A New Approach with Combined Stereotactic Trans-multiarc Beams for Radiosurgery Based on the Linear Accelerator : Photon Knife (입체적횡다증회전조사를 병합한 방사선수술의 새로운 접근 : 포톤나이프)
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- Radiation Oncology Journal
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- v.14 no.2
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- pp.149-158
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- 1996
Purpose : To get an accute steepness of dose gradients at outside the target volume in intracranial lesion and a less limitation of beam selection avoiding the high dose at normal brain tissue, this Photon Knife Radiosurgery System was developed in order to provide the three-dimensional dose distribution through the reconstruction of CT scan and the combined stereotactic trans-multiarc beam mode based on linear accelerator photon beam. Materials and methods : This stereotactic radiosurgery, Photon Knife based on linear accelerator photon beam was provided the non-coplanar multiarc and trans-multiarc irradiations. The stereotactic trans-multiarc beam mode can be obtained from the patient position in decubitus. This study has provided the 3-dimensional isodose curve and anatomical structures with the surface rendering technique. The dose distribution from the combined two trans-multiarcs (2M 2TM) was compared to that of four non-coplanar multiarcs (4M) with same collimator size of 25 mm in a diameter and total gantry movements. Results : In this study, it shows that the dose distributions of stereotactic beam mode are significantly depended on the selected couch and gantry angle in same collimator size. Practical dose distribution of combined stereotactic trans-multiarc beam has shown a more small rim thickness than that of the non-coplanar multiarc beam mode in axial, sagittal and coronal plane in our study. 3-Dimensional dose line displayed with surface rendering of irregular target shape is helpful to determine the target dose and to predict the prognosis in follow-up radiosurgery. Conclusions : 3-Dimensional dose line displayed with surface rendering of irregular target shape is essential in stereotactic radiosurgery. This combined stereotactic trans-multiarc beam has shown a less limitation of the selection couch and gantry beam angles for the target surrounding critical organs. It has shown that the dose distribution of combined trans-multiarc beam greatly depended on the couch and gantry angles. In our experiments, the absorbed dose has been decreased to
Purpose: Recently, the incidence of early gastric cancer (EGC) patients is rapidly increased in Korea. However, they're often not perceptible by surgical palpation or inspection. The aim of this study is 1) to develope a software that can locate the tumor and measure the mucosal distance from an anatomic landmark to the tumor using CT gastrography and 2) to compare the distance measured by the developed software with the distance measured by the pathologic findings. Materials and Methods: Between January 2004 and September 2005, sixty patients (male=45, female=15, mean 57.8 years old) estimated for EGC with preoperative CT scans and undergone gastrectomies in Kyungpook National University Hospital were enrolled in this study. Preoperative CT scans were performed after insufflations of room air via 5 Fr NG tube. The scans included the following parameters: (slice thickness/reconstruction interval: 0.625 mm, kVp: 120, mAs: 200). 3D volume rendering and measurement of the surface distance from the pylorus to the EGC were performed using the developed software. Results: The average difference between the lesion to pylorus distances measured from pathologic specimens and CT gastrography was
Purpose: Billroth II gastroenterostomy is a typical reconstruction method after distal gastrectomy for gastric carcinoma, but it has problems, especially frequent reflux esophagitis. Various methods have been tried to address this problem. Among them are Braun enteroenterostomy and Roux-en-Y gastroenterostomy, which are performed separately according to the size of the gastric remnant. The aim of our study was to determine whether these applications are compatible. Materials and Methods: Between September 2003 and April 2007, we performed Roux-en-Y gastroenterostomy operations (14 patients) when the size of the gastric remnant was <10%, Braun enteroenterostomy (17 patients) when the size was between 10 and 20%, and Billroth II gastroenterostomy (14 patients) when the size was between 20 and 40% after subtotal gastrectomy for gastric cancer by a single surgeon at our hospital. We analyzed the results of each treatment. We evaluated the symptoms and endoscopic findings using questionnaires and hospital records. To evaluate nutritional states, we reviewed albumin and hemoglobin levels and body weight changes. Results: All operations were performed safely mortality was 0% and postoperative complications were 8.9%. On endoscopy, reflux gastritis was observed to occur in 7.63%, 18.65% and 40.0%, respectively, of patients who had undergone Roux-en-Y, Braun and Billroth II operations (P=0.13). Reflux esophagitis was observed in 1 patient in the Roux-en-Y group and 1 patient in the Braun group. Endoscopic gastrostasis was observed in 2 patients in the Roux-en-Y group, one of which was thought to cause reflux esophagitis. Patients in the Roux-en-Y group and Braun groups ingested a lower volume of food than did those in the Billroth II group (respectively, 7.1%, 0.0% and 28.7%) and complained less of postprandial discomforts (respectively, 14.3%, 23.5% and 57.1%) and reflux symptoms (respectively 0.0%, 11.8% and 42.9%). Conclusion: The application of Braun enteroenterostomy and Roux-en-Y gastroenterostomy to the small gastric remnant may be effective for reducing reflux symptoms and abdominal discomfort after distal gastric resection. We recommend Roux-en-Y gastroenterostomy when the size of the gastric remnant is <10%, and Braun anastomosis in the others. It will need to be determined which reconstructive procedure is better for many different conditions.
