• The Journal of Korea Assosiation for Disability and Oral Health
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• v.10 no.1
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• pp.38-42
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• 2014

A tracheostomy tube serves as airway management for patients whose respiration is impeded due to inflammation, tumor, or traumatic events. If the patients who have tracheostomy tube, visit dental clinic for dental treatments, we should consider the underlying general condition of patients and then make treatment plans according to their state. A 22-Year old male patient, who had tracheostomy tube on his neck, came to our department for comprehensive dental treatment. Mild mental retardation was observed and he was taking anti-convulsant drugs for the prevention of epileptic seizure. Multiple advanced dental caries, hopeless teeth, and impacted third molars were also observed by clinical and radiographic examination. Due to the risk of epileptic seizure and low cooperativity to tolerate the treatment, general anesthesia was recommended by physician, and the anti-convulsant drug was administrated during procedure. In this case, we aimed to report the multidisciplinary approach for the dental treatment of patient having a tracheostomy tube.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.1
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• pp.319-323
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• 2012

Objective: To explore the feasibility of shrinking field technique after 40 Gy radiation through 18F-FDG PET/CT during treatment for patients with stage III non-small cell lung cancer (NSCLC). Methods: In 66 consecutive patients with local-advanced NSCLC, 18F-FDG PET/CT scanning was performed prior to treatment and repeated after 40 Gy. Conventionally fractionated IMRT or CRT plans to a median total dose of 66Gy (range, 60-78Gy) were generated. The target volumes were delineated in composite images of CT and PET. Plan 1 was designed for 40 Gy to the initial planning target volume (PTV) with a subsequent 20-28 Gy-boost to the shrunken PTV. Plan 2 was delivering the same dose to the initial PTV without shrinking field. Accumulated doses of normal tissues were calculated using deformable image registration during the treatment course. Results: The median GTV and PTV reduction were 35% and 30% after 40 Gy treatment. Target volume reduction was correlated with chemotherapy and sex. In plan 2, delivering the same dose to the initial PTV could have only been achieved in 10 (15.2%) patients. Significant differences (p<0.05) were observed regarding doses to the lung, spinal cord, esophagus and heart. Conclusions: Radiotherapy adaptive to tumor shrinkage determined by repeated 18F-FDG PET/CT after 40 Gy during treatment course might be feasible to spare more normal tissues, and has the potential to allow dose escalation and increased local control.

• Progress in Medical Physics
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• v.30 no.4
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• pp.104-111
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• 2019

Purpose: Online magnetic resonance-guided adaptive radiotherapy (MRgART), an emerging technique, is used to address the change in anatomical structures, such as treatment target region, during the treatment period. However, the electron density map used for dose calculation differs from that for daily treatment, owing to the variation in organ location and, notably, air pockets. In this study, we evaluate the dosimetric effect of electron density override on air pockets during online ART for pancreatic cancer cases. Methods: Five pancreatic cancer patients, who were treated with MRgART at the Seoul National University Hospital, were enrolled in the study. Intensity modulated radiation therapy plans were generated for each patient with 60Co beams on a ViewrayTM system, with a 45 Gy prescription dose for stereotactic body radiation therapy. During the treatment, the electron density map was modified based on the daily MR image. We recalculated the dose distribution on the plan, and the dosimetric parameters were obtained from the dose volume histograms of the planning target volume (PTV) and organs at risk. Results: The average dose difference in the PTV was 0.86Gy, and the observed difference at the maximum dose was up to 2.07 Gy. The variation in air pockets during treatment resulted in an under- or overdose in the PTV. Conclusions: We recommend the re-contouring of the air pockets to deliver an accurate radiation dose to the target in MRgART, even though it is a time-consuming method.

• Journal of Radiation Protection and Research
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• v.40 no.3
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• pp.147-154
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• 2015

