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The Influence of Aging on Pulmonary Function Tests in Elderly Korean Population (한국에서 노화에 따른 폐기능지표의 변화양상)

  • Lee, Jae-Myung;Kim, Eun-Jung;Kang, Min-Jong;Son, Jee-Woong;Lee, Seung-Joon;Kim, Dong-Gyu;Park, Myung-Jae;Lee, Myung-Goo;Hyun, In-Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.6
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    • pp.752-759
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    • 2000
  • Background : Many studies have shown that pulmonary function differs widely among race, age and geographical residency. By virtue of the improvement of nutrition and environment, the elderly population in Korea is markedly increasing and so are the ages of patients complaining respiratory symptoms. However, we do not have our own data on the pulmonary functional reserve of elderly persons in Korea. We evaluate the deterioration of pulmonary functional reserve and standardize the predictive values of pulmonary function in the elderly population. Method : Pulmonary function tests were conducted in 100 men and 100 women over the age of 65. We analyzed changes of FVC and $FEV_1$ according to age and height by linear regression. We compared our new multiple linear regression equation with other equations currently used in Korea. Results : In men, the mean age was $71.5{\pm}5.2$(mean${\pm}$SD) years and the mean height was $163.6{\pm}6.2$cm. The mean FVC was $3.42{\pm}0.49{\ell}$ and the mean $FEV_1, $2.72{\pm}v$. In women, the mean age was $72.0{\pm}5.1$ years and the mean height was $149.1{\pm}5.9$cm. The mean FVC was $2.22{\pm}0.42{\ell}$ and the mean $FEV_1$ $1.83{\pm}0.34{\ell}$. Multiple linear regression equation using age and height as an independent factors was as follows : FVC(${\ell}$)=1.857-0.0356$\times$age(year)+0.02517$\times$height(cm) (p<0.01, $R^2$=0.279), $FEV_1(${\ell}$)=1.340-0.02698$\times$age(year)+0.02021$\times$height(cm) (p<0.01, $R^2$=0.255) in men, FVC(${\ell}$) =-0.09765-0.03332$\times$age(year)+0.03164$\times$height(cm) (p<0.01, $R^2$=0.435), $FEV_1(${\ell}$)=-0.l69-0.02469$\times$age(year)+0.02539$\times$height(cm) (p<0.01, $R^2$=0.41) in women. Conclusion : We established prediction regressions for pulmonary functional tests in the elderly Korean population. We also confirmed that currently adopted equations do not exactly anticipate the expected pulmonary functional reserve in the aged person over 65 years old. We suggest that our new equations from this study should be applied to interpret the pulmonary function tests in the elderly population in Korea.

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Clinical and radiographic evaluation of $Neoplan^{(R)}$ implant with a sandblasted and acid-etched surface and external connection (SLA 표면 처리 및 외측 연결형의 국산 임플랜트에 대한 임상적, 방사선학적 평가)

  • An, Hee-Suk;Moon, Hong-Suk;Shim, Jun-Sung;Cho, Kyu-Sung;Lee, Keun-Woo
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.2
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    • pp.125-136
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    • 2008
  • Statement of problem: Since the concept of osseointegration in dental implants was introduced by $Br{{\aa}}nemark$ et al, high long-term success rates have been achieved. Though the use of dental implants have increased dramatically, there are few studies on domestic implants with clinical and objective long-term data. Purpose: The aim of this retrospective study was to provide long-term data on the $Neoplan^{(R)}$ implant, which features a sandblasted and acid-etched surface and external connection. Material and methods: 96 $Neoplan^{(R)}$ implants placed in 25 patients in Yonsei University Hospital were examined to determine the effect of the factors on marginal bone loss, through clinical and radiographic results during 18 to 57 month period. Results: 1. Out of a total of 96 implants placed in 25 patients, two fixtures were lost, resulting in 97.9% of cumulative survival rate. 2. Throughout the study period, the survival rates were 96.8% in the maxilla and 98.5% in the mandible. The survival rates were 97.6% in the posterior regions and 100% in the anterior regions. 3. The mean bone loss for the first year after prosthesis placement and the mean annual bone loss after the first year for men were significantly higher than that of women (P<0.05). 4. The group of partial edentulism with no posterior teeth distal to the implant prosthesis showed significantly more bone loss compared to the group of partial edentulism with presence of posterior teeth distal to the implant prosthesis in terms of mean bone loss for the first year and after the first year (P<0.05). 5. The mean annual bone loss after the first year was more pronounced in posterior regions compared to anterior regions (P<0.05). 6. No significant difference in marginal bone loss was found in the following factors: jaws, type of prostheses, type of opposing dentition, and submerged /non-submerged implants (P<0.05). Conclusion: On the basis of these results, the factors influencing marginal bone loss were gender, type of edentulism, and location in the arch, while the factors such as arch, type of prostheses, type of opposing dentition, submerged / non- submerged implants had no significant effect on bone loss. In the present study, the cumulative survival rate of the $Neoplan^{(R)}$ implant with a sandblasted and acid-etched surface was 97.9% up to a maximum 57-month period. Further long-term investigations for this type of implant system and evaluation of other various domestic implant systems are needed in future studies.

