• Title/Summary/Keyword: 치료정원

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Radiologic Equipment and Technicians according to the Distribution of the Population (인구 분포에 따른 방사선 장비 및 종사자에 관한 고찰)

  • Yoon, Chul-Ho;Choi, Jun-Gu
    • The Journal of Korean Society for Radiation Therapy
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    • v.21 no.2
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    • pp.57-65
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    • 2009
  • Purpose: The purpose of this paper is to provide basic data in order to systemize the management of demand and supply of radiologic technicians, to pursue a fair regional distribution of educational institutions, and furthermore to keep reasonable medical treatment and fee. This research was carried out through the investigation of radiologic equipments and technicians according to the distribution of the population. Materials and Methods: We compared and analyzed the correlation between regional population, the number of clinics and hospitals, the number of medical imaging devices, and the number of radiologists and radiologic technicians in 5 cities without "Gu" administrative units in 2008. Results: 27,317 radiologic technicians have been produced since the administration of the national qualifying exam for radiologic technicians. About 18,000 radiologic technicians are currently working. There are 39 colleges or universities with Departments of Radiology and the admission quota is 2,120 students excluding one college. The ratio of radiologic equipments to radiologic technicians is 2.6 to 1. Conclusion: There is a dilemma in which some radiologic technicians fail to find appropriate jobs while some clinics or hospitals are in need of radiologic technicians. This dilemma is due to unreasonable regional discrepancies in pay system and welfare situation, and excessive profit-oriented recruiting system of clinics and hospitals. The increase of students of Radiologic Departments and approval of additional departments will end up with producing superfluous high academic degree holders, which is on the contrary to the government policy to produce more job opportunities. So the policy of increasing Radiologic Departments should be reconsidered.

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Case Analysis of Pulmonary Sequestration (폐격리증에 대한 임상적 고찰)

  • Jeon, Yang-Bin;Shin, Sung-Ho;Chung, Tae-Yul;Kim, Hyuk;Ham, Si-Young;Lee, Chul-Bum;Chung, Won-Sang;Kim, Young-Hak;Kang, Jung-Ho;Jee, Heng-Ok
    • Journal of Chest Surgery
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    • v.31 no.12
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    • pp.1206-1211
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    • 1998
  • Background: Pulmonary sequestration is not common and it's diagnosis needs special care such as an aortogram ar tomography. Material and Method: We have experienced 13 patients who had pulmonary sequestration from January 1990 to September 1997. Result: Six men and seven women were treated and their mean age was 25.8±14.3 years. Their chief complaints were coughing, chest pain, and no symptoms in decreasing order. There were nine intralobar(ILS) and three extralobar(ELS) pulmonary sequestrations and one patient had both. There was no preference in location of either left or right. They were mainly diagnosed by aortography and their feeding arteries commonly originated from the lower thoracic aorta. The patients with ILS were treated by lobectomy and those with ELS by sequestrectomy. Conclusion: to treat pulmonary sequestration properhy, aortogram or chest CT is warranted to iidenty the abnormal origin of feeding artery.

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Angiographic Findings of an Isolated Meandering Pulmonary Vein: A Case Report (단독 사행 폐정맥의 혈관 조영술 소견: 증례 보고)

  • Ji Su Ko;Lyo Min Kwon;Han Myun Kim;Ji Young Woo;Yoo Na Kim;Jung Won Moon
    • Journal of the Korean Society of Radiology
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    • v.82 no.4
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    • pp.1018-1023
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    • 2021
  • A meandering pulmonary vein (MPV) is a rare pulmonary vascular anomaly characterized by an abnormal course of the pulmonary vein draining into the left atrium. We report the case of a 55-year-old female who was diagnosed with a right MPV on pulmonary angiography. Enhanced chest CT revealed a vascular structure with an abnormal course that drained into the right superior pulmonary vein in the right upper lobe, which resembled a pulmonary arteriovenous malformation (AVM). Pulmonary angiography performed to discriminate between an MPV and pulmonary AVM showed no feeding artery, normal parenchymal staining, and drainage to the left atrium via the culprit vessel. Thus, the patient was diagnosed with MPV. When an MPV is difficult to differentiate from other vascular anomalies on enhanced chest CT, pulmonary angiography can be helpful. By recognizing the angiographic findings of an MPV, unnecessary treatment can be prevented.

