The Structure of Korean Radiation Oncology in 1997 (국내 병원 별 방사선치료의 진료 구조 현황(1997년 현황을 중심으로 한 선진국과의 비교 구))
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- Radiation Oncology Journal
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- v.17 no.2
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- pp.172-178
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- 1999
Purpose : To measure the basic structural characteristics of radiation oncology facilities in Korea during 1997 and to compare personnel, equipments and patient loads between Korea and developed countries. Methods and Materials : Mail serveys we conducted in 1998 and data on treatment machines, personnel and peformed new patients were collected. Responses were obtained from the 100 percent of facilities. The consensus data of the whole country were summarized using Microsoft Excel program. Results: In Korea during 1997, 42 facilities delivered megavoltage radiation theraphy with 71 treatment machines, 100 radiation oncologists, 26 medical physicist, 205 technologists and 19,773 new patients. Eighty nine percent of facilities in Korea had linear accelators at least 6 MeV maximum photon energy. Ninety five percent of facilities had simulators while five percent of facilities had no simulator, Ninety one percent of facilities had computer planning systems and eighty three percent of facilities reported that they had a written quality assurance program. Thirty six percent of facilities had only one radiation oncologist and thirty eight percent of facilities had no medical physicists. The median of the distribution of annual patients load of a facility, patients load per a machine, patients load per a radiation oncologist, patients load per a therapist and therapists per a machine in Korea were 348 patients per a year, 263 patients per a machine, 171 patients per a radiation oncologist, 81 patients per a therapist, and 3 therapists per a machine respectively. Conclusions : The whole scale of the radiation oncology departments in Korea was smaller than Japan and USA in population ratio regard. In case of hardware level like linear accelerators, simulators and computer planning systems, there was no big differences between Korea and USA. The patients loads of radiation oncologists and therapists had no significant differences as compared with USA. However, it was desirable to consider the part time system in USA because there were a lot of hospitals which did not employ medical physicists.
The development of the aviation technology is beyond the people's imagination. For example, with some exaggeration, If the autopilot engage upon take off, You will realize that you are on the centerline of the foggy JFK runway 13R after 15 hours with only once or twice of intervention. But the more aviation technology develops, the more responsible the pilot will be who has the final authority of the aviation safety. In the JAL 706 accident caused by unidentified reason, the pilot increased pitch abruptly and overrode the control from the autopilot. The result of this process made the death of a flight attendant and some injuries of a few passengers. The district court found the pilot not guilty at the first trial on the ground that the control override was not connected to the possibility of foresight and avoidance of the human death. The pilot was proved to be innocent through the analysis of the DFDR and ADAS that the override did not precede the unidentified pitch up motion. The judicial precedent related to aviation accidents in Korea requires pilots' absolute and extended care compared to the ordinarily prudent or reasonably careful behaviors in the vehicle and medical accidents. Although there is some controversy about the standard care, the care required in the actual operation of high tech aircraft by a pilot should include objective and standard care and be judged by analysis of the scientific data. Although the pilot maintained the unusual hi speed that doesn't have safety margin and descended under turbulence in case of the JAL 706 accident, the court negatived its relation to the cause of pitch up. Also, the override of the control after initial pitch up might have caused the possibility of the death and injury, but the court denied it. Because of this complex cause of the aviation accidents, it is important for a court to figure out the core reason of the event and casual relationship with the pilot Now, It is required that the judgement of negligence in the aviation accidents should include an objective care with scientific data from simulated circumstances(or a simulator) as the Japanese court not from the theory of vehicle's negligence.
Purpose: We proposed the method using dose-volume Histogram index to compare prospective plan trials in tomotherapy planning optimization. Materials and Methods: For 3 patients in cranial region, thorax and abdominal region, we acquired computed tomography images with PQ 5000 in each case. Then we delineated target structure and normal organ contour with pinnacle Ver 7.6c, after transferred each data to tomotherapy planning system (hi-art system Ver 2.0), we optimized 3 plan trials in each case that used differ from beam width, pitch, importance. We analyzed 3 plan trials in each region with isodose distribution, dose-volume histogram and dose statistics. Also we verified 3 plan trials with specialized DVH-indexes that is dose homogeneity index in target organ, conformity index around target structure and dose gradient index in non-target structures. Results: We compared with the similarity of results that the one is decide the best plan trial using isodose distribution, dose volume histogram and dose statistics, and the another is using DVH-indexes. They all decided the same plan trial to better result in each case. Conclusion: In some of case, it was appeared a little difference of results that used to DVH-index for comparison of plan trial in tomotherapy by special goal in it. But because DVH-index represented both dose distribution in target structure and high dose risk about normal tissue, it will be reasonable method for comparison of many plan trials before the tomotherapy treatments.
