• Title/Summary/Keyword: body-image

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An Optimization Method of Measuring Heart Position in Dynamic Myocardial Perfusion SPECT with a CZT-based camera (동적 심근관류 SPECT에서 심장의 위치 측정방법에 대한 고찰)

  • Seong, Ji Hye;Lee, Dong Hun;Kim, Eun Hye;Jung, Woo Young
    • The Korean Journal of Nuclear Medicine Technology
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    • v.23 no.1
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    • pp.75-79
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    • 2019
  • Purpose Cadmium-zinc-telluride (CZT) camera with semiconductor detector is capable of dynamic myocardial perfusion SPECT for coronary flow reserve (CFR). Image acquisition with the heart positioned within 2 cm in the center of the quality field of view (QFOV) is recommended because the CZT detector based on focused multi-pinhole collimators and is stationary gantry without rotation. The aim of this study was to investigate the optimal method for measuring position of the heart within the center of the QFOV when performing dynamic myocardial perfusion SPECT with the Discovery NM 530c camera. Materials and Methods From June to September 2018, 45 patients were subject to dynamic myocardial perfusion SPECT with D530c. For accurate heart positioning, the patient's heart was scanned with a mobile ultrasound and marked at the top of the probe where the mitral valve (MV) was visible in the parasternal long-axis view (PLAX). And, the marked point on the patient's body matched with the reference point indicated CZT detector in dynamic stress. The heart was positioned to be in the center of the QFOV in rest. The coordinates of dynamic stress and rest were compared statistically. Results The coordinates of the dynamic stress using mobile ultrasound and those taken of the rest were recorded for comparative analysis with regard to the position of the couch and analyzed. There were no statistically significant differences in the coordinates of Table in & out, Table up & down, and Detector in & out (P > 0.05). The difference in distance between the 2 groups was measured at $0.25{\pm}1.00$, $0.24{\pm}0.96$ and $0.25{\pm}0.82cm$ respectively, with no difference greater than 2 cm in all categories. Conclusion The position of the heart taken using mobile ultrasound did not differ significantly from that of the center of the QFOV. Therefore, The use of mobile ultrasound in dynamic stress will help to select the correct position of the heart, which will be effective in clinical diagnosis by minimizing the image quality improvement and the patient's exposure to radiation.

The Development of a Benthic Chamber (BelcI) for Benthic Boundary Layer Studies (저층 경계면 연구용 Benthic chamber(BelcI) 개발)

  • Lee, Jae-Seong;Bahk, Kyung-Soo;Khang, Buem-Joo;Kim, Young-Tae;Bae, Jae-Hyun;Kim, Seong-Soo;Park, Jung-Jun;Choi, Ok-In
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.15 no.1
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    • pp.41-50
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    • 2010
  • We have developed an in-situ benthic chamber (BelcI) for use in coastal studies that can be deployed from a small boat. It is expected that BelcI will be useful in studying the benthic boundary layer because of its flexibility. BelcI is divided into three main areas: 1) frame and body chamber, 2) water sampler, and 3) stirring devices, electric controller, and data acquisition technology. To maximize in-situ use, the frame is constructed from two layers that consist of square cells. All electronic parts (motor controller, pA meter, data acquisition, etc.) are low-power consumers so that the external power supply can be safely removed from the system. The hydrodynamics of BelcI, measured by PIV (particle image velocimetry), show a typical "radial-flow impeller" pattern. Mixing time of water in the chamber is about 30 s, and shear velocity ($u^*$) near the bottom layer was calculated at $0.32\;cm\;s^{-1}$. Measurements of diffusivity boundary layer thickness showed a range of $180-230\;{\mu}m$. Sediment oxygen consumption rate, measured in-situ,was $84\;mmol\;O_2\;m^{-2}\;d_{-1}$, more than two times higher than on-board incubation results. Benthic fluxes assessed from in-situ incubation were estimated as follows: nitrate + nitrite = $0.18\;{\pm}\;0.07\;mmol\;m^{-2}\;d^{-1}$ ammonium $23\;{\pm}\;1\;mmol\;m^{-2}\;d^{-1}$ phosphate = $0.09\;{\pm}\;0.02\;mmol\;m^{-2}\;d^{-1}$ and silicate = $23\;{\pm}\;1\;mmol\;m^{-2}\;d^{-1}$.

