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A Comparison of Peripheral Doses Scattered from a Physical Wedge and an Enhanced Dynamic Wedge (금속쐐기와 기능강화동적쐐기의 조사야 주변부 선량 비교)

  • Park, Jong-Min;Kim, Hee-Jung;Min, Je-Soon;Lee, Je-Hee;Park, Charn-Il;Ye, Sung-Joon
    • Progress in Medical Physics
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    • v.18 no.3
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    • pp.107-117
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    • 2007
  • In order to evaluate the radio-protective advantage of an enhanced dynamic wedge (EDW) over a physical wedge (PW), we measured peripheral doses scattered from both types of wedges using a 2D array of ion-chambers. A 2D array of ion-chambers was used for this purpose. In order to confirm the accuracy of the device we first compared measured profiles of open fields with the profiles calculated by our commissioned treatment planning system. Then, we measured peripheral doses for the wedge angles of $15^{\circ},\;30^{\circ},\;45^{\circ},\;and\;60^{\circ}$ at source to surface distances (SSD) of 80 cm and 90 cm. The measured points were located at 0.5 cm depth from 1 cm to 5 cm outside of the field edge. In addition, the measurements were repeated by using thermoluminescence dosimeters (TLD). The peripheral doses of EDW were (1.4% to 11.9%) lower than those of PW (2.5% to 12.4%). At 15 MV energy, the average peripheral doses of both wedges were 2.9% higher than those at 6MV energy. At a small SSD (80 cm vs. 90 cm), peripheral dose differences were more recognizable. The average peripheral doses to the heel direction were 0.9% lower than those to the toe direction. The results from the TLD measurements confirmed these findings with similar tendency. Dynamic wedges can reduce unnecessary scattered doses to normal tissues outside of the field edge in many clinical situations. Such an advantage is more profound in the treatment of steeper wedge angles, and shorter SSD.

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Evaluation of the dose distribution in Mapcheck using Enhanced Dynamic Wedge (Enhanced Dynamic Wedge를 사용한 Mapcheck에서의 선량분포 평가)

  • Kang, Su-Man;Jang, Eun-Sun;Lee, Byung-Koo;Jung, Bong-Jae;Shin, Jung-Sub;Park, Cheol-Woo
    • Journal of the Korean Society of Radiology
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    • v.6 no.5
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    • pp.343-349
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    • 2012
  • Intensity Modulated Radiotherapy (IMRT) is increasing its use recently due to its benefits of minimizing the dose on surrounding normal organs and being able to target a high dose specifically to the tumor. The study aims to measure and evaluate the dose distribution according to its dynamic changes in Mapcheck. In order to verify the dose distribution by EDW angle($10^{\circ}$,$15^{\circ}$,$20^{\circ}$,$25^{\circ}$,$30^{\circ}$,$45^{\circ}$,$60^{\circ}$), field size (asymmetric field) and depth changes (1.5 cm, 5.0 cm) using IMRT in Clinac ix, a solid phantom was placed on the Mapcheck and 100MU was exposed by 6 MV, 10MV X-ray. Using a 6MV, 10MV energy, the percentage depth dose according to a dynamic changes at a maximum dose depth (1.5 cm) and at 5.0 cm depth showed the value difference of maximum 0.6%, less than 1%, which was calculated by a treatment program device considering the maximum dose depth at the center as 100%, the percentage depth dose was in the range between 2.4% and 7.2%. Also, the maximum value difference of a percentage depth dose was 4.1% in Y2-OUT direction, and 1.7% in Y1-IN direction. When treating a patient using a wedge, it is considered that using an enhanced dynamic wedge is effective to reduce the scattered dose which induces unnecessary dose to the surroundings. In particular, when treating a patient at clinic, a treatment must be performed considering that the wedge dose in a toe direction is higher than the dose in a heel direction.

