• Title/Summary/Keyword: Cyber-Therapy

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Primary Paravertebral Low-Grade Fibromyxoid Sarcoma

  • Lee, Woo-Jin;Park, Chong-Oon;Yoon, Seung-Hwan;Chu, Young-Chae
    • Journal of Korean Neurosurgical Society
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    • v.48 no.5
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    • pp.461-464
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    • 2010
  • The authors report a 58-year-old woman with low-grade fibromyxoid sarcoma primarily located in the right paravertebral area with extension to L4 neural foramen. The patient complained lower back pain with radiating pain along the posterolateral aspect of the right lower leg. She underwent subtotal surgical removal and Cyber Knife therapy. Diagnosis was made by strikingly characteristic microscopic appearance of a bland spindle cell sarcoma which contained numerous giant collagen rosettes and was also supported by immunohistological findings. The diagnostic image findings and literatures are reviewed and discussed.

Stereotactic Radiosurgery with the CyberKnife for Pituitary Adenomas

  • Cho, Chul-Bum;Park, Hae-Kwan;Joo, Won-Il;Chough, Chung-Kee;Lee, Kyung-Jin;Rha, Hyoung-Kyun
    • Journal of Korean Neurosurgical Society
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    • v.45 no.3
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    • pp.157-163
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    • 2009
  • Objective : In recent years, CyberKnife has emerged as an important treatment modality in the management of pituitary adenomas. Treatment results after performing CyberKnife and the complications of this procedure are reviewed. Methods : Twenty-six patients with pituitary adenomas received stereotactic radiosurgery with the CyberKnife (CKRS). The follow-up periods ranged from 7 months to 47 months (mean$\pm$SD : $30{\pm}12.7$ months). The patients consisted of 17 with non-functioning adenomas, 3 with prolactinomas and 6 with acromegaly. The change in the tumor volume, visual acuity, hormonal function, and complications by this therapy were analyzed in each case. Results : The tumor control rate was 92.3%. Hormonal function was improved in all of the 9 (100%) functioning adenomas. Hormonal normalization was observed in 4 of the 9 (44%) patients with a mean duration of 16 months. In two patients (7.6%), visual acuity worsened due to cystic enlargement of the tumor after CKRS. No other complications were observed. Conclusion : CyberKnife is considered safe and effective in selected patients with pituitary adenomas. However, longer follow-up is required for a more complete assessment of late toxicity and treatment efficacy.

Hypofractionated stereotactic body radiotherapy in low- and intermediate-risk prostate carcinoma

  • Kim, Hun Jung;Phak, Jeong Hoon;Kim, Woo Chul
    • Radiation Oncology Journal
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    • v.34 no.4
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    • pp.260-264
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    • 2016
  • Purpose: Stereotactic body radiotherapy (SBRT) takes advantage of low ${\alpha}/{\beta}$ ratio of prostate cancer to deliver a large dose in few fractions. We examined clinical outcomes of SBRT using CyberKnife for the treatment of low- and intermediate-risk prostate cancer. Materials and Methods: This study was based on a retrospective analysis of the 33 patients treated with SBRT using CyberKnife for localized prostate cancer (27.3% in low-risk and 72.7% in intermediate-risk). Total dose of 36.25 Gy in 5 fractions of 7.25 Gy were administered. The acute and late toxicities were recorded using the Radiation Therapy Oncology Group scale. Prostate-specific antigen (PSA) response was monitored. Results: Thirty-three patients with a median 51 months (range, 6 to 71 months) follow-up were analyzed. There was no biochemical failure. Median PSA nadir was 0.27 ng/mL at median 33 months and PSA bounce occurred in 30.3% (n = 10) of patients at median at median 10.5 months after SBRT. No grade 3 acute toxicity was noted. The 18.2% of the patients had acute grade 2 genitourinary (GU) toxicities and 21.2% had acute grade 2 gastrointestinal (GI) toxicities. After follow-up of 2 months, most complications had returned to baseline. There was no grade 3 late GU and GI toxicity. Conclusion: Our experience with SBRT using CyberKnife in low- and intermediate-risk prostate cancer demonstrates favorable efficacy and toxicity. Further studies with more patients and longer follow-up duration are required.

