• Journal of the Korean Orthopaedic Association
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• v.56 no.4
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• pp.317-325
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• 2021

Purpose: This study compared the functional and radiologic outcomes of intramedullary nailing (IMN) and minimally invasive plate osteosynthesis (MIPO) for tibia fractures in distal tibial spiral fractures combined with posterior malleolar fractures, as well as the functional and radiologic outcomes with and without fixation for posterior malleolar fractures. Materials and Methods: From January 2010 to December 2018 the radiological and clinical outcomes of 30 skeletally mature patients with tibial spiral fractures (AO Foundation/Orthopaedic Trauma Association classification 42-A1, B1, C1) combined with posterior malleolar fractures were analyzed. Sixteen patients were treated with IMN, and 14 patients were treated with MIPO. Depending on the surgical methods, the radiologic and clinical outcomes were compared by evaluating the bone union time, postoperative alignment, postoperative displacement of the posterior malleolar fragment, and American Orthopaedic Foot and Ankle Society (AOFAS) score. Moreover, the functional and clinical outcomes with and without fixation for posterior malleolar fractures were compared. Results: The mean bone union time was 21.8 weeks in the IMN group and 23.1 weeks in the MIPO group (p=0.500). At the final follow up, the mean alignment was coronal angulation of 1.8°, sagittal angulation of 1.6° in the IMN group and coronal angulation of 1.2° and sagittal angulation of 1.7° in the MIPO group (conoral angulation: p=0.131, sagittal angulation: p=0.850). The postoperative and final radiologic evaluation showed no displacement of the posterior malleolar fragment and excellent joint congruity in all cases. At the final follow-up, the mean AOFAS score was 88.0 on average in the IMN group and 87.6 on average in the MIPO group (p=0.905). The ankle range of motion and AOFAS score were similar in the fixation group and no fixation group for posterior malleolar fractures. Conclusion: Both IMN and MIPO for tibial spiral fractures combined with posterior malleolar fractures result in satisfactory radiological and clinical outcomes.

• The Journal of Korean Society for Radiation Therapy
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• v.34
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• pp.61-72
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• 2022

Purpose: Conventional CBCT(Cone-beam Computed-tomography) caused an error in the target volume due to organ movement in the area affected by respiratory movement. The purpose of this paper is to evaluate the usefulness of accuracy and time spent using the Gated CBCT function, which reduces errors when performing RGRT(respiratory gated radiation therapy), and to examine the appropriateness of phase. Materials and methods: To evaluate the usefulness of Gated CBCT, the QUASAR^TM respiratory motion phantom was used in the Truebeam STx^TM. Using lead marker inserts, Gated CBCT was scaned 5 times for every 20~80% phase, 30~70% phase, and 40~60% phase to measure the blurring length of the lead marker, and the distance the lead marker moves from the top phase to the end of the phase was measured 5 times. Using Cedar Solid Tumor Inserts, 4DCT was scanned for every phase, 20-80%, 30-70%, and 40-60%, and the target volume was contoured and the length was measured five times in the axial direction (S-I direction). Result: In Gated CBCT scaned using lead marker inserts, the axial moving distance of the lead marker on average was measured to be 4.46cm in the full phase, 3.11cm in the 20-80% phase, 1.94cm in the 30-70% phase, 0.90cm in the 40-60% phase. In Fluoroscopy, the axial moving distance of the lead marker on average was 4.38cm and the distance on average from the top phase to the beam off phase was 3.342cm in the 20-80% phase, 3.342cm in the 30-70% phase, and 0.84cm in the 40-60% phase. Comparing the results, the difference in the full phase was 0.08cm, the 20~80% phase was 0.23cm, the 30~70% phase was 0.10cm, and the 40~60% phase was 0.07cm. The axial lengths of ITV(Internal Target Volume) and PTV(Planning Target Volume) contoured by 4DCT taken using cedar solid tumor inserts were measured to be 6.40cm and 7.40cm in the full phase, 4.96cm and 5.96cm in the 20~80% phase, 4.42cm and 5.42cm in the 30~70% phase, and 2.95cm and 3.95cm in the 40~60% phase. In the Gated CBCT, the axial lengths on average was measured to be 6.35 cm in the full phase, 5.25 cm in the 20-80% phase, 4.04 cm in the 30-70% phase, and 3.08 cm in the 40-60% phase. Comparing the results, it was confirmed that the error was within ±8.5% of ITV Conclusion: Conventional CBCT had a problem that errors occurred due to organ movement in areas affected by respiratory movement, but through this study, obtained an image similar to the target volume of the setting phase using Gated CBCT and verified its usefulness. However, as the setting phase decreases, the scan time was increases. Therefore, considering the scan time and the error in setting phase, It is recommended to apply it to patients with respiratory coordinated stereotactic radiation therapy using a wide phase of 30-70% or more.