Characteristics of Everyday Movement Represented in Steve Paxton's Works: Focused on Satisfyin' Lover, Bound, Contact at 10th & 2nd- (스티브 팩스톤(Steve Paxton)의 작품에서 나타난 일상적 움직임의 특성에 관한 연구: , , 를 중심으로)

  • KIM, Hyunhee
    • Trans-
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    • v.3
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    • pp.109-135
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    • 2017
  • The purpose of this thesis is to analyze characteristics of everyday movement showed in performances of Steve Paxton. A work of art has been realized as a special object enjoyed by high class people as high culture for a long time. Therefore, a gap between everyday life and art has been greatly existed, and the emergence of everyday elements in a work of art means that public awareness involving social change is changed. The postmodernism as the period when a boundary between art and everyday life is uncertain was a postwar society after the Second World War and a social situation that rapidly changes into a capitalistic society. Changes in this time made scholars gain access academically concepts related to everyday life, and affected artists as the spirit of the times of pluralistic postmodernism refusing totality. At the same period of the time, modern dance also faced a turning point as post-modern dance. After the Second World War, modern dance started to be evaluated as it reaches the limit, and at this juncture, headed by dancers including the Judson Dance Theatre. Acting as a dancer in a dance company of Merce Cunningham, Steve Paxton, one of founders of the Judson Dance Theatre, had a critical mind of the conditions of dance company with the social structure and the process that movement is made. This thinking is showed in early performances as an at tempt to realize everyday motion it self in performances. His early activity represented by a walking motion attracted attention as a simple motion that excludes all artful elements of existing dance performances and is possible to conduct by a person who is not a dancer. Although starting the use of everyday movement is regarded as an open characteristic of post-modern dance, advanced researches on this were rare, so this study started. In addition, studies related to Steve Paxton are skewed towards Contact Improvisation that he rose as an active practician. As the use of ordinary movement before he focused on Contact Improvisation, this study examines other attempts including Contact Improvisation as attempts after the beginning of his performances. Therefore, the study analyzes Satisfyin' Lover, Contact at 10th & 2nd and Bound that are performances of Steve Paxton, and based on this, draws everyday characteristics. In addition, related books, academic essays, dance articles and reviews are consulted to consider a concept related to everyday life and understand dance historical movement of post-modern dance. Paxton attracted attention because of his activity starting at critical approach of movement of existing modern dance. As walking of performers who are not dancers, a walking motion showed in Satisfyin' Lover gave esthetic meaning to everyday movement. After that, he was affected by Eastern ideas, so developed Contact Improvisation making a motion through energy of the natural laws. In addition, he had everyday things on his performances, and used a method to deliver various images by using mundane movement and impromptu gestures originating from relaxed body. Everyday movement of his performances represents change in awareness of performances of the art of dancing that are traditionally maintained including change of dance genre of an area. His activity with unprecedented attempt and experimentation should be highly evaluated as efforts to overcome the limit of modern dance.

