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Benthic Marine Algae in the East Coast of Korea : Flora, Distribution and Community Structure (한국 동해 연안역의 저서 해조류 : 해조상, 분포 및 군집구조)

  • NAM Ki Wan;KIM Young Sik;KIM Young Hwan;SOHN Chul Hyun
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.29 no.5
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    • pp.727-743
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    • 1996
  • To know the floristic composition, vortical distribution and community structure of marine benthic algae inhabiting in the intertidal and subtidal zones of Yongil Bay, east coast of Korea, the study has performed using the quadrat method along a transect line from July, 1995 to June, 1996. In this area, a total of 144 species including 2 new red algae to Korea was found: 5 blue-green, 18 green, 20 brown and 101 red algae. The representative species throughout the year were Ulva pertusa, Gelidium amansii and Symphyocladia latiuscula. Dominant species were Sargassum thunbergii in spring, U. pertusa in summer and autumn. In winter, Chondrus ocellatus and Monostroma grevillei occurred dominantly. The standing crop exhibited mean value as $185.8g/m^2$ dry weight. Maximum value was recorded in spring $(267.3g/m^2)$ and minimum was observed in winter $(93.7g/m^2)$. Shannon's species diversity (H') and evenness (J') as maximum value were recorded in spring, whereas minimum values were shown in winter. Vertical distribution, rerognized by cluster analysis based on relative coverage of the species, could be divided into two or three algal groups except spring. In general, green algae (M. grevillei, Capsosiphon fulvescens, U. pefusa, Enteromorpha compressa) and brown algae (Sargassum fulvellum, S. thunbergii) were represented in the upper and middle zone and red algae (G. amansii, C. ocellatus, S. latiuscula, Crateloupia okamurae, Pachymeniopsis eilliptica) in the lower zone. The algal community varied according to season and environmental conditions. Particularly, seasonal variation of vortical distribution seemed to be affected primarily by water temperature. Also seasonal tidal level and tolerance of algal species to desiccation appeared to be associated with it in this area.

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A Study on lung dose of Intensity modulated and volumetric modulated arc therapy plans using restricted angle of Non-small cell lung cancer (비소세포 폐암의 제한된 각도를 이용한 세기변조와 용적변조회전 방사선치료계획의 폐 선량에 관한 연구)

  • Yeom, Misuk;Lee, Woosuk;Kim, Daesup;Back, Geummun
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.1
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    • pp.21-28
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    • 2014
  • Purpose : For non-small cell lung cancer, if the treatment volume is large or the total lung volume is small, and the tumor is located in midline of patient's body, total lung dose tends to increase due to tolerance dose of spinal cord. The purpose of this study is to compare and evaluate the total lung dose of three dimensional conformal radiotherapy(3D CRT), intensity modulated radiotherapy(IMRT) and volumetric modulated arc therapy(VMAT) using restricted angle for non-small cell lung cancer patients. Materials and Methods : The treatment plans for four patients, being treated on TrueBeam STx($Varian^{TM}$, USA) with 10 MV and prescribed dose of 60 Gy in 30 fractions, 3D CRT, restricted angle IMRT and VAMT radiotherapy plans were established. Planning target volume(PTV), dose to total lung and spinal cord were evaluated using the dose volume histogram(DVH). Conformity index(CI), homogeneity index(HI), Paddick's index(PCI) for the PTV, $V_{30}$, $V_{20}$, $V_{10}$, $V_5$, mean dose for total lung and maximum dose for spinal cord was assessed. Results : Average value of CI, HI and PCI for PTV was $0.944{\pm}0.009$, $1.106{\pm}0.027$, $1.084{\pm}0.016$ respectively. $V_{20}$ values from 3D CRT, IMRT and VMAT plans were 30.7%, 20.2% and 21.2% for the first patient, 33.0%, 29.2% and 31.5% for second patient, 51.3%, 34.3% and 36.9% for third patient, finally 56.9%, 33.7% and 40.0% for the last patient. It was noticed that the $V_{20}$ was lowest in the IMRT plan using restricted angle. Maximum dose for spinal cord was evaluated to lower than the tolerance dose. Conclusion : For non-small cell lung cancer, IMRT with restricted angle or VMAT could minimize the lung dose and lower the dose to spinal cord below the tolerance level. Considering PTV coverage and tolerance dose to spinal cord, it was possible to obtain IMRT plan with smaller angle and this could result in lower dose to lung when compared to VMAT.