• Journal of the Korean Arthroscopy Society
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• v.7 no.2
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• pp.160-168
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• 2003

Purpose : To analyze the anterior stability and functional results after the arthroscopic ACL reconstruction and meniscectomy based on meniscus status at the time of surgery. Materials and Methods : From October 1997 to October 2002, 78 patients (male 64 female 14) were treated by arthroscopic ACL reconstruction and meniscectomy and followed more than 12 months (range, $12\~72$ months, average: 32 months). Average age was 32 years old (range, $18\~57$ years old). We divided the patients into 4 groups; Both menisci was intact (BMI, control group), lateral meniscus removed (LMR), medial meniscus removed (MMR) and both menisci removed (BMR). Anterior passive displacement (objective stability) was estimated using KT-2000 arthrometer under the loading of 15lb,20lb and 30lb and evaluated anterior drawer test, Lachman test, range of motion, thigh circumference. Functional evaluation system of IKDC, OAK and Lysholm knee score was used. Results : Average anterior displacement under the loading of 30lb were 2.47 mm, 2.96 mm, 2.96 mm and 3.57 mm in each group(BMI, LMR, MMR, BMR) and it was statistically significant difference (p<0.05). There is no statistically significant difference in average anterior displacement under the loading of 15lb and 20lb in each group but it has showed decreasing tendency in meniscal removed groups. The mean anterior displacement was within 3 mm in 21 cases, 15 cases, 24 cases and 12 cases (total 72 cases, $94\%$) under the loading of 15lb and 20 cases, 15 cases, 24 cases and 11 cases (total 70 cases, $91\%$) under the loading 20lb of in each group and postoperative knee joint stability has showed increasing tendency (p>0.05). The mean score was 94.5, 93.2, 92.2 and 90.4 points in each group and 71 cases $(91\%)$ were more than excellent or good with a OAK score and fair results were noted 4 cases in both meniscal removed group. There were 65 cases $(83\%)$ with a Lysholm knee score more than excellent or good, and IKDC grading were more than normal or nearly normal in 74 cases $(95\%)$ except 4 cases (2 cases in MMR group and 2 cases in BMR group). Conclusion : Long-term anterior stability and functional results of a successful ACL reconstruction affected by tile status of the menisci at the time of surgery and KT-2000 arthrometer was good for estimation of objective follow up.

• The Journal of Korean Society for Radiation Therapy
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• v.30 no.1_2
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• pp.107-116
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• 2018

Purpose : Intensity-modulated radiation therapy(IMRT) has been widely used for radiation therapy of Prostate Cancer because it can reduce radiation adverse effects on normal tissues and deliver more dose to the Prostate than 3D radiation therapy. Volumetric modulated arc therapy(VMAT) has been widely used due to recent advances in equipment and treatment techniques. VMAT can reduce treatment time by up to 55 % compared to IMRT, minimizing motion error during treatment. Materials and Methods : In this study, compared the MU and DVH values of 10 patients with prostate cancer by classifying them into 4 groups with 5 LN-Prostate groups and 5 Only-Prostate. And DQA measurements were performed using ArcCHECK and MapCHECK. Results : The results of Target and OAR dose distribution of Prostate patients are as follows. $D_{max}$ was in the range of 100~110 % in 4 groups, and more than 110 % of hot spot was not seen. Only-Prostate ($P_1$, $P_2$) without LN had a satisfactory dose distribution for the target dose, but slightly better for 2 arc plan($P_2$) than 1 arc plan($P_1$). The target dose $D_{98%}$ distribution in the LN-Prostate ($P_{L1}$, $P_{L2}$) group showed better 2 arc plan($P_{L2}$) than 1 arc plan($P_{L1}$), But in the case of 1 arc plan($P_{L1}$), the target dose $D_{98%}$ value was not enough. In OAR, the dose distribution of 1 Arc($P_1$) Plan and 2 Arc($P_2$) Plan in the Only-Prostate ($P_1$, $P_2$) Group satisfied the prescribed dose value. But, The dose distribution of 1 arc($P_1$) was slightly higher. In LN-Prostate OAR, 1 Arc($P_{L1}$) Plan showed higher dose than the prescribed dose. The Gamma evaluation pass rate of ArcCHECK and MapCHECK calculated from the DQA measurements was slightly higher than 99 % and the mean error range of the point dose measurements using the CC04 ion chamber was less than 1 %. Conclusion : In this study, Only-Prostate ($P_1$, $P_2$) group, the dose of 2 Arc plan was better. However, considering the treatment time and MU value, 1 Arc treatment method was more suitable. In the LN-Prostate ($P_{L1}$, $P_{L2}$) group, 2 Arc($P_{L2}$) treatment method showed better results and satisfied with Target $D_{98%}$ and OAR prescription dose.