The effect of rooming-in care on the emotional stability of newborn infants (모자동실이 신생아의 정서적 안정에 미치는 영향)

  • Ahn, So Yoon;Ko, Sun Young;Kim, Kyung Ah;Lee, Yeon Kyung;Shin, Son Moon
    • Clinical and Experimental Pediatrics
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    • v.51 no.12
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    • pp.1315-1319
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    • 2008
  • Purpose : We aimed to examine the effect of rooming-in care on newborn infants emotional stability by comparing them with those cared for in a nursery. Methods : Forty-eight full-term newborn infants born at Cheil General Hospital between July 1 and October 31, 2007, were enrolled. Twenty-four newborn infants were roomed-in in their mothers rooms (rooming-in group), and 24 newborns were cared for in the hospital nursery (the nursery group) for the first 3 days of their lives. Those with perinatal problems that required medical treatment were excluded. By using Brazeltons neonatal behavior assessment scale, we measured irritability and self-quieting as well as the duration of crying after heel-stick puncture for the newborn metabolic screening test. Results : The rooming-in group had a higher irritability score than the nursery group ($6.8{\pm}1.7$ vs. $4.2{\pm}2.1$, P<0.001), thereby suggesting stable behavior against external irritation; the former also had a higher self-quieting activity score ($5.9{\pm}0.3$ vs. $4.5{\pm}1.8$, P=0.001), thereby suggesting that stability was reached quickly from the irritated state. Time taken to stop crying after the heel-stick puncture was significantly shorter in the rooming-in group than in the nursery group ($17{\pm}15.1$ seconds vs. $115.3{\pm}98.5$ seconds, P<0.001). Conclusion : These results show that newborn infants in the rooming-in group exhibit more stable behavior against external irritation and can be stabilized from an irritated state more quickly than infants cared for in the nursery, even after a few days of rooming-in care.

Intraoperative Ultrasound-Guided Percutaneous Repair of a Ruptured Achilles Tendon: A Comparative Study with Open Repair (초음파 유도하 경피적 아킬레스건 봉합술: 개방적 봉합술과의 비교 연구)

  • Kang, Dong Hun;Kang, Chan;Hwang, Deuk Soo;Song, Jae Hwang;Choi, Bo Sung
    • Journal of the Korean Orthopaedic Association
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    • v.53 no.6
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    • pp.522-529
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    • 2018
  • Purpose: To compare the clinical outcomes of ultrasound-guided percutaneous repair (USPR) and open repair in a ruptured Achilles tendon. Materials and Methods: The outcomes of 12 patients with USPR (group A) and 18 patients with open repair (group B) from January 2015 to February 2017 were analyzed retrospectively. The postoperative clinical evaluations were performed using the Arner-Lindholm scale, American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Achilles tendon total rupture score (ATRS), and visual analogue scale for the overall satisfaction and cosmetic satisfaction with the scar, and the starting time of single heel raises. The complications were also evaluated. Results: The Arner-Lindholm scale, AOFAS ankle-hindfoot score, ATRS, starting time of single heel raises were similar in both groups (all p>0.05). Group A showed a significantly higher overall patient's satisfaction and cosmetic satisfaction in than group B (all p<0.05). Two cases of Achilles tendon elongation were encountered in group A, and 1 case of re-rupture with deep infection and 1 case of superficial infection were experienced in group B. Conclusion: USPR showed good clinical outcomes and high satisfaction as well as a low rate of complications, such as sural nerve injury. Therefore, USPR can be considered as an effective surgical treatment option for Achilles tendon ruptures.

Relationship between Attenuation of Impact Shock at High Frequency and Flexion-Extension of the Lower Extremity Joints during Downhill Running

  • Ryu, Ji-Seon;Yoon, Suk-Hoon;Park, Sang-Kyoon
    • Korean Journal of Applied Biomechanics
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    • v.26 no.2
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    • pp.167-174
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    • 2016
  • Objective: The purpose of this study was to determine the interrelationship between ranges of motion of the knee and ankle joints on the sagittal plane and the attenuation magnitude of impact shock at high frequency (9~20 Hz) in the support phase during downhill running. Method: Fifteen male heel-toe runners with no history of lower extremity injuries were recruited for this study (age, $25.07{\pm}5.35years$; height, $175.4{\pm}4.6cm$; mass, $75.8{\pm}.70kg$). Two uniaxial accelerometers were mounted to the tuberosity of tibia and sacrum, respectively, to measure acceleration signals. The participants were asked to run at their preferred running speed on a treadmill set at $0^{\circ}$, $7^{\circ}$, and $15^{\circ}$ downhill. Six optical cameras were placed around the treadmill to capture the coordinates of the joints of the lower extremities. The power spectrum densities of the two acceleration signals were analyzed and used in the transfer function describing the gain and attenuation of impact shock between the tibia and the sacrum. Angles of the knee and ankle joints on the sagittal plane and their angle ranges were calculated. The Pearson correlation coefficient was used to test the relationship between two variables, the magnitude of impact shock, and the range of joint angle under three downhill conditions. The alpha level was set at .05. Results: Close correlations were observed between the knee joint range of motion and the attenuation magnitude of impact shock regardless of running slopes (p<.05), and positive correlations were found between the ranges of motion of the knee and ankle joints and the attenuation magnitude of impact shock in $15^{\circ}$ downhill running (p<.05). Conclusion: In conclusion, increased knee flexion might be required to attenuate impact shock during downhill and level running through change in stride or cadence while maintaining stability, and strong and flexible ankle joints are also needed in steeper downhill running.