Daily Setup Uncertainties and Organ Motion Based on the Tomoimages in Prostatic Radiotherapy (전립선암 치료 시 Tomoimage에 기초한 Setup 오차에 관한 고찰)

  • Cho, Jeong-Hee;Lee, Sang-Kyu;Kim, Sei-Joon;Na, Soo-Kyung
    • The Journal of Korean Society for Radiation Therapy
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    • v.19 no.2
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    • pp.99-106
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    • 2007
  • Purpose: The patient's position and anatomy during the treatment course little bit varies to some extend due to setup uncertainties and organ motions. These factors could affected to not only the dose coverage of the gross tumor but over dosage of normal tissue. Setup uncertainties and organ motions can be minimized by precise patient positioning and rigid immobilization device but some anatomical site such as prostate, the internal organ motion due to physiological processes are challenge. In planning procedure, the clinical target volume is a little bit enlarged to create a planning target volume that accounts for setup uncertainties and organ motion as well. These uncertainties lead to differences between the calculated dose by treatment planning system and the actually delivered dose. The purpose of this study was to evaluate the differences of interfractional displacement of organ and GTV based on the tomoimages. Materials and Methods: Over the course of 3 months, 3 patients, those who has applied rectal balloon, treated for prostatic cancer patient's tomoimage were studied. During the treatment sessions 26 tomoimages per patient, Total 76 tomoimages were collected. Tomoimage had been taken everyday after initial setup with lead marker attached on the patient's skin center to comparing with C-T simulation images. Tomoimage was taken after rectal balloon inflated with 60 cc of air for prostate gland immobilization for daily treatment just before treatment and it was used routinely in each case. The intrarectal balloon was inserted to a depth of 6 cm from the anal verge. MVCT image was taken with 5 mm slice thickness after the intrarectal balloon in place and inflated. For this study, lead balls are used to guide the registration between the MVCT and CT simulation images. There are three image fusion methods in the tomotherapy, bone technique, bone/tissue technique, and full image technique. We used all this 3 methods to analysis the setup errors. Initially, image fusions were based on the visual alignment of lead ball, CT anatomy and CT simulation contours and then the radiation therapist registered the MVCT images with the CT simulation images based on the bone based, rectal balloon based and GTV based respectively and registered image was compared with each others. The average and standard deviation of each X, Y, Z and rotation from the initial planning center was calculated for each patient. The image fusions were based on the visual alignment of lead ball, CT anatomy and CT simulation contours. Results: There was a significant difference in the mean variations of the rectal balloon among the methods. Statistical results based on the bone fusion shows that maximum x-direction shift was 8 mm and 4.2 mm to the y-direction. It was statistically significant (P=<0.0001) in balloon based fusion, maximum X and Y shift was 6 mm, 16mm respectively. One patient's result was more than 16 mm shift and that was derived from the rectal expansions due to the bowl gas and stool. GTV based fusion results ranging from 2.7 to 6.6 mm to the x-direction and 4.3$\sim$7.8 mm to the y-direction respectively. We have checked rotational error in this study but there are no significant differences among fusion methods and the result was 0.37$\pm$0.36 in bone based fusion and 0.34$\pm$0.38 in GTV based fusion.

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Future Direction of National Health Insurance (국민건강보험 발전방향)

