Hepatoma is one of 3 most common malignancies in Korea, the survival rate is not improved since last decades because of delayed diagnosis and limited treatment conditions. Radiation was one of treatment options but the impact on the survival is not remarkable. High dose exposure to target area was suggested for improved effect but low tolerance dose of normal liver tissue is the main limited factor. IMRT is the advanced form of 3DCRT, for focusing high dose on target with minimal dose to surrounding normal tissues. Motion of the tumor by respiration, cardiac pulsation and peristalsis is the main treatment harrier of IMRT for treatment of hepatoma patients. Development of QA technique for acceptable geometrical uncertainties and dose error on target volume is essential for IMRT in clinical treatment but proper QA technique is not yet developed. This study compared the verification film dosimetry with measured dose in phantom and calculated dose in planning computer on exactly same conditions of patient treatments. Within 3% dose differences between 3 groups were confirmed. We suggest that our verification QA technique is easy, economic, iterative and acceptable in clinical application for advanced hepatoma patients.
Journal of The Korean Dental Society of Anesthesiology
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v.8
no.1
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pp.22-28
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2008
Background: Cerebral palsy (CP) is non-progressive disorder of motion and posture. In CP patient, there are difficulties in dental treatment because of uncontrolled movement of limb and head, and conjoined disabilities such as cognitive impairment, sensory loss, seizures, communication and behavioral disturbances. It is reported that CP patients have high incidence in caries and a higher prevalence of periodontal disease. But, despite the need for oro-dental care, these patients often are unlikely to receive adequate treatment without sedation or general anesthesia because of uncontrolled movements of the trunk or head. Methods: We reviewed the 58 cases of 56 patients with CP who underwent outpatient general anesthesia for dental treatment at the clinic for the disabled in Seoul National University Dental Hospital. Results: The mean age was 19 (2-54) years. The number of male patient was 40 and that of female was 18. They all had severe spastic cerebral palsy and 22 had sever mental retardation, 15 epilepsy, 8 organic brain disorder, 1 blindness, 2 deafness and cleft palate. For anesthesia induction, 14 cases was needed physical restriction who had sever mental retardation and cooperation difficulty, but 44 cases showed good or moderate cooperation. Drugs used for anesthesia induction were thiopental (37 cases), sevoflurane (14 cases), ketamine (3 cases ) and propofol (4 cases). All patients except one were done nasotracheal intubation for airway management and 4 cases were needed difficult airway management and 1 patient already had tracheostomy tube. Mean total anesthetic time was $174{\pm}56$ min and staying time at PACU was $88{\pm}39$ min. There was no death or long term hospitalization because of severe complications. Conclusion: If general anesthesia is needed, pertinent diagnostic tests and workup about anomaly, and appropriate anesthetic planning are essential for safety.
The Journal of the Convergence on Culture Technology
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v.7
no.4
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pp.791-800
/
2021
British housing types began with detached houses using wood based on early Germanic cultures, and gradually divided into multi-story houses such as terraces houses, with the influx of houses using stone from Latin cultures influenced by France. Today, various types of housing types such as detached houses, townhouses, and apartments are mixed, and their origins can be found in housing types that have continued from the past. Housing types existing in the UK continue their context through this historical development process, but housing types in the UK also have been combined with those of other cultures, leading to modern housing types. In this paper, we examine the process of the UK's peculiar development of housing types superimposed with the recurring motion to the traditional European urban structures prior to the industrial revolution during contemporary years, and perimeter block collective housings of today; then, we study the process of applying the UK case as a concept of practical design and planning in order to continuously consider Korea's modern urban structure and corresponding types of housing. Through this process, we explore the identity of the housing type in Korea, which is pursuing fundamental changes in residential culture beyond quantitative housing supply in the process of rapid urbanization.
The development of autonomous vehicles are currently being actively carried out by various companies and research institutes. Expectations for commercialization in daily life as well as specific industries are also rising. Simulators for autonomous vehicles are an essential element in algorithm development and execution considering stability and cost. In this need, various simulators and platforms for simulators are emerging, but research on simulations that reflect various meteorological environmental factors in the real world is still insufficient. This paper proposes a traffic simulation for autonomous vehicles that can consider the weather environment. The weather environment that can be set is largely classified into four categories, and an improved collision prevention algorithm to apply them is presented. Simulation development was conducted through Carla's Python API, a development tool for autonomous driving, and the performance results were compared with existing collision algorithms. Through this, we tried to propose improvements for the development of advanced self-driving vehicle simulations that can reflect various weather environmental factors in real life.