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Trend of Medical Care Utilization and Medical Expenditure of the Elderly Cohort (노인 코호트의 의료이용 및 입원진료비 변화 추이 -공.교 의료보험 대상자를 대상으로-)

  • Lee, Kyeong-Soo;Kang, Pock-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.2 s.57
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    • pp.437-461
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    • 1997
  • Because of a significant improvement in the economic situation and development of scientific techniques in Korea during the last 30 years, the life expectancy of the Korean people has lengthened considerably and as a result, the number of the elderly has markedly increased. Such an increase of the number of aged population brought about many social, economic, and medical problems which were never seriously considered before. This study was conducted to assess the trend of medical care utilization and medical expenditure of the elderly. The data of each patient in the study were taken from computer database maintained for administrative purpose by the Korea Medical Insurance Corporation. The study population was 132,670 who were 60 years old or more and registered in Korean Medical Insurance Corporation from 1989 to 1993. The study subjects were predominantly female(56.3%) and 10,000-20,000 Won premium group(50.6%). The following are summaries of findings : The total increase of the number of inpatient cases was 40.5% from 1989 through 1993. The average annual increase was 3.7% in inpatient medical expenditures per case, 4.4% in inpatient medical expenditures per day and 0.08% in length of stay per case from 1989 through 1993. Cataract was the most prevalent disease of 10 leading frequent diseases in all ages from 1989 through 1993. The case mix in 1993 compared to 1989 revealed that cataract and ischemic cerebral disease were increased whereas essential hypertension and pulmonary tuberculosis were decreased . The average annual increase of medical expenditures was 3.8% in general hospitals, 6.3% in hospitals and 2.4% in clinics. From 1989 through 1993, medical expenditures used by high-cost patients accounted for about 14% to 20% of all expenditures for inpatient care, while they represented less than 2.5% of the elderly population. Time series analysis revealed that total medical expenditures and doctor's fee for inpatient will be progressively increased whereas drug expenditures for inpatient will be decreased. And there will be no change in length of stay. Based on the above results, the factors increasing medical cost and utilization should be identified and the method of cost containment for the elderly health care should be developed systematically.

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Development of Practical Problem-Based Home Economics Teaching.Learning Process Plans by Blended Learning Strategy - Focusing on a Unit 'the Youth and Consumer Life' - (Blended Learning(BL) 전략을 활용한 실천적 문제 중심 가정과 교수 학습 과정안 개발 - '청소년과 소비생활' 단원을 중심으로 -)

  • Lee, Jin-Hee;Chae, Jung-Hyun
    • Journal of Korean Home Economics Education Association
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    • v.20 no.4
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    • pp.19-42
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    • 2008
  • The purpose of this study was to develop practical problem-based home economics teaching.learning process plans about a unit 'the youth and consumer life' of middle school eighth-grade Technology and Home Economics by applying blended learning(BL) strategy. According to ADDIE instructional design model, this study was conducted in the following procedure: analysis, design/development, implementation, and evaluation. In the stage of design and development, the selected unit was converted into a practical problem-based unit, and practical problem-based teaching. learning process plans were designed in detail by using BL strategy. An online study room for practical problem-based home economics instruction grounded in BL strategy was prepared by using Edunet(http://community.edunet4u.net/${\sim}$consumer2). Eight-session lesson plans were mapped out, and study aids for students and materials for teachers were prepared. In the implementation stage, the first-session teaching plans that dealt with a minor question 'what preparations should be made to become a wise consumer' were utilized when instruction was provided to 115 eighth graders who were in three different province, and the other one was in a middle school in the city of Daejeon. The experimental teaching was implemented for two weeks in the following procedure: preliminary program, pre-online learning, main instruction and post- online learning. The preliminary program was carried out in a session in the classroom, and pre-online learning was provided before the main instruction was given in a session in the classroom. After the main instruction was completed, post-online learning was offered. In the evaluation stage, a survey was conducted on all the learners and teachers to find out their opinions and suggestions.

