며, 이를 위해서 본 논문에서는 Gauss-Newton 방법을 이용한 Bard 알고리즘을 사용하였다. 서울 구로구 시흥동 산사태 발생 지역의 산사면에 대하여 개발된 모델을 적용하여 예제 해석을 수행함으로써, 지하수 흐름 모델이 산사태 발생

• The Journal of Korean Society for Radiation Therapy
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• v.18 no.1
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• pp.43-51
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• 2006

Purpose: To resolution of A hospital-handmade modification double tilt angle immobilization system (DTAB immobilization system) and to report the clinical results of it. Material and Methods: It was developed in conjunction with the breast board for patients unable to achieve and maintain the desired uncomfortable respiration and position of set-up needed in the treatment of RT (This custom design provides an alternative to accomplishing this desired head angle needed to relax position treatment area, realizing that the lenses totally protected eye-ball out) By using the angled breast board and SBDD(small bowel device), reproducibility of set-up and patient comfort were addressed throughout the simulation, computed tomography planning and treatment process. Results: Usually patients the error range-within 5 mm. When use of Aqua patients error range-within 3 mm. Conclusion: It was constructed in tandem with a unique custom-built double tilt angle board (DTAB). It was designed to eliminate clinical set-up problems with head immobilization and instability during treatment, thus providing for a more comfortable head rest for the patient.

• Radiation Oncology Journal
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• v.8 no.1
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• pp.115-124
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• 1990

The characteristics of 23 MV photon beam have been presented with respect to clinical parameters of central axis depth dose, tissue-maxi mum ratios, scatter-maximum ratios, surface dose and scatter correction factors. The nominal accelerating potential was found to be $18.5\pm0.5$ MV on the central axis. The half-value layer (HVL) of this photon beam was measured with narrow beam geometry from central axis, and it has been showed the thickness of $24.5\;g/cm^2$. The tissue-maximum ratio values have been determined from measured percentage depth dose data. In our experimental dosimetry, the surface dose of maximum showed only $9.6\%$ of maximum dose at $10\times10\;cm^2$, 100 cm SSD, without blocking tray in. The TMR'S of $0\times0$ field size have been determined to get average $2.3\%$ uncertainties from three different methodis; are zero effective attenuation coefficient, non-ilnear least square fit of TMR's data and effective linear attenuation coefficient from the HVL of 23 MV photon beams of dual energy linear accelerator.