• Title/Summary/Keyword: 치료계획시스템

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Usefulness assessment of secondary shield for the lens exposure dose reduction during radiation treatment of peripheral orbit (안와 주변 방사선 치료 시 수정체 피폭선량 감소를 위한 2차 차폐의 유용성 평가)

  • Kwak, Yong Kuk;Hong, Sun Gi;Ha, Min Yong;Park, Jang Pil;Yoo, Sook Hyun;Cho, Woong
    • The Journal of Korean Society for Radiation Therapy
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    • v.27 no.1
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    • pp.87-95
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    • 2015
  • Purpose : This study presents the usefulness assessment of secondary shield for the lens exposure dose reduction during radiation treatment of peripheral orbit. Materials and Methods : We accomplished IMRT treatment plan similar with a real one through the computed treatment planning system after CT simulation using human phantom. For the secondary shield, we used Pb plate (thickness 3mm, diameter 25mm) and 3 mm tungsten eye-shield block. And we compared lens dose using OSLD between on TPS and on simulation. Also, we irradiated 200 MU(6 MV, SPD(Source to Phantom Distance)=100 cm, $F{\cdot}S\;5{\times}5cm$) on a 5cm acrylic phantom using the secondary shielding material of same condition, 3mm Pb and tungsten eye-shield block. And we carried out the same experiment using 8cm Pb block to limit effect of leakage & transmitted radiation out of irradiation field. We attached OSLD with a 1cm away from the field at the side of phantom and applied a 3mm bolus equivalent to the thickness of eyelid. Results : Using human phantom, the Lens dose on IMRT treatment plan is 315.9cGy and the real measurement value is 216.7cGy. And after secondary shield using 3mm Pb plate and tungsten eye-shield block, each lens dose is 234.3, 224.1 cGy. The result of a experiment using acrylic phantom, each value is 5.24, 5.42 and 5.39 cGy in case of no block, 3mm Pb plate and tungsten eye-shield block. Applying O.S.B out of the field, each value is 1.79, 2.00 and 2.02 cGy in case of no block, 3mm Pb plate and tungsten eye-shield block. Conclusion : When secondary shielding material is used to protect critical organ while irradiating photon, high atomic number material (like metal) that is near by critical organ can be cause of dose increase according to treatment region and beam direction because head leakage and collimator & MLC transmitted radiation are exist even if it's out of the field. The attempt of secondary shield for the decrease of exposure dose was meaningful, but untested attempt can have a reverse effect. So, a preliminary inspection through Q.A must be necessary.

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The evaluation of lens absorbed dose according to the Optimold for whole brain radiation therapy (전뇌 방사선치료 시 Optimold에 따른 수정체의 흡수선량 평가)

  • Yang, Yong Mo;Park, Byoung Suk;Ahn, Jong Ho;Song, Ki Won
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.1
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    • pp.77-81
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    • 2014
  • Purpose : In the current whole brain Radiation Therapy, Optimold was used to immobilize the head. However, skin dose was increased about 22% due to the scattering radiation by the Optimold. Since the minimum dose causing cataracts was 2 Gy, it could be seen that the effects were large especially on the lens. Therefore, in the whole brain Radiation Therapy, it was to compare and to evaluate the lens absorbed dose according to the presence of Optimold in the eyeball part. Materials and Methods : In order to compare and to evaluate the lens absorbed dose according to the presence of Optimold in the eyeball part, the Optimold mask was made ??up to 5mm bolus on the part of the eye lens in the human model phantom (Anderson Rando Phantom, USA). In the practice treatment, to measure the lens dose, the simulation therapy was processed by placing the GafChromic EBT3 film under bolus, and after the treatment plan was set up through the treatment planning system (Pinnacle, PHILIPS, USA), the treatments were measured repeatedly three times in the same way. After removing the Optimold mask in the eyeball part, it was measured in the same way as above. After scanning the film and measuring the dose by using the Digital Flatbed Scanner (Expression 10000XL, EPSON, USA), the doses were compared and evaluated according to the presence of Optimold mask in the eyeball part. Results : When there was the Optimold mask in the eyeball part, it was measured at $10.2cGy{\pm}1.5$ in the simulation therapy, and at $24.8cGy{\pm}2.7$ in the treatment, and when the Optimold mask was removed in the eye part, it was measured at $12.9cGy{\pm}2.2$ in the simulation therapy, and at $17.6cGy{\pm}1.5$ in the treatment. Conclusion : In case of removing the Optimold mask in the eyeball part, the dose was increased approximately 3 cGy in the simulation therapy and was reduced approximately 7 cGy in the treatment in comparison to the case that the Optimold mask was not removed. During the whole treatment, since the lens absorbed dose was reduced about 27%, the chance to cause cataracts and side effects was considered to be reduced due to decrease of the absorbed dose to the eye lens which had the high sensitivity on the radiation.

