• Title/Summary/Keyword: 치료계획 가이드라인

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Treatment Planning Guideline of EBT Film-based Delivery Quality Assurance Using Statistical Process Control in Helical Tomotherapy (토모테라피에서 통계적공정관리를 이용한 EBT 필름 기반의 선량품질보증의 치료계획 가이드라인)

  • Chang, Kyung Hwan
    • Journal of radiological science and technology
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    • v.45 no.5
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    • pp.439-448
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    • 2022
  • The purpose of this study was to analyze the results from statistical process control (SPC) to recommend upper and lower control limits for planning parameters based on delivery quality assurance (DQA) results and establish our institutional guidelines regarding planning parameters for helical tomotherapy (HT). A total of 53 brain, 41 head and neck (H & N), and 51 pelvis cases who had passing or failing DQA measurements were selected. The absolute point dose difference (DD) and the global gamma passing rate (GPR) for all patients were analyzed. Control charts were used to evaluate upper and lower control limits (UCL and LCL) for all assessed treatment planning parameters. Treatment planning parameters were analyzed to provide its range for DQA pass cases. We confirmed that the probability of DQA failure was higher when the proportion of leaf open time (LOT) below 100 ms was greater than 30%. LOT and gantry period (GP) were significant predictor for DQA failure using the SPC method. We investigated the availability of the SPC statistic method to establish the local planning guideline based on DQA results for HT system. The guideline of each planning parameter in HT may assist in the prediction of DQA failure using the SPC statistic method in the future.

A Study on the Design Guidelines of Healing Landscape in Housing Complexes (공동주택에서 치유조경계획을 위한 가이드라인 연구)

  • Chun, Hyunwoo;Lee, Shiyoung
    • Journal of the Korean Institute of Landscape Architecture
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    • v.44 no.5
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    • pp.26-37
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    • 2016
  • As activities and convenience of residents in outdoor spaces in apartment houses have been considered important, strategies for making outdoor spaces in apartment houses healing spaces have emerged as a major interest. The purpose of this study is to draw elements for planning healing to create healing spaces in collective housing areas and to present design guidelines. The findings of this study are as follows. Functional elements of a healing environment were classified into safe environment, therapeutic environment, ancillary environment, orientation-reinforcing environment, amenities, and social environment. Outdoor spaces in collective housing areas were divided into collective housing entrance areas, internal and external spread areas, outdoor activity areas, and areas by theme. First, collective housing entrance areas should be planned in such a manner that residents can feel the area is private and easy to recognize. Second, internal and external spread areas should be planned in such a manner that they are easy to access and communicate with neighbors. Third, outdoor activity areas should be divided into an open space, resting space, playing space, and sports space. Open spaces should be planned in such a manner that they can command a fine view and respect the privacy of nearby residents. Resting spaces should be equipped with a shelter that protects users from direct sunlight, rain, and snow as well as include a movable bench. Playing spaces should be built considering development of children's curiosity, adventurous spirit, character, stimulation, and physical health. Playing spaces should be designed in such a manner that roadways and sidewalks can be separated for safe traffic. Sport spaces should be planned in such a manner that they can be associated with a pavilion and trail that provide residents with an opportunity to communicate with each other and rest. Fourth, spaces by theme are classified into sense garden, therapeutic garden, experiential garden, and learning garden. Sense gardens are a small garden based on the five senses. Sense gardens should be designed in such a manner that they can improve users' mental and physical health through programs that stimulate the sense of sight, auditory sense, and olfactory sense. Therapeutic gardens should be designed in such a manner that they can provide a comfortable and relaxing space by minimizing noise. It is advisable for therapeutic gardens to be equipped with a medicinal herb garden, meditation garden, and sense garden. Experiential and learning gardens should be designed in such a manner that they can provide users with a space in which they can enjoy nature and leisure activities. It is advisable for experiential and learning gardens to be equipped with a tea garden, vegetable garden, and camping garden. Healing programs should be designed in such a manner that users can feel relaxed by providing a healing environment, making the most of the natural environment. Further research on evaluating whether the findings of this study are effective in healing in a qualitative and quantitative manner is needed.