  • Park, Eun-Cheol
    • Health Policy and Management
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    • v.27 no.4
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    • pp.273-275
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    • 2017
  • It has been forty years since the implementation of National Health Insurance (NHI) in South Korea. Following the 1977 legislature mandating medical insurance for employees and dependents in firms with more than 500 employees, South Korea expanded its health insurance to urban residents in 1989. Resultantly, total expenses of the National Health Insurance Service (NHIS) have greatly increased from 4.5 billion won in 1977 to 50.89 trillion won in 2016. With multiple insurers merging into the NHI system in 2000, a single-payer healthcare system emerged, along with separation policy of prescribing and dispensing. Following such reform, an emerging financial crisis required injections from the National Health Promotion Fund. Forty years following the introduction of the NHI system, both praise and criticism have been drawn. In just 12 years, the NHI achieved the fastest health population coverage in the world. Current medical expenditure is not high relative to the rest of the Organization for Economic Cooperation and Development. The quality of acute care in Korea is one of the best in the world. There is no sign of delayed diagnosis and/or treatment for most diseases. However, the NHI has been under-insured, requiring high-levels of out-of-pocket money from patients and often causing catastrophic medical expenses. Furthermore, the current environmental circumstances of the NHI are threatening its sustainability. Low birth rate decline, as well as slow economic growth, will make sustainment of the current healthcare system difficult in the near future. An aging population will increase the amount of medical expenditure required, especially with the baby-boomer generation of those born between 1955 and 1965. Meanwhile, there is always the problem of unification for the Korean Peninsula, and what role the health insurance system will have to play when it occurs. In the presidential election, health insurance is a main issue; however, there is greater focus on expansion and expenditure than revenue. Many aspects of Korea's NHI system (1977) were modeled after the German (1883) and Japanese (1922) systems. Such systems were created during an era where infections disease control was most urgent and thus, in the current non-communicable disease (NCD) era, must be redesigned. The Korean system, which is already forty years old, must be redesigned completely. Although health insurance benefit expansion is necessary, financial measures, as well as moral hazard control measures, must also be considered. Ultimately, there are three aspects that we must consider when attempting redesign of the system. First, the health security system must be reformed. NHI and Medical Aid must be amalgamated into one system for increased effectiveness and efficiency of the system. Within the single insurer system of the NHI must be an internal market for maximum efficiency. The NHIS must be separated into regions so that regional organizers have greater responsibility over their actions. Although insurance must continue to be imposed nationally, risk-adjustment must be distributed regionally and assessed by different regional systems. Second, as a solution for the decreasing flow of insurance revenue, low premium level must be increased to an appropriate level. Likewise, the national reserve fund (No. 36, National Health Insurance Act) must be enlarged for re-unification preparation. Third, there must be revolutionary reform of benefit package. The current system built a focus on communicable diseases which is inappropriate in this NCD era. Medical benefits must not be one-time events but provide chronic disease management. Chronic care models, accountable care organization, patient-centered medical homes, and other systems that introduce various benefit packages for beneficiaries must be implemented. The reimbursement system of medical costs should be introduced to various systems for different types of care, as is the case with part C (Medicare Advantage Program) of America's Medicare system that substitutes part A and part B. Pay for performance must be expanded so that there is not only improvement in quality of care but also medical costs. Moreover, beneficiaries of the NHI system must be aware of the amount of their expenditure through a deductible payment system so that spending can be profiled and monitored. The Moon Jae-in Government has announced its plans to expand the NHI system; however, it is important that a discussion forum is created so that more accurate analysis of the NHI, its environments, and current status of health care system, can take place for reforming NHI.

Social Network Analysis for the Effective Adoption of Recommender Systems (추천시스템의 효과적 도입을 위한 소셜네트워크 분석)