Diagnosis and Treatment of Malocclusions using the Invisalign System (인비절라인 시스템을 이용한 부정교합의 진단 및 치료)

  • Kim, Hyungsoo;Ahn, Jae-Hyun;Boyd, Robert L.
    • The korean journal of orthodontics
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    • v.33 no.1 s.96
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    • pp.21-29
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    • 2003
  • Recent developments in software technology have made it possible to create a virtual three-dimensional model of the dental arches from digitally scanned casts of a patient's dentition. This modelmay then be manipulated with software to produce stages of tooth movement from the initial malocclusion to the final desired occlusion. A sterolithograghic model is made for each stage of tooth movement which is the basis for construction of a series of clear and thin overlay appliances. These appliances are worn full time by the patient to move the teeth according to the programmed stages of movement. Malocclusions involving mild to moderate crowding and space closure have been proven to be successfully treated with this appliance. Experience with this appliance has demonstrated excellent patient compliance with less discomfort, improved esthetics and oral hygiene control, when compared with fixed orthodontic appliances. Orthodontic treatment with this appliance is a potentially useful alternative approach to fixed appliances for treatment of a variety of malocclusions in patients with fully erupted permanent teeth.

A Survey on the Critical Success Factors of Knowledge Management Using AHP (AHP 분석을 이용한 지식경영-실천요소의 중요도에 관한 실증적 연구)

  • 이영수;박준아;정광식;김진우
    • Proceedings of the Korea Inteligent Information System Society Conference
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    • 1999.03a
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    • pp.85-94
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    • 1999
  • 지식경영을 효과적으로 수행하기 위해서 기업은 지식경영을 구성하고 있는 요소를 정확히 이해할 필요가 있고, 이러한 중요 요소에 따라 투자가 이루어져야 한다. 본 연구는 지식경영의 중요 요소들을 제시함으로써, 앞으로 지식경영을 계획하고 있는 기업이 효과적으로 지식경영을 추진할 수 있는 활동 지침 및 투자 방향을 제시하고자 한다. 이를 위해, 본 연구에서는 각종 국내외 지식경영 관련 문헌에서 논의된 사항을 중심으로, 지식경영을 구성하는 30개의 중요요소를 추출하고, 분석계층도(AHP)를 이용하여 지식경영을 달성하기 위한 요소들을 위계적 구조로 정리하고, 최종단계에서 238개의 지식경영 구현의 평가기준을 마련하였다. 또한 실제로 지식경영 구현 요소들의 상대적 중요성을 파악하기 위해, 먼저 국내에서 지식경영을 추진하고 있으나 관심을 보이고 있는 48개 기업의 담당자를 대상으로 각 기업에서 추진하고 있는 지식경영의 현황 파악을 위해 지식경영 실천의 평가기준에 대한 설문을 실시하였다. 이 두 가지 설문 조사 결과를 종합해 볼 때, 기업에서는 지식경영 구현 요소 중에서 인프라 내의 프로세스와 프로세스를 구성하는 지식의 활용과 전파 등이 중요하다고 인식하고 있는 반면, 실제로는 인프라 내의 정보기술과 프로세스를 구성하는 다른 한 축인 지식의 창출과 축적 면에 투자가 이루어진 것으로 나타났다. 이 외에도 지식화, 성과와 가치의 연계 그리고 지식의 가시화 등의 요소들은 상대적 중요도 인식과는 반대로 지식경영 추진에 있어 외면당하고 있는 것으로 나타났다. 따라서 본 연구는 지식 경영의 이러한 불균형을 시정할 수 있는 방향으로 앞으로의 투자가 수행되어야 할 것을 제안하고 있다. 알 수 있다.한 것으로 연구되었다. 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.alization)가 나타난다. 그러나 무의식에 대칭화만 있는 것은 아니며, 의식의 사고양식인 비대칭도 어느 정도 나타나며, 대칭화의 정도에 따라, 대상들이 잘 구분되어 있는 단계, 의식수준의 감정단계, 집단 내에서의 대칭화 단계, 집단간에서의 대칭화 단계, 구분이 없어지는 단계로 구분하였다.systems. We believe that this taxonomy is a significant contributi