Keum Ki Chang;Lee Sang-wook;Shin Hyun Soo;Kim Gwi Eon;Sung Jinsil Seong;Lee Chang Geol;Chu Sung Sil;Chang Sei-Kyung;Suh Chang Ok
Radiation Oncology Journal
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v.18
no.2
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pp.107-113
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2000
Purpose : The goal of this study 닌as to improve the accuracy of three-dimensional conformal radiotherapy (3-D CRT) by measuring the treatment setup error and physiological movement of liver based on the analysis of images which were obtained by electronic portal imaging device (EPID). Materials and Methods : For 10 patients with hepatocellular carcinoma, 4-7 portal images were obtained by using EPID during the radiotherapy from each patient daiiy. We analyzed the setup error and physiological movement of liver based on the verification data. We also determined the safety margin of the tumor in 3-D CRT through the analysis of physiological movement. Results : The setup errors were measured as 3mm with standard deviation 1.70 mm in x direction and 3.7 mm with standard deviation 1.88 mm in y direction respectively. Hence, deviation were smaller than 5mm from the center of each axis. The measured range of liver movement due to the physiological motion was 8.63 mm on the average. Considering the motion of liver and setup error, the safety margin of tumor was at least 15 mm. Conclusion : EPID is a very useful device for the determination of the optimal margin of the tumor, and thus enhance the accuracy and stability of the 3-D CRT in patients with hepatocellular carcinoma.
This research aims to provide the characteristics of the world's first active lidar sensor Atmospheric Laser Doppler Instrument (ALADIN) wind data and Geostationary Korea Multi Purpose Satellite 2A (GK2A) Atmospheric Motion Vector (AMV) data by comparing two wind data. As a result of comparing the data from September 2019 to August 1, 2020, The total number of collocated data for the AMV (using IR channel) and Mie channel ALADIN data is 177,681 which gives the Root Mean Square Error (RMSE) of 3.73 m/s and the correlation coefficient is 0.98. For a more detailed analysis, Comparison result considering altitude and latitude, the Normalized Root Mean Squared Error (NRMSE) is 0.2-0.3 at most latitude bands. However, the upper and middle layers in the lower latitudes and the lower layer in the southern hemispheric are larger than 0.4 at specific latitudes. These results are the same for the water vapor channel and the visible channel regardless of the season, and the channel-specific and seasonal characteristics do not appear prominently. Furthermore, as a result of analyzing the distribution of clouds in the latitude band with a large difference between the two wind data, Cirrus or cumulus clouds, which can lower the accuracy of height assignment of AMV, are distributed more than at other latitude bands. Accordingly, it is suggested that ALADIN wind data in the southern hemisphere and low latitude band, where the error of the AMV is large, can have a positive effect on the numerical forecast model.
Purpose: The least constrained prosthesis is generally recommended in primary total knee arthroplasty (TKA). Nevertheless, a varus/valgus constrained (VVC) prosthesis should be implanted when a semi-constrained prosthesis is not good for adequate stability, especially in the coronal plane. In domestic situations, however, the VVC prosthesis could not always be prepared for every primary TKA case. Therefore, it is sometimes impractical to use a VVC prosthesis for unsual unstable situations. This study provides information for preparing VVC prostheses in the preoperative planning of primary TKA through an analysis of primary VVC TKA cases. Materials and Methods: This study reviewed 1,797 primary TKAs, performed between May 2003 and February 2016. The reasons for requiring VVC prosthesis and the preoperative conditions in 29 TKAs that underwent primary TKA with a VVC prosthesis were analyzed retrospectively. Results: In primary TKA, 29 cases (1.6%) in 27 patients (6 male and 21 female) used VVC prosthesis. Two patients underwent a VVC prosthesis on both knees. The mean age of the patients was 63.4 years old (34-79 years). The mean flexion contracture was 16.2° (-20°-90°), and the mean angle of great flexion was 111.7° (35°-145°). The situations requiring a VVC prosthesis were severe valgus deformity in 10 knees, knee stiffness requiring extensive soft tissue release in 10 knees, previously injured collateral ligaments in five knees, and distal femoral bone defect due to avascular necrosis in four knees. The mean tibiofemoral angle was 25.7° (21°-43°) in 10 cases with a valgus deformity. The mean flexion contracture was 37.5° (20°-90°), and the mean range of motion was 48.5° (10°-70°) in 10 cases with knee stiffness. Conclusion: The preparation of VVC prosthesis is recommended, even for primary TKA in cases of severe valgus deformity (tibiofemoral angle>20°), stiff knee (the range of motion: less than 70° with more than 20° flexion contracture), and the cases with a previous collateral ligament injury. This information will help in the preparation of adequate TKA prostheses for unusual unstable situations.