Case report - An esthetic restoration treatment based on digital mockup (Case report - Digital Mockup을 활용한 심미 수복 치료 증례보고)

  • Kwon, Hyung Kyoo
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.31 no.2
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    • pp.64-74
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    • 2022
  • Digital dentistry is becoming a mainstream of dental practice. We are already used to intraoral scan, guided implant surgery, manufacture of prosthesis (CAD-CAM) in our daily practice; those are not sensational anymore. However, treatment planning with digital simulations is not spotlighted enough. In this report, a digital mockup was utilized to visualize the final goal of maxillary rehabilitation including all anterior and posterior teeth, and persuade a patient who wanted restoration of only anterior teeth. We will also discuss the use of digital mockup and its actual copy as the guide of altered vertical dimension through the clinical process.

Psychosomatic Integrative Care for Psychosocial Distress of Patients With Breast Cancer (유방암 환자의 정신사회적 디스트레스에 대한 정신신체의학적 통합치료)

  • Yang, Chan-Mo;Jang, Seung-Ho;Lee, Hye-Jin;Lee, Sang-Yeol
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.2
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    • pp.77-85
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    • 2021
  • Breast cancer is the most prevalent oncological disease among women. Various psychosocial distress is common at the diagnosis, treatment, and posttreatment phase of breast cancer. For the treatment of breast cancer, not only medical treatment but also psychosomatic integrative care will be needed. Patients with breast cancer may lead to increased vulnerability to stress, adjustment disorder, anxiety disorder, and depressive disorder, and these psychiatric diseases and conditions are associated with recurrence or exacerbation of breast cancer. Psychosocial treatment of anxiety and depression could increase the quality of life of patients and decrease the recurrence and progression of breast cancer. In this article, we reviewed 5 clinical breast cancer survivorship guidelines focused on psychosomatic integrative care including psychosocial treatment and alternative treatment for psychosocial distress. Because 5 treatment guidelines were using various definitions of evidence, we confirmed evidence of various psychosocial treatments for patients with breast cancer based on the definition of evidence by the US Preventive Service Task Force (USPSTF) guideline. We also reviewed the effect size of psychosocial treatment for anxiety, depression, mood, and quality of life in patients with breast cancer. This article discusses the barrier to the delivery of psychosomatic integrative care and suggests integrative care planning for breast cancer. Multi-disciplinary teams, patient's needs assessment, information technology support, patient and caregiver engagement, planned periodic monitoring of psychosocial distress by a psychosomatic specialist or consultation-liaison psychiatrist are recommended as key features of a psychosomatic integrated care plan.

Evaluation of Cancer Incidence Rate using Exposure Dose to Surrounding Normal Organs during Radiation Therapy for Prostate Cancer (전립선암의 방사선 치료 시 주변 정상장기 피폭선량을 이용한 암발생확률 평가)

  • Lee, Joo-Ah
    • Journal of the Korean Society of Radiology
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    • v.16 no.3
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    • pp.351-356
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    • 2022
  • The purpose of this study was to evaluate the cancer incidence rate and provide basic data by measuring the photoneutron dose generated during intensity-modulated radiation therapy and volumetric modulated arc therapy used in radiation therapy for prostate cancer. The optically stimulated luminescence albedo neutron dosimeter for neutron measurement was placed on the Rando phantom in the abdomen and thyroid and photoneutron dose generated was measured. As a result of the study, intensity-modulated radiation therapy (7 portal) was measured to be higher than volumetric rotational radiation therapy in both abdominal and thyroid locations. When the cancer incidence rate was evaluated using the nominal risk coefficient of ICRP 103, the cancer incidence rate due to exposure to the colon and thyroid during intensity-modulated radiation therapy was 9.9 per 1,000 people, and volumetric rotational radiation therapy for 1,000 people. It was 3.5 per person. Based on the principle of ALARA (As low as reasonably archievable), it is considered to be a guideline for minimizing the exposure dose to normal organs in the establishment of a radiation treatment plan.

