• Title/Summary/Keyword: Case Report

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Development of 2.5D Electron Dose Calculation Algorithm (2.5D 전자선 선량계산 알고리즘 개발)

  • 조병철;고영은;오도훈;배훈식
    • Progress in Medical Physics
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    • v.10 no.3
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    • pp.133-140
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    • 1999
  • In this paper, as a preliminary study for developing a full 3D electron dose calculation algorithm, We developed 2.5D electron dose calculation algorithm by extending 2D pencil-beam model to consider three dimensional geometry such as air-gap and obliquity appropriately. The dose calculation algorithm was implemented using the IDL5.2(Research Systems Inc., USA), For calculation of the Hogstrom's pencil-beam algorithm, the measured data of the central-axis depth-dose for 12 MeV(Siemens M6740) and the linear stopping power and the linear scattering power of water and air from ICRU report 35 was used. To evaluate the accuracy of the implemented program, we compared the calculated dose distribution with the film measurements in the three situations; the normal incident beam, the 45$^{\circ}$ oblique incident beam, and the beam incident on the pit-shaped phantom. As results, about 120 seconds had been required on the PC (Pentium III 450MHz) to calculate dose distribution of a single beam. It needs some optimizing methods to speed up the dose calculation. For the accuracy of dose calculation, in the case of the normal incident beam of the regular and irregular shaped field, at the rapid dose gradient region of penumbra, the errors were within $\pm$3 mm and the dose profiles were agreed within 5%. However, the discrepancy between the calculation and the measurement were about 10% for the oblique incident beam and the beam incident on the pit-shaped phantom. In conclusions, we expended 2D pencil-beam algorithm to take into account the three dimensional geometry of the patient. And also, as well as the dose calculation of irregular field, the irregular shaped body contour and the air-gap could be considered appropriately in the implemented program. In the near future, the more accurate algorithm will be implemented considering inhomogeneity correction using CT, and at that time, the program can be used as a tool for educational and research purpose. This study was supported by a grant (#HMP-98-G-1-016) of the HAN(Highly Advanced National) Project, Ministry of Health & Welfare, R.O.K.

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Studies on the Character of Forest Purchasers and It's Forestry Activities -A Case Study on the Transfer of Forest Ownership and Forest Investment- (산림취득자본(山林取得資本)의 성격(性格)과 그들의 임업생산(林業生産)에 관(関)한 연구(硏究) -산림(山林)의 소유변동(所有変動)과 그들의 임업투자(林業投資) 사례(事例)-)

  • Park, Myong Kyu;Lee, Tchang Bok
    • Journal of Korean Society of Forest Science
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    • v.55 no.1
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    • pp.59-67
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    • 1982
  • The objectives of this report is to evaluate the contribution of forest investments by the forest owners for the developments of private forests in the villages where the forest production, especially, chestnut production is active. The results obtained are as follows : 1) Newly purchased forest lands of 526 hectares, 71 percent, in 741 hectares by 96 farmers were replanted with chestnut trees for chestnut production. 2) As the chestnut production is considered to be the unique source of the early capital return in management of forests, selling and buying of forest lands in the area surveyed are enhanced to reforest the forest land with chestnut seedlings. 3) Most of new farmers being engaged in plantation and production of chestnuts in the forests are employees of private industries and government agencies, and merchants in neighboring towns. 4) All materials and expenses for formation of chestnut orchards are generally supplied by forest land owners. 5) Active buying and selling of newly established chestnut bushes are surely served as the estate in the area, thus, the trading of the bushes of young chestnut seedling also enhances the forest as the estate. 6) The management of forest established with chestnut orchards is a special form for forest investment, it makes possible to encourage imputing of capital to the new form of forests, chestnut orchards, and it could be a good possible model for private forest development as compared with that of government funding.