• Journal of the Korean Institute of Telematics and Electronics B
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• v.33B no.11
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• pp.140-149
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• 1996

Cursive characters are written on an economical principle to reduce the motion of a pen in the limit of distinction between characters. That is, the pen is not lifted up to move for writing a next stroke, the pen is not moved at all, or connected two strokes chance their shapes to a similar and simple shape which is easy to be written. For these reasons, strokes and korean alphabets are not only easy to be changed, but also difficult to be splitted. In this paper, we propose a curvature stroke modeling method for splitting and matching by using a structural primitive. A curvature stroke is defined as a substroke which does not change its curvanture. Input strokes handwritten in a cursive style are splitted into a sequence of curvature strokes by segmenting the points which change the direction of rotation, which occur a sudden change of direction, and which occur an excessive rotation Each reference of korean alphabets is handwritten in a printed style and is saved as a sequence of curvature strikes which is generated by splitting process. And merging process is used to generate various sequences of curvature strikes for matching. Here, it is also considered that imaginary strokes can be written or omitted. By using a curvature stroke as a unit of recognition, redundant splitting points in input characters are effectively reduced and exact matching is possible by generating a reference curvature stroke, which consists of the parts of adjacent two korean alphasbets, even when the connecting points between korean alphabets are not splitted. The results showed 83.6% as recognition rate of the first candidate and 0.99sec./character (CPU clock:66MHz) as processing time.

• The Journal of Korean Society for Radiation Therapy
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• v.29 no.2
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• pp.75-81
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• 2017

Purpose: To evaluate the reproducibility of image-guided radiotherapy using ultrasonography which is non-invasive, without radiation exposure for prostate cancer patients. Materials and Methods: We analyzed the setup variation of 1,105 images for 26 prostate cancer patients and the mean, standard deviation and 3D-error in AP, RL and SI directions. Setup variations were classified 0-1 mm, 1-3 mm, 3-5 mm, 5 mm and more. Results: The mean and standard deviation of setup variation in AP, RL and SI directions was $1.87{\pm}1.36mm$, $1.73{\pm}1.22mm$ and $2.01{\pm}1.40mm$. The 3D-error in AP, RL and SI directions was $3.63{\pm}1.63mm$. The frequency of setup variation in AP direction was 29 % in the range from 0 mm to 1 mm, 50.2 % in the range from 1 mm to 3 mm, 19.6 % in the range from 3 mm to 5 mm and 1.3 % in the range of 5 mm or more. In RL direction, the frequency was 31.3 % in the range from 0 mm to 1 mm, 52.5 % in the range from 1 mm to 3 mm, 15.8 % in the range from 3 mm to 5 mm and 0.5 % in the range of 5 mm or more. SI direction, the frequency of errors in the range from 0 mm to 1 mm was 26.3 %, 50.2 % in the range from 1 mm to 3 mm, 22.4 % in the range from 3 mm to 5 mm, and 1.1 % in the range of 5 mm or more. Conclusion: The setup error was highest in the SI direction of $2.01{\pm}1.40mm$. The frequency in each direction was the highest in more than 50 % in the range from 1 mm to 3 mm. $Clarity^{TM}$ Auto scan is possible to monitoring the motion of the prostate during the treatment and to repositioning the patient. In conclusion real-time image-guided radiotherapy using ultrasonography will be increase the reproducibility of radiation therapy.