The effect of prone pelvic blocking on hamstring muscle relaxation and sacral movement (엎드린 자세에서의 다리이음뼈 블록중재가 넙다리뒤근육 이완과 호흡시 엉치뼈 움직임에 미치는 영향)

  • Cha, Kyung-Su;Kim, Ka-Eun;Jung, Ki-Hun;Jung, Seung-Eun;Park, Soon-Kwon;Cho, Il-Young
    • Journal of Digital Convergence
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    • v.10 no.10
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    • pp.397-404
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    • 2012
  • The purpose of this study is to investigate the change of hamstring muscle relaxation and craniosacral reciprocal movement by using S. O. T. (sacrooccipital technique) categoryⅠ block-intervention process. 26 subjects with heel tension were randomly divided into two groups (EXP=13 and CON=13). This study carried out the category I block-intervention process on the experimental group and the false block-intervention process on the control group. Then, this study measured the sit-and-reach and sacral reciprocal movement of subjects before and after the intervention. The result values before and after the intervention were analyzed through ANCOVA by using SPSS PC Program (Ver. 20.0). In both investigations, the degree of hamstring muscle relaxation and the change of sacral reciprocal movement, there were statistically significant differences between the experimental group and the control group as [F(1, 23)=7.73, p<0.5] and [F(1, 23)=7.07, p<.05] respectively. According to the results of this study, it is expected that S. O. T category I bllock-intervention technique will have positive effect on both hamstring muscle relaxation and craniosacral reciprocal movement.

The Study of Plantar Foot Pressure Distribution during Obstacle Crossing with Different Height in Normal Young Adults (보행 시 장애물 높이에 따른 정상 성인의 족저압 분포 연구)

  • Han, Jin-Tae;Lee, Myung-Hee;Kim, Kyoung
    • Korean Journal of Applied Biomechanics
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    • v.18 no.2
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    • pp.1-9
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    • 2008
  • The purpose of this study was to investigate the effect of different obstacle heights on the plantar foot pressure during obstacle crossing. Sixteen healthy adults who had no musculoskeletal disorders were instructed to perform unobstructed level walking and to step over obstacles corto 10cm, 20cm, 30cm. Plantar foot forces and pressures were recorded by the Footmat system(Tekscan, Boston, USA) during level and obstacle walking with barefoot. Plantar foot surface was defined as seven regions for pressure measurement; two toe regions, three forefoot regions, one midfoot region, one heel region. One-way ANOVA was used to compare each region data of foot according to various heights. The results indicated that there are significant differences on peak pressure and maximal forces regarding each region at stance phase. As height of obstacle became high, the pathway of COP had a tendency to be short and abducted. Plantar pressure of foot could be changed by obstacle height and these findings demonstrated that obstacle with different height have an effect on structure and function of the foot.

Surgical Repair of Achilles Tendon Rupture by Minimal Incision Technique (최소 절개 기법에 의한 아킬레스건 파열의 수술적 봉합술)