The application of a respiratory gated radiotherpy method to the lung radiation surgery was evaluated compared with the conventional method in which the whole tumor motion range is considered in the delineation of PTV (Planning target volume). The four dimensional CT simulation images were acquired for the five NSCLC (Non-small cell lung cancer) patients for radiation surgery. The respiratory gated plan was prepared with the 50% phase CT images and the conventional method was planned based on the ITV (Internal target volume) which include all the target volumes created in each phase CT images within a whole respiratory period. The DVH (Dose volume histogram) of OAR (Organ at risk) which calculated in each method was compared for the evaluation of the plan properness. The relative decrease of OARs' DVH were verified in the application of respiratory gated method. The average decrease rate were $16.88{\pm}9.97%$ in the bronchus, $34.13{\pm}19.15%$ in the spinal cord, $28.42{\pm}18.49%$ in the chest wall and $32.48{\pm}16.66%$ in the lung. Based on these results, we can verified the applicability and the effectiveness of the respiratory gated method in the lung radiation surgery.
Kim, Woo-Cheol;Chung, Eun-Ji;Lee, Chang-Geol;Chu, Sung-Sil;Kim, Gwi-Eon
Radiation Oncology Journal
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v.14
no.1
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pp.69-76
/
1996
Purpose : The aim of this study is to investigate the random and systematic errors and tumor movement using electronic portal imaging device in lung cancer patients for the adequate margin in the treatment planning of 3-dimensional conformal therapy. Material and Methods : The electronic portal imaging device is matrix ion chamber type(Portal Vision, Varian). Ten patients of lung cancer treated with chest irradiation were selected for this study. Patients were treated in the supine position without immobilization device. All treatments were delivered by an 10 MV linear accelerator that had the portal imaging system mounted to its ganrty. AP or PA field Portal images were only analyzed. Radiation therapy field included the tumor, mediastinum and supraclavicular lymph nodes. A total of 103 portal images were analyzed for set-up deviation and 10 multiple images were analyzed for tumor movement because of respiration and cardiac motion. Result : The average values of setup displacements in the x, y direction was 1.41 mm, 1 78 mm, respectively. The standard deviation of systematic component was 4.63 mm, 4.11 mm along the x, y axis, respectively while the random component was 4.17 mm in the x direction and 3.31 mm in the y direction. The average displacement from respiratory movement was 12.2 mm with a standard deviation of 4.03 mm. Conclusion : The overall set-up displacement includes both random and systematic component and respiratory movement. About 10 mm, 25 mm margins along x, y axis which considered the set-up displacement and tumor movement were required for initial 3-dimensional conformal treatment planning in the lung cancer patients and portal images should be made and analyzed during first week of treatment, individually.
Lee, Soon Sung;Choi, Sang Hyoun;Min, Chul Kee;Kim, Woo Chul;Ji, Young Hoon;Park, Seungwoo;Jung, Haijo;Kim, Mi-Sook;Yoo, Hyung Jun;Kim, Kum Bae
Progress in Medical Physics
/
v.26
no.3
/
pp.168-177
/
2015
For evaluating the treatment planning accurately, the quality assurance for treatment planning is recommended when patients were treated with IMRT which is complex and delicate. To realize this purpose, treatment plan quality assurance software can be used to verify the delivered dose accurately before and after of treatment. The purpose of this study is to evaluate the accuracy of treatment plan quality assurance software for each IMRT plan according to MLC DLG (dosimetric leaf gap). Novalis Tx with a built-in HD120 MLC was used in this study to acquire the MLC dynalog file be imported in MobiusFx. To establish IMRT plan, Eclipse RTP system was used and target and organ structures (multi-target, mock prostate, mock head/neck, C-shape case) were contoured in I'mRT phantom. To verify the difference of dose distribution according to DLG, MLC dynalog files were imported to MobiusFx software and changed the DLG (0.5, 0.7, 1.0, 1.3, 1.6 mm) values in MobiusFx. For evaluation dose, dose distribution was evaluated by using 3D gamma index for the gamma criteria 3% and distance to agreement 3 mm, and the point dose was acquired by using the CC13 ionization chamber in isocenter of I'mRT phantom. In the result for point dose, the mock head/neck and multi-target had difference about 4% and 3% in DLG 0.5 and 0.7 mm respectively, and the other DLGs had difference less than 3%. The gamma index passing-rate of mock head/neck were below 81% for PTV and cord, and multi-target were below 30% for center and superior target in DLGs 0.5, 0.7 mm, however, inferior target of multi-target case and parotid of mock head/neck case had 100.0% passing rate in all DLGs. The point dose of mock prostate showed difference below 3.0% in all DLGs, however, the passing rate of PTV were below 95% in 0.5, 0.7 mm DLGs, and the other DLGs were above 98%. The rectum and bladder had 100.0% passing rate in all DLGs. As the difference of point dose in C-shape were 3~9% except for 1.3 mm DLG, the passing rate of PTV in 1.0 1.3 mm were 96.7, 93.0% respectively. However, passing rate of the other DLGs were below 86% and core was 100.0% passing rate in all DLGs. In this study, we verified that the accuracy of treatment planning QA system can be affected by DLG values. For precise quality assurance for treatment technique using the MLC motion like IMRT and VMAT, we should use appropriate DLG value in linear accelerator and RTP system.
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