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Overwintering pattern of larvae of Chilo suppressalis Walker in the bioenergy crop Miscanthus sacchariflorus cv. Geodae 1 (바이오에너지작물 거대억새 가해 해충 이화명나방 유충 월동양상)

  • An, Gi Hong;Yang, Jungwoo;Jang, Yun-Hui;Um, Kyoung Ran;Kim, Seok;Cha, Young-Lok;Yoon, Young-Mi;Moon, Youn-Ho;Ahn, Joung Woong;Yu, Gyeong-Dan
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.59 no.3
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    • pp.369-374
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    • 2014
  • The rice stem borer (Chilo suppressalis Walker) was one of the most destructive pest of rice for the 1960s and 1970s in Korea. Recently, it is newly recognized as a potential risk factor to the biomass yield of bioenergy crops. The current research was firstly conducted to investigate overwintering larvae population density and pattern of rice stem borer attacking Miscanthus sacchariflorus cv. Geodae 1 which is referred to as an ideal lignocellulosic bioenergy crop in Korea. Population density of larvae per $1m^2$ in stems and rhizomes at the Miscanthus experimental plots and rates of damage (wormhole, abscission) of M. sacchariflorus cv. Goedae 1 were investigated from October 2012 to March 2013. The population of larvae per $1m^2$ in stems of Miscanthus were 23, 4, 1, and 1 in October, November, December 2012, and January 2013, respectively. Over the same period, the population of larvae in basal stem rots and rhizomes were increased, whereas decreased in stems. Interestingly, the positions of larvae for overwintering in Miscanthus were confirmed to 5~10 cm below the soil surface such as basal stem rot and rhizome, whereas the most common overwintering position known in rice is a part of stem on the ground such as rice straw and rice stubble. It would suggest that the larvae gradually moved to bottom of stems and rhizomes in soil in line with decline in temperature. Moreover, the damage rates of stems per $1m^2$ were up to more than 50% in some places. In conclusion, this might be the first report that rice stem borer could affect the productivity of biomass of Miscanthus in case of mass cultivation. Moreover, it should be necessary to make a decision in insect control management for this bioenergy feedstock and other related crops.

Hook Plate Fixation for Unstable Distal Clavicle Fractures: A Prospective Study (불안정 원위 쇄골 골절의 치료에서 Hook 금속판을 이용한 전향적 연구)

  • Kim, Kyung-Cheon;Shin, Hyun-Dae;Cha, Soo-Min;Jeon, Yoo-Sun
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.6-12
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    • 2011
  • Purpose: We wanted to analyze and report on the radiologic and clinical results of prospective Hook plate fixation for unstable distal clavicle fractures after a minimum of 2 years follow up. Materials and Methods: We followed up 17 out of 20 cases that underwent prospective Hook plate fixation from 2008 to 2009. We performed radiologic follow up at 2 weeks, 6 weeks, 3 months, 6 months, 18 months and 24 months postoperatively. The clinical results were evaluated at 12 months and 24 months postoperatively. Results: The mean period for bony fusion was 14.5 weeks and the plate was removed after an average of 20.2 weeks. The VAS pain scores were 0.7 and 0.8, the UCLA scores were 33.5 and 33.3, the ASES scores were 92.8 and 92.5, the Constant-Murley scores were 81.5 and 77.0, the KSS scores were 92.5 and 94.3 and the ranges of motion were $173.3^{\circ}$ and $173.7^{\circ}$ of flexion, $56.0^{\circ}$ and $54.5^{\circ}$ of external rotation, $62.3^{\circ}$ and $63.5^{\circ}$ of the internal rotation, $172.0^{\circ}$ and $172.6^{\circ}$ of abduction and $43.3^{\circ}$, and $42.9^{\circ}$ of extension at 1 and 2 years follow-up, respectively. There was no statistically significant difference of clinical outcomes and the range of motion at 1 year and 2 year postoperatively (p>0.05). There was no other complication except 1 case of delayed union. Conclusion: For Hook plate fixation at 2 years postoperatively, the complications will be decreased and excellent clinical results should occur.