The scatter photons and photoneutrons from high energy photon beams (more than 10 MV) will increase the undesired dose to the patient and the staff working in linear accelerator room. This undesired dose which is found at out-of-field area can increase the probability of secondary malignancy. The purpose of this study is to determine the equivalent dose of scatter photons and neutrons generated by 3 different treatment techniques: 3D-conformal, intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT). The measurement was performed using two types of the optically stimulation luminescence detectors (OSL and OSLN) in the Alderson Rando phantom that was irradiated by 3 different treatment techniques following the actual prostate cancer treatment plans. The scatter photon and neutron equivalent dose were compared among the 3 treatments techniques at the surface in the out-of-field area and the critical organs. Maximum equivalent dose of scatter photons and neutrons was found when using the IMRT technique. The scatter neutrons showed average equivalent doses of 0.26, 0.63 and $0.31mSv{\cdot}Gy^{-1}$ at abdominal surface region which was 20 cm from isocenter for 3D, IMRT and VMAT, respectively. The scattered photons equivalent doses were 6.94, 10.17 and $6.56mSv{\cdot}Gy^{-1}$ for 3D, IMRT and VMAT, respectively. For the 5 organ dose measurements, the scattered neutron and photon equivalent doses in out of field from the IMRT plan were highest. The result revealed that the scatter equivalent doses for neutron and photon were higher for IMRT. So the suitable treatment techniques should be selected to benefit the patient and the treatment room staff.

• The Journal of Korean Medicine
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• v.38 no.3
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• pp.73-85
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• 2017

Objectives: The purpose of this study was to investigate the status of Korean medicine treatment, and to analyze problems and demands to provide basic data on Korean medicine in military medical services. Methods: This survey was completed by 30 volunteer Korean medicine military doctors on service via a web-based questionnaire system. The questionnaire was developed through in-depth interviews with Korean medicine military doctors and consisted of general information on the subject, overall characteristics of the medical environment, current status of Korean medicine care in each workplace, problems and needs, and related clinical evidence and education. Results: Korean medicine military doctors administered acupuncture treatment most frequently in clinical practice. The most common complaints were related to musculoskeletal diseases, which accounted for 86.5% of all diseases, including those of the respiratory, digestive, and nervous systems. Most of the problems in Korean medicine care were pointed out as being due to a lack of awareness of Korean medicine in the military. Many doctors were aware that it is necessary to establish clinical evidence for Korean medicine in the military, and were also positive about the possibility of performing clinical research in the military, but the experience of actual participation in clinical research or related education was uncommon. Conclusions: Korean medicine military treatment differs from private medical care due to the specificity of each workplace and the military medical system. In the future, it will be necessary to establish an appropriate Korean medicine treatment model in the military suitable for these characteristics and strategic plans for clinical evidence.

• Progress in Medical Physics
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• v.32 no.3
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• pp.59-69
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• 2021

Purpose: The relationship between computed tomography (CT) number and electron density (ED) has been investigated in previous studies. However, the role of these measures for guiding cancer treatment remains unclear. Methods: The CT number was plotted against ED for different imaging protocols. The CT number was imported into ED tables for the Pinnacle treatment planning system (TPS) and was used to determine the effect on dose calculations. Conversion tables for radiation dose calculations were generated and subsequently monitored using a dosimeter to determine the effect of different CT scanning protocols and treatment sites. These tables were used to retrospectively recalculate the radiation therapy plans for 41 patients after an incorrect scanning protocol was inadvertently used. The gamma index was further used to assess the dose distribution, percentage dose difference (DD), and distance-to-agreement (DTA). Results: For densities <1.1 g/cm³, the standard deviation of the CT number was ±0.6% and the greatest variation was noted for brain protocol conditions. For densities >1.1 g/cm³, the standard deviation of the CT number was ±21.2% and the greatest variation occurred for the tube voltage and head and neck (H&N) protocol conditions. These findings suggest that the factors most affecting the CT number are the tube voltage and treatment site (brain and H&N). Gamma index analyses for the 41 retrospective clinical cases, as well as brain metastases and H&N tumors, showed gamma passing rates >90% and <90% for the passing criterion of 2%/2 and 1%/1 mm, respectively. Conclusions: The CT protocol should be carefully decided for TPS. The correct protocol should be used for the corresponding TPS based on the treatment site because this especially affects the dose distribution for brain metastases and H&N tumor recognition. Such steps could help reduce systematic errors.