Purpose: There has been recent interest in the radioactivity uptake and image acquisition of radioactivity concentration. The degree of uptake is strongly affected by many factors containing
Art is the product from the combination of politics, economy, and social and cultural aspects. Recent development of digital media has affected on the expansion of visual expression in art. Digital media allow artists to use sound and physical interaction as well as image as an plastic element for making a work of art. Also, digital media help artists create an interactive, synaesthetic and visual perceptive environment by combining viewers' physical interaction with the reconstruction of image, sound, light, and among other plastic elements. This research was focused on the analysis of the relationship between images in art work and the viewer and data visualization using sound from the perspective of visual perception. This research also aimed to develop an interactive art by visualizing physical data with sound generating from outer stimulus or the viewer. Physical data generating from outer sound can be analyzed in various aspects. For example, Sound data can be analyzed and sampled within pitch, volume, frequency, and etc. This researcher implemented a new form of media art through the visual experiment of LED light triggered by sound frequency generating from viewers' voice or outer physical stimulus. Also, this researcher explored the possibility of various visual image expression generating from the viewer's reaction to illusionary characteristics of light(LED), which can be transformed within external physical data in real time. As the result, this researcher used a motif from Piet Mondrian's Broadway Boogie Woogie in order to implement a visual perceptive interactive work reacting with sound. Mondrian tried to approach at the essence of visual object by eliminating unnecessary representation elements and simplifying them in painting and making them into abstraction consisting of color, vertical and horizontal lines. This researcher utilized Modrian's simplified visual composition as a representation metaphor in oder to transform external sound stimulus into the element of light(LED), and implemented an environment inducing viewers' participation, which is a dynamic composition maximizing a synaesthetic expression, differing from Modrian's static composition.
Loss of maxillary molar teeth leads to rapid loss of crestal bone and inferior expansion of the maxillary sinus floor (secondary pneumatization). Rehabilitation of the site with osseointegrated dental implants often represents a clinical challenge because of the insufficient bone volume resulted from this phenomenon. Boyne & James proposed the classic procedure for maxillary sinus floor elevation entails preparation of a trap door including the Schneiderian membrane in the lateral sinus wall. Summers proposed another non-invasive method using a set of osteotome and the osteotome sinus floor elevation (OSFE) was proposed for implant sites with at least 5-6mm of bone between the alveolar crest and the maxillary sinus floor. The change of grafted material in maxillary sinus is important for implant survival and the evaluation of graft height after maxillary sinus floor elevation is composed of histologic evaluation and radiomorphometric evaluation. The aim of the present study was radiographically evaluate the graft height change after maxillary sinus floor elevation and the influence of the graft material type in height change and the bone remodeling of grafts in sinus. A total of 59 patients (28 in lateral approach and 31 in crestal approach) who underwent maxillary sinus floor elevation composed of lateral approach and crestal approach were radiographically followed for up to about 48 months. Change in sinusgraft height were calculated with respect to implant length (IL) and grafted sinus height(BL). It was evaluated the change of the graft height according to time, the influence of the approach technique (staged approach and simultaneous approach) in lateral approach to change of the graft height, and the influence of the type of graft materials to change of the graft height. Patients were divided into three class based on the height of the grafted sinus floor relative to the implant apex and evaluated the proportion change of that class (Class I, in which the grafted sinus floor was above the implant apex; Class II, in which the implant apex was level with the grafted sinus floor; and Class III, in which the grafted sinus floor was below the implant apex). And it was evaluated th bone remodeling in sinus during 12 months using SGRl(by
