• 제목/요약/키워드: treatment target

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The Effect of Behavior Modification on Enhancing Patient Adherence to Tuberculosis Treatment Regimens (Video프로그램을 통한 환자교육이 결핵환자 치료이행행위에 미치는 영향)

  • 정은리
    • Journal of Korean Academy of Nursing
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    • v.26 no.3
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    • pp.697-708
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    • 1996
  • Most efforts to improve tuberculosis treatment adherence target the patient and his or her behavior. This study examined the effects of behavioral modification training for these patients. Based on Bandura's behavioral principles of modeling, intervention strategies using a video program were devised to elicit specific patient target behaviors considered to improve patients' adherence to tuberculosis treatment regimens. A random assignment, two-group(experimental group and control group) research design including 81 subjects was used. The main outcomes measured were pill taking measured with the Medication Event Monitoring System(MEMS) Medication Cap, patients' self-efficacy, and their knowledge of tuberculosis. The findings are as follows : 1) There was a significant difference between the experimental group and the control group in patients' feelings of self-efficacy. That is, the patients who received the behavior modification program showed greater feeling of self-efficacy to initiate and change their behavior for the tuberculosis treatment regimen than the patients who did not receive the program(t=3.51, p=0.01). 2) There was a significant difference between the experimental group and the control group in patients' knowledge of tuberculosis. That is, the patients who received the behavior modification program showed higher level of knowledge of tuberculosis than the patients who did not receive the program(t=2.15, p=0.03) 3) There was a significant difference between the experimental group and the control group in patients' adherence to tuberculosis treatment regimens. That is, the patients who received the behavior modification program showed greater adherence to the treatment regimens than the patients who did not receive the program(t=5.11, p=0.00). The study findings provided useful insights into nursing practice, particularly in planning intervention strategies aimed at enhancing patients' adherence in tuberculosis that may also be relevant to other chronic diseases with patient adherence problems.

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Clinical Implementation of an In vivo Dose Verification System Based on a Transit Dose Calculation Tool for 3D-CRT

  • Jeong, Seonghoon;Yoon, Myonggeun;Chung, Weon Kuu;Chung, Mijoo;Kim, Dong Wook
    • Journal of the Korean Physical Society
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    • v.73 no.10
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    • pp.1571-1576
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    • 2018
  • We developed and evaluated an algorithm to calculate the target radiation dose in cancer patients by measuring the transmitted dose during 3D conformal radiation treatment (3D-CRT) treatment. The patient target doses were calculated from the transit dose, which was measured using a glass dosimeter positioned 150 cm from the source. The accuracy of the transit dose algorithm was evaluated using a solid water phantom for five patient treatment plans. We performed transit dose-based patient dose verification during the actual treatment of 34 patients who underwent 3D-CRT. These included 17 patients with breast cancer, 11 with pelvic cancer, and 6 with other cancers. In the solid water phantom study, the difference between the transit dosimetry algorithm with the treatment planning system (TPS) and the measurement was $-0.10{\pm}1.93%$. In the clinical study, this difference was $0.94{\pm}4.13%$ for the patients with 17 breast cancers, $-0.11{\pm}3.50%$ for the eight with rectal cancer, $0.51{\pm}5.10%$ for the four with bone cancer, and $0.91{\pm}3.69%$ for the other five. These results suggest that transit-dosimetry-based in-room patient dose verification is a useful application for 3D-CRT. We expect that this technique will be widely applicable for patient safety in the treatment room through improvements in the transit dosimetry algorithm for complicated treatment techniques (including intensity modulated radiation therapy (IMRT) or volumetric modulated arc therapy (VMAT).

