• Journal of The Korean Dental Society of Anesthesiology
• /
• v.14 no.3
• /
• pp.167-172
• /
• 2014

Background: Propofol is the most commonly used anesthetic for sedation and target-controlled infusion (TCI) is useful for dental treatment. However, it is important to assess and maintain an adequate depth of sedation in patients with severe intellectual disabilities Therefore, in this study we aimed to evaluate the adequate propofol target concentration for dental treatment in severely intellectually disabled patients. Methods: We undertook retrospective review of the sedation records of severely intellectually disabled patients who underwent dental treatment under TCI propofol sedation from September 2011 to April 2012. We evaluated the initial target concentration, stabilized concentration of propofol and monitored vital signs, including BIS score using sedation records. Results: Total 20 patients (10 male and 10 female patients) were included in the study. Every participant was severely intellectually disabled. The mean sedation duration was $70{\pm}16$ (45-100) minutes. The initial propofol target concentration infusion amount was $2.7{\pm}0.45$ (2.0-3.0) mcg/ml. The propofol effect site concentration (Ce) was $2.6{\pm}0.7$ (1.0-4.0) mcg/ml. The average value of BIS was $52.6{\pm}13$ (28-81). During the treatment period, there were no severe complications. Conclusions: The average propofol Ce for deep sedation without any complications in intellectually disabled patients was 2.6 mcg/ml.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.19 no.4
• /
• pp.217-226
• /
• 2019

Background: We aimed to assess the dose needed to achieve the propofol effect-site concentration using target-controlled infusion in intellectually disabled patients and to detail the most effective method for achieving a safe level of consciousness without hemodynamic changes as well as detail any resulting adverse effects. Methods: We performed a retrospective review of sedation service records of 138 intellectually disabled patients (51, mental retardation; 36, autism; 30, brain lesion, 12 genetic diseases, 9 dementia) aged over 15 years and weighing over 30 kg. These patients had received propofol via target-controlled infusion in the special care dental clinic of Seoul National University Dental Hospital from May 2008 to September 2018 for restorative treatment (112), minor surgery (13), prosthodontics (7), periodontics treatment (5), and implant (1). Results: For all groups, the duration of dental treatments was $43{\pm}18$ minutes, total sedation time was $73{\pm}23$ minutes, and total BIS values was $57{\pm}12$. The propofol maintenance dosage values for each group were: mental retardation, $3{\pm}0.5(2-4){\mu}g/ml$; autism, $3.1{\pm}0.7(2-5){\mu}g/ml;$; brain lesion, $2.8{\pm}0.7(1.5-5){\mu}g/ml;$; genetic disease, $2.9{\pm}0.9(1-4){\mu}g/ml;$ and dementia $2.3{\pm}0.7(1-3.4){\mu}g/ml;$. Conclusions: The dementia group needed a lower dosage to reach a safe, effective propofol effect-site concentration than the other groups. Since there were no complications, deep sedation is a great alternative to general anesthesia for dental treatment of intellectually disabled patients.

• Journal of radiological science and technology
• /
• v.34 no.1
• /
• pp.51-58
• /
• 2011