Analysis on Longitudinal Dose according to Change of Field Width (선속 폭(Field Width) 변화에 따른 종축선량 분석)

  • Jung, Won-Seok;Back, Jong-Geal;Shin, Ryung-Mi;Oh, Byung-Cheon;Jo, Jun-Young;Kim, Gi-Chul;Choi, Tae-Gu
    • The Journal of Korean Society for Radiation Therapy
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    • v.23 no.2
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    • pp.109-117
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    • 2011
  • Purpose: To analyze the accuracy of tumor volume dose following field width change, to check the difference of dose change by using self-made moving car, and to evaluate practical delivery tumor dose when tomotherapy in the treatment of organ influenced by breathing. Materials and Methods: By using self-made moving car, the difference of longitudinal movement (0.0 cm, 1.0 cm, 1.5 cm, 2.0 cm) was applied and compared calculated dose with measured dose according to change of field width (1.05 cm, 2.50 cm, 5.02 cm) and apprehended margin of error. Then done comparative analysis in degree of photosensitivity of DQA film measured by using Gafchromic EBT film. Dose profile and Gamma histogram were used to measure degree of photosensitivity of DQA film. Results: When field width were 1.05 cm, 2.50 cm, 5.02 cm, margin of error of dose delivery coefficient was -2.00%, -0.39%, -2.55%. In dose profile of Gafchromic EBT film's analysis, the movement of moving car had greater motion toward longitudinal direction and as field width was narrower, big error increased considerably at high dose part compared to calculated dose. The more field width was narrowed, gamma index had a large considerable influence of moving at gamma histogram. Conclusion: We could check the difference of longitudinal dose of moving organ. In order to small field width and minimize organ moving due to breathing, it is thought to be needed to develop breathing control unit and fixation tool.

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Study of Scatter Influence of kV-Conebeam CT Based Calculation for Pelvic Radiotherapy (골반 방사선 치료에서 산란이 kV-Conebeam CT 영상 기반의 선량계산에 미치는 영향에 대한 연구)

  • Yoon, KyoungJun;Kwak, Jungwon;Cho, Byungchul;Kim, YoungSeok;Lee, SangWook;Ahn, SeungDo;Nam, SangHee
    • Progress in Medical Physics
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    • v.25 no.1
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    • pp.37-45
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    • 2014
  • The accuracy and uniformity of CT numbers are the main causes of radiation dose calculation error. Especially, for the dose calculation based on kV-Cone Beam Computed Tomography (CBCT) image, the scatter affecting the CT number is known to be quite different by the object sizes, densities, exposure conditions, and so on. In this study, the scatter impact on the CBCT based dose calculation was evaluated to provide the optimal condition minimizing the error. The CBCT images was acquired under three scatter conditions ("Under-scatter", "Over-scatter", and "Full-scatter") by adjusting amount of scatter materials around a electron density phantom (CIRS062, Tissue Simulation Technology, Norfolk, VA, USA). The CT number uniformities of CBCT images for water-equivalent materials of the phantom were assessed, and the location dependency, either "inner" or "outer" parts of the phantom, was also evaluated. The electron density correction curves were derived from CBCT images of the electron density phantom in each scatter condition. The electron density correction curves were applied to calculate the CBCT based doses, which were compared with the dose based on Fan Beam Computed Tomography (FBCT). Also, 5 prostate IMRT cases were enrolled to assess the accuracy of dose based on CBCT images using gamma index analysis and relative dose differences. As the CT number histogram of phantom CBCT images for water equivalent materials was fitted with a gaussian function, the FHWM (146 HU) for "Full-scatter" condition was the smallest among the FHWM for the three conditions (685 HU for "under scatter" and 264 HU for "over scatter"). Also, the variance of CT numbers was the smallest for the same ingredients located in the center and periphery of the phantom in the "Full-scatter" condition. The dose distributions calculated with FBCT and CBCT images compared in a gamma index evaluation of 1%/3 mm criteria and in the dose difference. With the electron density correction acquired in the same scatter condition, the CBCT based dose calculations tended to be the most accurate. In 5 prostate cases in which the mean equivalent diameter was 27.2 cm, the averaged gamma pass rate was 98% and the dose difference confirmed to be less than 2% (average 0.2%, ranged from -1.3% to 1.6%) with the electron density correction of the "Full-scatter" condition. The accuracy of CBCT based dose calculation could be confirmed that closely related to the CT number uniformity and to the similarity of the scatter conditions for the electron density correction curve and CBCT image. In pelvic cases, the most accurate dose calculation was achievable in the application of the electron density curves of the "Full-scatter" condition.