  • Park, Jong-Hak;Cho, Yoon-Ho
    • Journal of Intelligence and Information Systems
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    • v.17 no.4
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    • pp.305-316
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    • 2011
  • Recommender system is the system which, by using automated information filtering technology, recommends products or services to the customers who are likely to be interested in. Those systems are widely used in many different Web retailers such as Amazon.com, Netfix.com, and CDNow.com. Various recommender systems have been developed. Among them, Collaborative Filtering (CF) has been known as the most successful and commonly used approach. CF identifies customers whose tastes are similar to those of a given customer, and recommends items those customers have liked in the past. Numerous CF algorithms have been developed to increase the performance of recommender systems. However, the relative performances of CF algorithms are known to be domain and data dependent. It is very time-consuming and expensive to implement and launce a CF recommender system, and also the system unsuited for the given domain provides customers with poor quality recommendations that make them easily annoyed. Therefore, predicting in advance whether the performance of CF recommender system is acceptable or not is practically important and needed. In this study, we propose a decision making guideline which helps decide whether CF is adoptable for a given application with certain transaction data characteristics. Several previous studies reported that sparsity, gray sheep, cold-start, coverage, and serendipity could affect the performance of CF, but the theoretical and empirical justification of such factors is lacking. Recently there are many studies paying attention to Social Network Analysis (SNA) as a method to analyze social relationships among people. SNA is a method to measure and visualize the linkage structure and status focusing on interaction among objects within communication group. CF analyzes the similarity among previous ratings or purchases of each customer, finds the relationships among the customers who have similarities, and then uses the relationships for recommendations. Thus CF can be modeled as a social network in which customers are nodes and purchase relationships between customers are links. Under the assumption that SNA could facilitate an exploration of the topological properties of the network structure that are implicit in transaction data for CF recommendations, we focus on density, clustering coefficient, and centralization which are ones of the most commonly used measures to capture topological properties of the social network structure. While network density, expressed as a proportion of the maximum possible number of links, captures the density of the whole network, the clustering coefficient captures the degree to which the overall network contains localized pockets of dense connectivity. Centralization reflects the extent to which connections are concentrated in a small number of nodes rather than distributed equally among all nodes. We explore how these SNA measures affect the performance of CF performance and how they interact to each other. Our experiments used sales transaction data from H department store, one of the well?known department stores in Korea. Total 396 data set were sampled to construct various types of social networks. The dependant variable measuring process consists of three steps; analysis of customer similarities, construction of a social network, and analysis of social network patterns. We used UCINET 6.0 for SNA. The experiments conducted the 3-way ANOVA which employs three SNA measures as dependant variables, and the recommendation accuracy measured by F1-measure as an independent variable. The experiments report that 1) each of three SNA measures affects the recommendation accuracy, 2) the density's effect to the performance overrides those of clustering coefficient and centralization (i.e., CF adoption is not a good decision if the density is low), and 3) however though the density is low, the performance of CF is comparatively good when the clustering coefficient is low. We expect that these experiment results help firms decide whether CF recommender system is adoptable for their business domain with certain transaction data characteristics.

A Study on the Development of a Simulation Model for Predicting Soil Moisture Content and Scheduling Irrigation (토양수분함량 예측 및 계획관개 모의 모형 개발에 관한 연구(I))