Precision evaluation of the treatment that used coordinates confirmation of couch in case of two forgets adjoined. (Couch의 좌표 확인을 이용한 치료 위치 이동의 정확성 평가)

  • Seo Jeong-min;Jeong Cheon-young;Park Young-hwan;Song Ki-won
    • The Journal of Korean Society for Radiation Therapy
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    • v.15 no.1
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    • pp.35-40
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    • 2003
  • I. Purpose Confirming an error to be able to break out in a method to move couch manually while operator sees the skin marks on patient in case of curing head who got 2 targets adjoined, so we analyze coordinates price of couch, evaluate reproducibility and precision of change movements between targets. II. Materials and Methods In radiotherapy, for confirming errors in manual movements by operators by exchanging between two targets to treat patient head, we read coordinates price(vertical, longitudinal, lateral three directions of couch) shown on a monitor of LINAC( CL 2100, Varian, USA) in order to evaluate accuracy about the length that moved in time for moving couch manually. After reading movement length of coordinates recorded in three directions of all treatment, we compared distance between targets recorded in RTP(Pinnacle, ADAC, USA) with reading coordinates price of couch, setting actually done the same patient for ten times, coordinates were recorded, treated for evaluating averages and degrees of errors and standard deviations. III. Results In method to confirm skin marks of patient by operators' view and to move couch manually, average standard deviations of movements between two targets are vertical 1.4mm, longitudinal 0.9mm, lateral 2.2mm in each direction. As for the error in straight dimension, it is about 3.6mm averages and 5.1mm maximum. The average of errors in each directions was vertical 1mm, longitudinal 0.7mm, lateral 2.7mm. The greatest error broke out in lateral direction with $25\%$ of all cases ; to exceed an error average. IV. Conclusions If operators moved manually couch for changing target points, errors about 3.6mm average degrees occur. It is important that operators confirm the errors prices of actual couch coordinates for asking a correct movement between the targets adjoined each other ; in case of treatment demanding high precision like 3D conformal therapy or IMRT. Therefore, if we apply couch coordinates confirmation to reproducibility and to precision evaluation of treatment, it's expected that we can execute high-quality radiotherapy.

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Dosimetric Comparison of One Arc & Two Arc VMAT Plan for Prostate cancer patients (Prostate Cancer 환자에 대한 One Arc와 Two Arc VMAT Plan의 선량 측정 비교 분석)

  • Kim, Byoung Chan;Kim, Jong Deok;Kim, Hyo Jung;Park, Ho Chun;Baek, Jeong Ok
    • The Journal of Korean Society for Radiation Therapy
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    • v.30 no.1_2
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    • pp.107-116
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    • 2018
  • Purpose : Intensity-modulated radiation therapy(IMRT) has been widely used for radiation therapy of Prostate Cancer because it can reduce radiation adverse effects on normal tissues and deliver more dose to the Prostate than 3D radiation therapy. Volumetric modulated arc therapy(VMAT) has been widely used due to recent advances in equipment and treatment techniques. VMAT can reduce treatment time by up to 55 % compared to IMRT, minimizing motion error during treatment. Materials and Methods : In this study, compared the MU and DVH values of 10 patients with prostate cancer by classifying them into 4 groups with 5 LN-Prostate groups and 5 Only-Prostate. And DQA measurements were performed using ArcCHECK and MapCHECK. Results : The results of Target and OAR dose distribution of Prostate patients are as follows. $D_{max}$ was in the range of 100~110 % in 4 groups, and more than 110 % of hot spot was not seen. Only-Prostate ($P_1$, $P_2$) without LN had a satisfactory dose distribution for the target dose, but slightly better for 2 arc plan($P_2$) than 1 arc plan($P_1$). The target dose $D_{98%}$ distribution in the LN-Prostate ($P_{L1}$, $P_{L2}$) group showed better 2 arc plan($P_{L2}$) than 1 arc plan($P_{L1}$), But in the case of 1 arc plan($P_{L1}$), the target dose $D_{98%}$ value was not enough. In OAR, the dose distribution of 1 Arc($P_1$) Plan and 2 Arc($P_2$) Plan in the Only-Prostate ($P_1$, $P_2$) Group satisfied the prescribed dose value. But, The dose distribution of 1 arc($P_1$) was slightly higher. In LN-Prostate OAR, 1 Arc($P_{L1}$) Plan showed higher dose than the prescribed dose. The Gamma evaluation pass rate of ArcCHECK and MapCHECK calculated from the DQA measurements was slightly higher than 99 % and the mean error range of the point dose measurements using the CC04 ion chamber was less than 1 %. Conclusion : In this study, Only-Prostate ($P_1$, $P_2$) group, the dose of 2 Arc plan was better. However, considering the treatment time and MU value, 1 Arc treatment method was more suitable. In the LN-Prostate ($P_{L1}$, $P_{L2}$) group, 2 Arc($P_{L2}$) treatment method showed better results and satisfied with Target $D_{98%}$ and OAR prescription dose.