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A Study on the Management of Non-Communicable Disease in Fiji (피지에서의 만성병 관리)

  • Kim, Daeseon;Romakin, Pablo;Rafai, Eric;Lee, Chulwoo
    • Journal of Appropriate Technology
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    • v.6 no.2
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    • pp.163-173
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    • 2020
  • For the successful execution of an ODA project, it is necessary to know what areas are weak and necessary to the country of demand exactly. The health sector is also a top priority in most of developing countries. This study was carried out to introduce non-communicable disease (NCD) in Fiji for ODA projects planning. The major causes of death in Fiji in 2016 are diabetes, ischemic heart disease, cerebrovascular disease, chronic kidney disease, lower respiratory infect, asthma in ranking. The major causes of death in Korea in same year are cancer, ischemic heart diseases, cerebrovascular diseases, pneumonia, suicide, diabetes in the order of ranking. The chronic disease as non-communicable disease (NCD) has been increasing continuously due to changes in lifestyle and consumption patterns and population aging in prevalence rate. This global trend is also apparent in Fiji and Korea, reflected in increasing mortality and personal costs for the treatment and management of NCD. The need for a sustained comprehensive treatment tailored for individual patients has suggested from many studies and the development of a systematic program to manage NCD patients to provide such care have been recommended. The Fiji government developed Non-communicable Diseases Strategic Plan 2015-2019 and has tried to reduce the prevalence rate of non-communicable diseases by factors. The WHO global action plan guiding national-level NCD policies requires an NCD prevention and control model at the community level, presenting strategic goals and detailed options for the introduction and application of the approach to communities. It is necessary to develop an NCD prevention and control model, consisting of a strategy of community intervention, education for students and NCD patients, and the legal enactment of NCD that adequately meets the needs of community members.

The Structure of Korean Radiation Oncology in 1997 (국내 병원 별 방사선치료의 진료 구조 현황(1997년 현황을 중심으로 한 선진국과의 비교 구))