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This study presents the research results of the BMT(Benchmark Model Test) simulations of the DECOVALEX-2019 project Task B. Task B named 'Fault slip modelling' is aiming at developing a numerical method to predict fault reactivation and the coupled hydro-mechanical behavior of fault. BMT scenario simulations of Task B were conducted to improve each numerical model of participating group by demonstrating the feasibility of reproducing the fault behavior induced by water injection. The BMT simulations consist of seven different conditions depending on injection pressure, fault properties and the hydro-mechanical coupling relations. TOUGH-FLAC simulator was used to reproduce the coupled hydro-mechanical process of fault slip. A coupling module to update the changes in hydrological properties and geometric features of the numerical mesh in the present study. We made modifications to the numerical model developed in Task B Step 1 to consider the changes in compressibility, Permeability and geometric features with hydraulic aperture of fault due to mechanical deformation. The effects of the storativity and transmissivity of the fault on the hydro-mechanical behavior such as the pressure distribution, injection rate, displacement and stress of the fault were examined, and the results of the previous step 1 simulation were updated using the modified numerical model. The simulation results indicate that the developed model can provide a reasonable prediction of the hydro-mechanical behavior related to fault reactivation. The numerical model will be enhanced by continuing interaction and collaboration with other research teams of DECOVALEX-2019 Task B and validated using the field experiment data in a further study.
Purpose : 3D conformal radiotherapy, the optimum dose delivered to the tumor and provided the risk of normal tissue unless marginal miss, was restricted by organ motion. For tumors in the thorax and abdomen, the planning target volume (PTV) is decided including the margin for movement of tumor volumes during treatment due to patients breathing. We designed the respiratory gating radiotherapy device (RGRD) for using during CT simulation, dose planning and beam delivery at identical breathing period conditions. Using RGRD, reducing the treatment margin for organ (thorax or abdomen) motion due to breathing and improve dose distribution for 3D conformal radiotherapy. Materials and Methods : The internal organ motion data for lung cancer patients were obtained by examining the diaphragm in the supine position to find the position dependency. We made a respiratory gating radiotherapy device (RGRD) that is composed of a strip band, drug sensor, micro switch, and a connected on-off switch in a LINAC control box. During same breathing period by RGRD, spiral CT scan, virtual simulation, and 3D dose planing for lung cancer patients were peformed, without an extended PTV margin for free breathing, and then the dose was delivered at the same positions. We calculated effective volumes and normal tissue complication probabilities (NTCP) using dose volume histograms for normal lung, and analyzed changes in doses associated with selected NTCP levels and tumor control probabilities (TCP) at these new dose levels. The effects of 3D conformal radiotherapy by RGRD were evaluated with DVH (Dose Volume Histogram), TCP, NTCP and dose statistics. Results : The average movement of a diaphragm was 1.5 cm in the supine position when patients breathed freely. Depending on the location of the tumor, the magnitude of the PTV margin needs to be extended from 1 cm to 3 cm, which can greatly increase normal tissue irradiation, and hence, results in increase of the normal tissue complications probabiliy. Simple and precise RGRD is very easy to setup on patients and is sensitive to length variation (+2 mm), it also delivers on-off information to patients and the LINAC machine. We evaluated the treatment plans of patients who had received conformal partial organ lung irradiation for the treatment of thorax malignancies. Using RGRD, the PTV margin by free breathing can be reduced about 2 cm for moving organs by breathing. TCP values are almost the same values
Purpose: It is essential to minimize the movement of tumor due to respiratory movement at the time of respiration controlled radiotherapy of non-small cell lung cancer patient. Accordingly, this Study aims to evaluate the usefulness of restricted respiratory period by comparing and analyzing the treatment plans that apply free and restricted respiration period respectively. Materials and Methods: After having conducted training on 9 non-small cell lung cancer patients (tumor n=10) from April to December 2011 by using 'signal monitored-breathing (guided- breathing)' method for the 'free respiratory period' measured on the basis of the regular respiratory period of the patents and 'restricted respiratory period' that was intentionally reduced, total of 10 CT images for each of the respiration phases were acquired by carrying out 4D CT for treatment planning purpose by using RPM and 4-dimensional computed tomography simulator. Visual gross tumor volume (GTV) and internal target volume (ITV) that each of the observer 1 and observer 2 has set were measured and compared on the CT image of each respiratory interval. Moreover, the amplitude of movement of tumor was measured by measuring the center of mass (COM) at the phase of 0% which is the end-inspiration (EI) and at the phase of 50% which is the end-exhalation (EE). In addition, both observers established treatment plan that applied the 2 respiratory periods, and mean dose to normal lung (MDTNL) was compared and analyzed through dose-volume histogram (DVH). Moreover, normal tissue complication probability (NTCP) of the normal lung volume was compared by using dose-volume histogram analysis program (DVH analyzer v.1) and statistical analysis was performed in order to carry out quantitative evaluation of the measured data. Results: As the result of the analysis of the treatment plan that applied the 'restricted respiratory period' of the observer 1 and observer 2, there was reduction rate of 38.75% in the 3-dimensional direction movement of the tumor in comparison to the 'free respiratory period' in the case of the observer 1, while there reduction rate was 41.10% in the case of the observer 2. The results of measurement and comparison of the volumes, GTV and ITV, there was reduction rate of
The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70
The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70