• Progress in Medical Physics
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• v.15 no.4
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• pp.179-185
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• 2004

To deal with tumor motion from respiration is one of the important issues for the advanced treatment techniques, such as the intensity modulated radiation therapy (IMRT), the image guided radiation therapy (IGRT), the three dimensional conformal therapy (3D-CRT) and the Cyber Knife. Studies including the active breath control (ABC) and the gated radiation therapy have been reported. Authors have developed the device for reducing the respiration effects and the diaphragm motions with this device were observed to determined the effectiveness of the device. The device consists of four belts to immobilize diaphragm motion and the vacuum cushion. Diaphragm motions without and with device were monitored fluoroscopically. Diaphragm motion ranges were found to be 1.14 ～ 3.14 cm (average 2.14 cm) without the device and 0.72～1.95 cm (average 1.16 cm) with the device. The motion ranges were decreased 20 ～ 68.4% (average 44.9%.) However, the respiration cycle was increased from 4.4 seconds to 3.7 seconds. The CTV-PTV margin could be decreased significantly with the device developed in this study, which may be applied to the treatments of the tumor sited diaphragm region.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2003.09a
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• pp.37-37
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• 2003

목적 : 일반적으로 세기조절방사선치료 조사면의 작은 조각 크기에 대해, 이상적인 플루언스 지도 혹은 치료계획장치로부터의 최적화된 결과에 가까운 선량분포에서 더 좋은 leaf sequence를 얻을 수 있다. 한편, 치료중 장기의 움직임이 가장 작은 조각 크기의 선택을 방해하는 문제는 항상 존재한다. 게다가, 전통적인 정지 조사면과 달리 표적이 움직이는 동안 조사면 자체도 움직이므로 움직이는 표적에 대한 세기조절방사선치료의 경우에서 적절한 표적 마진에 관한 질문이 제기되어왔다. 따라서, 이 연구에서는 조각 크기에 대한 치료중 표적 움직임의 효과를 연구하였다. 대상 및 방법 : 세기조절방사선치료 플루언스 지도에 대해, 다양한 크기 - 0.5$\times$0.5, 1.0$\times$1.0, $1.5\times$1.5, 2.0$\times$2.0, 3.0$\times$3.0, 4.0$\times$4.0, 5.0$\times$5.0 $ extrm{cm}^2$ - 의 정사각형 패턴들을 설계하였고, Leaf sequence 는 step-and-shoot 빔 전달 방법을 이용하였다. 인접 조각들 사이의 세기 비율은 0.2, 0.4, 0.6, 0.8, 1.0로 하였고, 표적 움직임은 범위가 0.5-2.0 cm인 사인곡선 형태로 가정하였다. 움직임 묘사를 위해 동적 leaf 의 움직임이 표적의 움직임 을 반영하도록 계산되었고 움직임의 효과를 분석하기 위해 필름선량측정을 수행하였다. 결과 : 인접 조각의 세기 비율은 모든 경우에서 저하되었고, 호흡 진폭의 반보다 작은 조각 크기에 대한 선량분포는 임상적으로 유의할만큼 저하된 세기 지도를 보였다. 조각에 대해 방사선 조사시간의 두 호흡주기이상에 대해서는, 표적 마진 주위의 선량분포가 통상적인 정지 조사면에서와 같았다. 결론 : 플루언스 지도에서 세기조절방사선치료 조각의 최소 크기는 치료중 장기 움직임을 고려한 후 선택되어야 한다. 조각에 대한 방사선 조사시간의 두 호흡주기이상에 대해서는, 표적 마진을 기존의 정지 조사면과 같게 정의할 수 있었다.

• The Journal of the Korea Contents Association
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• v.10 no.3
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• pp.258-265
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• 2010

The purposes of this study was to determine the effects of limited hyperextension at knee joint using Limited Motion Knee Brace on balance and walking in patients with hemiplegia. The subjects of this study were 20 post-stroke hemiplegic patients admitted. Subjects were randomly assigned to either experimental group (Limited Motion Knee Brace group) or control group (manual restriction group). Both groups received traditional physical therapy intervention. The effects of each therapeutic method were evaluated by measurements of gait ability assesment, Berg balance scale (BBS), 10-meter walk speed (10MWS), Timed Up & Go (TUG) Test. The results of this research were as followings: (1) After treatment, there were significant BBS scores differences in both experimental and control group compared with pre-treatment(p<0.05). (2) After treatment, there were significant TUG test scores differences in both experimental and control group compared with pre-treatment (p<0.05). (3) After treatment, there were significant 10MWS differences in both experimental and control group compared with pre-treatment (p<0.05). (4) There were significant BBS scores differences in third and fourth week between experimental and control group (p<0.05). It was concluded that Limited Motion Knee Brace was effective for improving balance and for reducing fatigue for experimental group. Therefore, further studies are required to investigate the effect of knee orthosis for improving balance and walking in patients with hemiplegia.