Purpose: For better PET imaging with accuracy the transmission scanning is inevitably required for attenuation correction. The attenuation is affected by condition of acquisition and patient position, consequently quantitative accuracy may be decreased in emission scan imaging. In this paper, the present study aims at providing the measurement for attenuation varying with the positions of the patient's arm in whole body PET/CT, further performing the comparative analysis over its SUV changes. Materials and Methods: NEMA 1994 PET phantom was filled with
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
The Album of Complete Views of Seas and Mountains comprises sixty real scenery landscape paintings depicting Geumgangsan Mountain, the Haegeumgang River, and the eight scenic views of Gwandong regions, as well as fifty-one pieces of writing. It is a rare example in terms of its size and painting style. The paintings in this album, which are densely packed with natural features, follow the painting style of the Southern School yet employ crude and unconventional elements. In them, stones on the mountains are depicted both geometrically and three-dimensionally. Since 1973, parts of this album have been published in some exhibition catalogues. The entire album was opened to the public at the special exhibition "Through the Eyes of Joseon Painters: Real Scenery Landscapes of Korea" held at the National Museum of Korea in 2019. The Album of Complete Views of Seas and Mountains was attributed to Kim Eung-hwan (1742-1789) due to the signature on the final leaf of the album and the seal reading "Bokheon(painter's penname)" on the currently missing album leaf of Chilbodae Peaks. However, there is a strong possibility that this signature and seal may have been added later. This paper intends to reexamine the creator of this album based on a variety of related factors. In order to understand the production background of Album of Complete Views of Seas and Mountains, I investigated the eighteenth-century tradition of drawing scenic spots while travelling in which scenery of was depicted during private travels or official excursions. Jeong Seon(1676-1759), Sim Sa-jeong(1707-1769), Kim Yun-gyeom(1711-1775), Choe Buk(1712-after 1786), and Kang Se-hwang(1713-1791) all went on a journey to Geumgangsan Mountain, the most famous travel destination in the late Joseon period, and created paintings of the mountain, including Album of Pungak Mountain in the Sinmyo Year(1711) by Jeong Seon. These painters presented their versions of the traditional scenic spots of Inner Geumgangsan and newly depicted vistas they discovered for themselves. To commemorate their private visits, they produced paintings for their fellow travelers or sponsors in an album format that could include several scenes. While the production of paintings of private travels to Geumgangsan Mountain increased, King Jeongjo(r. 1776-1800) ordered Kim Eung-hwan and Kim Hong-do, court painters at the Dohwaseo(Royal Bureau of Painting), to paint scenic spots in the nine counties of the Yeongdong region and around Geumgangsan Mountain. King Jeongjo selected these two as the painters for the official excursion taking into account their relationship, their administrative experience as regional officials, and their distinct painting styles. Starting in the reign of King Yeongjo(r. 1724-1776), Kim Eung-hwan and Kim Hong-do served as court painters at the Dohwaseo, maintained a close relationship as a senior and a junior and as colleagues, and served as chalbang(chief in large of post stations) in the Yeongnam region. While Kim Hong-do was proficient at applying soft and delicate brushstrokes, Kim Eung-hwan was skilled at depicting the beauty of robust and luxuriant landscapes. Both painters produced about 100 scenes of original drawings over fifty days of the official excursion. Based on these original drawings, they created around seventy album leaves or handscrolls. Their paintings enriched the tradition of depicting scenic spots, particularly Outer Inner Geumgang and the eight scenic views of Gwandong around Geumgangsan Mountain during private journeys in the eighteenth century. Moreover, they newly discovered places of scenic beauty in the Outer Geungang and Yeongdong regions, establishing them as new painting themes. The Album of Complete Views of Seas and Mountains consists of four volumes. The volumes I, II include twenty-nine paintings of Inner Geumgangsan; the volume III, seventeen scenes of Outer Geumgangsan; and the volume IV, fourteen images of Maritime Geumgangsan and the eight scenic views of Gwandong. These paintings produced on silk show crowded compositions, geometrical depictions of the stones and the mountains, and distinct presentation of the rocky peaks of Geumgangsan Mountain using white and grayish-blue