Basic Data Analysis of the Quality Control for Patient Safety in Department of Radiation Oncologyat Yeungnam University Hospital (영남대학교병원의 환자안전을 위한 정도관리의 기초자료 분석)

  • Oh, Se An;Kim, Sung Kyu;Yea, Ji Woon;Kang, Min Kyu;Lee, Joon Ha;Lee, Rena
    • Progress in Medical Physics
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    • v.26 no.2
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    • pp.112-117
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    • 2015
  • In order to establish the quality control on patient safety following the guideline presented by American Association of Physicists in Medicine (AAPM) TG-100 committee, we aim to analyze the modes based on errors occurred during treatment of patients at the radiation oncology department at Yeungnam University Hospital and establish a quality control guideline for patient safety when patient-centered radiation treatment is conducted. We aim to analyze the errors that can occur during radiation treatment at the radiation department, and assess the frequency of error, the severity of error affecting patients, and probability of proceeding without noticing error, with scores. The places where errors can take place were divided into CT simulation treatment room, treatment planning room, and treatment room for the analysis. In CT simulation treatment room, an error from using the immobilization device showed the highest Risk Priority Number (RPN) value of 60, and an error from simulation treatment information input showed the lowest of 6. In treatment planning room, an error from selecting the radiation dose calculation model showed the highest RPN value of 168, and an error of patient treatment start date showed the lowest of 36. In treatment room, a Table Bar error showed the highest RPN value of 252, a weight change error showed 190, and a Pillow error showed the lowest of 24.

A Study on the Digital Therapeutics Based Community Care for Rehabilitation in Dysarthria in the Post-COVID-19 Era (Post-COVID-19 시대 마비말장애 재활을 위한 디지털 치료제 기반의 커뮤니티케어 방안)

  • Lee, Sang-Do
    • Journal of the Korea Convergence Society
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    • v.13 no.1
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    • pp.313-323
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    • 2022
  • The purpose of this study was to explore ways a digital therapeutics-based community care plans for the rehabilitation in dysarthria in a situation where non-face-to-face services are expanding in the COVID-19 era. To this end, a qualitative study was conducted on experts working in hospitals, speech-language pathology centers, and social welfare centers, and as a result of the study, 3 topics, 9 sub-themes, and 18 content units were derived. Based on the analysis results, the digital therapeutics-based community care model consisted of 9 types: remote diagnosis, telepractice, rehabilitation training program, peer supporters, clinical support, communication, psychosocial intervention, and care plan services. This study will be able to provide basic data for health care & welfare services using digital therapeutics and guidelines for establishing shared care plans based on multidisciplinary cooperation.

Dosimetric Comparison of Left-sided Whole Breast Irradiation using a Virtual Bolus with VMAT and static IMRT (좌측 유방의 세기변조 방사선치료 시 Virtual Bolus 적용에 따른 선량 변화 비교 평가)

  • Lim, Kyeong Jin;Kim, Tae Woan;Jang, Yo Jong;Yang, Jin Ho;Lee, Seong Hyeon;Yeom, Du Seok;Kim, Seon Yeong
    • The Journal of Korean Society for Radiation Therapy
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    • v.31 no.2
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    • pp.51-63
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    • 2019
  • Purpose: Radiation therapy for breast cancer should consider the change in breast shape due to breathing and swelling. In this study, we evaluate the benefit of using virtual bolus for IMRT of left breast cancer. Materials and methods: 10 patients with early breast cancer who received radiation therapy after breastconserving surgery compared the VMAT and IMRT plans using the virtual bolus method and without using it. The first analysis compared the V95%, HI, CI of treatment volume, Dmean, V5, V20, V30 of ipsilateral lung, and Dmean of heart in VMAT plan made using the virtual bolus method(VMAT_VB) to the plan without using it(VMAT_NoVB) in case there is no change in the breast. In IMRT, the same method was used. The second analysis compared TCP and NTCP based on each treatment plan in case there is 1cm expansion of treatment volume. Result: If there is no change in breast, V95% in VB Plan(VMAT_VB, IMRT_VB) and NoVB Plan(VMAT_NoVB, IMRT_NoVB) is all over 99% on each treatment plan. V95% in VMAT_NoVB and VMAT_VB is 99.80±0.17% and 99.75±0.12%, V95% in IMRT_NoVB and IMRT_VB is 99.67±0.26% and 99.51±0.15%. Difference of HI, CI is within 3%. OAR dose in VB plan is a little high than NoVB plan, and did not exceed guidelines. If there is 1cm change in breast, VMAT_NoVB and IMRT_NoVB are less effective for treatment. But VMAT_VB and IMRT_VB continue similar treatment effect compared in case no variation of breast. Conclusion: This study confirms the benefit of using a virtual bolus during VMAT and IMRT to compensate potential breast shape modification.