Study on BMI, Dietary Behavior, and Nutrient Intake Status According to Frequency of Breakfast Intake in Female College Students in Chuncheon Area (춘천지역 일부 여대생의 아침식사 빈도에 따른 BMI, 식행동 및 영양소 섭취상태)

  • Kim, Yoon-Sun;Kim, Bok-Ran
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.46 no.10
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    • pp.1234-1242
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    • 2017
  • The purpose of this study was to investigate BMI, dietary behavior, and nutrient intake status according to frequency of breakfast intake in female college students (n=253) in Chuncheon area. This study was conducted by employing a self-administered questionnaire. Dietary assessment was measured by the 24-h recall method. The subjects were divided into two groups by frequency of breakfast: Five to seven times per week (eating breakfast group, n=139) and none to four times per week (skipping breakfast group, n=114). The living with parents group showed significant high frequency of breakfast intake, whereas the self-boarding group showed significant low frequency of breakfast intake. The body image satisfaction score of the 5~7 times/week group was higher than that of the 0~4 times/week group. The average height and weight of the 5~7 times/week group were $161.0{\pm}0.1cm$ and $52.6{\pm}7.6kg$, respectively, whereas those of the 0~4 times/week group were $160.7{\pm}0.1cm$ and $57.1{\pm}11.8kg$, respectively. The average body mass index (BMI) values of the 5~7 times/week and 0~4 times/week groups were $19.8{\pm}1.9kg/m^2$ and $21.5{\pm}3.4kg/m^2$, respectively. The dietary behavior score of the 5~7 times/week group was higher than that of the 0~4 times/week group. The daily averages for energy, carbohydrate, and protein intakes in the 5~7 times/week group were significantly higher than those of the 0~4 times/week group. Intakes of vitamin A, vitamin $B_1$, vitamin $B_2$, niacin, vitamin $B_6$, P, Zn, and cholesterol in the 5~7 times/week group were significantly higher than those of the 0~4 times/week group. Multiple regression analysis revealed that resident type was the most significant variable associated with breakfast intake frequency. Therefore, strengthening dietary education programs that largely focus on resident type will greatly contribute to prevent skipping breakfast.

Medical Information Dynamic Access System in Smart Mobile Environments (스마트 모바일 환경에서 의료정보 동적접근 시스템)

  • Jeong, Chang Won;Kim, Woo Hong;Yoon, Kwon Ha;Joo, Su Chong
    • Journal of Internet Computing and Services
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    • v.16 no.1
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    • pp.47-55
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    • 2015
  • Recently, the environment of a hospital information system is a trend to combine various SMART technologies. Accordingly, various smart devices, such as a smart phone, Tablet PC is utilized in the medical information system. Also, these environments consist of various applications executing on heterogeneous sensors, devices, systems and networks. In these hospital information system environment, applying a security service by traditional access control method cause a problems. Most of the existing security system uses the access control list structure. It is only permitted access defined by an access control matrix such as client name, service object method name. The major problem with the static approach cannot quickly adapt to changed situations. Hence, we needs to new security mechanisms which provides more flexible and can be easily adapted to various environments with very different security requirements. In addition, for addressing the changing of service medical treatment of the patient, the researching is needed. In this paper, we suggest a dynamic approach to medical information systems in smart mobile environments. We focus on how to access medical information systems according to dynamic access control methods based on the existence of the hospital's information system environments. The physical environments consist of a mobile x-ray imaging devices, dedicated mobile/general smart devices, PACS, EMR server and authorization server. The software environment was developed based on the .Net Framework for synchronization and monitoring services based on mobile X-ray imaging equipment Windows7 OS. And dedicated a smart device application, we implemented a dynamic access services through JSP and Java SDK is based on the Android OS. PACS and mobile X-ray image devices in hospital, medical information between the dedicated smart devices are based on the DICOM medical image standard information. In addition, EMR information is based on H7. In order to providing dynamic access control service, we classify the context of the patients according to conditions of bio-information such as oxygen saturation, heart rate, BP and body temperature etc. It shows event trace diagrams which divided into two parts like general situation, emergency situation. And, we designed the dynamic approach of the medical care information by authentication method. The authentication Information are contained ID/PWD, the roles, position and working hours, emergency certification codes for emergency patients. General situations of dynamic access control method may have access to medical information by the value of the authentication information. In the case of an emergency, was to have access to medical information by an emergency code, without the authentication information. And, we constructed the medical information integration database scheme that is consist medical information, patient, medical staff and medical image information according to medical information standards.y Finally, we show the usefulness of the dynamic access application service based on the smart devices for execution results of the proposed system according to patient contexts such as general and emergency situation. Especially, the proposed systems are providing effective medical information services with smart devices in emergency situation by dynamic access control methods. As results, we expect the proposed systems to be useful for u-hospital information systems and services.