The Egg Detection Rates of Enterobius Vermicularis among Preschool and School Children in Masan and Changwon Areas in Korea (마산, 창원지역에서 아동들의 요충 감염 실태 연구)

  • Jo, Mi Hyun;Kim, Won Yeob;Chuung, Won Jo;Ma, Sang Hyeok;Choi, Sang Ho;Kong, Hyun-Hee;Chung, Dong-Il
    • Pediatric Infection and Vaccine
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    • v.6 no.1
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    • pp.107-115
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    • 1999
  • Purpose : Enterobiasis is probably one of the most common parasitic infection world-wide. Human is the only known host of Enterobius vermicularis. Children are more commonly infected with Enterobius vermicularis than adults and infections are commonly recurred. In Korea, there is a high prevalence. So, we performed this study to evaluate the present status of Enterobius vermicularis infection among children in the Masan, Changwon areas and to determine the efficacy of flubendazole against this parasitic nematode. Methods : From November to December, 1997, urban and rural elementary school children and urban preschool children were examined for the presence of Enterobius vermicularis egg. All the children were examined once by an adhesive cellotape anal swab technique in the early morning at home by their parents guided by specific instructions for the technique. Results : 1) A total of 644 adhesive cellotape anal swab specimens was collected from 205 urban elementary school children, 290 rural elementary school children and 145 urban preschool children. Among them, 114(17.7%) were positive for Enterobius vermicularis eggs. There was no significant differences in the rate with regard to sex. 2) In the preschool children, the egg detection rate was 42(29.0%) out of 145 children. This rate was significantly higher compared with 72(14.4%) of 499 school children. 3) The egg detection rates in the rural and urban school children were 15.2, 13.7% respectively. There was no significant difference in both groups. In the 3rd grade and below in elementary school children, there was a higher rate compared with above 4th grade group. 4) In day care center where egg detection rate was high as 41%, the children were given two doses of 100mg flubendazole every 3 weeks, including staffs and family members. After treatment, egg detection rate fatted as 6%. Conclusion : Our data demonstrated that there was high prevalence of Enterobius vermicularis infection. In the light of these results, it is necessary to examine and treat children as soon as possible.

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An Analysis for Effects of Stain Family Drugs on Osteogenic Differentiation using Human Periosteum-derived Mesenchymal Stem Cells (스타틴(statin) 약물이 성체줄기세포의 골분화에 미치는 영향)