Superficial Esophageal Cancer Treated with Multidisciplinary Care: A Case Report (다학제 접근을 통해 치료에 성공한 표재성 식도암 1례)

  • Oh, Gyu Man;Park, Moo In;Jung, Kyoung Won;Kang, Sung Min;Son, Min Young;Kim, Jae Hyun;Moon, Won;Park, Seun Ja
    • Journal of Digestive Cancer Reports
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    • v.8 no.1
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    • pp.71-75
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    • 2020
  • Esophageal cancer is easy to infiltrate and metastasize because esophagus does not have serosa, and is difficult to remove it because esophagus is in the middle of the chest. Because of this, treatments of esophageal cancer do not always follow the guideline. In this situation, efforts to increase treatment efficiency and improve survival rate through multidisciplinary treatment are increasing. In this case, we report the patient with three superficial esophageal cancers (one in cervical esophagus and two in thoracic esophagus). The patient was treated with concurrent chemoradiotherapy instead of surgery through multidisciplinary discussion. The patient reached a complete remission through this discussion. This case is intended to inform the usefulness of multidisciplinary treatment in patients with esophageal cancer.

A Development of Evaluation Indicators for Performance Improvement of Horticultural Therapy Garden (원예치료정원의 성능개선을 위한 평가지표 개발)

  • Ahn, Je-Jun;Park, Yool-Jin
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.36 no.4
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    • pp.113-123
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    • 2018
  • The purpose of this research is to develop evaluation indicators forperformance improvement of horticultural therapy garden. In order to achieve a therapeutic purpose, the gardening activity held by the trained horticultural therapist. Moreover, horticultural therapy is 'a medical model' for the treatment and basic premise of the research was set, as horticultural therapy garden is characterized area to support activities of patients and horticultural therapist functionally and efficiently. For this study, three times of Delphi and AHP techniques were proceeded to export panels who were recruited by purposive sampling. Through these techniques, it was possible to deduct the evaluation indicator which maximizes the performance of the horticultural therapy garden. The evaluation items were prioritized by typing and stratification of the indicator. The results and discussions were stated as followings. Firstly, a questionnaire of experts was conducted to horticultural therapists and civil servants who were in charge of horticultural therapy. As results(horticultural therapists: 87.8%, civil servants: 75.2%), It is possible to conclude that both positions have the high recognition and agreed on the necessity of horticultural therapy. Secondly, Delphi investigation was conducted three times in order to develop the evaluation indicator for performance evaluation. After Delphi analysis, total 34 of evaluation elements to improve the performance of the horticultural therapy garden by reliability and validity analysis results. Thirdly, AHP analysis of each evaluation indicator was conducted on the relative importance and weighting. Moreover, the results showed 'interaction between nature and human' as the most important element, and in order of 'plan of the program', 'social interaction', 'sustainable environmental', and 'universal design rule', respectively. On the other hand, the exports from the university and research institute evaluated the importance of 'interaction between nature and human', while horticultural therapists chose 'plan of the program' as the most important element. Fourthly, the total weight was used to develop weight applied evaluation indicator for the performance evaluation of the horticultural therapy garden. The weight applying to evaluation index is generally calculated multiply the evaluation scores and the total weight using AHP analysis. Finally, 'the evaluation indicator and evaluation score sheet for performance improvement of the horticultural therapy garden' was finally stated based on the relative order of priority between evaluation indicators and analyzing the weight. If it was deducted the improvement points for the efficiency of already established horticultural therapy garden using the 'weight applied evaluation sheet', it is possible to expand it by judging the importance with the decision of the priority because the item importance decided by experts was reflected. Moreover, in the condition of new garden establishment, it is expected to be helpful in suggesting ways for performance improvement and in setting the guidelines by understanding the major indicators of performance improvement in horticultural therapy activity.