EFFECT OF INDUCTION CHEMOTHERAPY ON FLAP SURVIVAL RATE IN MICROSURGERY (종양수술전 화학요법이 미세수술시 피판생존율에 미치는 영향)

  • Kim, Uk-Kyu;Kim, Yong-Deok;Byun, June-Ho;Shin, Sang-Hun;Chung, In-Kyo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.29 no.6
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    • pp.421-429
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    • 2003
  • Purpose : Neoadjuvant chemotherapy is commonly used to treat cancer patients as adjunct treatment, but if the microvascular tissue transfer is performed simulataneously with cancer resection surgery, the induction chemotherapy might affect the survival rate of vascularized free flap. Our study will focus on the effect of induction chemotherapy on the free flaps which were made on white rat abdomen after injection of 5-FU. Materials and Methods: The experimental rat groups were divided into three groups (total 24 rats) as a normal control group, 24 hrs group after 5-FU injection, 3 days group after 5-FU injection. Inferior abdominal island flaps of 8 Sprague Dawley rats on each group were made and immediately were induced into an ischemic state by clamping the supplying inferior epigastric artery and vein with microvascular clamp for a hour to induce a similiar free flap circumstance, then the inferior abdominal skin flaps were reperfused by releasing the clamps. The flaps on abdomen were repositioned and sutured. The experimental data for flap survival rate was collected by digital photo taking, analysed by computer image program to compare with the flap luminosity. The rats were sacrificed at 3 days, 5 days, 7 days after flap preparation and specimens of the flap were taken and stained with H-E staining. The microscopic finding was made under magnification of 200 and 400. Results: 1. Gross findings on each groups showed the healing condition was good as following sequences; normal, 24 hrs group after chemotherapy, 3 days group after chemotherpy. 2. The values of flap luminosity for evaluation of flap survival rate also showed the same sequences as gross findings of healing state. 3. The microscopic findings of epidermis necrosis, inflammation state, dermis fibrosis, vessel change, fatty tissue layer thinning were compared with each group. The 3 days group after chemotherapy showed remarkably poor healing condition compared to other groups. Conclusion: Chemotherapy agents affected the healing process of free flap, but healing condition was recovered spontaneously as post-injection periods passed out. In opposite to our expectation, 3 days group showed the bad flap condition in comparing with 24 hours group which was considered as immatured body circulation state of chemotherapy agent. It showed that 3 weeks in human being after chemotherapy was not proper as timing of microvascular tissue transfer if 3 days group in rat was considered as same healing period of 3 weeks in human being. More delayed healing timing than 3 weeks might be required in clinical application of free tissue transfer.