  • Kim Mi Sook;Yoo Seoung Yul;Cho Chul Koo;Yoo Hyung Jun;Yang Kwang Mo;Je Young Hoon;Lee Dong Hun;Lee Dong Han;Kim Do Jun
    • Radiation Oncology Journal
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    • v.17 no.2
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    • pp.172-178
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    • 1999
  • Purpose : To measure the basic structural characteristics of radiation oncology facilities in Korea during 1997 and to compare personnel, equipments and patient loads between Korea and developed countries. Methods and Materials : Mail serveys we conducted in 1998 and data on treatment machines, personnel and peformed new patients were collected. Responses were obtained from the 100 percent of facilities. The consensus data of the whole country were summarized using Microsoft Excel program. Results: In Korea during 1997, 42 facilities delivered megavoltage radiation theraphy with 71 treatment machines, 100 radiation oncologists, 26 medical physicist, 205 technologists and 19,773 new patients. Eighty nine percent of facilities in Korea had linear accelators at least 6 MeV maximum photon energy. Ninety five percent of facilities had simulators while five percent of facilities had no simulator, Ninety one percent of facilities had computer planning systems and eighty three percent of facilities reported that they had a written quality assurance program. Thirty six percent of facilities had only one radiation oncologist and thirty eight percent of facilities had no medical physicists. The median of the distribution of annual patients load of a facility, patients load per a machine, patients load per a radiation oncologist, patients load per a therapist and therapists per a machine in Korea were 348 patients per a year, 263 patients per a machine, 171 patients per a radiation oncologist, 81 patients per a therapist, and 3 therapists per a machine respectively. Conclusions : The whole scale of the radiation oncology departments in Korea was smaller than Japan and USA in population ratio regard. In case of hardware level like linear accelerators, simulators and computer planning systems, there was no big differences between Korea and USA. The patients loads of radiation oncologists and therapists had no significant differences as compared with USA. However, it was desirable to consider the part time system in USA because there were a lot of hospitals which did not employ medical physicists.

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Verification of Skin Dose in Tomotherapy Using the Developed Phantom for Image Based Radiation Treatment System (영상 기반 치료 장비용 팬톰을 이용한 토모테라피 피부 선량 검증)

  • Park, Ji-Yeon;Chang, Ji-Na;Oh, Seung-Jong;Kang, Dae-Gyu;Jung, Won-Gyun;Lee, Jeong-Woo;Jang, Hong-Suk;Kim, Hoi-Nam;Park, Hae-Jin;Kim, Sung-Hwan;Suh, Tae-Suk
    • Progress in Medical Physics
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    • v.20 no.2
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    • pp.88-96
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    • 2009
  • Radiation treatment for skin cancer has recently increased in tomotherapy. It was reported that required dose could be delivered with homogeneous dose distribution to the target without field matching using electron and photon beam. Therapeutic beam of tomotherapy, however, has several different physical characteristic and irradiation of helical beam is involved in the mechanically dynamic factors. Thus verification of skin dose is requisite using independent tools with additional verification method. Modified phantom for dose measurement was developed and skin dose verification was performed using inserted thermoluminescent dosimeters (TLDs) and GafChromic EBT films. As the homogeneous dose was delivered to the region including surface and 6 mm depth, measured dose using films showed about average 2% lower dose than calculated one in treatment planning system. Region indicating about 14% higher and lower absorbed dose was verified on measured dose distribution. Uniformity of dose distribution on films decreased as compared with that of calculated results. Dose variation affected by inhomogeneous material, Teflon, little showed. In regard to the measured dose and its distribution in tomotherapy, verification of skin dose through measurement is required before the radiation treatment for the target located at the curved surface or superficial depth.

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Development of 2.5D Photon Dose Calculation Algorithm (2.5D 광자선 선량계산 알고리즘 개발)

  • 조병철;오도훈;배훈식
    • Progress in Medical Physics
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    • v.10 no.2
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    • pp.103-114
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    • 1999
  • In this study, as a preliminary study for developing a full 3D photon dose calculation algorithm, We developed 2.5D photon dose calculation algorithm by extending 2D calculation algorithm to allow non-coplanar configurations of photon beams. For this purpose, we defined the 3d patient coordinate system and the 3d beam coordinate system, which are appropriate to 3d treatment planning and dose calculation. and then, calculate a transformation matrix between them. For dose calculation, we extended 2d "Clarkson-Cunningham" model to 3d one, which can calculate wedge fields as well as regular and irregular fields on arbitrary plane. The simple Batho's power-law method was implemented as an inhomogeneity correction. We evaluated the accuracy of our dose model following procedures of AAPM TG#23; radiation treatment planning dosimetry verifications for 4MV of Varian Clinac-4. As results, PDDs (percent depth dose) of cubic fields, the accuracy of calculation are within 1% except buildup region, and $\pm$3% for irregular fields and wedge fields. And for 45$^{\circ}$ oblique incident beam, the deviations between measurements and calculations are within $\pm$4%. In the case of inhomogeneity correction, the calculation underestimate 7% at the lung/water boundary and overestimate 3% at the bone/water boundary. At the conclusions, we found out our model can predict dose with 5% accuracy at the general condition. we expect our model can be used as a tool for educational and research purpose.. purpose..

