• The Journal of Korean society of community based occupational therapy
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• v.9 no.2
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• pp.13-22
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• 2019

Objective : The purpose of this technical research is to determine decline of episodic memory by normal aging focucing on object, spatial location, and temporal order memory. Methods : We allocated seventy-seven of healthy adults from twenty to eighty years old, and performed computer-based cognitive tasks which were consisted of the object, spatial location, and temporal order memory. We used OpenSesame(OpenSesame Inc, OR), put ten pictures people normally see in their daily life, and evaluated those aspects through asking the objects types, object spatial locations, and picture temporal orders from 10 sheets of the picture. Results : Object and spatial location memory were not affected by normal aging whereas, temporal order memory significantly decreased with normal aging. Specifically, temporal order memory for in their age of forty was significantly decreased compared with their age of twenty and object memory at their age of eighty was relatively high compared to spatial location and temporal order memory. We found out that temporal order memory worse fastest and object memory lasted longest. Conclusion : In this study, we confirmed characteristics of declines of episodic memory consisting of object, spatial location, and temporal order memory. Notably, we could specifically identify declines of spatial location and temporal order memory with normal aging previous studies investigated on a limited basis using conventional neuropsychological assessments. These findings would be helpful to screen impairment in episodic memory by normal aging and provide an evidence that cognitive intervention for healthy older adults needs to include spatial and temporal aspect of memory.

• Radiation Oncology Journal
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• v.19 no.3
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• pp.275-286
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• 2001

Purpose : To setup procedures of quality assurance (OA) for implementing intensity modulated radiation therapy (IMRT) clinically, report OA procedures peformed for one patient with prostate cancer. Materials and methods : $P^3IMRT$ (ADAC) and linear accelerator (Siemens) with multileaf collimator are used to implement IMRT. At first, the positional accuracy, reproducibility of MLC, and leaf transmission factor were evaluated. RTP commissioning was peformed again to consider small field effect. After RTP recommissioning, a test plan of a C-shaped PTV was made using 9 intensity modulated beams, and the calculated isocenter dose was compared with the measured one in solid water phantom. As a patient-specific IMRT QA, one patient with prostate cancer was planned using 6 beams of total 74 segmented fields. The same beams were used to recalculate dose in a solid water phantom. Dose of these beams were measured with a 0.015 cc micro-ionization chamber, a diode detector, films, and an array detector and compared with calculated one. Results : The positioning accuracy of MLC was about 1 mm, and the reproducibility was around 0.5 mm. For leaf transmission factor for 10 MV photon beams, interleaf leakage was measured $1.9\%$ and midleaf leakage $0.9\%$ relative to $10\times\;cm^2$ open filed. Penumbra measured with film, diode detector, microionization chamber, and conventional 0.125 cc chamber showed that $80\~20\%$ penumbra width measured with a 0.125 cc chamber was 2 mm larger than that of film, which means a 0.125 cc ionization chamber was unacceptable for measuring small field such like 0.5 cm beamlet. After RTP recommissioning, the discrepancy between the measured and calculated dose profile for a small field of $1\times1\;cm^2$ size was less than $2\%$. The isocenter dose of the test plan of C-shaped PTV was measured two times with micro-ionization chamber in solid phantom showed that the errors upto $12\%$ for individual beam, but total dose delivered were agreed with the calculated within $2\%$. The transverse dose distribution measured with EC-L film was agreed with the calculated one in general. The isocenter dose for the patient measured in solid phantom was agreed within $1.5\%$. On-axis dose profiles of each individual beam at the position of the central leaf measured with film and array detector were found that at out-of-the-field region, the calculated dose underestimates about $2\%$, at inside-the-field the measured one was agreed within $3\%$, except some position. Conclusion : It is necessary more tight quality control of MLC for IMRT relative to conventional large field treatment and to develop QA procedures to check intensity pattern more efficiently. At the conclusion, we did setup an appropriate QA procedures for IMRT by a series of verifications including the measurement of absolute dose at the isocenter with a micro-ionization chamber, film dosimetry for verifying intensity pattern, and another measurement with an array detector for comparing off-axis dose profile.

• Progress in Medical Physics
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• v.8 no.2
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• pp.77-85
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• 1997

Verification of patients setup was very important during radiotherapy. Therefore, we have developed an 1-dimensional on-line portal imaging system and measured the differential linearity of the system. Isooctane(2,2,4-TetraMethyl Pentane) was used as liquid ionization material. And the geometry of the system was designed which has 2mm position resolution and 20cm measurable range. And then the differential linearity of the system was 4.7％.

