• Title/Summary/Keyword: clinical Application

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Development of Abdominal Compression Belt and Evaluation of the Efficiency for the Reduction of Respiratory Motion in SBRT (체부 정위방사선치료 시 호흡운동 감소를 위한 복부 압박기구 개발 및 유용성 평가)

  • Hwang, Seon-Bung;Kim, Il-Hwan;Kim, Woong;Im, Hyeong-Seo;Gang, Jin-Mook;Jeong, Seong-Min;Kim, Gi-Hwan;Lee, Ah-Ram;Cho, Yu-Ra
    • The Journal of Korean Society for Radiation Therapy
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    • v.23 no.1
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    • pp.13-19
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    • 2011
  • Purpose: It's essential to minimize the tumor motion and identify the exact location of the lesions to achieve the improvement in radiation therapy efficiency during SBRT. In this study, we made the established compression belt to reduce respiratory motion and evaluated the usefulness of clinical application in SBRT. Materials and Methods: We analyzed the merits and demerits of the established compression belt to reduce the respiratory motion and improved the reproducibility and precision in use. To evaluate the usefulness of improved compression belt for respiratory motion reduction in SBRT, firstly, we reviewed the spiral CT images acquired in inspiration and expiration states of 8 lung cancer cases, respectively, and analyzed the three dimensional tumor motion related to respiration. To evaluate isodose distribution, secondly, we also made the special phantom using EBT2 film (Gafchronic, ISP, USA) and we prepared the robot (Cartesian Robot-2 Axis, FARARCM4H, Samsung Mechatronics, Korea) to reproduce three dimensional tumor motion. And analysis was made for isodose curves and two dimensional isodose profiles with reproducibility of respiratory motion on the basis of CT images. Results: A respiratory motion reduction compression belt (Velcro type) that has convenient use and good reproducibility was developed. The moving differences of three dimensional tumor motion of lung cancer cases analyzed by CT images were mean 3.2 mm, 4.3 mm and 13 mm each in LR, AP and CC directions. The result of characteristic change in dose distribution using the phantom and rectangular coordinates robot showed that the distortion of isodose has great differences, mean length was 4.2 mm; the differences were 8.0% and 16.8% each for cranio-caudal and 8.1% and 10.9% each for left-right directions in underdose below the prescribed dose. Conclusion: In this study, we could develop the convenient and efficient compression belt that can make the organs' motion minimize. With this compression belt, we confirmed that underdose due to respiration can be coped with when CTV-PTV margins of mean 6 mm would be used. And we conclude that the respiratory motion reduction compression belt we developed can be used for clinical effective aids along with the gating system.

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A Clinical Study of Soeumin Doksamkwankaeijungtang (독삼관계이중탕(獨參官桂理中湯)의 소음인(小陰人) 인후통(咽喉痛) 치험례(治驗例))

  • Huh, Manhn-hoi;Song, Il-byung
    • Journal of Sasang Constitutional Medicine
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    • v.12 no.1
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    • pp.240-259
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    • 2000
  • 1. Background and Purpose I intented to be helpful to understand the consitutional symptoms of soar throat and the application of the prescription through a clinical study of Soeumin Doksamkwankaeijungtang. 2. Methods I studied 16 patients(1 man and 15 women) treated by Doksamkwankaeijungtang in Chewon Oriental Clinic. And then I investigated the characteristics of patients treated by Doksamkwankaeijungtang, remedial values and side effects. 3. Results Doksamkwankaeijungtang was used in the age groups between twenties and sixties. There were 28 kinds of chief complaints including soar throat, tonsilitis, allergic rheum, bitter taste, dry throat, dry cough, stomatitis, lower abdominal pains, climacteric syndrome, etc. The distributions of remedial values were completely recovered (56.25%), much improved (18.75%), slightly improved(6.25%), no improved(12.5%), aggravated(6.25%), side effects(18.75%). There was one aggravated patient. Using the prescription, I prescribed it without any changing and addition according to the symptoms of soar throat. The remedial value of Doksamkwankaeijungtang was effective and not influenced by the dosage of Ginseng. The onset of action was very quick by the changes of dosage without the relation of age. Side effects were upward tendency of blood presser, headache, chest pain, etc. 4. Conclusion Doksamkwankaeijungtang was specifically effective in soar throat of Soeumin.