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A Study on the Application of Outlier Analysis for Fraud Detection: Focused on Transactions of Auction Exception Agricultural Products (부정 탐지를 위한 이상치 분석 활용방안 연구 : 농수산 상장예외품목 거래를 대상으로)

  • Kim, Dongsung;Kim, Kitae;Kim, Jongwoo;Park, Steve
    • Journal of Intelligence and Information Systems
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    • v.20 no.3
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    • pp.93-108
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    • 2014
  • To support business decision making, interests and efforts to analyze and use transaction data in different perspectives are increasing. Such efforts are not only limited to customer management or marketing, but also used for monitoring and detecting fraud transactions. Fraud transactions are evolving into various patterns by taking advantage of information technology. To reflect the evolution of fraud transactions, there are many efforts on fraud detection methods and advanced application systems in order to improve the accuracy and ease of fraud detection. As a case of fraud detection, this study aims to provide effective fraud detection methods for auction exception agricultural products in the largest Korean agricultural wholesale market. Auction exception products policy exists to complement auction-based trades in agricultural wholesale market. That is, most trades on agricultural products are performed by auction; however, specific products are assigned as auction exception products when total volumes of products are relatively small, the number of wholesalers is small, or there are difficulties for wholesalers to purchase the products. However, auction exception products policy makes several problems on fairness and transparency of transaction, which requires help of fraud detection. In this study, to generate fraud detection rules, real huge agricultural products trade transaction data from 2008 to 2010 in the market are analyzed, which increase more than 1 million transactions and 1 billion US dollar in transaction volume. Agricultural transaction data has unique characteristics such as frequent changes in supply volumes and turbulent time-dependent changes in price. Since this was the first trial to identify fraud transactions in this domain, there was no training data set for supervised learning. So, fraud detection rules are generated using outlier detection approach. We assume that outlier transactions have more possibility of fraud transactions than normal transactions. The outlier transactions are identified to compare daily average unit price, weekly average unit price, and quarterly average unit price of product items. Also quarterly averages unit price of product items of the specific wholesalers are used to identify outlier transactions. The reliability of generated fraud detection rules are confirmed by domain experts. To determine whether a transaction is fraudulent or not, normal distribution and normalized Z-value concept are applied. That is, a unit price of a transaction is transformed to Z-value to calculate the occurrence probability when we approximate the distribution of unit prices to normal distribution. The modified Z-value of the unit price in the transaction is used rather than using the original Z-value of it. The reason is that in the case of auction exception agricultural products, Z-values are influenced by outlier fraud transactions themselves because the number of wholesalers is small. The modified Z-values are called Self-Eliminated Z-scores because they are calculated excluding the unit price of the specific transaction which is subject to check whether it is fraud transaction or not. To show the usefulness of the proposed approach, a prototype of fraud transaction detection system is developed using Delphi. The system consists of five main menus and related submenus. First functionalities of the system is to import transaction databases. Next important functions are to set up fraud detection parameters. By changing fraud detection parameters, system users can control the number of potential fraud transactions. Execution functions provide fraud detection results which are found based on fraud detection parameters. The potential fraud transactions can be viewed on screen or exported as files. The study is an initial trial to identify fraud transactions in Auction Exception Agricultural Products. There are still many remained research topics of the issue. First, the scope of analysis data was limited due to the availability of data. It is necessary to include more data on transactions, wholesalers, and producers to detect fraud transactions more accurately. Next, we need to extend the scope of fraud transaction detection to fishery products. Also there are many possibilities to apply different data mining techniques for fraud detection. For example, time series approach is a potential technique to apply the problem. Even though outlier transactions are detected based on unit prices of transactions, however it is possible to derive fraud detection rules based on transaction volumes.

A Study on the Clustering Method of Row and Multiplex Housing in Seoul Using K-Means Clustering Algorithm and Hedonic Model (K-Means Clustering 알고리즘과 헤도닉 모형을 활용한 서울시 연립·다세대 군집분류 방법에 관한 연구)