• Proceedings of the KSLP Conference
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• 2003.11a
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• pp.139-140
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• 2003

성대 결절 환자들은 잘못된 발성 패턴으로 인한 음성의 오용과 남용이 질환의 원인인 경우가 대부분이다. 관찰할 수 있는 발성 패턴은 성대 내근과 외후두근의 사용, 인두, 혀, 턱의 움직임, 호흡 방법, 억양의 변화 등 다양하다. 이러한 발성 패턴이 하나 혹은 그 이상 잘못 되어 있을 경우에는 후두에 좋지 않은 영향을 미쳐 기능성 후두 질환, 성대 결절, 성대 폴립 등의 기질적 질환과 연계될 수 있다. 성대 결절에서 일반적으로 관찰되는 발성 패턴으로는 성대 전체를 강하게 접촉하여 발성하는 경우와 반대로 성대 수직면 위쪽 즉 상순쪽만 가볍게 부딪혀서 발성하는 경우로 나타난다. 두 경우 모두에서 성대 결절이 발생하며 그 기와 위치가 조금씩 달라지게 된다. 이렇게 성대 결절이 발생했을 경우 널리 제시되고 있는 치료 방법으로 환자의 잘못된 발성 습관에 대한 상담과 함께 하품-한숨 접근법이나 노래 조로 말하기, 저작하기와 같은 성대 접촉을 줄일 수 있도록 하는 것이다. 그러나 성대 접촉이 되지 않아 발생된 성대 결절 환자의 경우는 일시적으로 결절의 크기는 줄일 수 있을 것이나 치료 결과가 유지되는 측면의 고려가 부족한 것이 사실이다. 따라서 본 연구에서는 성대 결절 환자들의 발성 패턴을 관찰하고 그 상태에 따라 음성 치료를 접근하여 치료 결과 및 유지 효과를 확인하고자 한다. (중략)

• Progress in Medical Physics
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• v.11 no.1
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• pp.49-57
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• 2000

New method about the dose optimization problem in radiation treatment was researched. Since all conditions are more complex and there are more relevant variables, the solution of three-dimensional treatment planning is much more complicate than that of current two-dimensional one. There(ore, in this study, as a method to solve three-dimensional dose optimization problem, the considered variables was minized and researched by reducing the domain that solutions can exist and pre-determining the important beam parameters. First, the dangerous beam range that passes critical organ was found by coordinate transformation between linear accelerator coordinate and patient coordinate. And the beam size and rotation angle for rectangular collimator that conform tumor at arbitrary beam position was also determined. As a result, the available beam position could be reduced and the dependency on beam size and rotation angle, that is very important parameter in treatment planning, totally removed. Therefore, the resultant combinations of relevant variables could be greatly reduced and the dose optimization by objective function can be done with minimum variables. From the above results, the dose optimization problem was solved for the two-dimensional radiation treatment planning useful in clinic. The objective function was made by combination of dose gradient, critical organ dose and dose homogeniety. And the optimum variables were determined by applying step search method to objective function. From the dose distributions by optimum variables, the merit of new dose optimization method was verified and it can be implemented on commercial radiation treatment planning system with further research.

• Journal of Digital Convergence
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• v.14 no.5
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• pp.427-432
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• 2016

The purpose of this study was to investigate drowning death patients on clinical care and prevention. Drowning accidents that occurred in the Republic of Korea were identified by using the Emergency Activity Daily Report Data from the National Emergency Management Agency (NEMA). The age of drowning accidents was 20-29 years (25.4%). Drowning cases for the months of August was 17.6%. The main circumstance involved in the drowning cases was swimming (45.0%). Half of swimming incidents related the drowning accidents of people attempting to save a life of a family member or friend from the water. The most common location was at a lake or reservoir (40.2%). Drowning is a main cause of accidents in the Republic of Korea. Preventive strategies that may be beneficial for persons contain life jackets or life rings supply, upgrading swimming ability, placing lifeguards based on public education activities.

• Radiation Oncology Journal
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• v.20 no.1
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• pp.41-52
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• 2002