• Journal of the Korea Convergence Society
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• v.13 no.1
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• pp.109-118
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• 2022

The purpose of this study is to identify trends in the application of artificial intelligence by analyzing upper extremity movement assessment and artificial intelligence convergence research using a systematic literature review method. The research was conducted using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Among the 380 articles searched in three databases, 8 articles were finally selected according to the selection and exclusion criteria. For the evaluation of upper extremity movement, motion performance evaluation, FMA, and ARAT were used. For quantification, data were extracted using various tools, and upper extremity movement classification, recovery prognosis prediction, and evaluation tool score were predicted using artificial intelligence. This study is meaningful in that it systematically reviewed studies that objectively evaluated upper extremity movement using artificial intelligence and identified the direction in which artificial intelligence is being applied. Based on this, the introduction of artificial intelligence technology in the assessment of upper extremity movements is expected to help objectively identify the intervention effect and the patient's recovery.

• Progress in Medical Physics
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• v.23 no.3
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• pp.169-176
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• 2012

Frameless method in brain radiosurgery has advantages relative to rigid head-frame method in terms of patient friendly and flexible application of multi-fractionation. However, it has also disadvantages and the most negative point is that it cannot control the patient motion during treatment as lowly as the level of the frame-based radiosurgery, which could affect to the treatment accuracy. In the present study, we analyzed the geometric uncertainty of the intra-fraction motion using the actual treatment records of 294-CyberKnife treatments for brain tumors. Based on the analysis, we statistically presented the magnitude of intra-fraction motion in frameless radiosurgy. The result could provide the quantitative information to determine the adequate treatment margins to compensate the intra-fraction movements.

• Journal of Radiation Protection and Research
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• v.35 no.2
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• pp.63-68
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• 2010

The ultimate goal of radiation treatment is to use enough radiation dosage in order to examine a tumor while protecting normal tissue. Respiratory guided radiotherapy is being clinically implemented to examine a given stabilized area in order to compensate for the problems of patient breathing. This study investigates the effects of breathing movements on 40 patients with liver cancer through the actual radiation therapy plan using 4D-CT and respiratory guided radiotherapy using RPM. Using a commercial RPM respiratory gating system 4D-CT, we acquired 4D CT on multislice helical CT scanners that use different approaches to 4D CT image reconstruction. The results from analyzing forty patients according to age and direction showed no relationship between gender and transition change. The mean left-right, anteroposterior, and craniocaudal total movements were $3.19{\pm}1.29$, $5.44{\pm}2.07$, and $12.54{\pm}4.70$ mm, respectively. Changes were the largest with CC directions and as patients advanced in age, movements were larger. Therefore, as changes occur in treatment areas because of movements caused from breathing, respiratory gating system is put into operation to revise movement and can increase the radiotherapeutics effects in treating liver cancer.

• Therapeutic Science for Rehabilitation
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• v.2 no.2
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• pp.61-66
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• 2013

Objective : The purpose of this study was to analysis of disparity between bilateral hand movement when performing activity of daily living using accelerometer. Methods : The subjects of this study included 6 healthy adults. The assessment tool used Jebsen Hand Function Test and accelerometer. The subjects performed 7 sub-tests after wearing accelerometer around wrist. Results : Among sub-tests, writing was the only significantly correlated with difference between dominant and non-dominant hand(t=-2.394, p<.05). Further, non-dominant hand (M=2476.2, SD=802.2) showed more movement than dominant hand(M=1456.2, SD=667.6). Conclusion : This results indicated that accelerometer is useful tool for assessment of bilateral hand movement. Considering demographic characteristics, various subject group, further study is needed.