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Dosimetric Comparison between Intensity Modulated Radiotherapy and 3 Dimensional Conformal Radiotherapy in the Treatment of Rectal Cancer

  • Simson, David K;Mitra, Swarupa;Ahlawat, Parveen;Sharma, Manoj Kumar;Yadav, Girigesh;Mishra, Manindra Bhushan
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.11
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    • pp.4935-4937
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    • 2016
  • Objective: To compare dosimetric parameters of 3 dimensional conformal radiotherapy (3 DCRT) and intensity modulated radiotherapy (IMRT) in terms of target coverage and doses to organs at risk (OAR) in the management of rectal carcinoma. Methods: In this prospective study, conducted between August 2014 and March 2016, all patients underwent CT simulation along with a bladder protocol and target contouring according to the Radiation Therapy Oncology Group (RTOG) guidelines. Two plans were made for each patient (3 DCRT and IMRT) for comparison of target coverage and OAR. Result: A total of 43 patients were recruited into this study. While there were no significant differences in mean Planning Target Volume (PTV) D95% and mean PTV D98% between 3 DCRT and IMRT, mean PTV D2% and mean PTV D50% were significantly higher in 3 DCRT plans. Compared to IMRT, 3 DCRT resulted in significantly higher volumes of hot spots, lower volumes of cold spots, and higher doses to the entire OAR. Conclusion: This study demonstrated that IMRT achieves superior normal tissue avoidance (bladder and bowel) compared to 3 DCRT, with comparable target dose coverage.

Pharmacologic Treatment of Essential Hypertension (고혈압의 약물 치료)

  • Shim, B.S.
    • Journal of Yeungnam Medical Science
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    • v.6 no.2
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    • pp.1-11
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    • 1989
  • 고혈압의 치료 목적은 부작용없이 지속적으로 혈압을 정상으로 유지하여 target organ의 손상을 막고 수명을 연장시키는데 있다. 이러한 목적을 달성하기 위하여 특히 약제 선택이 아주 중요하며 Stepped care approach와 Individualized approach을 동시에 이용하면 좋은 효과를 얻을 것으로 기대된다.

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Optimal Localization through DSA Distortion Correction for SRS

  • Shin, Dong-Hoon;Suh, Tae-Suk;Huh, Soon-Nyung;Son, Byung-Chul;Lee, Hyung-Koo;Choe, Bo-Young;Shinn, Kyung-Sub
    • Progress in Medical Physics
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    • v.11 no.1
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    • pp.39-47
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    • 2000
  • In Stereotactic Radiosurgery (SRS), there are three imaging methods of target localization, such as digital subtraction Angiography (DSA), computed tomography (CT), magnetic resonance imaging (MRI). Especially, DSA and MR images have a distortion effect generated by each modality. In this research, image properties of DSA were studied. A first essential condition in SRS is an accurate information of target locations, since high dose used to treat a patient may give a complication on critical organ and normal tissue. Hut previous localization program did not consider distortion effect which was caused by image intensifier (II) of DSA. A neurosurgeon could not have an accurate information of target locations to operate a patient. In this research, through distortion correction, we tried to calculate accurate target locations. We made a grid phantom to correct distortion, and a target phantom to evaluate localization algorithm. The grid phantom was set on the front of II, and DSA images were obtained. Distortion correction methods consist of two parts: 1. Bilinear transform for geometrical correction and bilinear interpolation for gray level correction. 2. Automatic detection method for calculating locations of grid crosses, fiducial markers, and target balls. Distortion was corrected by applying bilinear transform and bilinear interpolation to anterior-posterior and left-right image, and locations of target and fiducial markers were calculated by the program developed in this study. Localization errors were estimated by comparing target locations calculated in DSA images with absolute locations of target phantom. In the result, the error in average with and without distortion correction is $\pm$0.34 mm and $\pm$0.41 mm respectively. In conclusion, it could be verified that our localization algorithm has an improved accuracy and acceptability to patient treatment.