The Effect of Seat Surface Inclination on Respiratory Function and Speech Production in sitting (앉은 자세에서 의자 표면 경사도가 호흡기능과 구어 산출에 미치는 영향)

  • Shin, Hwa-Kyung;Kim, Hye-Su;Lee, Ok-Bun
    • The Journal of Korean Physical Therapy
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    • v.24 no.1
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    • pp.29-34
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    • 2012
  • Purpose: The purpose of this study was to evaluate the difference between respiratory function and speech production, according to the seat surface inclination while in the sitting position. Methods: Respiratory function (FVC, FEV1) and speech production (inspiratory frequency, unit reading time, paragraph reading time) were measured in 3 sitting conditions: horizontal seat surface, seat surface tilted forward 15 degrees, and seat surface tilted backward 15 degrees. Results: We found that the mean values of FVC and FEV1 were statistically significant different according to three types of sitting positions (p<0.05). The following result was observed: forward tilted sitting > horizontal sitting > backward tilted sitting. There was no significant difference in speech production between the different positions. Respiratory function and speech production had a significantly negative correlation in the forward tilted condition and the backward tilted condition. Conclusion: This finding suggests that the seat surface inclination have an effect on respiratory function. Especially, forward tilted sitting may be an effective posture that may help increases the respiratory function.

Evaluation on the Accuracy of Targeting Error Correction Through the Application of Target Locating System in Robotic CyberKnife (로봇 사이버나이프에서 위치인식시스템을 이용한 Targeting Error값 보정의 정확성 평가)

  • Jeong, Young-Joon;Jung, Jae-Hong;Lim, Kwang-Chae;Cho, Eun-Ju
    • The Journal of Korean Society for Radiation Therapy
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    • v.21 no.1
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    • pp.1-7
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    • 2009
  • Purpose: The purpose is to evaluate the accuracy of correcting the targeting error through the Target Location System (TLS) for the location change error of the reference point which arises from the movement or motion of patient during the treatment using the CyberKnife. Materials and Methods: In this test, Gafchromic MD-55 film was inserted into the head and neck phantom to analyze the accuracy of the targeting, and then the 6 MV X-ray of CyberKnife (CyberKnife Robotic Radiosurgery System G4, Accuray, US) was irradiated. End to End (E2E) program was used to analyze the accuracy of targeting, which is provided by Accuray Corporation. To compute the error of the targeting, the test was carried out with the films that were irradiated 12 times by maintaining the distance within the rage of $0{\pm}0.2\;mm$ toward x, y, z from the reference point and maintaining the angle within the rage of $0{\pm}0.2^{\circ}$ toward roll, pitch, yaw, and then with the films which were irradiated 6 times by applying intentional movement. And the correlation in the average value of the reference film and the test film were analyzed through independent samples t-test. In addition, the consistency of dose distribution through gamma-index method (dose difference: 3%) was quantified, compared, and analyzed by varying the distance to agreement (DTA) to 1 mm, 1.5 mm, 2 mm, respectively. Results: E2E test result indicated that the average error of the reference film was 0.405 mm and the standard deviation was 0.069 mm. The average error of the test film was 0.413 mm with the standard deviation of 0.121 mm. The result of independent sampling t-test for both averages showed that the significant probability was P=0.836 (confidence level: 95%). Besides, by comparing the consistency of dose distribution of DTA through 1 mm, 1.5 mm, 2 mm, it was found that the average dose distribution of axial film was 95.04%, 97.56%, 98.13%, respectively in 3,314 locations of the reference film, consistent with the average dose distribution of sagittal film that was 95.47%, 97.68%, 98.47%, respectively. By comparing with the test film, it was found that the average dose distribution of axial film was 96.38%, 97.57%, 98.04%, respectively, at 3,323 locations, consistent with the average dose distribution of sagittal film which was 95.50%, 97.87%, 98.36%, respectively. Conclusion: Robotic CyberKnife traces and complements in real time the error in the location change of the reference point caused by the motion or movement of patient during the treatment and provides the accuracy with the consistency of over 95% dose distribution and the targeting error below 1 mm.