  • 김철회;고재군
    • Magazine of the Korean Society of Agricultural Engineers
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    • v.19 no.1
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    • pp.4279-4295
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    • 1977
  • Two types of model were established in order to product the soil moisture content by which information on irrigation could be obtained. Model-I was to represent the soil moisture depletion and was established based on the concept of water balance in a given soil profile. Model-II was a mathematical model derived from the analysis of soil moisture variation curves which were drawn from the observed data. In establishing the Model-I, the method and procedure to estimate parameters for the determination of the variables such as evapotranspirations, effective rainfalls, and drainage amounts were discussed. Empirical equations representing soil moisture variation curves were derived from the observed data as the Model-II. The procedure for forecasting timing and amounts of irrigation under the given soil moisture content was discussed. The established models were checked by comparing the observed data with those predicted by the model. Obtained results are summarized as follows: 1. As a water balance model of a given soil profile, the soil moisture depletion D, could be represented as the equation(2). 2. Among the various empirical formulae for potential evapotranspiration (Etp), Penman's formula was best fit to the data observed with the evaporation pans and tanks in Suweon area. High degree of positive correlation between Penman's predicted data and observed data with a large evaporation pan was confirmed. and the regression enquation was Y=0.7436X+17.2918, where Y represents evaporation rate from large evaporation pan, in mm/10days, and X represents potential evapotranspiration rate estimated by use of Penman's formula. 3. Evapotranspiration, Et, could be estimated from the potential evapotranspiration, Etp, by introducing the consumptive use coefficient, Kc, which was repre sensed by the following relationship: Kc=Kco$.$Ka+Ks‥‥‥(Eq. 6) where Kco : crop coefficient Ka : coefficient depending on the soil moisture content Ks : correction coefficient a. Crop coefficient. Kco. Crop coefficients of barley, bean, and wheat for each growth stage were found to be dependent on the crop. b. Coefficient depending on the soil moisture content, Ka. The values of Ka for clay loam, sandy loam, and loamy sand revealed a similar tendency to those of Pierce type. c. Correction coefficent, Ks. Following relationships were established to estimate Ks values: Ks=Kc-Kco$.$Ka, where Ks=0 if Kc,=Kco$.$K0$\geq$1.0, otherwise Ks=1-Kco$.$Ka 4. Effective rainfall, Re, was estimated by using following relationships : Re=D, if R-D$\geq$0, otherwise, Re=R 5. The difference between rainfall, R, and the soil moisture depletion D, was taken as drainage amount, Wd. {{{{D= SUM from { {i }=1} to n (Et-Re-I+Wd)}}}} if Wd=0, otherwise, {{{{D= SUM from { {i }=tf} to n (Et-Re-I+Wd)}}}} where tf=2∼3 days. 6. The curves and their corresponding empirical equations for the variation of soil moisture depending on the soil types, soil depths are shown on Fig. 8 (a,b.c,d). The general mathematical model on soil moisture variation depending on seasons, weather, and soil types were as follow: {{{{SMC= SUM ( { C}_{i }Exp( { - lambda }_{i } { t}_{i } )+ { Re}_{i } - { Excess}_{i } )}}}} where SMC : soil moisture content C : constant depending on an initial soil moisture content $\lambda$ : constant depending on season t : time Re : effective rainfall Excess : drainage and excess soil moisture other than drainage. The values of $\lambda$ are shown on Table 1. 7. The timing and amount of irrigation could be predicted by the equation (9-a) and (9-b,c), respectively. 8. Under the given conditions, the model for scheduling irrigation was completed. Fig. 9 show computer flow charts of the model. a. To estimate a potential evapotranspiration, Penman's equation was used if a complete observed meteorological data were available, and Jensen-Haise's equation was used if a forecasted meteorological data were available, However none of the observed or forecasted data were available, the equation (15) was used. b. As an input time data, a crop carlender was used, which was made based on the time when the growth stage of the crop shows it's maximum effective leaf coverage. 9. For the purpose of validation of the models, observed data of soil moiture content under various conditions from May, 1975 to July, 1975 were compared to the data predicted by Model-I and Model-II. Model-I shows the relative error of 4.6 to 14.3 percent which is an acceptable range of error in view of engineering purpose. Model-II shows 3 to 16.7 percent of relative error which is a little larger than the one from the Model-I. 10. Comparing two models, the followings are concluded: Model-I established on the theoretical background can predict with a satisfiable reliability far practical use provided that forecasted meteorological data are available. On the other hand, Model-II was superior to Model-I in it's simplicity, but it needs long period and wide scope of observed data to predict acceptable soil moisture content. Further studies are needed on the Model-II to make it acceptable in practical use.

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USEFULNESS OF SIMPLE SHIELDING TECHNIQUE USING MULTILEAF COLLIMATOR IN BREAST RADIATION THERAPY