  • Kwon, Soonjae;Kim, Seonghyeon;Tak, Onsik;Jeong, Hyeonhee
    • Journal of Intelligence and Information Systems
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    • v.23 no.3
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    • pp.95-118
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    • 2017
  • Recent centrally the downtown area, the transaction between the row housing and multiplex housing is activated and platform services such as Zigbang and Dabang are growing. The row housing and multiplex housing is a blind spot for real estate information. Because there is a social problem, due to the change in market size and information asymmetry due to changes in demand. Also, the 5 or 25 districts used by the Seoul Metropolitan Government or the Korean Appraisal Board(hereafter, KAB) were established within the administrative boundaries and used in existing real estate studies. This is not a district classification for real estate researches because it is zoned urban planning. Based on the existing study, this study found that the city needs to reset the Seoul Metropolitan Government's spatial structure in estimating future housing prices. So, This study attempted to classify the area without spatial heterogeneity by the reflected the property price characteristics of row housing and Multiplex housing. In other words, There has been a problem that an inefficient side has arisen due to the simple division by the existing administrative district. Therefore, this study aims to cluster Seoul as a new area for more efficient real estate analysis. This study was applied to the hedonic model based on the real transactions price data of row housing and multiplex housing. And the K-Means Clustering algorithm was used to cluster the spatial structure of Seoul. In this study, data onto real transactions price of the Seoul Row housing and Multiplex Housing from January 2014 to December 2016, and the official land value of 2016 was used and it provided by Ministry of Land, Infrastructure and Transport(hereafter, MOLIT). Data preprocessing was followed by the following processing procedures: Removal of underground transaction, Price standardization per area, Removal of Real transaction case(above 5 and below -5). In this study, we analyzed data from 132,707 cases to 126,759 data through data preprocessing. The data analysis tool used the R program. After data preprocessing, data model was constructed. Priority, the K-means Clustering was performed. In addition, a regression analysis was conducted using Hedonic model and it was conducted a cosine similarity analysis. Based on the constructed data model, we clustered on the basis of the longitude and latitude of Seoul and conducted comparative analysis of existing area. The results of this study indicated that the goodness of fit of the model was above 75 % and the variables used for the Hedonic model were significant. In other words, 5 or 25 districts that is the area of the existing administrative area are divided into 16 districts. So, this study derived a clustering method of row housing and multiplex housing in Seoul using K-Means Clustering algorithm and hedonic model by the reflected the property price characteristics. Moreover, they presented academic and practical implications and presented the limitations of this study and the direction of future research. Academic implication has clustered by reflecting the property price characteristics in order to improve the problems of the areas used in the Seoul Metropolitan Government, KAB, and Existing Real Estate Research. Another academic implications are that apartments were the main study of existing real estate research, and has proposed a method of classifying area in Seoul using public information(i.e., real-data of MOLIT) of government 3.0. Practical implication is that it can be used as a basic data for real estate related research on row housing and multiplex housing. Another practical implications are that is expected the activation of row housing and multiplex housing research and, that is expected to increase the accuracy of the model of the actual transaction. The future research direction of this study involves conducting various analyses to overcome the limitations of the threshold and indicates the need for deeper research.

A Study on the Growth Diagnosis and Management Prescription for Population of Retusa Fringe Trees in Pyeongji-ri, Jinan(Natural Monument No. 214) (진안 평지리 이팝나무군(천연기념물 제214호)의 생육진단 및 관리방안)