The aim of the study is to analyze the dose delivery error depending on the depth variation according to target positions and arc trajectories by comparing the simulated treatment planning with the actual dose delivery in conformal arc therapy. We simulated the conformal arc treatment planning with the three target positions (center, 2.5 cm, and 5 cm in the phantom). For the experiments, IMRT body phantom (I’mRT Phantom, Wellhofer Dosimetry, Germany) was used for treatment planning with CT (Computed Tomography, Light speed 16, GE, USA). The simulated treatment plans were established by three different target positions using treatment planning system (Eclipse, ver. 6.5, VMS, Palo Alto, USA). The radiochromic film (Gafchromic EBT2, ISP, Wayne, USA) and dose analysis software (OmniPro-IMRT, ver. 1.4, Wellhofer Dosimetry, Germany) were used for the measurement of the planned arc delivery using 6 MV photon beam from linear accelerator (CL21EX, VMS, Palo Alto, USA). Gamma index (DD: 3%, DTA: 2 mm) histogram and dose profile were evaluated for a quantitative analysis. The dose distributions surrounded by targets were also compared with each plans and measurements by conformity index (CI), and homogeneity index (HI). The area covered by 100% isodose line was compared to the whole target area. The results for the 5 cm-shifted target plan show that 23.8%, 35.6%, and 37% for multiple conformal arc therapy (MCAT), single conformal arc therapy (SCAT), and multiple static beam therapy, respectively. In the 2.5 cm-shifted target plan, it was shown that 61%, 21.5%, and 14.2%, while in case of center-located target, 70.5%, 14.1%, and 36.3% for MCAT, SCAT, and multiple static beam therapy, respectively. The values were resulted by most superior in the MCAT, except the case of the 5 cm-shifted target. In the analysis of gamma index histogram, it was resulted of 37.1, 27.3, 29.2 in the SCAT, while 9.2, 8.4, 10.3 in the MCAT, for the target positions of center, shifted 2.5 cm and 5 cm, respectively. The fail proportions of the SCAT were 2.8 to 4 times as compared to those of the MCAT. In conclusion, dose delivery error could be occurred depending on the target positions and arc trajectories. Hence, if the target were located in the biased position, the accurate dose delivery could be performed through the optimization of depth according to arc trajectory.

• Journal of Environmental Health Sciences
• /
• v.27 no.2
• /
• pp.119-126
• /
• 2001

The key point in establishing water quality management measures is how to decide the load reduction for pollution sources. This study was performed to compare reduction methods for BOD loadings to achieve water quality standards at the end of the Yeongsan river. The target year is 2006 and 2011 and reduction methods are uniform treatment and treatment by influence rate. Using QUAL2E model, the study was performed under the conditions of establishing and non-establishing the publicly owned treatment works(POTWs). Uniform treatment which allocate the same reduction rate to pollution sources showed that all streams into the river should be applied for the reduction. However, treatment by influence rate which allocate the reduction rate by the order of influence rate showed that achieving target quality might be possible with a few streams for the reduction. But total amount of load reduction of streams was not significantly different from two methods.

• International journal of advanced smart convergence
• /
• v.11 no.4
• /
• pp.28-40
• /
• 2022

Although precise temperature control in the heat treatment process is a key factor in process reliability, there are many cases where there is no separate heat source control optimization system in the field. To solve this problem, the program monitors the temperature data according to the heat source change through sensor communication in a recursive method based on multiple variables that affect the process, and the target heat source value and the actual heat treatment heat source to match the internal air temperature and material temperature. A control optimization system was constructed. Through this study, the error rate between the target temperature and the atmosphere (material surface) temperature of around 10.7% with the existing heat source control method was improved to an improved result of around 0.1% using a process optimization algorithm and system.

• Progress in Medical Physics
• /
• v.1 no.1
• /
• pp.23-29
• /
• 1990

In order to explane the stereotactic procedure, the three steps of the procedure (target localization, dose planning, and radiation treatment) must be examined separately. The ultimate accuracy of the full procedure is dependent on each of these steps and on the consistancy of the approach The concern in this article was about dose planning, which is a important factor to the success of radiation treatment. The major factor in dose planning is a dosimetry system to evaluate the dose delivered to the target and normal tissues in the patient, while it generates an optimal dose distribution that will satisfy a set of clinical criteria for the patient. A three-dimensional treatment planning program is a prerequisite for treatment plan optimization. It must cover 3-D methods for representing the patient, the dose distributions, and beam settings. The major problems and possible modelings about 3-D factors and optimization technique were discussed to simplify and solve the problems associatied with 3-D optimization, with relative ease and efficiency. These modification can simplify the optimization problem while saving time, and can be used to develop reference dose planning system to prepare standard guideline for the selection of optimum beam parameters, such as the target position, collimator size, arc spacing, the variation in arc length and weight. The method yields good results which can then be simulated and tailored to the individual case. The procedure needed for dose planning in stereotactic radiosurgery is shown in figure 1.