  • Lee, Kyu Chan;Lee, Seok Ho;Lee, Seung Heon;Sung, Kihoon;Ahn, So Hyun;Choi, Jinho;Dong, Kap Sang;Kim, Hyo Jin;Chun, Yong Seon;Park, Heung Kyu
    • Journal of Radiation Protection and Research
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    • v.39 no.4
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    • pp.168-175
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    • 2014
  • This study was designed to assess whether the conventional tangential technique, using a multileaf collimator (MLC), allows a reduced dose to the organs at risk (OAR) in breast radiation therapy. A total of forty right and left 20 for each breast cancer patients that underwent radiation therapy after breast conserving surgery were included in this study. For each patient, the planning target volume (PTV) and OAR (heart, left anterior descending artery (LAD), liver and lung) were defined and dose distribution were produced for conventional tangential beams using 6 MV photons. The treatment plans were made using the following two techniques for all patients. For the first plan (P1), MLC was designed to shield as much of OAR as possible without compromising the coverage of PTV. In the second plan (P2), the treatment plan was created without using MLC. Dose-volume histograms for OARs were calculated for all plans. For left breast cancer, the percentage of maximum dose ($D_{max%}$) and mean dose ($D_{mean%}$) of OARs (heart and LAD) were calculated, and for right breast cancer, the percentage of the mean dose ($D_{mean%}$) of the liver was calculated. The $D_{mean%}$ of the lung was calculated in all patients. The mean values of $D_{max%}$ of the heart ($86.9{\pm}19.5%$ range, 35.1-100.6%) in P1 were significantly lower than in P2 ($98.3{\pm}3.4%$ range, 91.7-105.2%) (p=0.001). The mean values of $D_{max%}$ of LAD ($78.4{\pm}22.5%$ range, 26.5-99.7%) in P1 was significantly lower than in P2 ($93.3{\pm}8.1%$ range, 67.9-102.1%) (p<0.001). In P1, the mean values of $D_{mean%}$ of the liver ($4.8{\pm}2.0%$) were significantly lower than in P2 ($6.2{\pm}2.5%$) (p<0.001). The mean values of $D_{mean%}$ of the lung were significantly lower in P1 ($9.3{\pm}2.3%$) than in P2 ($9.7{\pm}2.4%$) (p<0.001). P1, by using MLC, allows a significantly reduced dose to OAR compared with P2. We can suggest that it is reasonable to routinely use MLC in the conventional tangential technique for breast radiation therapy considering the primary tumor location.

Planting Method of Buffer Green Space in the Reclaimed Seaside Areas, Rokko Island, Kobe, Japan (일본 고베시(신호시(神戶市)) 로코(육갑(六甲))아일랜드 임해매립지의 완충녹지 식재기법 연구)

  • Han, Bong-Ho;Kim, Jong-Yup;Choi, Jin-Woo;Cho, Yong-Hyeon
    • Korean Journal of Environment and Ecology
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    • v.24 no.2
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    • pp.157-165
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    • 2010
  • This study was carried out to suggest the basic data of planting method for construction of buffer green space based on the land use in case of reclaimed land by analyzing land structure, planting concept, and planting structure in buffer green space, Rokko Island, Kobe, Japan. Rokko Island(total area: 580ha) is divided into port and logistics industry area and urban area by constructing the box type large-scale buffer green space. The land structure of buffer green space were biased mounding type, parallel mounding type, and complex mounding type. The width of buffer green space was 50meters in case of northern area, from 28 to 32meters in case of eastern area, and 37.5meters in case of western area, and the slope of that was from 18 to 25 degrees and the height of that was from 2 to 15meters. There were applied landscape and buffer planting concept on the sea side area of northern buffer green space, on the other hand landscape and shade planting concept on the Inner city side area of that. According to the result of planting structure analysis of northern buffer green space, the main woody species were those of deciduous-evergreen species grow in warm-temperate forest zone such as Quercus glauca, Cinnamomum camphora, Machilus thunbergii, Elaeagnus maritima. The results of maximum number of species and planting density by $100mm^2$ was that 9 species 22 individuals in canopy layer, 9 species 15 individuals in understory layer, 3 species 67 individuals in shrub layer, and 14 species 104 individuals in total. The plant coverage of northern buffer green space based on the ecological planting method was from 69 to 139% in case of canopy layer, from 26 to 38% in case of understory layer, from 6 to 7% in case of shrub layer, and from 101 to 184% in total. Index of plant crown volume of northern buffer green space based on the ecological planting method was from 1.40 to $3.12m^3/m^2$ in case of canopy layer, from 0.43 to $0.55m^3/m^2$ in case of understory layer, $0.06m^3/m^2$ in case of shrub layer, and from 1.89 to $3.73m^3/m^2$ in total.