• Journal of Music and Human Behavior
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• v.19 no.2
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• pp.81-103
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• 2022

The effects of therapeutic instrumental music performance (TIMP) using a ukulele were examined in adults with central nervous system damage and impaired hand functions. The participants were three adults with neurological damage who participated in 30-min sessions twice a week over 6 weeks. Changes in hand function was measured by the Box and Block Test (BBT), the 9-Hole Peg Test (9-HPT), and the Jebsen-Taylor Hand Function Test (JTHFT). Following the intervention, all three participants showed increases in the BBT and 9-HPT scores, indicating positive changes in fine motor coordination and dexterity. In terms of the JTHFT, all three participants showed increases in the "writing" and "card flipping" subtask scores, indicating that the intervention was effective in improving more coordinated finger movements. All participants reported the satisfaction with the intervention. They also pointed out that they were motivated to play the ukulele and that following the intervention used their affected hand more frequently in daily activities. These findings suggest that TIMP with a ukulele for patients with central nervous system damage can have positive effects on their functional hand movements and motivate these patients to practice their rehabilitation exercises.

• The Journal of Korean Society for Radiation Therapy
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• v.26 no.1
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• pp.69-76
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• 2014

Purpose : To evaluate the changes of the motion of abdominal cavity between interfraction and intrafraction by using abdominal compression for reducing abdominal motion. Materials and Methods : 60 MVCT images were obtained before and after tomotherapy from 10 prostate cancer patients over the whole radiotherapy period. Shift values ( X -lateral Y -longitudinal Z -vertical and Roll ) were measured and from it, the correlation of between interfraction set up change and intrafraction target motion was analyzed when applying abdominal compression. Results : The motion changes of interfraction were X-average $0.65{\pm}2.32mm$, Y-average $1.41{\pm}4.83mm$, Z-average $0.73{\pm}0.52mm$ and Roll-average $0.96{\pm}0.21mm$. The motion changes of intrafraction were X-average $0.15{\pm}0.44mm$, Y-average $0.13{\pm}0.44mm$, Z-average $0.24{\pm}0.64mm$ and Roll-average $0.1{\pm}0.9mm$. The average PTV maximum dose difference was minimum for 10% phase and maximum for 70% phase. The average Spain cord maximum dose difference was minimum for 0% phase and maximum for 50% phase. The average difference of $V_{20}$, $V_{10}$, $V_5$ of Lung show bo certain trend. Conclusion : Abdominal compression can minimize the motion of internal organs and patients. So it is considered to be able to get more ideal dose volume without damage of normal structures from generating margin in small in producing PTV.

• Progress in Medical Physics
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• v.23 no.2
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• pp.91-98
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• 2012

Verification of internal organ motion during treatment and its feedback is essential to accurate dose delivery to the moving target. We developed an offline based internal organ motion verification system (IMVS) using cine EPID images and evaluated its accuracy and availability through phantom study. For verification of organ motion using live cine EPID images, a pattern matching algorithm using an internal surrogate, which is very distinguishable and represents organ motion in the treatment field, like diaphragm, was employed in the self-developed analysis software. For the system performance test, we developed a linear motion phantom, which consists of a human body shaped phantom with a fake tumor in the lung, linear motion cart, and control software. The phantom was operated with a motion of 2 cm at 4 sec per cycle and cine EPID images were obtained at a rate of 3.3 and 6.6 frames per sec (2 MU/frame) with $1,024{\times}768$ pixel counts in a linear accelerator (10 MVX). Organ motion of the target was tracked using self-developed analysis software. Results were compared with planned data of the motion phantom and data from the video image based tracking system (RPM, Varian, USA) using an external surrogate in order to evaluate its accuracy. For quantitative analysis, we analyzed correlation between two data sets in terms of average cycle (peak to peak), amplitude, and pattern (RMS, root mean square) of motion. Averages for the cycle of motion from IMVS and RPM system were $3.98{\pm}0.11$ (IMVS 3.3 fps), $4.005{\pm}0.001$ (IMVS 6.6 fps), and $3.95{\pm}0.02$ (RPM), respectively, and showed good agreement on real value (4 sec/cycle). Average of the amplitude of motion tracked by our system showed $1.85{\pm}0.02$ cm (3.3 fps) and $1.94{\pm}0.02$ cm (6.6 fps) as showed a slightly different value, 0.15 (7.5% error) and 0.06 (3% error) cm, respectively, compared with the actual value (2 cm), due to time resolution for image acquisition. In analysis of pattern of motion, the value of the RMS from the cine EPID image in 3.3 fps (0.1044) grew slightly compared with data from 6.6 fps (0.0480). The organ motion verification system using sequential cine EPID images with an internal surrogate showed good representation of its motion within 3% error in a preliminary phantom study. The system can be implemented for clinical purposes, which include organ motion verification during treatment, compared with 4D treatment planning data, and its feedback for accurate dose delivery to the moving target.