Short-term Results of Endobronchial Brachytherapy for Malignant Airway Obstructions (악성 기도 폐쇄에 대한 기관내 근접 조사 방사선치료의 단기 임상 경험)

  • Ahn Yong Chan;Lim Do Hoon;Choi Dong Rak;Kim Moon Kyung;Kim Dae Yong;Huh Seung Jae;Kim Ho Joong;Chung Man Pyo;Kwon O Jung;Rhee Chong Heon
    • Radiation Oncology Journal
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    • v.14 no.4
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    • pp.299-306
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    • 1996
  • Purpose : Respiratory symptoms related with malignant airway disease have been the main causes of lowered qualify of life and also sometimes may be life-threatening if not properly managed. The authors report the short-term experiences of endobronchial brachytherapy for symptomatic malignant airway obstruction using high dose rate after-loading brachytherapy unit. Materials and Methdos : Twenty-five Patients with symptomatic malignant airway obstruction were treated with endobronchial brachytherapy between the period of December 1994 and March 1996 at Department of Radiation Oncology of Samsung Medical Center Twenty-one ($84\%$) were patients with non-small cell lung cancer, three with tracheal malignancies, and one with recurrence of esophageal cancer. Twenty Patients were given elective external beam radiation therapy, while six were given endobronchial laser evaporation therapy on emergency bases in addition to endobronchial brachytherapy. Three procedures for each patient were planned and total of 70 procedures were completed. Results : Improvement rates of major respiratory symptoms after endobronchial brachytherapy procedures were $88\%$(22/25). $96\%$(22/23), $100\%$ (15/15), and $100\%$(9/9) for cough, dyspnea, hemoptysis and obstructive pneumonia, respectively. ECOG performance scores were improved in $56\%$ of total patients group, while there was no case with worsened ECOG score. Fifteen patients died and the median interval from the start of treatment to death was 4 months (range: $1\~17$ months), while that of ten survivors was 9 months (range $5\~19$ months). There were five patients with controlled intrathoracic disease, who have survived over one rear. All deaths were associated with uncontrolled local and/or distant disease. Four Patients died of massive fatal hemoptysis, three of who received emergency endobronchial laser evaporation therapy before the start of endobronchial brachytherapy. Conclusion : Endobronchial brachytherapy has been confirmed as an excellent palliative treatment modality improving respiratory symptoms as well as patients' general performance status. Based on the current observations, use of endobronchial brachytherapy in curative setting as a boost technique may be warranted.

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Beam Shaping by Independent Jaw Closure in Steveotactic Radiotherapy (정위방사선치료 시 독립턱 부분폐쇄를 이용하는 선량분포개선 방법)

  • Ahn Yong Chan;Cho Byung Chul;Choi Dong Rock;Kim Dae Yong;Huh Seung Jae;Oh Do Hoon;Bae Hoonsik;Yeo In Hwan;Ko Young Eun
    • Radiation Oncology Journal
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    • v.18 no.2
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    • pp.150-156
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    • 2000
  • Purpose : Stereotactic radiation therapy (SRT) can deliver highly focused radiation to a small and spherical target lesion with very high degree of mechanical accuracy. For non-spherical and large lesions, however, inclusion of the neighboring normal structures within the high dose radiation volume is inevitable in SRT This is to report the beam shaping using the partial closure of the independent jaw in SRT and the verification of dose calculation and the dose display using a home-made soft ware. Materials and Methods : Authors adopted the idea to partially close one or more independent collimator jaw(5) in addition to the circular collimator cones to shield the neighboring normal structures while keeping the target lesion within the radiation beam field at all angles along the arc trajectory. The output factors (OF's) and the tissue-maximum ratios (TMR's) were measured using the micro ion chamber in the water phantom dosimetry system, and were compared with the theoretical calculations. A film dosimetry procedure was peformed to obtain the depth dose profiles at 5 cm, and they were also compared with the theoretical calculations, where the radiation dose would depend on the actual area of irradiation. Authors incorporated this algorithm into the home-made SRT software for the isodose calculation and display, and was tried on an example case with single brain metastasis. The dose-volume histograms (DVH's) of the planning target volume (PTV) and the normal brain derived by the control plan were reciprocally compared with those derived by the plan using the same arc arrangement plus the independent collimator jaw closure. Results : When using 5.0 cm diameter collimator, the measurements of the OF's and the TMR's with one independent jaw set at 30 mm (unblocked), 15.5 mm, 8.6 mm, and 0 mm from th central beam axis showed good correlation to the theoretical calculation within 0.5% and 0.3% error range. The dose profiles at 5 cm depth obtained by the film dosimetry also showed very good correlation to the theoretical calculations. The isodose profiles obtained on the home-made software demonstrated a slightly more conformal dose distribution around the target lesion by using the independent jaw closure, where the DVH's of the PTV were almost equivalent on the two plans, while the DVH's for the normal brain showed that less volume of the normal brain receiving high radiation dose by using this modification than the control plan employing the circular collimator cone only. Conclusions : With the beam shaping modification using the independent jaw closure, authors have realized wider clinical application of SRT with more conformal dose planning. Authors believe that SRT, with beam shaping ideas and efforts, should no longer be limited to the small spherical lesions, but be more widely applied to rather irregularly shaped tumors in the intracranial and the head and neck regions.