Evaluation of Dose Reduction of Cardiac Exposure Using Deep-inspiration Breath Hold Technique in Left-sided Breast Radiotherapy (좌측 유방암 방사선 치료에서 깊은 들숨 호흡법을 이용한 심장 선량 감소 평가)

  • Jung, Joo-Young;Kim, Min-Joo;Jung, Jae-Hong;Lee, Seu-Ran;Suh, Tae-Suk
    • Progress in Medical Physics
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    • v.24 no.4
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    • pp.278-283
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    • 2013
  • Breast cancer is the leading cause of cancer death in women worldwide and the number of women breast cancer patient was increased continuously. Most of breast cancer patient has suffered from unnecessary radiation exposure to heart, lung. Low radiation dose to the heart could lead to the worsening of preexisting cardiovascular lesions caused by radiation induced pneumonitis. Also, several statistical reports demonstrated that left-sided breast cancer patient showed higher mortality than right-sided breast cancer patient because of heart disease. In radiation therapy, Deep Inspiration Breath Hold (DIBH) technique which the patient takes a deep inspiration and holds during treatment and could move the heart away from the chest wall and lung, has showed to lead to reduction in cardiac volume and to minimize the unnecessary radiation exposure to heart during treatment. In this study, we investigated the displacement of heart using DIBH CT data compared to free-breathing (FB) CT data and radiation exposure to heart. Treatment planning was performed on the computed tomography (CT) datasets of 10 patients who had received lumpectomy treatments. Heart, lung and both breasts were outlined. The prescribed dose was 50 Gy divided into 28 fractions. The dose distributions in all the plans were required to fulfill the International Commission on Radiation Units and Measurement specifications that include 100% coverage of the CTV with ${\geq}95%$ of the prescribed dose and that the volume inside the CTV receiving >107% of the prescribed dose should be minimized. Scar boost irradiation was not performed in this study. Displacement of heart was measured by calculating the distance between center of heart and left breast. For the evaluation of radiation dose to heart, minimum, maximum and mean dose to heart were calculated. The present study demonstrates that cardiac dose during left-sided breast radiotherapy can be reduced by applying DIBH breathing control technique.

The dosimetric guide of treatment modalities for Left side breast irradiation after conservative surgery (좌측 유방암 방사선 치료 시 치료 기법에 따른 선량적 고찰)

  • Kim, Tae Min;Moon, Sung Kong;Kim, Li Zzy;Kim, Se Young;Park, Ryeung Hwang;Kim, Joo Ho;Cho, Jung Heui
    • The Journal of Korean Society for Radiation Therapy
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    • v.30 no.1_2
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    • pp.153-160
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    • 2018
  • Purpose : We retrospectively analyzed doses of each radiation therapy technique used in the treatment for left breast cancer patients after partial mastectomy through dose results for normalorgans and tumor volume to use this as a clinical reference for radiation therapy of domestic left breast cancer patients. Materials and Methods : 40 patients who underwent partial mastectomy on left breast cancer were classified in 3 treatment methods. The treatment plan was evaluated by HI(homogeneity index), $D_{95%}$, and CI(conformity index), and the $V_{hot}$ for gross tumor volume and clinical target volume of each treatment method. In Cyberknife treatment, tumor volume was the same as high dose volume in the other techniques, so no consideration was given to clinical target volume. Treatment plan evaluation for normal organs were evaluated by mean dose on ipsilateral lung, heart, left anterior descending artery, opposite breast and lung, and non-target tissue. Result : Treatment with volumetric arc radiotherapy(VMAT) showed $95.84{\pm}0.75%$ of $D_{95%}$ on the clinical target volume, significantly higher than that of 3D-CRT. The $D_{95%}$ value of the total tumor volume was slightly higher than the other treatments. In Cyberknife treatment, the dose to the normal organs was significantly lower than other treatments. Overall, the maximum dose and mean dose to the heart were $26.2{\pm}6.12Gy$ and $1.88{\pm}0.2Gy$ in VMAT treatment and $20.25{\pm}9.35Gy$ and $1.04{\pm}0.19Gy$ in 3D-CRT therapy, respectively. Conclusion : In comparison on 3D-CRT and VMAT, most of the dosimetric parameters for the evaluation of the treatment plan showed similar values, so that there is no significant difference in treatment plan evaluation. It is possible to select the treatment method according to the patient's anatomical structure or possibility of breath control. Cyberknife treatment is very useful treatment for normal organs because of its accurate dose exposure to the tumor volume However, it has restrictions to treat the local area, to have relatively long treatment time and to involve invasive procedure.

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