  • Rho, Jae-Hyun;Oh, Hyun-Kyung;Han, Sang-Yub;Choi, Yung-Hyun;Son, Hee-Kyung
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.36 no.3
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    • pp.115-127
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    • 2018
  • This study was attempted to find out the value of cultural assets through the clear diagnosis and prescription of the dead and weakness factors of the Population of Retusa Fringe Trees in Pyeongji-ri, Jinan(Natural Monument No. 214), The results are as follows. First, Since the designation of 13 natural monuments in 1968, since 1973, many years have passed since then. In particular, despite the removal of some of the buried soil during the maintenance process, such as retreating from the fence of the primary school after 2010, Second, The first and third surviving tree of the designated trees also have many branches that are dead, the leaves are dull, and the amount of leaves is small. vitality of tree is 'extremely bad', and the first branch has already been faded by a large number of branches, and the amount of leaves is considerably low this year, so that only two flowers are bloomed. The second is also in a 'bad'state, with small leaves, low leaf density, and deformed water. The largest number 1 in the world is added to the concern that the s coverd oil is assumed to be paddy soils. Third, It is found that the composition ratio of silt is high because it is known as '[silty loam(SiL)]'. In addition, the pH of the northern soil at pH 1 was 6.6, which was significantly different from that of the other soil. In addition, the organic matter content was higher than the appropriate range, which is considered to reflect the result of continuous application for protection management. Fourth, It is considered that the root cause of failure and growth of Jinan pyeongji-ri Population of Retusa Fringe Trees group is chronic syndrome of serious menstrual deterioration due to covered soil. This can also be attributed to the newly planted succession and to some of the deaths. Fifthly, It is urgent to gradually remove the subsoil part, which is estimated to be the cause of the initial damage. Above all, it is almost impossible to remove the coverd soil after grasping the details of the soil, such as clayey soil, which is buried in the rootstock. After removal of the coverd soil, a pestle is installed to improve the respiration of the roots and the ground with Masato. And the dead 4th dead wood and the 5th and 6th dead wood are the best, and the lower layer vegetation is mown. The viable neck should be removed from the upper surface, and the bark defect should undergo surgery and induce the development of blindness by vestibule below the growth point. Sixth, The underground roots should be identified to prepare a method to improve the decompression of the root and the respiration of the soil. It is induced by the shortening of rotten roots by tracing the first half of the rootstock to induce the generation of new roots. Seventh, We try mulching to suppress weed occurrence, trampling pressure, and soil moisturizing effect. In addition, consideration should be given to the fertilization of the foliar fertilizer, the injection of the nutrients, and the soil management of the inorganic fertilizer for the continuous nutrition supply. Future monitoring and forecasting plans should be developed to check for changes continuously.

Growth Efficiency, Carcass Quality Characteristics and Profitability of 'High'-Market Weight Pigs ('고체중' 출하돈의 성장효율, 도체 품질 특성 및 수익성)

  • Park, M.J.;Ha, D.M.;Shin, H.W.;Lee, S.H.;Kim, W.K.;Ha, S.H.;Yang, H.S.;Jeong, J.Y.;Joo, S.T.;Lee, C.Y.
    • Journal of Animal Science and Technology
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    • v.49 no.4
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    • pp.459-470
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    • 2007
  • Domestically, finishing pigs are marketed at 110 kg on an average. However, it is thought to be feasible to increase the market weight to 120kg or greater without decreasing the carcass quality, because most domestic pigs for pork production have descended from lean-type lineages. The present study was undertaken to investigate the growth efficiency and profitability of ‘high’-market wt pigs and the physicochemical characteristics and consumers' acceptability of the high-wt carcass. A total of 96 (Yorkshire × Landrace) × Duroc-crossbred gilts and barrows were fed a finisher diet ad laibtum in 16 pens beginning from 90-kg BW, after which the animals were slaughtered at 110kg (control) or ‘high’ market wt (135 and 125kg in gilts & barrows, respectively) and their carcasses were analyzed. Average daily gain and gain:feed did not differ between the two sex or market wt groups, whereas average daily feed intake was greater in the barrow and high market wt groups than in the gilt and 110-kg market wt groups, respectively(P<0.01). Backfat thickness of the high-market wt gilts and barrows corrected for 135 and 125-kg live wt, which were 23.7 and 22.5 mm, respectively, were greater (P<0.01) than their corresponding 110-kg counterparts(19.7 & 21.1 mm). Percentages of the trimmed primal cuts per total trimmed lean (w/w), except for that of loin, differed statistically (P<0.05) between two sex or market wt groups, but their numerical differences were rather small. Crude protein content of the loin was greater in the high vs. 110-kg market group (P<0.01), but crude fat and moisture contents and other physicochemical characteristics including the color of this primal cut were not different between the two sexes or market weights. Aroma, marbling and overall acceptability scores were greater in the high vs. 110-kg market wt group in sensory evaluation for fresh loin (P<0.01); however, overall acceptabilities for cooked loin, belly and ham were not different between the two market wt groups. Marginal profits of the 135- and 125-kg high-market wt gilt and barrow relative to their corresponding 110-kg ones were approximately -35,000 and 3,500 wons per head under the current carcass grading standard and price. However, if it had not been for the upper wt limits for the A- and B-grade carcasses, marginal profits of the high market wt gilt and barrow would have amounted to 22,000 and 11,000 wons per head, respectively. In summary, 120~125-kg market pigs are likely to meet the consumers' preference better than the 110-kg ones and also bring a profit equal to or slightly greater than that of the latter even under the current carcass grading standard. Moreover, if only the upper wt limits of the A- & B-grade carcasses were removed or increased to accommodate the high-wt carcass, the optimum market weights for the gilt and barrow would fall upon their target weights of the present study, i.e. 135 and 125 kg, respectively.