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Domestic Trend Analysis of Virtual Reality Therapy for the Treatment Anxiety Disorders (불안장애에 대한 가상현실치료 국내동향분석)

  • Cheong, Moon Joo;Kim, Jeesu;Lyu, Yeoung-Su;Kang, Hyung Won
    • Journal of Oriental Neuropsychiatry
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    • v.31 no.4
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    • pp.279-288
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    • 2020
  • Objectives: Many fields have changed since covid-19, psychotherapy being no exception. With the pandemic associated increase in untact treatment, interest in virtual reality exposure therapy has also increased. The aim of study was to analyze recent literature using virtual reality therapy for the treatment of anxiety disorders. Methods: We searched five databases from dates between October 1 to November 1, 2020. We selected articles related to the treatment of anxiety disorders using virtual reality therapy and analyzed the trend of that, not thesis but domestic articles. Results: There were 6 RCT studies and 3 were case reports where, based on the DSM-4, the participants presented with anxiety disorders including 2 with presentation anxiety, 1 heterosexual anxiety, 1 test anxiety, 1 social anxiety, 1 dental anxiety, 2 Acrophobia, and 1 social phobia. Treatment sessions varied from 1 session to 18 sessions, but 5 studies conducted 4 sessions, and all studies attempted virtual reality exposure for 30-minute time periods. 8 studies used HMD as the VR device and 1 study did not report a device. Conclusions: Anxiety disorders treated using virtual reality included speech anxiety and acrophobia. Median treatment session number was 4 and sessions were less than 30 minutes. The most common VR device used was an HMD. VR psychotherapy showed limitations relating to patient experience including cyber sickness and a lack of immersion. In addition, most of the studies were conducted with patients who visited hospitals utilizing Western medical practices. Currently, virtual reality therapy (VRT) intervention in oriental medicine is lacking. The lack of research in this area suggests analyzing data from VR psychotherapy in oriental medicine could provide novel and useful information.

A Case Study on the Effectiveness of tDCS to Reduce Cyber-Sickness in Subjects with Dizziness

  • Chang Ju Kim;Yoon Tae Hwang;Yu Min Ko;Seong Ho Yun;Sang Seok Yeo
    • The Journal of Korean Physical Therapy
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    • v.36 no.1
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    • pp.39-44
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    • 2024
  • Purpose: Cybersickness is a type of motion sickness induced by virtual reality (VR) or augmented reality (AR) environments that presents symptoms including nausea, dizziness, and headaches. This study aimed to investigate how cathodal transcranial direct current stimulation (tDCS) alleviates motion sickness symptoms and modulates brain activity in individuals experiencing cybersickness after exposure to a VR environment. Methods: This study was performed on two groups of healthy adults with cybersickness symptoms. Subjects were randomly assigned to receive either cathodal tDCS intervention or sham tDCS intervention. Brain activity during VR stimulation was measured by 38-channel functional near-infrared spectroscopy (fNIRS). tDCS was administered to the right temporoparietal junction (TPJ) for 20 minutes at an intensity of 2mA, and the severity of cybersickness was assessed pre- and post-intervention using a simulator sickness questionnaire (SSQ). Result: Following the experiment, cybersickness symptoms in subjects who received cathodal tDCS intervention were reduced based on SSQ scores, whereas those who received sham tDCS showed no significant change. fNIRS analysis revealed that tDCS significantly diminished cortical activity in subjects with high activity in temporal and parietal lobes, whereas high cortical activity was maintained in these regions after intervention in subjects who received sham tDCS. Conclusion: These findings suggest that cathodal tDCS applied to the right TPJ region in young adults experiencing cybersickness effectively reduces motion sickness induced by VR environments.

The Development and Evaluation of an e-Learning Program for Novice Nurses before Beginning to Work in a Hospital Using KMS(Knowledge Management System) (지식경영 시스템을 활용한 신규간호사 e-Learning 프로그램 개발 및 평가)

  • Song, Young-Shin
    • The Journal of Korean Academic Society of Nursing Education
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    • v.13 no.1
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    • pp.82-89
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    • 2007
  • Purpose: The purpose of this study was to develop and evaluate an e-Learning Program designed to enhance novice nurses's performance ability Method: The e-Learning program was designed for novice nurses before beginning to work in a hospital using a KMS(Knowledge Management System). This study was carried out from February 2006 to April 2007. The program had progressive steps including design, pilot test & modification, contents development, program application and evaluation. After the program design and pilot testing, the learner's satisfaction was analyzed. Result: The program site is http://kms.emc.ac.kr titled, 'Cyber Education Center'. The sixteen part course has been developed as follows: blood sugar test, skin test, insulin test 1, insulin test 2, blood culture, blood sampling, heat therapy, cold therapy, glycerin enema, preparation of operation, oxygen therapy, suction technique, transfusion, foley catheterization and aseptic technique. The overall learner's satisfaction score was 4.08 out of 5 points. Conclusion: E-Learning could be useful for education and nursing work. This method may be effective for clinical nurses.