  • Moon, Dong Kyu;Yun, Jeong-Won;Kim, Bo Gyu;Lee, A Ram;Moon, Sun Young;Byun, June-Ho;Hwang, Sun-Chul;Woo, Dong Kyun
    • Journal of Life Science
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    • v.29 no.12
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    • pp.1337-1344
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    • 2019
  • Osteoporosis is characterized by a reduction in bone mass and typically manifests as an increase in fractures. Because this disease is common in elderly populations and lifespans are rapidly increasing, the incidence of osteoporosis has also grown. Most drugs currently used for osteoporosis treatment target osteoclasts in the bone tissue to prevent absorption. However, these medications also cause certain side effects and, furthermore, cannot increase bone mass. Thus, in order to control osteoporosis, regenerative medicine that utilizes adult stem cells and osteoblasts has been extensively studied. Statins, also known as 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors, are cholesterol-lowering drugs that have been widely prescribed for cardiovascular diseases. Interestingly, recent studies have reported the beneficial effects of various statins on bone formation via the activation of osteoblasts. Thus, the current study investigated the effects of seven statin-family drugs on osteoblast activity during osteogenic differentiation using adult stem cells from human periosteal tissue. Specifically, statin effects on alkaline phosphatase activity, an early marker of bone cell differentiation, and on calcium deposit, a late marker of bone cell differentiation, were assessed. The results demonstrate that some statins (for example, pitavastatin and pravastatin) have a weak but positive effect on bone formation, and the findings therefore suggest that statin treatments can be a novel modulator for osteogenic differentiation and regenerative medicine using periosteal stem cells.

Surgical Treatment of Pulmonary Metastases (전이성 폐암의 외과적 치료)

  • Kang, Jeong-Ho;Ro, Sun-Kyun;Chung, Won-Sang;Kim, Hyuck;Ban, Dong-Gyu;Kim, Young-Hak
    • Journal of Chest Surgery
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    • v.40 no.2 s.271
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    • pp.103-108
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    • 2007
  • Background: Surgical resection is an important modality in the treatment of pulmonary metastases from various solid tumors. We analyzed 37 patients who underwent surgical treatments of pulmonary metastases in our hospital from 1996 to 2005. Material and Method: Age, sex, disease free interval, operative procedure, the number of pulmonary metastases, and lymphatic metastasis were investigated with admission and operative records, and pathologic reports. Actuarial survival and comparisons between each survival rate were calculated according to Kaplan-Meier method and log-rank test, respectively, Result: Complete resections were carried out in 34 of 37 patients. The primary tumor was carcinoma in 25 cases, sarcoma in 10, and others in 2. The number of pulmonary metastases was 1 in 25 cases and 2 or more in 12 cases. 3-year and 5-year survival rates after complete resection were 50.5% and 35.9%, respectively. 3-year and 5-year survival rates for carcinoma were 64.5% and 45.0%, respectively, and 3-year survival rate for sarcoma was 17.5%. Otherwise, none of the operative procedures, the number of pulmonary metastases, lymphatic metastasis, adjunctive therapy and the disease free interval in the case of carcinoma significantly affected the survival rates. Conclusion: Complete resection of pulmonary metastasis in well selected patients allows high long term survival rate with low mortality and morbidity. Long-term follow up and randomized prospective studies were necessary to determine the prognostic factors of pulmonary metastases after surgical resection.

Clinical Results alter Pulmonary Endarterectomy as a Curative Surgical Method in Chronic Thromboembolic Pulmonary Hypertension: an Approach to Operative Classification of Thromboembolic Disease (만성 폐동맥 색전증의 치료로서 내막제거술의 임상적 결과: 색전증 분류에 따른 접근)