Development of an Offline Based Internal Organ Motion Verification System during Treatment Using Sequential Cine EPID Images (연속촬영 전자조사 문 영상을 이용한 오프라인 기반 치료 중 내부 장기 움직임 확인 시스템의 개발)

  • Ju, Sang-Gyu;Hong, Chae-Seon;Huh, Woong;Kim, Min-Kyu;Han, Young-Yih;Shin, Eun-Hyuk;Shin, Jung-Suk;Kim, Jing-Sung;Park, Hee-Chul;Ahn, Sung-Hwan;Lim, Do-Hoon;Choi, Doo-Ho
    • Progress in Medical Physics
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    • v.23 no.2
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    • pp.91-98
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    • 2012
  • Verification of internal organ motion during treatment and its feedback is essential to accurate dose delivery to the moving target. We developed an offline based internal organ motion verification system (IMVS) using cine EPID images and evaluated its accuracy and availability through phantom study. For verification of organ motion using live cine EPID images, a pattern matching algorithm using an internal surrogate, which is very distinguishable and represents organ motion in the treatment field, like diaphragm, was employed in the self-developed analysis software. For the system performance test, we developed a linear motion phantom, which consists of a human body shaped phantom with a fake tumor in the lung, linear motion cart, and control software. The phantom was operated with a motion of 2 cm at 4 sec per cycle and cine EPID images were obtained at a rate of 3.3 and 6.6 frames per sec (2 MU/frame) with $1,024{\times}768$ pixel counts in a linear accelerator (10 MVX). Organ motion of the target was tracked using self-developed analysis software. Results were compared with planned data of the motion phantom and data from the video image based tracking system (RPM, Varian, USA) using an external surrogate in order to evaluate its accuracy. For quantitative analysis, we analyzed correlation between two data sets in terms of average cycle (peak to peak), amplitude, and pattern (RMS, root mean square) of motion. Averages for the cycle of motion from IMVS and RPM system were $3.98{\pm}0.11$ (IMVS 3.3 fps), $4.005{\pm}0.001$ (IMVS 6.6 fps), and $3.95{\pm}0.02$ (RPM), respectively, and showed good agreement on real value (4 sec/cycle). Average of the amplitude of motion tracked by our system showed $1.85{\pm}0.02$ cm (3.3 fps) and $1.94{\pm}0.02$ cm (6.6 fps) as showed a slightly different value, 0.15 (7.5% error) and 0.06 (3% error) cm, respectively, compared with the actual value (2 cm), due to time resolution for image acquisition. In analysis of pattern of motion, the value of the RMS from the cine EPID image in 3.3 fps (0.1044) grew slightly compared with data from 6.6 fps (0.0480). The organ motion verification system using sequential cine EPID images with an internal surrogate showed good representation of its motion within 3% error in a preliminary phantom study. The system can be implemented for clinical purposes, which include organ motion verification during treatment, compared with 4D treatment planning data, and its feedback for accurate dose delivery to the moving target.

A Study of the Reactive Movement Synchronization for Analysis of Group Flow (그룹 몰입도 판단을 위한 움직임 동기화 연구)