Comparison of CT based-CTV plan and CT based-ICRU38 plan in brachytherapy planning of uterine cervix cancer (자궁경부암 강내조사 시 CT를 이용한 CTV에 근거한 치료계획과 ICRU 38에 근거할 치료계획의 비교)

  • Shim JinSup;Jo JungKun;Si ChangKeun;Lee KiHo;Lee DuHyun;Choi KyeSuk
    • The Journal of Korean Society for Radiation Therapy
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    • v.16 no.2
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    • pp.9-17
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    • 2004
  • Purpose : Although Improve of CT, MRI Radio-diagnosis and Radiation Therapy Planing, but we still use ICRU38 Planning system(2D film-based) broadly. 3-Dimensional ICR plan(CT image based) is not only offer tumor and normal tissue dose but also support DVH information. On this study, we plan irradiation-goal dose on CTV(CTV plan) and irradiation-goal dose on ICRU 38 point(ICRU38 plan) by use CT image. And compare with tumor-dose, rectal-dose, bladder-dose on both planning, and analysis DVH Method and Material : Sample 11 patients who treated by Ir-192 HDR. After 40Gy external radiation therapy, ICR plan established. All the patients carry out CT-image scanned by CT-simulator. And we use PLATO(Nucletron) v.14.2 planing system. We draw CTV, rectum, bladder on the CT image. And establish plan irradiation-$100\%$ dose on CTV(CTV plan) and irradiation-$100\%$ dose on A-point(ICRU38 plan) Result : CTV volume($average{\pm}SD$) is $21.8{\pm}26.6cm^3$, rectum volume($average{\pm}SD$) is $60.9{\pm}25.0cm^3$, bladder volume($average{\pm}SD$) is $116.1{\pm}40.1cm^3$ sampled 11 patients. The volume including $100\%$ dose is $126.7{\pm}18.9cm^3$ on ICRU plan and $98.2{\pm}74.5cm^3$ on CTV plan. On ICRU planning, the other one's $22.0cm^3$ CTV volume who residual tumor size excess 4cm is not including $100\%$ isodose. 8 patient's $12.9{\pm}5.9cm^3$ tumor volume who residual tumor size belows 4cm irradiated $100\%$ dose. Bladder dose(recommended by ICRU 38) is $90.1{\pm}21.3\%$ on ICRU plan, $68.7{\pm}26.6\%$ on CTV plan, and rectal dose is $86.4{\pm}18.3\%,\;76.9{\pm}15.6\%$. Bladder and Rectum maximum dose is $137.2{\pm}50.1\%,\;101.1{\pm}41.8\%$ on ICRU plan, $107.6{\pm}47.9\%,\;86.9{\pm}30.8\%$ on CTV plan. Therefore CTV plan more less normal issue-irradiated dose than ICRU plan. But one patient case who residual tumor size excess 4cm, Normal tissue dose more higher than critical dose remarkably on CTV plan. $80\%$over-Irradiated rectal dose(V80rec) is $1.8{\pm}2.4cm^3$ on ICRU plan, $0.7{\pm}1.0cm^3$ on CTV plan. $80\%$over-Irradiated bladder dose(V80bla) is $12.2{\pm}8.9cm^3$ on ICRU plan, $3.5{\pm}4.1cm^3$ on CTV plan. Likewise, CTV plan more less irradiated normal tissue than ICRU38 plan. Conclusion : Although, prove effect and stability about previous ICRU plan, if we use CTV plan by CT image, we will reduce normal tissue dose and irradiated goal-dose at residual tumor on small residual tumor case. But bigger residual tumor case, we need more research about effective 3D-planning.

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