• Progress in Medical Physics
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• v.31 no.3
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• pp.54-62
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• 2020

Dose calculation algorithms play an important role in radiation therapy and are even the basis for optimizing treatment plans, an important feature in the development of complex treatment technologies such as intensity-modulated radiation therapy. We reviewed the past and current status of dose calculation algorithms used in the treatment planning system for radiation therapy. The radiation-calculating dose calculation algorithm can be broadly classified into three main groups based on the mechanisms used: (1) factor-based, (2) model-based, and (3) principle-based. Factor-based algorithms are a type of empirical dose calculation that interpolates or extrapolates the dose in some basic measurements. Model-based algorithms, represented by the pencil beam convolution, analytical anisotropic, and collapse cone convolution algorithms, use a simplified physical process by using a convolution equation that convolutes the primary photon energy fluence with a kernel. Model-based algorithms allowing side scattering when beams are transmitted to the heterogeneous media provide more precise dose calculation results than correction-based algorithms. Principle-based algorithms, represented by Monte Carlo dose calculations, simulate all real physical processes involving beam particles during transportation; therefore, dose calculations are accurate but time consuming. For approximately 70 years, through the development of dose calculation algorithms and computing technology, the accuracy of dose calculation seems close to our clinical needs. Next-generation dose calculation algorithms are expected to include biologically equivalent doses or biologically effective doses, and doctors expect to be able to use them to improve the quality of treatment in the near future.

• Journal of Convergence for Information Technology
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• v.11 no.7
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• pp.172-180
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• 2021

This study was carried out to provide basic data for improving oral health management plans by identifying the actual conditions of dental treatment use and criteria for selecting dental medical institutions for foreign students. The survey method was a survey of 145 foreign students at S University, and the collected data was conducted with the SPSS 24.0 program. As a result of the analysis, dental caries treatment was the most common among all nationalities in the dental experience. When the oral health education program was important, the will to use dental treatment in the future was positive. Therefore, in the future, it is required to revitalize oral health education programs and provide health care information for foreign students.

• Journal of The Korea Institute of Healthcare Architecture
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• v.26 no.4
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• pp.7-14
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• 2020

Purpose: The purpose of this study is to provide basic information for the establishment of a Heavy Ion Therapy center by analyzing the cases of Heavy Ion Therapy devices, introducing the equipment and space composition of Heavy Ion Therapy equipments. Methods: This study is carried out by study the Heavy Ion Therapy, by figure out status of the installation of treatment centers around the world and by analyze the composition of Heavy Ion Therapy equipments and spaces through case studies. Results: The results of this study, which investigated the treatment of Heavy Ion Therapy and analyzed the plans of the five Heavy Ion Therapy centers, are summarized as follows. 1) Heavy Ion equipment requires a significant floor area. Vertical as well, many cross-sectional areas need to be secured for the construction of a delivery system. The Heavy Ion Therapy device should be built as a shielded wall because of the radiation leaking. Therefore, it is necessary to consist of a independent treatment center. 2) The size of Heavy Ion devices is getting smaller. Linac can be put into syncrotron. and the size of syncrotron, delivery system, and rotating-gantry is getting smaller. 3) Japan is often installed for treatment, and control rooms are integrated, while Europe has secured research space and each control room is separated. Implications: People are not familiar with the Heavy Ion Therapy. And the effectiveness of the treatment is not well promoted yet. Hopefully, more attention will be paid to the research involved in the Heavy Ion Therapy.

• Journal of the Korean Burn Society
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• v.23 no.2
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• pp.42-53
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• 2020

Purpose: It is important to consider both clinical factors and epidemiological factors in treating burn patients in emergency rooms. However, many emergency medical staffs happen to miss their chances of treating burns based on these considerations. This study is designed to find a better treatment for burn patients in emergency rooms along this approach. Methods: This study was conducted based on the data of the burn patients visiting the emergency room of a single general hospital from January 2015 to December 2019. The epidemiological and clinical factors were extracted out of the data, then the relationship between the prognosis and these factors were analyzed. Results: Most of burn accidents occurred at home, and were caused by hot water, soup, drinks, oil, etc. Especially, flame burns showed high hospitalization rate, surgical rate and mortality. In addition, their prognosis was poor when the affected area included facial, limb and perineal areas etc., or any inhalation burn co-existed. Also, the hospitalization rate and period increased when the treatment time was delayed or the pre-treatment was taken. There was a strong relationship between prognosis and the period of follow-up when patients were admitted during the period. Conclusion: It is difficult for medical staffs to evaluate prognosis of burns in emergency rooms due to progressive damages. Precise treatment and disposition are essential for patients' good prognosis. Therefore, medical staffs should establish treatment plans by identifying the patient's epidemiological and clinical factors, rather than giving prescriptions based on fragmentary and superficial symptoms.