  • Ryu, Joon Mo;Park, Seung-Bo;Kim, Jae Kyeong
    • Journal of Intelligence and Information Systems
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    • v.19 no.1
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    • pp.79-94
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    • 2013
  • Recently, the high value added business is steadily growing in the culture and art area. To generated high value from a performance, the satisfaction of audience is necessary. The flow in a critical factor for satisfaction, and it should be induced from audience and measures. To evaluate interest and emotion of audience on contents, producers or investors need a kind of index for the measurement of the flow. But it is neither easy to define the flow quantitatively, nor to collect audience's reaction immediately. The previous studies of the group flow were evaluated by the sum of the average value of each person's reaction. The flow or "good feeling" from each audience was extracted from his face, especially, the change of his (or her) expression and body movement. But it was not easy to handle the large amount of real-time data from each sensor signals. And also it was difficult to set experimental devices, in terms of economic and environmental problems. Because, all participants should have their own personal sensor to check their physical signal. Also each camera should be located in front of their head to catch their looks. Therefore we need more simple system to analyze group flow. This study provides the method for measurement of audiences flow with group synchronization at same time and place. To measure the synchronization, we made real-time processing system using the Differential Image and Group Emotion Analysis (GEA) system. Differential Image was obtained from camera and by the previous frame was subtracted from present frame. So the movement variation on audience's reaction was obtained. And then we developed a program, GEX(Group Emotion Analysis), for flow judgment model. After the measurement of the audience's reaction, the synchronization is divided as Dynamic State Synchronization and Static State Synchronization. The Dynamic State Synchronization accompanies audience's active reaction, while the Static State Synchronization means to movement of audience. The Dynamic State Synchronization can be caused by the audience's surprise action such as scary, creepy or reversal scene. And the Static State Synchronization was triggered by impressed or sad scene. Therefore we showed them several short movies containing various scenes mentioned previously. And these kind of scenes made them sad, clap, and creepy, etc. To check the movement of audience, we defined the critical point, ${\alpha}$and ${\beta}$. Dynamic State Synchronization was meaningful when the movement value was over critical point ${\beta}$, while Static State Synchronization was effective under critical point ${\alpha}$. ${\beta}$ is made by audience' clapping movement of 10 teams in stead of using average number of movement. After checking the reactive movement of audience, the percentage(%) ratio was calculated from the division of "people having reaction" by "total people". Total 37 teams were made in "2012 Seoul DMC Culture Open" and they involved the experiments. First, they followed induction to clap by staff. Second, basic scene for neutralize emotion of audience. Third, flow scene was displayed to audience. Forth, the reversal scene was introduced. And then 24 teams of them were provided with amuse and creepy scenes. And the other 10 teams were exposed with the sad scene. There were clapping and laughing action of audience on the amuse scene with shaking their head or hid with closing eyes. And also the sad or touching scene made them silent. If the results were over about 80%, the group could be judged as the synchronization and the flow were achieved. As a result, the audience showed similar reactions about similar stimulation at same time and place. Once we get an additional normalization and experiment, we can obtain find the flow factor through the synchronization on a much bigger group and this should be useful for planning contents.

A Comparative Study on Buddhist Painting, MokWooDo (牧牛圖: PA Comparative Study on Buddhist Painting, MokWooDo (牧牛圖: Painting of Bull Keeping) and Confucian/Taoist Painting, SipMaDo (十馬圖: Painting of Ten Horses) - Focused on SimBeop (心法: Mind Control Rule) of the Three Schools: Confucianism, Buddhism and Taoism -nd Control Rule) of the Three Schools: Confucianism, Buddhism and Taoism - (불가(佛家) 목우도(牧牛圖)와 유·도(儒·道) 십마도(十馬圖) 비교 연구 - 유불도(儒佛道) 삼가(三家)의 심법(心法)을 중심으로 -)