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Optimization of Surface Treatment System for Concrete Structures to Control Chloride Penetration (콘크리트 구조물용 표면도장공법의 차염성능의 최적화에 대한 연구)

  • Lee Chang-Soo;Sung Jae-Duk;Yoon In-Seok
    • Proceedings of the Korea Concrete Institute Conference
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    • 2004.11a
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    • pp.233-236
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    • 2004
  • The purpose of this paper is to evaluate performance on reducing the chloride diffusion of surface treatment systems with elapsed time, treatment thickness, treatment frequency, and the types of surface treatment - coating, penetrator, and both all. Based on this paper, the guideline to applicate surface treatment systems will be established and comprehended how effective the resistance of chloride diffusion is. The selection of surface treatment materials and thickness to acquire service life of target will be possible. It is also expected to select optimum surface treatment system groups to resist chloride diffusion effectively and to estimate increased service life as the effect of durability enhancement.

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Method of Establishing Two-Storied Forests in Natural Deciduous Forests by Stand Structure Adjustment in Pyeongchang Area (임분구조 조정에 의한 평창지역 천연 활엽수림의 이단림 조성 방안)

  • Sung, Joo Han;Lee, Young Geun;Park, Ko Eun;Shin, Man Yong
    • Journal of Korean Society of Forest Science
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    • v.104 no.3
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    • pp.427-433
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    • 2015
  • This study was conducted to provide a method of establishing two-storied forests by the adjustment of stand structures in natural deciduous forests of Pyeongchang area. Three permanent sampling plots of 0.09 ha were established in study site and some tree variables were measured in each sampling plot before the treatment of two-storied system. Stand attributes and stand structures before treatment were estimated based on the data measured in sampling plots. The results indicate that the current stand status is different from typical stand structures of two-storied forests. A simulation technique was applied to predict stand attributes and stand structures after the treatment of two-storied system. Results suggest that significant time is required to accomplish target stand structures even after applying the treatment of two-storied system. Number of trees in the upper canopy class after treatment was predicted to be 170 trees/ha, which adequately meets the target of two-storied forests. It was predicted, however, that the lower canopy class trees has much less trees compared with the typical stand structures of two-storied forests. This problem could be solved with ingrowth of infant trees over time or by under-planting of tolerant species. It is confirmed that the target growing stock volumes of the upper canopy class should be approximately $150m^3/ha$ considering stand status after treatment. It is predicted that twenty years of conversion period is required to accomplish this goal. The changes in stand structures over time should be assessed based on stand inventory carried out every five years, and additional treatments for inducing two-storied forests should be applied if necessary.

Overview of Helicobacter pylori and Treatment Options (헬리코박터 파일로리(Helicobacter pylori) 감염 및 치료법 개요)

  • Song, Young Goo
    • Economic and Environmental Geology
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    • v.48 no.3
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    • pp.241-246
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    • 2015
  • Helicobacter pylori is an important transmissible human pathogen found on the luminal surface of the gastric epithelium. The organism can persist in the stomach indefinitely and causes gastroduodenal inflammation that may proceed to atrophic gastritis, peptic ulcer, gastric MALT lymphoma, and gastric cancer. Standard triple therapy which consists of proton pump inhibitor (PPI) plus two antibiotics (amoxicillin and clarithromycin) is now generally used in Korea, however, eradication rates of H. pylori has been decreasing due to increasing antibiotic resistance. In this review, current second-line treatment regimens, difficult problems on treatment, necessity of local target therapy, applicability of clay minerals as a drug delivery system (DDS), and a new therapeutic strategy and its study plans will be discussed.