pigments. This album reflects the Joseon painting style of the mid- and late eighteenth century, integrating influences from Jeong Seon, Kang Se-hwang, Sim Sa-jeong, Jeong Chung-yeop(1725-after 1800), and Kim Hong-do. In particular, some paintings in the album show similarities to Kim Hong-do's Album of Famous Mountains in Korea in terms of its compositions and painterly motifs. However, "Yeongrangho Lake," "Haesanjeong Pavilion," and "Wolsongjeong Pavilion" in Kim Eung-hwan's album differ from in the version by Kim Hong-do. Thus, Kim Eung-hwan was influenced by Kim Hong-do, but produced his own distinctive album. The Album of Complete Views of Seas and Mountains includes scenery of "Jaundam Pool," "Baegundae Peak," "Viewing Birobong Peak at Anmunjeom groove," and "Baekjeongbong Peak," all of which are not depicted in other albums. In his version, Kim Eung-hwan portrayed the characteristics of the natural features in each scenic spot in a detailed and refreshing manner. Moreover, he illustrated stones on the mountains using geometric shapes and added a sense of three-dimensionality using lines and planes. Based on the painting traditions of the Southern School, he established his own characteristics. He also turned natural features into triangular or rectangular chunks. All sixty paintings in this album appear rough and unconventional, but maintain their internal consistency. Each of the fifty-one writings included in the Album of Complete Views of Seas and Mountains is followed by a painting of a scenic spot. It explains the depicted landscape, thus helping viewers to understand and appreciate the painting. Intimately linked to each painting, the related text notes information on traveling from one scenic spot to the next, the origins of the place names, geographic features, and other related information. Such encyclopedic documentation began in the early nineteenth century and was common in painting albums of Geumgangsan Mountain in the mid- nineteenth century. The text following the painting of Baekhwaam Hermitage in the Album of Complete Views of Seas and Mountains documents the reconstruction of the Baekhwaam Hermitage in 1845, which provides crucial evidence for dating the text. Therefore, the owner of the Album of Complete Views of Seas and Mountains might have written the texts or asked someone else to transcribe them in the mid- or late nineteenth century. In this paper, I have inferred the producer of the Album of Complete Views of Seas and Mountains to be Kim Eung-hwan based on the painting style and the tradition of drawing scenic spots during official trips. Moreover, its affinity with the Handscroll of Pungak Mountain created by Kim Ha-jong(1793-after 1878) after 1865 is another decisive factor in attributing the album to Kim Eung-hwan. In contrast to the Album of Famous Mountains in Korea by Kim Hong-do, the Album of Complete Views of Seas and Mountains exerted only a minor influence on other painters. The Handscroll of Pungak Mountain by Kim Ha-jong is the sole example that employs the subject matter from the Album of Complete Views of Seas and Mountains and follows its painting style. In the Handscroll of Pungak Mountain, Kim Ha-jong demonstrated a painting style completely different from that in the Album of Seas and Mountains that he produced fifty years prior in 1816 for Yi Gwang-mun, the magistrate of Chuncheon. He emphasized the idea of "scholar thoughts" by following the compositions, painterly elements, and depictions of figures in the painting manual style from Kim Eung-hwan's Album of Complete Views of Seas and Mountains. Kim Ha-jong, a member of the Gaeseong Kim clan and the eldest grandson of Kim Eung-hwan, is presumed to have appreciated the paintings depicted in the nature of Album of Complete Views of Seas and Mountains, which had been passed down within the family, and newly transformed them. Furthermore, the contents and narrative styles of Yi Yu-won's writings attached to the paintings in the Handscroll of Pungak Mountain are similar to those of the fifty-one writings in Kim Eunghwan's album. This suggests a possible influence of the inscriptions in Kim Eung-hwan's album or the original texts from which these inscriptions were quoted upon the writings in Kim Ha-jong's handscroll. However, a closer examination will be needed to determine the order of the transcription of the writings. The Album of Complete View of Seas and Mountains differs from Kim Hong-do's paintings of his official trips and other painting albums he influenced. This album is a siginificant artwork in that it broadens the understanding of the art world of Kim Eung-hwan and illustrates another layer of real scenery landscape paintings in the late eighteenth century.