  • Park, So-Hyun;Lee, Jung-Han
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.40 no.4
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    • pp.67-80
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    • 2022
  • SipWooDo (十牛圖: Painting of Ten Bulls), a Buddhist painting, is a kind of Zen Sect Buddhism painting, which is shown as a mural in many of main halls of Korean Buddhist temples. MokWooDo has been painted since Song Dynasty of China. It paints a cow, a metaphor of mind and a shepherd boy who controls the cow. It comes also with many other types of works such as poetry called GyeSong, HwaWoonSi and etc. That is, it appeared as a pan-cultural phenomenon beyond ideology and nation not limited to Chinese Buddhist ideology of an era. This study, therefore, selects MokWooDo chants that represent Confucianism, Buddhism and Taoism to compare the writing purposes, mind discipline methods and ultimate goals of such chant literatures in order to integrate and comprehend the ideologies of such three schools in the ideologically cultural aspect, which was not fully dealt with in the existing studies. In particular, the study results are: First, the SipWooDo of Buddhist School is classified generally into Bo Myoung's MokWooDo and Kwak Ahm's SimWooDo (尋牛圖: Painting of Searching out a Bull). Zen Sect Buddhism goes toward nirvana through enlightenment. Both MokWooDo and SimWooDo of Buddhist School are the discipline method of JeomSu (漸修: Discipline by Steps). They were made for SuSimJeungDo (修心證道: Enlightenment of Truth by Mind Discipline), which appears different in HwaJe (畫題: Titles on Painting) and GyeSong (偈頌: Poetry Type of Buddhist Chant) between Zen Sect Buddhism and Doctrine Study Based Buddhism, which are different from each other in viewpoints. Second, Bo Myoung's MokWooDo introduces the discipline processes from MiMok (未牧: Before Tamed) to JinGongMyoYu (眞空妙有: True Vacancy is not Separately Existing) of SsangMin (雙泯: the Level where Only Core Image Appears with Every Other Thing Faded out) that lie on the method called BangHalGiYong (棒喝機用: a Way of Using Rod to Scold). On the other side, however, it puts its ultimate goal onto the way to overcome even such core image of SsangMin. Third, Kwak Ahm's SimWooDo shows the discipline processes of JeomSu from SimWoo (尋牛: Searching out a Bull) to IpJeonSuSu (入鄽垂手: Entering into a Place to Exhibit Tools). That is, it puts its ultimate goal onto HwaGwangDongJin (和光同塵: Harmonized with Others not Showing your own Wisdom) where you are going together with ordinary people by going up to the level of 'SangGuBori (上求菩提: Discipline to Go Up to Gain Truth) and HaHwaJungSaeng (下化衆生: Discipline to Go Down to Be with Ordinary People)' through SaGyoIpSeon (捨敎入禪: Entering into Zen Sect Buddhism after Completing a Certain Volume of Doctrine Study), which are working for leading the ordinary people of all to finding out their Buddhist Nature. Fourth, Shimiz Shunryu (清水春流)'s painting YuGaSipMaDo (儒家十馬圖: Painting of Ten Horses of Confucian School) borrowed Bo Myoung's MokWooDo. That is, it borrowed the terms and pictures of Buddhist School. However, it features 'WonBulIpYu (援佛入儒: Enlightenment of Buddhist Nature by Confucianism)', which is based on the process of becoming a greatly wise person through Confucian study to go back to the original good nature. From here, it puts its goal onto becoming a greatly wise person, GunJa who is completely harmonized with truth, through the study of HamYang (涵養: Mind Discipline by Widening Learning and Intelligence) that controls outside mind to make the mind peaceful. Its ultimate goal is in accord with "SangCheonJiJae, MuSeongMuChee (上天之載, 無聲無臭: Heaven Exists in the Sky Upward; It is Difficult to Get the Truth of Nature, which has neither sound nor smell)' words from Zhōngyōng. Fifth, WonMyeongNhoYin (圓明老人)'s painting SangSeungSuJinSamYo (上乘修真三要: Painting of Three Essential Things to Discipline toward Truth) borrowed Bo Myoung's MokWooDo while it consists of totally 13 sheets of picture to preach the painter's will and preference. That is, it features 'WonBulIpDo (援佛入道: Following Buddha to Enter into Truth)' to preach the painter's doctrine of Taoism by borrowing the pictures and poetry type chants of Buddhist School. Taoism aims to become a miraculously powerful Taoist hermit who never dies by Taoist healthcare methods. Therefore, Taoists take the mind discipline called BanHwanSimSeong (返還心性: Returning Back to Original Mind Nature), which makes Taoists go ultimately toward JaGeumSeon (紫金仙) that is the original origin by changing into a saint body that is newly conceived with the vital force of TaeGeuk abandoning the existing mind and body fully. This is a unique feature of Taoism, which puts its ultimate goal onto the way of BeopShinCheongJeong (法身淸淨: Pure and Clean Nature of Buddha) that is in accord with JiDoHoiHong (至道恢弘: Getting to Wide and Big Truth).