  • Lim, Ju-Yong;Lee, Jae-Won;Kim, Jeong-Won;Jung, Sung-Ho;Je, Hyoung-Gon;Song, Hyun;Chung, Cheol-Hyun;Choo, Suk-Jung
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.591-597
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    • 2008
  • Background: Pulmonary endarterectomy is widely accepted as a treatment for chronic thromboembolic pulmonary hypertension. Based on our experiences, we sought to find ways to reduce perioperative complications and to improve surgical outcomes in patients undergoing pulmonary endarterectomy. Material and Method: This study was designed as a retrospective analysis of 20 patients with pulmonary hypertension who underwent pulmonary endarterectomy between January 1998 and March 2008. All patients presented with chronic dyspnea. Deep vein thrombosis (DVT) was the major cause of chronic pulmonary thromboembolism (55%). Seventeen patients (85%) underwent inferior vena cava (IVC) filter placement. Thirteen patients underwent surgery under total circulatory arrest, while the others underwent surgery while on low flow cardiopulmonary bypass. Concomitant tricuspid annuloplasty was done in 6 patients (66%) whose tricuspid regurgitation was as severe as grade IV/IV. The mean follow-up duration was $45{\pm}32$ months. Result: Using of University of California, San Diego (UCSD), thromboembolism classification, 4 patients (20%) were type 1, 8 patients (40%) were type II, and 8 patients (40%) were type III. Right ventricular systolic pressure was reduced significantly from $77{\pm}29$ mmHg to $37{\pm}19$ mmHg after pulmonary endarterectomy (p<0.001). The degree of tricuspid regurgitation and the NYHA functional class were all improved postoperatively. Reperfusion edema occurred in 7 cases (35%). The incidence of reperfusion edema was higher in the UCSD type III group than in the other group (25% vs 50%, p=0.25) and the length of postoperative intensive care unit stay was longer in type III group ($5{\pm}2$ days vs $9{\pm}7$ days, p=0.07). The early mortality rate was 10%, and the late mortality rate was 15% (n=3); one death was due to progression of underlying non-Hodgkin's lymphoma, and the other deaths were related to recurrent thromboembolism and persistent pulmonary hypertension, respectively. Conclusion: Pulmonary endarterectomy, as a curative surgical method for treating chronic thromboernbolic pulmonary hypertension, should be performed aggressively in patients diagnosed with chronic thromboembolic pulmonary hypertension, and an effort should be made to reduce the frequency of perioperative complications and to improve surgical outcomes.

The Clinical Effect and Construction of a Stereotactic Whole Body Immobilization Device (전신 정위 고정장치 제작과 임상효과에 대한 연구)

  • 정진범;정원균;서태석;최경식;진호상;지영훈
    • Progress in Medical Physics
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    • v.15 no.1
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    • pp.30-38
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    • 2004
  • Purpose: To develop a whole body frame for the purpose of reducing patient motion and minimizing setup error for extra-cranial stereotactic radiotherapy, and to evaluate the repositioning setup error of a patient in the frame. Materials and Methods: The developed whole body frame is composed of a base plate, immobilizer, vacuum cushion, ruler and belts. The dimension of the base plate is 130 cm in length, 50 cm in width and 1 cm in thickness. The material used in the base plate of the frame was bakelite and the immobilizer was made of acetal. In addition, Radiopaque angio-catheter wires were engraved on the base plate for a coordinate system to determine the target localization. The measurement for radiation transmission and target localization is peformed in order to test the utilization of the frame. Also, a Matlab program analyzed the patients setup error by using the patient's setup images obtained from a CCTV camera and digital record recorder (DVR). Results: A frame that is useful for CT simulation and radiation treatment was fabricated. The frame structure was designed to minimize collisions from the changes in the rotation angle of the gantry and to maximize the transmission rate of the Incident radiation at the lateral or posterior oblique direction. The lightening belts may be used for the further reduction of the patient motion, and the belts can be adjusted so that they are not in the way of beam direction. The radiation transmission rates of this frame were measured as 95% and 96% at 10 and 21 MV, respectively. The position of a test target on the skin of a volunteer is accurately determined by CT simulation using the coordinate system in the frame. The estimated setup errors by Matlab program are shown 3.69$\pm$1.60, 2.14$\pm$0.78 mm at the lateral and central chest, and 7.11 $\pm$2.10, 6.54$\pm$2.22 mm at lateral and central abdomen, respectively. The setup error due to the lateral motion of breast is shown as 6.33$\pm$ 1.55 mm. Conclusion: The development and test of a whole body frame has proven very useful and practical in the radiosurgery for extra-cranial cancers. It may be used in determining target localization, and it can be used as a patient immobilization tool. More experimental data should be obtained in order to improve and confirm the results of the patient setup error.

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