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The confucian view of human being of Lee Je-ma and his spirits to apply Sasang Constitutional Medicine (이제마(李濟馬)의 유학적(儒學的) 인간관(人間觀)과 의학정신(醫學精神))

  • Song, Il-byung
    • Journal of Sasang Constitutional Medicine
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    • v.12 no.1
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    • pp.1-9
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    • 2000
  • 1. Objects of Research Dong-mu Lee Je-ma was tried to solve the diseases of human beings through Sasang Constitutional Medicine with new viewpoints on human beings and life compared with the existed medicine. So it was very important to understand his medical views in order to apply Sasang Constitutional Medicine in clinical treatment. In this paper, I tried to find his medical views on human beings, life, and diseases to get informations in clinical application. 2. Methods of Research It was researched as bibliologically with his writings such as "Dongyi Soose Bowon(東醫壽世保元)", "Dongyi Soose Bowon Sasang Chobongyun(東醫壽世保元四象草本卷)", "Dongmu Yugo(東武遺稿)", "Gyuk-chigo(格致藁)". 3. Results and Conclusions The conclusions were as follows. 1. "I Ching"'s recognition of Things is that based on Yin-yang theory, originated from Taoism, and aimed to 'the Fine point of Easiness and Simpleness(易簡之妙)'. On the other hand, Dong-mu's is that based on Sasang theory, originated from Confucianism and designed to developed 'the Fine point of Easiness and Simpleness' in view of Sasang(四象). 2. Dong-mu Lee Je-ma had devoted himself in his whole life to establishing new paradigm in the Confucianism, inventing new medicine and, furthermore, embodying the spirit of General health maintenance. 3. Dong-mu Lee Je-ma recognized 'the Fine point of Easiness and Simpleness' in view of Sasang and offered new viewpoint of human being through summarizing various existing viewpoints. 4. Dong-mu Lee Je-ma established new viewpoint of life span of human being through offering new ideas such as 'Inherent vitality(命脈實數)', 'Essential power of organ(臟의 本常之氣)' and 'Regimen in ordinary life(生息允補之道)'. 5. Dong-mu Lee Je-ma embodied 'the Fine point of Easiness and Simpleness' in medicine through offering, in a wide meaning, the spirit of the General health maintenance and the spirit of the Positive medical treatment.

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Clinical Analysis of 500 Cases of Coronary Artery Bypass Grafting (관상동맥 우회술 500례의 임상적 고찰)