• Journal of Korean Society of Environmental Engineers
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• v.29 no.3
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• pp.348-356
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• 2007

Statistical and probabilistic method was used in the analysis of data, which is the most effective one in describing the various natures, and the methodology relating the results with the design was developed. Influents and effluents of three treatment plants were analyzed and the focus was made on BOD, COD, SS, IN, TP The fluctuations of influent such as BOD, COD, SS were extremely large and their standard deviations(st.dev) were more than 10 mg/L. but those of TN, TP were small; the st.dev was 6.6 mg/L for TN, 0.6 mg/L for TP, respectively. But, effluent concentration showed consistent pattern regardless of the influent fluctuations, the st.dev was ranged between 0.28 and 4.48 mg/L. Effluent distributional characteristics were as follows; BOD, COD were distributed normally, but SS, TN, and TP, log-normally; unsymmetric and skewed to the right. The coefficient of reliability(COR) based on the results of statistics of data was introduced to evaluate the process performance an4 to reflect the process performance to the process design. The coefficient of reliability relates the design value(the goal) with the standards and it can be used in operating treatment facilities under a certain reliability level and/or in evaluating the reliability of the treatment facilities on operation. Each treated water quality of effluent showed the half of water quality standards in the level of 50% percentile and all treatment plant was achieved 100% probability of water quality standards. It was concluded that the variability of the process performance should be reflected to the design procedure and the standards through the analysis based on the statistics and the probability.

• Progress in Medical Physics
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• v.10 no.2
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• pp.63-71
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• 1999

For the purpose of utilization in 3-D conformal radiotherapy and whole body radiosurgery, the Whole Body 3-Dimensional Topographic Radiation Therapy System has been developed. Whole body frame was constructed in order to be installed on the couch. Radiopaque catheters were engraved on it for the dedicated coordinate system and a MeV-Green immobilizer was used for the patient setup by the help of side panels and plastic rods. By designing and constructing the whole body frame in this way, geometrical limitation to the gantry rotation in 3-D conformal radiotherapy could be minimized and problem which radiation transmission may be altered in particular incident angles was solved. By analyzing CT images containing information of patient setup with respect to the whole body frame, localization and coordination of the target is performed so that patient setup error may be eliminated between simulation and treatment. For the verification of setup, the change of patient positioning is detected and adjusted in order to minimize the setup error by means of comparison of the body outlines using 3 CCTV cameras. To enhance efficiency of treatment procedure, this work can be done in real time by watching the change of patient setup through the monitor. The method of image subtraction in IDL (Interactive Data Language) was used to visualize the change of patient setup. Rotating X-ray system was constructed for detecting target movement due to internal organ motion. Landmark screws were implanted either on the bones around target or inside target, and variation of target location with respect to markers may be visualized in order to minimize internal setup error through the anterior and the lateral image information taken from rotating X-ray system. For CT simulation, simulation software was developed using IDL on GUI(Graphic User Interface) basis for PC and includes functions of graphic handling, editing and data acquisition of images of internal organs as well as target for the preparation of treatment planning.

• Journal of Biosystems Engineering
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• v.2 no.1
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• pp.7-24
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• 1977