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Hemolytic-uremic Syndyome Associated with Bloody Diarrhea (혈변을 동반한 용혈성 요독 증후군 5례)

  • Kim Jung-Sim;Park Eun-Jung;Chung So-Hee;Ko See-Hwan;Uhm Mee-Ryung;Park Moon-Su;Lee Heung-Jea;Jin Dong-Kyu
    • Childhood Kidney Diseases
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    • v.1 no.2
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    • pp.170-175
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    • 1997
  • Purpose : Hemolytic uremic syndrome(HUS), known as a most common cause of childhood renal failure in western countries, has been a relatively rare disease in Korea. Although the reported cases were not related to any specific cause in Korea, there was an outbreak of HUS with bloody diarrhea in Japan last year. We report here that we experienced the several typical HUS last year. Patients : From Jan.1996 to Dec. 1996, five patients were diagnosed as HUS at Samsung Seoul Medical Center, Dept. Pediatrics. Results : 1) The age of onset was below 3 years in 3 cases and above 9 years in 2 cases. 2) All the cases happened between summer and autumn. Three patients had domestic travel and 4 patients drank well or spring water before the symptoms. 3) The clinical manifestation was generalized edema, oliguria, anuria and hematuria. The bloody diarrhea were present in 5 cases and 1 patient had operation with the impression of appendicitis. 4) There was no bacteria which was isolated from the blood or stool samples. 5) Renal biopsies were performed in 2 cases, because of protracted clinical course. One showed microthrombotic angiopathy and the other cortical necrosis with necrotizing glomeruli. 6) Complete recovery was the outcome in 4 cases and one case progressed to chronic renal failure. Conclusion : In conclusion, typical HUS associated with bloody diarrhea, epidemic and good prognosis can be found in Korea and careful surveillance of the pre-clinical cases will be necessary.

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Urological Manifestations and Laboratory Findings in Patients with Tethered Cord Syndrome (Tethered cord 증후군에서 비뇨기계 증상 및 검사 소견)

  • Jung Tae-Sung;Kim Eun-Jung;Lee Eun-Sil;Shin Son-Moon;Moon Han-Ku;Park Yong-Hoon
    • Childhood Kidney Diseases
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    • v.1 no.2
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    • pp.155-160
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    • 1997
  • Purpose : Tethered cord syndrome is characterized by progressive motor and sensory disturbances in lower extremities, foot deformities caused by a pathologic fixation of spinal cord resulting in excessive stretching of the spinal cord. It is also frequently associated with urological symptoms include urinary frequency, incontinence, enuresis, urgency and recurrent urinary tract infection. Because there is few report in the literature about urological manifestations of theterd cord syndrome, we conducted a retrospective study on the patients diagnosed as tethered cord syndrome to delineate the characteristics of urologic manifestations in tethered cord syndrome and to establish the policy to evaluate patients who is suspected of tethered cord syndrome. Method : A retrospective study was conducted by reviewing the medical records of nine patients who was diagnosed as tethered cord syndrome from November 1991 to July 1996 in Yeungnam University Hospital. Result : 1) The age distribution of nine patients was as follows; 5 patients were under 2 years, 1 case from 2 to 6 years and 3 cases from 6 to 10 years. 2) Of 9 patients 6 had voiding frequency, urinary incontinence, enuresis, urgency and loss of micturation sense. Radiologic urodynamic studies revealed neurogenic bladder in 5 patients, hydronephrosis and hydroureter in 3, vesicoureteral reflux in 3. 3) Of 6 patients with urological abnormal manifestations 4 underwent spinal cord surgery (detethering). In spite of surgical intervention, the urological manifestations improved in only one patient. Conclusion : Urological abnormalities were common in tethered cord syndrome. Abnormal laboratory findings including urodynamic study were found even before the onset of urological symptoms. We have to concern tethered cord syndrome as one of common causes of voiding frequency and enuresis and to evaluate urological abnormalities as thetered cord syndrome is diagnosed.