  • Shin, Yoon-Cheol;Kim, Ki-Bong;Ahn, Hyuk;Chae, Hurn;Rho, Joon-Ryang;Suh, Kyung-Phill
    • Journal of Chest Surgery
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    • v.32 no.6
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    • pp.525-531
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    • 1999
  • Background: We analyzed five hundred patients who underwent either isolated or concomitant coronary artery bypass grafting(CABG) between November 1981 and June 1997. Material and Method: There were 330 males and 170 females with a mean age of 57.4$\pm$8.9 years. To evaluate the preoperative status, we performed electrocardiograghy, echocardiography, MIBI scan, Duplex sonogram, common blood test including CK and LDH and coronary angiography. Result: Preoperative clinical diagnoses were unstable angina in 282 (56.4%), stable angina in 141 (28.2%), postinfarction angina in 58 (11.6%), acute myocardial infarction in 8 (1.6%), variant angina in 7 (1.4%) and failed percutaneous transluminal coronary angioplasty in 4 (0.8%) patients. Preoperative angiographic diagnoses were three-vessel disease in 263 (52.6%), two-vessel disease in 93 (18.6%), one-vessel disease in 71 (14.2%), left main disease in 68 (13.6%), and others in 5 (1.0%) patients. Patients had various risk factors for coronary disease, and the frequency of the risk factors such as hypertension, diabetes and smoking showed increasing tendency year by year. We used saphenous vein grafts in 1143, internal thoracic artery grafts in 442, radial artery graft in 17, and gastroepiploic artery graft in 1 anastomosis. The mean number of grafts was 3.2$\pm$1.2 per patient. Concomitant operations were prosthetic valve replacement or valvuloplasty in 31, coronary endarterectomy and angioplasty in 27, left main coronary angioplasty in 13, carotid endarterectomy in 5, and neurologic problems, bleeding, and perioperative myocardial infarction. The mean follow-up period was 25$\pm$23 months and there were 5 cases of reoperation. Conclusion: We hope that the surgical results would improve with the accumulation of experience, application of new myocardial protection technique, and timely intervention of mechanical assisted devices.

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Analysis of temperature changes and sterilization effect of diode laser for the treatment of peri-implantitis by wavelength and irradiation time (임플란트 주위염 치료용 diode laser의 파장 및 조사시간에 따른 온도 변화와 살균효과 분석)

  • Seol, Jeong-Hwan;Lee, Jun Jae;Kum, Kee-Yeon;Lee, Jong-Ho;Lim, Young-Joon
    • Journal of Dental Rehabilitation and Applied Science
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    • v.33 no.3
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    • pp.178-188
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    • 2017
  • Purpose: We compared the effects of newly developed diode laser (Bison 808 nm Diode laser) on the treatment of peri-implantitis with conventional products (Picasso 810 nm Diode laser) by comparing the surface temperature of titanium disc and bacterial sterilization according to laser power. Materials and Methods: The titanium disc was irradiated for 60 seconds and 1 - 2.5 W using diode laser 808 nm and 810 nm. The surface temperature of the titanium disc was measured using a temperature measurement module and a temperature measurement program. In addition, in order to investigate the sterilizing effect according to the laser power, 808 nm laser was irradiated after application of bacteria to sandblasted large-grit acid-etched (SLA) and resorbable blast media (RBM) coated titanium discs. The irradiated disks were examined with scanning electron microscopy. Results: Both 808 nm and 810 nm lasers increased disk surface temperature as the power increased. When the 810 nm was irradiated under all conditions, the initial temperature rise rate, the descending rate, and the temperature change before and after was higher than that of 808 nm. Disk surface changes were not observed on both lasers at all conditions. Bacteria were irradiated with 808 nm, and the bactericidal effect was increased as the power increased. Conclusion: When applying these diode lasers to the treatment of peri-implantitis, 808 nm which have a bactericidal effect with less temperature fluctuation in the same power conditions would be considered safer. However, in order to apply a laser treatment in the dental clinical field, various safety and reliability should be secured.

An Experimental Study on Radioprotective Effect of DDC, MEA, and WR-2721 (DDC, MEA, WR-2721의 방사선(放射線) 방호효과(防護效果)에 관(關)한 연구(硏究))