Purpose : 3D conformal radiotherapy, the optimum dose delivered to the tumor and provided the risk of normal tissue unless marginal miss, was restricted by organ motion. For tumors in the thorax and abdomen, the planning target volume (PTV) is decided including the margin for movement of tumor volumes during treatment due to patients breathing. We designed the respiratory gating radiotherapy device (RGRD) for using during CT simulation, dose planning and beam delivery at identical breathing period conditions. Using RGRD, reducing the treatment margin for organ (thorax or abdomen) motion due to breathing and improve dose distribution for 3D conformal radiotherapy. Materials and Methods : The internal organ motion data for lung cancer patients were obtained by examining the diaphragm in the supine position to find the position dependency. We made a respiratory gating radiotherapy device (RGRD) that is composed of a strip band, drug sensor, micro switch, and a connected on-off switch in a LINAC control box. During same breathing period by RGRD, spiral CT scan, virtual simulation, and 3D dose planing for lung cancer patients were peformed, without an extended PTV margin for free breathing, and then the dose was delivered at the same positions. We calculated effective volumes and normal tissue complication probabilities (NTCP) using dose volume histograms for normal lung, and analyzed changes in doses associated with selected NTCP levels and tumor control probabilities (TCP) at these new dose levels. The effects of 3D conformal radiotherapy by RGRD were evaluated with DVH (Dose Volume Histogram), TCP, NTCP and dose statistics. Results : The average movement of a diaphragm was 1.5 cm in the supine position when patients breathed freely. Depending on the location of the tumor, the magnitude of the PTV margin needs to be extended from 1 cm to 3 cm, which can greatly increase normal tissue irradiation, and hence, results in increase of the normal tissue complications probabiliy. Simple and precise RGRD is very easy to setup on patients and is sensitive to length variation (+2 mm), it also delivers on-off information to patients and the LINAC machine. We evaluated the treatment plans of patients who had received conformal partial organ lung irradiation for the treatment of thorax malignancies. Using RGRD, the PTV margin by free breathing can be reduced about 2 cm for moving organs by breathing. TCP values are almost the same values $(4\~5\%\;increased)$ for lung cancer regardless of increasing the PTV margin to 2.0 cm but NTCP values are rapidly increased $(50\~70\%\;increased)$ for upon extending PTV margins by 2.0 cm. Conclusion : Internal organ motion due to breathing can be reduced effectively using our simple RGRD. This method can be used in clinical treatments to reduce organ motion induced margin, thereby reducing normal tissue irradiation. Using treatment planning software, the dose to normal tissues was analyzed by comparing dose statistics with and without RGRD. Potential benefits of radiotherapy derived from reduction or elimination of planning target volume (PTV) margins associated with patient breathing through the evaluation of the lung cancer patients treated with 3D conformal radiotherapy.

• Radiation Oncology Journal
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• v.5 no.2
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• pp.137-140
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• 1987

In brachytherapy of uterine conical cancer using a high dose rate remote afterloading system, it is of prime importance to deliver a accurate dose in each fractionated treatment by minimizing the difference between the pre-treatment planned and post-treatment calculated doses. The post-treatment calculated point A dose was not much different from the pretreatment planned dose (500 cGy). The $average{\pm}standard$ deviation was $500\pm18cGy$ and 84 percent of 82 intracavitary radiotherapy was within the range of $500\pm25cGy$.

• Radiation Oncology Journal
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• v.25 no.1
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• pp.54-61
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• 2007

[ $\underline{Purpose}$ ]: The purpose of this study is to develop a practical method for determining accurate marker positions for prostate cancer radiotherapy using CT images and kV x-ray images obtained from the use of the on- board imager (OBI). $\underline{Materials\;and\;Methods}$: Three gold seed markers were implanted into the reference position inside a prostate gland by a urologist. Multiple digital image processing techniques were used to determine seed marker position and the center-of-mass (COM) technique was employed to determine a representative reference seed marker position. A setup discrepancy can be estimated by comparing a computed $COM_{OBI}$ with the reference $COM_{CT}$. A proposed algorithm was applied to a seed phantom and to four prostate cancer patients with seed implants treated in our clinic. $\underline{Results}$: In the phantom study, the calculated $COM_{CT}$ and $COM_{OBI}$ agreed with $COM_{actual}$ within a millimeter. The algorithm also could localize each seed marker correctly and calculated $COM_{CT}$ and $COM_{OBI}$ for all CT and kV x-ray image sets, respectively. Discrepancies of setup errors between 2D-2D matching results using the OBI application and results using the proposed algorithm were less than one millimeter for each axis. The setup error of each patient was in the range of $0.1{\pm}2.7{\sim}1.8{\pm}6.6\;mm$ in the AP direction, $0.8{\pm}1.6{\sim}2.0{\pm}2.7\;mm$ in the SI direction and $-0.9{\pm}1.5{\sim}2.8{\pm}3.0\;mm$ in the lateral direction, even though the setup error was quite patient dependent. $\underline{Conclusion}$: As it took less than 10 seconds to evaluate a setup discrepancy, it can be helpful to reduce the setup correction time while minimizing subjective factors that may be user dependent. However, the on-line correction process should be integrated into the treatment machine control system for a more reliable procedure.

• Journal of the Korean Society of Radiology
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• v.13 no.4
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• pp.637-643
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• 2019

To verify internal movements of the body, a DICOM file obtained from CT and a Geant4 code were used to simulate lung cancer patients. In addition, the method is applied to measure the movement of tumor when the movement of t he tumor is located inhale and exhale by creating a virtual tumor in the self-produced moving phantom, and to check the distribution of dose in the treatment plan and the accuracy of tumor in PTV for respiratory and lung cancer patients. It was confirmed that 97% or more respiratory control radiation therapy was effective even if the moving area was more than 3cm, in the 40% to 70% range. Dose distribution with respiratory radiation therapy applied to moving targets, measured by film in the actuation phantom, was shown to be within a 3mm margin of error for dose distribution containing 90%. It was confirmed that for actual patient breathing curves, the treatment time may be shorter than that due to the longer expiratory time.