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Endoscopic Radial Artery Harvest: Techniques & Results (내시경을 이용한 요골동맥 수확법의 수술 방법과 결과)

  • Jeong, Young-Kyun;Lee, Jong-Tae;Cho, Jun-Yong;Kim, Kyu-Tae;Chang, Bong-Hyun
    • Journal of Chest Surgery
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    • v.39 no.1 s.258
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    • pp.35-41
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    • 2006
  • Background: The radial arteries are being used more often for coronary artery bypass grafting, We tried to the endoscopic radial artery harvest to reduce the cosmetic problems and neurologic complications of the conventional open harvesting and report the techniques and early results. Material and Method: The 86 patients underwent coronary artery bypass grafting between May 2003 and April 2005 had their nondominant radial artery endoscopically removed through a 2 cm incision at the wrist. The radial pedicle was dissected and was divided at antecubial area through a 5 mm counterincision. Result: The 23 patients complained of neuralgias on territory of superficial raidal none but no one complained of neuralgias on territory of lateral antebrachial cutaneous none. There was no functional impairment of the hand. There was no wound complication except a localized hematoma. All patients were contacted by telephone after postoperative 7.9$\pm$3.6 months. The 4 patients still complained of neuralgia. All the patients were satisfied with the aesthetics of the wounds. The multidetectional tomography was done on the 66 patients for the estimation of early patency of radial artery. There were 2 cases of stenosis and a case of occlusion. Conclusion: Endoscopic radial artery harvest had no functional impairment of the hand, lesser rate of neurologic complications and outstanding aesthetics. The results of early patency of the radial artery was similar to conventional methods. Therefore, we think that endoscopic radial artery harvest is the optimal procedure.

Heart Transplantation: the Seiong General Hospital Experience (심장이식 환자의 임상적 고찰)

  • 박국양;박철현
    • Journal of Chest Surgery
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    • v.29 no.6
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    • pp.606-613
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    • 1996
  • Cardiac transplantation has been the treatment of patients with end-stage heart disease since it was first performed in 1967. In Korea the first case was performed in 1992 and 42 patients underwent heart trans- plantation so far. The purpose of this article is to report short-term result of cardiac transplantation at our center. Between April 1994 and September 1995, 14 patients had undergone orthotopic heart transplantations. There was 12 male and 2 female patients. Mea recipient age was 34 years(range 11 to 54 years) and mean donor age was 28.4 years(16 to 50 years). Mean graft ischemic time was 120.7minutes(80 to 280 minutes). The follow-up period after transplantation was 11 months(3 to 17 months). Recipient diagnosis included dilated cardiomyopathy in 10, ischemic cardiomyopathy in 2, valvular cardiomyopathy in 1, congenital complex heart disease in 1 patient. The preoperative status of the recipients were state I (50%) and ll (50%) by UNOS classification and class 111 (5 patients) and class IV (9) by NYHA functional class. All patients were treated with triple-drug immunosuppression (cyclosporine, azathioprine, steroid) and induction with RATG. The rejection episodes were 5 times in 3 patients during the follow-up. Causes of infection were aspergillosis (2), and hepes zoster (1), CMV pneumonitis (1). Permanent pace- maker was inserted in 1 patient. Currently 9 patients are alive with seven patients in WYHA functional class I and two in class l . The ejection fraction increased from preoperative value of 19.9 $\pm$ 3.4% to postoperative value of 69.0 $\pm$ 5.6%. The causes of death were cellular rejection (1),chronic graft failure due to size-mismatching (1),respirat- oxy insufficiency due to asthma attack (1), subarachnoid hemorrhage (1), and RIO humoral rejection (1).

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