This paper is the forth and fifth one of the study on balanced type oscillating mole drainer. In the light of the results from previous reports about the model tests, some design criteria were established and a prototype machine was set up for experimental purpose. Motion characteristics and functionof the each parts of the machine were checked and analyzed. After that, performance tests of the prototype machine were carried out in thefield. Obtained results are summarized as follows ; 1. Ten centimeter of the bullet diameter was determined so as to be able to attach it to the tractors with capacity of 30 PS to 40 PS. 2. To maintain the balance between the moments of the front shank and rear shank, the oscillating amplitude of the rear bullet was determined to be larger than that of the front bullet. At the same time , the oscillating direction of the rear bullet was designed with the inclines of ten to thirty degrees. 3. An octagonal dynamo transduced was developed for measuring the compressive force of the upper link is measuring the draft force of the machine. Acceptable linear relationship between forces and strain responses from O.D.T. was obtained. 4. Analysing the balancing mechanism of the acting part of the machine , it was found that the total draft force of the machine was equal to the difference between the sum of the draft force produced from the right and left side bending moments of the lower drawber and the compressive force on the upper link. 5. There are acceptable linear relationship between the strain and twisting moment by driving shaft, and between strain and shank moment. Above results enable us to carry out the field experiment with prototype machine. 6. When the test machine was used in the field, it was possible to reduce the oscillating acceleration by forty percent in average as compared it with the single bullet mole drainer. 7. When the test machine was used under the oscillating condition, the dratt torce was reduced by 27 percent to 59 percent as compared it with the test machine under non-oscillating condition, while the draft force was increased by 7 percent to 20 percent as compared it with the mole drainer having oscillating single bullet. The reasoning behind this fact was considered as the resistance force due to the rear shank and bullet. 8. As the amplitude and frequency of the bullet were increased, the torque was increased accordingly. This tendency could be varied with the various characteristics of the given soils. And the larger frequency and amplitute, the more increasing oscil\ulcornerlating power but decreasing draft brce were needed, and draft force was increased as the velocity was increased.9. When the amplitude of the rear bullet was designed to be larger than that of the front bullet, the minimum value of the moment was lowered and oscillating acceleration was reduced. And when the oscillating direction of the rear bullet was declined back\ulcornerwards, oscillating acceleration was increased along with the increasing angle of decli\ulcornernation. When the test machine was operated in high speed, the difference between maximum moments and minimum ones became narrow. This varying magnitude of moments appeared on the moment oscillogram seems to be correlated to the oscillating acceleration and draft force. 10. From the analysis of variance, it was found that those factors such as frequency, amplitude, and operating velocity significantly affected in the oscillating acceleration, the draft resistance, the torque, the moment, and the total power required. And interaction between frequency and amplitude affected in the oscillating acceleration. 11. Within the given situation of this study, the most preferable operating conditions of the test machine were 7 Hz in oscillating frequency, 0.54 m/sec in operating velocity, and 39.1 mm in oscillating amplitude of front and rear bullets. However, it is necessary to select the proper frequency and magnitude of oscillation depending on the soil properties of the field in which the mole drainer is practiced by use of a bal1nced type oscillating mole drainer. 12. It is recommended that a comparative study of the mole drainers would be performed in the near future using two separate balanced oscillating bullet with the one which is operated by oscillating the movable bullet in a single cylinder or other balanced type which may be single oscillating bullet with spring, damper or balancing weight, and that of thing. To expand the applicability of the balanced type oscillating mole drainer in practical use, it is suggested to develop a new mechanism which perform mole drain with vinyl pipe or filling material such as rice hull.

• Korean Journal of Applied Biomechanics
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• v.12 no.2
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• pp.51-63
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• 2002

This study sought to identify the kinematic characteristics at entrance to the straight course from the curvilinear course in the 200m-track game. For this purpose, this study was conducted for 4 sprinters by setting the 10m-section combined from the curvilenear track to the straight course and shooting them with the camcorder. It was set up to include all the sections of analysis by using the framework of the control point knowing the coordinate of the space and actual analysis was conducted on the motion showing the best records by conducting it for each subject five times. As a result, the following conclusion was drawn: It was found that the subjects showed the average stride of 4.5${\pm}$0.41 times at the 10-meter section and the required time of 1.42${\pm}$0.04sec. They showed the ratio average stride to height of 1.25${\pm}$0.20% and the average speed of 7.06${\pm}$0.19m/s. The displacement in the center of gravity of the human body at the section combined from the curvilinear course to the straight course was moving along the inward course of the curvilinear course, and the displacement of the leg located at the outward direction(right) was found to be larger than that of the leg located at the inward direction(left). In the speed of the left and right hand segments, it was found that the speed of the right hand located in the outward direction was faster than that of the left hand located at the inward, and it was found that the subjects progressed in the curvilinear course. The subjects showed the larger angle of the shoulder joint when the upper arm was located in the forward direction than when the it was located in the backward direction. In the curvilinear course, they showed the lower value of the lateral angle of the trunk when the right foot located at the outward direction left the ground than when the left foot located at the inward direction left the ground. And it was found that the lateral angle of the trunk became lower with approaching the straight course.