  • Chung, In-Young;Koh, Joo-Hwan;Chung, Hyun-Woo;Chil, Soo-Yil;Yoo, Seong-Yul;Koh, Kyoung-Hwan
    • Journal of Radiation Protection and Research
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    • v.11 no.2
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    • pp.114-122
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    • 1986
  • At present, the treatments of the radiation-induced diseases are only performing by the palliative treatment technique. Moreover, radiation protective agents are a little toxic for human being and this seriously limits their applicability with various complications in clinical uses. Accordingly, as a part of the aim of gain of the basic data for protective roles of some radioprotectors, the present investigation was carried out to evaluate the comparative radioprotective effects by the administration of DDC, MEA, WR-2721. Results are shown for statistically significant analysis and correlation with each group as follows; 1. The proper doses of the radioprotectors were DDC; 1,550 mg/kg, MEA; 450 mg/kg, WR-2721; 780 mg/kg of the mouse body weight. 2. DMF(Dose modification factor) of LD 50/10 and LD 50/30 for whole body irradiation was DDC; 1.2, MEA; 1.4, WR-2721; 1.9 and DDC; 1.7, MEA; 1.8, WR-2721; 2.5 respectively. 3. DMF for radiation reaction of jejunal crypt was DDC: 1.07, MEA: 1.21 and WR-2721: 1.76 and that of jejunal crypt cell was DDC: 1.04, MEA: 1.08 and WR-2721: 1.38 respectively. 4. Conclusively, WR-2721 was the most effective drung among the three radioprotectors and this result must be a supportive data for further study for clinical application.

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Evaluation of 3DVH Software for the Patient Dose Analysis in TomoTherapy (토모테라피 환자 치료 선량 분석을 위한 3DVH 프로그램 평가)

  • Song, Ju-Young;Kim, Yong-Hyeob;Jeong, Jae-Uk;Yoon, Mee Sun;Ahn, Sung-Ja;Chung, Woong-Ki;Nam, Taek-Keun
    • Progress in Medical Physics
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    • v.26 no.4
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    • pp.201-207
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    • 2015
  • The new function of 3DVH software for dose calculation inside the patient undergoing TomoTherapy treatment by applying the measured data obtained by ArcCHECK was recently released. In this study, the dosimetric accuracy of 3DVH for the TomoTherapy DQA process was evaluated by the comparison of measured dose distribution with the dose calculated using 3DVH. The 2D diode detector array MapCHECK phantom was used for the TomoTherapy planning of virtual patient and for the measurement of the compared dose. The average pass rate of gamma evaluation between the measured dose in the MapCHECK phantom and the recalculated dose in 3DVH was $92.6{\pm}3.5%$, and the error was greater than the average pass rate, $99.0{\pm}1.2%$, in the gamma evaluation results with the dose calculated in TomoTherapy planning system. The error was also greater than that in the gamma evaluation results in the RapidArc analysis, which showed the average pass rate of $99.3{\pm}0.9%$. The evaluated accuracy of 3DVH software for TomoTherapy DQA process in this study seemed to have some uncertainty for the clinical use. It is recommended to perform a proper analysis before using the 3DVH software for dose recalculation of the patient in the TomoTherapy DQA process considering the initial application stage in clinical use.

Biodistribution and Metabolism of I-123 Labelled Fatty Acid(I) : [I-123]15-(p-iodophenyl)pentadecanoic acid(IPPA) (I-123 표지 지방산의 체내 분포 및 대사(I) : [I-123]15-(p-iodophenyl)pentadecanoic acid(IPPA))

  • Chang, Young Soo;Lee, Dong Soo;Jeong, Jae Min;Suh, Yong-Sup;Chung, June-Key;Lee, Myung Chul;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.1
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    • pp.50-60
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    • 1998
  • I-123 labelled fatty acids are suitable for investigation of regional myocardial metabolism, so they are on the clinical trial. However, the precise properties of these materials are not characterized yet. We have synthesized phenylpentadecanoic acid and labeled this compound with I-123. The purpose of this study was to examine the stability, biodistribution, metabolism and SPECT imaging of [I-123]15-(p-iodophenyl)pentadecanoic acid(I-123-IPPA) that we made. The stability test of I-123-IPPA in serum of rat, mouse and human showed no free I-123 after 1 hour. In biodistribution study in mice for various time intervals after injection(5, 10, 15, 30, 60 minutes), uptake in myocardium was 14.5%ID/g(5 min), and 1.9%ID/heart(5 min), while uptake in muscles was 2.6%ID/g(5 min). Myocardium to blood ratio and myocardium to lung ratio increased for 5 min after injection and then decreased rapidly. Chromatographic data of rat blood and urine showed that little PPA was found in blood and urine at 15-20 min after injection. The myocardial I-123-IPPA SPECT images of a dog with myocardial infarction showed defects similar to those of Tc-99m-MIBI and F-18-FDG. These data suggest that I-123-IPPA is quite stable in vitro and shows favorable biodistribution in mice. SPECT imaging with I-123-IPPA demonstrated infarct zone as photon defect in dog model of myocardial infarction. I-123-IPPA may be used for the evaluation of fatty acid metabolism in clinical trials in Korea.