A Clinical Evaluation of Splanchnic Nerve Block (내장신경차단에 관한 임상적 연구)

  • Kim, Soo-Yeoun;Oh, Hung-Kun;Yoon, Duek-Mi;Shin, Yang-Sik;Lee, Youn-Woo;Kim, Jong-Rae
    • The Korean Journal of Pain
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    • v.1 no.1
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    • pp.34-46
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    • 1988
  • Intractable pain from advanced carcinoma of the upper abdomen is difficult to manage. One method used to control pain associated with these malignancies is to block off the splanchnic nerve. In 1919 Kappis described a technique by which the splanchnic nerve of the upper abdomen could be anesthetized, using a percutaneous injection. This method has been used for the relief of upper abdominal pain due to hematoma and cancer of the pancreas, stomach, gall bladder, bile duct, and colon. During the Period from November 1968 to January 1986, this method was used in 208 cases of malignancy at Severance Hospital and clinically evaluated. Patients were retroactively grouped according to the stage of development of technique used. Twelve patients who received the treatment in the period from November 1968 to March 1977 were designate4i as group 1, 26 patients from April 1977 to April 1979 as group 2, and 170 from May 1979 to January 1986 as group 3. The results are as follows: 1) The number of patients receiving splanchnic nerve block has been increasing since 1977. 2) A total of 208 patients, including 133 males and 75 females, ranging in age from 18 to 84 and averaging 51. 3) The causes of pain were stomach cancer 90, pancreatic cancer 69, and miscellaneous cancer 49 cases respectively. 4) There were 57.7% who had surgery. and 3.7% of whom had chemotherapy before the splanchnic nerve block was done. 5) These blocks were carried out with the patient in the prone position as described by Dr. Moore. For group 2 and 3, C-arm image intensifier was used. In group 1, a 22 gauze loom long needle was inserted at the lower border of the 12th rib on each aide about 7\;cm from the midline. The average distance from the midline was $6.60{\pm}0.61\;cm$ on the left side and $6.60{\pm}0.83\;cm$ on the right side in group 2, and $5.46{\pm}0.76\;cm$ on the left side and $5.49{\pm}0.69\;cm$ on the right side in group 3. The average depth to which the needle was inserted was $8.60{\pm}0.52\;cm$ on the left side and $8.74{\pm}0.60\;cm$ on the right side in group 2, and $8.96{\pm}0.63\;cm$ on the left side and $9.18{\pm}0.57\;cm$ on the right side in group 3. 6) The points of the inserted needles were positioned in the upper quarter anteriorly, 51.8% on the left side and 54.4% n the right side of the L1 vertebra by lateral roentgenogram in group 3. The inserted needle points were located in the upper and anterolateral part, of the L1 vertebra 68.5% on the left side and 60.6won the right side, on the anteroposterior rentgenogram in group 3. The needle tip was not advanced beyond the anterior margin of the vertebral body. 7) In some case of group 3, contrast media was injected before the block was done. It shows, the spread upward along the anterior mal gin of the vertebral body. 8) The concentration and the average amount of drug used in each group was as follows: In group 1, $39.17{\pm}6.69\;ml$ of 0.5% -l% lidocaine or 0.25% bupivacaine were injected for the test block and one to three days after the test block $40.00{\pm}4.26\;ml$ of 50% alcohol was injected for the semipermanent block. In group 2, $13.75{\pm}4.88\;ml$ of 1% lidocaine were used as the test block and followed by $46.17{\pm}4.37\;ml$ of 50% alcohol was injected as the semipermanent block. In group 3, $15.63{\pm}1.19\;ml$ of 1% lidocaine for test block followed by $15.62{\pm}1.20\;ml$ of pure alcohol and $16.05{\pm}2.58\;ml$ of 50% alcohol for semipermanent block were injected. 9) The result of the test block was satisfactory in all cases. However the semipermanent block was 83.3 percent of the patients in group 1 who received relief from pain for at least 2 weeks after the block, 73.1% in group 2, and 91.8% in group 3. In these unsuccessful cases, 2 cases in group 1 were controlled by narcotics but 7 cases in group 2 and 14 cases in group 3 received the same splanchnic nerve block 1 or 2 times again within 2 weeks. But, in some cases it was 3 to i months before the 2nd block and in 1 cases even 7 years. 10) The most common complications of splanchnic nerve block were hypotensino(25.5%) occasional flushing of the face, nausea, vomiting, and chest discomfort. 11) For the patients in group 3, the supplemental block most commonly used was a continuous epidural block; it was used as a diagnostic block and to afford relief from pain before the splanchnic nerve block was done. 12) The interval between the receiving of the alcohol block and discharge was from 5 to 8 days in 61 cases(31.1%) and from 1 to 2 days in 48 cases(24.5%). From the above results, it can be concluded that the splanchnic nerve block done in the prone position with pure and 50% alcohol immediately after an effective test block with 1% lidocaine under C-arm fluoroscopic control is satisfactory and reliable. How to minimize the repeat block is still a problem to be solved.