  • Jung, Hong-Geun;Paik, Ho-Dong
    • Journal of Korean Foot and Ankle Society
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    • v.9 no.2
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    • pp.173-178
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    • 2005
  • Propose: There have been many debates about the ideal surgical technique for acute Achilles tendon rupture. The purpose of this study is to review and analyze the clinical outcome of the acute Achilles tendon ruptures that had been repaired by indirect suture technique with minimal incision that utilized an instrument called Achillon (Newdeal, France). Materials and Methods: This study is based on the 14 cases (14 patients) of acute Achilles tendon total ruptures that have been repaired by minimal incision technique utilizing Achillon instrument from June 2003 to December 2004. Two cases were reruptured before 8 weeks and repaired again using Krackow suture which left 12 feet for postoperative functional evaluation with at least 6 months of follow-up. Ten cases were men and average age at time of injury was 34.4 (26-49) years. The time from injury to surgery was an average of 4.5 (1-9) days and the postoperative evaluations were done by an Arner-Lindholm scale and AOFAS score. The ability to return to original work and sports activities as well as patient satisfaction were also evaluated. Results: The follow-up period was averaged for 13.2 (6-24) months. Seventy-one percent of cases were ruptured during sports activities. The ruptured level was the average of 5.1 cm (3.2-8 cm) above calcaneal attachment and the skin incision was averaged for 2.7 cm (2.5-3.0 cm) long. At final follow-up, standing on tip-toe was possible in all cases while the heel-floor height on ruptured side was shorter by 0.7 cm (0-2 cm). By Arner-Lindholm evaluation scale, 9 cases were excellent, and 3 cases were good. Overall AOFAS score was an average of 96.1 (94-100), and all patients were satisfied with the result. Patients returned to work at an average of 1.3 months after the surgery and pre-injury sports activities were all possible from at 6 months after operation. Conclusion: Since we have treated acute Achilles tendon ruptures with minimal incision technique utilizing the Achillon and gained encouraging functional results with all patients returning to previous work with high patient satisfaction, this technique could be recommended as one of the ideal surgical options for the Achilles tendon ruptures.

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Tumors of the Foot and Ankle (족부 및 족관절에 발생한 종양)

  • Shin, Kyoo-Ho;Park, Hong-Jun;Kim, Jong-Min;Hahn, Soo-Bong;Kang, Eung-Shick
    • The Journal of the Korean bone and joint tumor society
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    • v.6 no.2
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    • pp.69-76
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    • 2000
  • Purpose : Tumors of the foot and ankle are uncommon compared with those arising in the other sites, and the malignant tumors are rare. We analyzed the data of patients who have been diagnosed as having a tumor of the foot and ankle. Materials and Methods : Between 1989 and 1998, we treated 72 patients and analyzed on their clinical characteristics retrospectively. Results : Fifty-three cases were benign. Included are 30 cases of soft tissue tumor and 23 cases of bone tumor. Malignant tumor was in 19 cases (26%), including 17 cases of soft tissue tumor, one cases of metastatic tumor. The most common benign tumor was fibroma in soft tissue and osteochondroma in bone. Malignant melanoma was the most common malignant tumor of the foot (7 cases). The predilection site for benign tumors was around toes while for the malignant tumor mostly arises in the heel. Among 19 malignant tumors, local recurrence developed in 3 cases and the distant metastasis occurred in 8 cases. Conclusion : The ratio of malignant tumor and metastasis was high. Therefore, when we faced with a tumor of the foot and ankle, the histopathologic confirmation is essential through biopsy before the definite initial treatment.

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Characteristics of the Human Strength Acting on the Lightweight Wall of Buildings (인간이 경량벽체에 가하는 수평하중의 크기에 관한 연구)

  • Choi, Soo-Kyung;Roh, Yong-Woon;Kim, Sang-Heon;Lee, Young-Do
    • Journal of the Korea Institute of Building Construction
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    • v.15 no.5
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    • pp.473-481
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    • 2015
  • The purpose of this research is to comprehend experimentally the characteristics of human strength for using as the basic data of impact resistance test method of lightweight wall. Human motions exerting static load are classified to 4 types. Pushes with two hands or shoulder are defined as the instantaneously forcing motions with hands or shoulder put on the force plate. Leanings back or one-hand against the wall are defined as motions of taking a rest in their respective comfortable posture. Human motions exerting dynamic load are classified to 3 types. Selecting 3 levels of motion strength (weak, middle, strong), 3 levels of force plate stiffness (A: 20kN/cm, B: 4.7kN/cm, C: 2.2kN/cm), and 30 male subjects, load was measured when they applied strength to the force plate. Results of this research are as follows: (1) The maximum load ratio (Pmax/W) of static load for each motion was 1.17-1.25 in two hands pushing, 0.95-0.99 in shoulder pushing, 0.16-0.18 in back leaning, and 0.12-0.15 in one hand leaning. (2) Human dynamic load and object collision were different in the load characteristics. (3) The maximum load ratio of dynamic load for each motion was 10.07 in heel kick, 4.46 in shoulder hitting, and 5.58 in fist blow.