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Clinical Application of Stent-graft in Thoracic Aortic Diseases (흉부 대동맥 질환에서 스텐트-그라프트의 임상적 적용)

  • Kim, Kyung-Hwan;Lee, Cheul;Chang, Ji-Min;Chung, Jin-Wook;Ahn, Hyuk;Park, Jae-Hyung
    • Journal of Chest Surgery
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    • v.34 no.9
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    • pp.698-703
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    • 2001
  • Background: Endovascular stent-graft insertion in aortic diseases is now generally accepted as an attractive alternative treatment modality. We reviewed our clinical experiences of endovascular stent-graft insertion in thoracic aorta. Material and Method: Since 1995, we performed 8 cases of endovasclar stent-graft insertion. Preoperative diagnoses were aortic aneurysms in 4, traumatic aortic ruptures in 3, and ruptured aortic pseudoaneurysm in 1. All procedures were performed in angiography room with the guidance of fluoroscopy. The stent-graft device is a custom-made 0.35mm thickness Z-shaped stainless steel wires, intertwined with each other using polypropylene suture ligation. It is covered with expanded Dacron vascular graft. Result: All procedures were performed successfully. Follow-up studies revealed 2 minimal perigraft leakages. There was no significant leakage or graft migration. 2 patients expired due to multiple organ failure and fungal sepsis. Other survivors(6) are doing well. Conclusion: Endovascular stent-graft insertion is relatively saft and effective treatment modality in the managment of various types of aortic diseases. In may be an effective alternative in aortic diseases of great surgical risk.

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Comparison of Enhanced Dynamic Wedge with Physical Metal Wedge based on the Basic Dosimetric Parameters (선량계측인자에 따른 기능강화동적쐐기와 금속쐐기의 비교)

  • Lee Jeong-Woo;Hong Semie;Choi Kyoung-Sik;Chung Jin-Beom;Choe Bo-Young;Jang Hong Seok;Suh Tae-Suk
    • Progress in Medical Physics
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    • v.16 no.2
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    • pp.70-76
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    • 2005
  • For clinical implementation of Enhanced Dynamic Wedge (EDW), it is necessary to adequately analyze and commission its dosimetric properties in comparison to common physical metal wedge (MTW). This study was implemented with the essential measurements of parameters for clinical application, such as percentage depth dose, peripheral dose, surface dose, effective wedge factor, and wedge profile. In addition, through the comparison study of EDW with open and MTW, the analysis was performed to characterize the EDW. We also compared EDW dose profiles of measured values using chamber array 24 (CA24) with calculated values using radiation treatment planning system. PDDs of EDW showed good agreements between $0.2\~0.5\%$ of open beam, but $2\%$ differences with MTW. In the result of the measurements of peripheral dose, it was shown that MTW was about $1\%$ higher than open field and EDW. The surface doses of $60^{\circ}$ MTW showed 10% lower than the others. We found that effective wedge factor of EDW had linear relationships according to Y jaw sizes and was independent of X jaw sizes and was independent of X jaw sizes and asymmetric Y jaw opening. In comparison with measured values and calculate values from Golden-STT based radiation treatment planning system (RTP system), it showed very good agreement within difference of $1\%$. It could be concluded that EDW is a very reliable and useful tool as a beam modification substitute for conventional MTW.

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