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An accuracy analysis of Cyberknife tumor tracking radiotherapy according to unpredictable change of respiration (예측 불가능한 호흡 변화에 따른 사이버나이프 종양 추적 방사선 치료의 정확도 분석)

  • Seo, jung min;Lee, chang yeol;Huh, hyun do;Kim, wan sun
    • The Journal of Korean Society for Radiation Therapy
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    • v.27 no.2
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    • pp.157-166
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    • 2015
  • Purpose : Cyber-Knife tumor tracking system, based on the correlation relationship between the position of a tumor which moves in response to the real time respiratory cycle signal and respiration was obtained by the LED marker attached to the outside of the patient, the location of the tumor to predict in advance, the movement of the tumor in synchronization with the therapeutic device to track real-time tumor, is a system for treating. The purpose of this study, in the cyber knife tumor tracking radiation therapy, trying to evaluate the accuracy of tumor tracking radiation therapy system due to the change in the form of unpredictable sudden breathing due to cough and sleep. Materials and Methods : Breathing Log files that were used in the study, based on the Respiratory gating radiotherapy and Cyber-knife tracking radiosurgery breathing Log files of patients who received herein, measured using the Log files in the form of a Sinusoidal pattern and Sudden change pattern. it has been reconstituted as possible. Enter the reconstructed respiratory Log file cyber knife dynamic chest Phantom, so that it is possible to implement a motion due to respiration, add manufacturing the driving apparatus of the existing dynamic chest Phantom, Phantom the form of respiration we have developed a program that can be applied to. Movement of the phantom inside the target (Ball cube target) was driven by the displacement of three sizes of according to the size of the respiratory vertical (Superior-Inferior) direction to the 5 mm, 10 mm, 20 mm. Insert crosses two EBT3 films in phantom inside the target in response to changes in the target movement, the End-to-End (E2E) test provided in Cyber-Knife manufacturer depending on the form of the breathing five times each. It was determined by carrying. Accuracy of tumor tracking system is indicated by the target error by analyzing the inserted film, additional E2E test is analyzed by measuring the correlation error while being advanced. Results : If the target error is a sine curve breathing form, the size of the target of the movement is in response to the 5 mm, 10 mm, 20 mm, respectively, of the average $1.14{\pm}0.13mm$, $1.05{\pm}0.20mm$, with $2.37{\pm}0.17mm$, suddenly for it is variations in breathing, respective average $1.87{\pm}0.19mm$, $2.15{\pm}0.21mm$, and analyzed with $2.44{\pm}0.26mm$. If the correlation error can be defined by the length of the displacement vector in the target track is a sinusoidal breathing mode, the size of the target of the movement in response to 5 mm, 10 mm, 20 mm, respective average $0.84{\pm}0.01mm$, $0.70{\pm}0.13mm$, with $1.63{\pm}0.10mm$, if it is a variant of sudden breathing respective average $0.97{\pm}0.06mm$, $1.44{\pm}0.11mm$, and analyzed with $1.98{\pm}0.10mm$. The larger the correlation error values in both the both the respiratory form, the target error value is large. If the motion size of the target of the sine curve breathing form is greater than or equal to 20 mm, was measured at 1.5 mm or more is a recommendation value of both cyber knife manufacturer of both error value. Conclusion : There is a tendency that the correlation error value between about target error value magnitude of the target motion is large is increased, the error value becomes large in variation of rapid respiration than breathing the form of a sine curve. The more the shape of the breathing large movements regular shape of sine curves target accuracy of the tumor tracking system can be judged to be reduced. Using the algorithm of Cyber-Knife tumor tracking system, when there is a change in the sudden unpredictable respiratory due patient coughing during treatment enforcement is to stop the treatment, it is assumed to carry out the internal target validation process again, it is necessary to readjust the form of respiration. Patients under treatment is determined to be able to improve the treatment of accuracy to induce the observed form of regular breathing and put like to see the goggles monitor capable of the respiratory form of the person.

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