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Compare to Evaluate the Imaging dose of MVCT and CBCT (Tomotherapy MVCT와 Linac CBCT의 Imaging dose 비교평가)

  • Yoon, Bo Reum;Hong, Mi Lan;Ahn, Jong Ho;Song, Ki Won
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.1
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    • pp.83-89
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    • 2014
  • Purpose : In case of the intensity modulated radiation therapy (IMRT) using Tomotherapy and linear accelerator (Linac), it was to compare and to evaluate the imaging dose of MVCT and CBCT that were performed daily for the correct set up of the patient. Materials and Methods : The human body model Phantom (Anderson rando Phantom, USA) was divided into the three parts as Head, Thorax, pelvis, and after GafChromic EBT3 film cut to the size of $0.5{\times}0.5cm2$.in the center of the recording area were situated on the ant, post, left, and right surface of the phantom and 2cm in depth from the ant, post, left, right, and center surface of the phantom, the surface dose and inner dose were measured repeatedly three times, respectively, using the tomotherapy (Hi Art) and the OBI of NovalisTx. The measured film calculated the output value by RIP version6.0 and then the average value of the dose was calculated by the one-way analysis of variance. Results : Using the human body model phantom, the results of MVCT and CBCT performance were that measurements of MVCT inner dose were showed $15.43cGy{\pm}6.05$ in the head, $16.62cGy{\pm}3.08$ in the thorax, $16.81cGy{\pm}5.24$ in the pelvis, and measurements of CBCT inner dose were showed $13.28{\pm}3.68$ in the head, from $13.66{\pm}4.04$ in the thorax, $15.52{\pm}3.52$ in the pelvis. The measurements of surface dose were showed in case of MVCT performance, $11.64{\pm}4.05$ in the head, $12.16{\pm}4.38$ in the thorax, $12.05{\pm}2.71$ in the pelvis, and in case of CBCT performance, $14.59{\pm}3.51$ in the head, $15.82{\pm}2.89$ in the thorax, $17.48{\pm}2.80$ in the pelvis, respectively. Conclusion : In case of Inner dose, the MVCT using MV energy showed higher than the CBCT using kV energy at 1.16 times in the head, at 1.22 times in the thorax, at 1.08 times in the pelvis, and in case of surface dose, the CBCT was higher than MVCT, at 1.25 times in the head, at 1.30 times in the thorax, at 1.45 times in the pelvis. Imaging dose was a small amount compared to the therapeutic dose but it was thought to affect partially to normal tissue because it was done in daily schedule. However, IMRT treatment was necessarily parallel with the IGRT treatment through the image-guide to minimize errors between planned and actual treatment. Thus, to minimize imaging dose that the patients receive, when planning the treatment, it should be set up a treatment plan considering imaging dose, or it must be performed by minimizing the scan range when shooting MVCT.