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Implant Supported Fixed Restoration for Maxillary Edentulism using CAD/CAM Guided Implant Surgery (NobelGuide$^{TM}$) and Immediate Loading (상악 완전 무치악 환자의 CAD/CAM 을 이용한 임플란트 식립(NobelGuide$^{TM}$) 및 즉시하중 후 고정성 보철수복 증례)

  • Huh, Yoon-Hyuk;Yi, Yang-Jin;Kim, Dae-Gon;Cho, Lee-Ra;Park, Chan-Jin
    • Journal of Dental Rehabilitation and Applied Science
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    • v.28 no.4
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    • pp.423-439
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    • 2012
  • This case report described a technique utilizing a computer-aided design (CAD)/computer-aided machining (CAM) - guided surgical implant placement and prefabricated temporary fixed prosthesis for an immediately loaded restoration. The advantages of CAD/CAM guided implant procedures are flapless, minimally invasive surgery and shorter surgery time. With this technique, less postoperative morbidity and delivery of prosthesis for immediate function would be possible. A patient with an edentulous maxilla received 8 implants in maxilla using CAD/CAM surgical templates. Prefabricated provisional maxillary implant supported fixed prosthesis were connected immediately after implant installation. Provisional prosthesis was evaluated for aesthetics, function during 6 months. Definitive implant supported fixed porcelain fused metal bridges were fabricated.

Evaluation of Dose and Position Compensation of Parotid Gland Using CT On-rail System in Head-and-Neck Cancer (두경부 암환자 치료 시 CT On-rail System을 이용한 이하선의 위치 보정 및 선량 평가)

  • Jang, Hyeong-Jun;Im, Chung-Geun;Chun, Geum-Sung;Jeong, Il-Seon;Kim, Hoi-Nam
    • The Journal of Korean Society for Radiation Therapy
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    • v.20 no.2
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    • pp.83-89
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    • 2008
  • Purpose: The checking method of target and normal structure are used by MVCBCT, KVCBCT, CT On-rail System, Ultrasound in H&N cancer patient. In case of MVCT, the utilization of bone structure is valuable to check around tissue. But the utilization of soft tissue is not enough. The point of this paper is dose variation in movable parotid and changeable volume of H&N cancer patient of CT On-rail System. Materials and Methods: The object of H&N cancer patient is 5 in this hospital. The selected patient are scanned ARTISTE CT Vision (CT On-ral System) a triweekly. After CT scanning, tranfered coordinates are obtained by movable of parotid gland comparison with planning image. Checking for the changeable volume of parotid gland. A Obtained CT image are tranfered to the RTP System. So dose variation are checked by following changed volume. Results: The changes of target coordinate by the parotid gland movement are X: -0.4~0.4 cm, Y: -0.4~0.3 cm, Z: -0.3~0.3 cm. the volume of GTV is decreased to about 7.11%/week and then both parotid gland volume are shrinked about 4.81%/week (Lt), 2.91%/week (Rt). At the same time, each parotid gland are diminished in radiation dose as 3.66%/week (Lt), 2.01%/week. Conclusion: Images from CT on the rail System which are able to aquire the better quality images of soft tissue in Target area than MVCBCT. After replanning and dose redistribution by required images, It could gain not only the correction of the patient set-tup errors but exact dose distribution. Accordingly, the delivery of compensated dose, It makes that we could do Adaptive Targeting Radiotherapy and need Real Time Adaptive Targeting Radiotherapy by reduce beam delivary time.

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