• Journal of The Korean Dental Society of Anesthesiology
• /
• v.10 no.2
• /
• pp.209-213
• /
• 2010

Anxiety and fear is two main factors that keep patients from going to dental clinic. Especially, patients may feel implants operations are more traumatic. Intravenous conscious sedation for dental treatment can make patient comfortable and relaxable. Midazolam is more popular for sedation for dental treatment, but target-controlled infusion (TCI) of propofol and remifentanil is gaining wide popularity. A 54-year-old female patient who had severe dental phobia was referred to our dental hospital. She had past history of 2 times of hyperventilation and syncope during dental treatment. The patient showed a lot of dental anxiety and fear to dental treatments and stress reduction protocol was needed. We administered intravenous conscious sedation using target controlled infusion system with remifentanil and propofol. During sedation, we monitored the status of consciousness with bispectral index and vital signs. Dental treatment could be finished successfully without any problems.

• Korean Journal of Head & Neck Oncology
• /
• v.37 no.2
• /
• pp.11-17
• /
• 2021

Head and neck cancer is the 6^th most frequently diagnosed solid tumor in the world. Alcohol consumption, smoking, and HPV infection are associated with the incidence of head and neck squamous cell carcinoma (HNSCC). Although a multidisciplinary approach is a key strategy for the treatment of locally advanced HNSCC, systemic therapy is the mainstream of recurrent or metastatic HNSCC treatment. Stage IV HNSCC has a relatively poor prognosis with median overall survival of around one year. There have been many clinical trials to investigate the efficacy of target agents in the treatment of HNSCC. In the HPV-negative HNSCC, TP53 and CDKN2A are the most commonly mutated genes. In the HPV-positive HNSCC, the PI3K pathway is frequently altered. EGFR, PI3K, cell cycle pathway, MET, HRAS, and IL6/JAK/STAT pathway are explored targets in HNSCC. In this study, we review the target pathways and agents under research. We also introduce here umbrella trials of recurrent or metastatic HNSCC conducted by the Korea Cancer Study Group. The combination of target agents with immune checkpoint inhibitors or cytotoxic chemotherapies would be a future step in the precision medicine of HNSCC treatment.

• The Journal of Korean Society for Radiation Therapy
• /
• v.12 no.1
• /
• pp.20-25
• /
• 2000

The accuracy of the target localization was evaluated by conventional and spiral CT in stereotactic radiosurgerv. Conventional and spiral CT images were obtained with geometrical phantom, which was designed to produce exact three-dimensional coordinates of several objects within 0.1mm error range. Geometrical phantom was attached by BRW headframe, intermediate head ring, and CT localizer. Twentv-seven slices of conventional CT image were scanned at 3 mm slice thickness. Spiral CT images were scanned at 3 mm slice thickness from the pitch value 1 to 3, and twenty-seven slices of image were obtained per each the pitch value. These CT images were transferred to a treatment planning system(X-knife, Radionics) by ethernet, Three-dimensional coordinates of these images measured from the treatment planning system were compared to known values of geometrical phantom. The mean localization error of the target localization of conventional CT was 1.4mm. In case of spiral CT, the error of the target localization was within 1.6mm from the pitch value 1 to 1.3, but was more than 30mm above the pitch value 1.5. In conclusion, as the localization error of spiral CT was increased in high pitch value compared to conventional CT, the application of spiral CT will be with caution in stereotactic radiosurgery.

• Journal of Korean Society on Water Environment
• /
• v.37 no.3
• /
• pp.175-189
• /
• 2021

In this study, 48 streams in the Sapgyo Watershed were selected, and the Load Duration Curves (LDC) were drawn up for each stream using water quality and flow monitoring over the last three years (2018-2020), and it was evaluated whether the target water quality was achieved for each flow section. As a result of evaluating whether or not the target water quality exceeded according to the LDC, it was found that 22 rivers exceeded the target water quality. Five rivers exceeded the target water quality due to point pollutant sources, 13 rivers exceeded the target water quality due to non-point pollutant sources, and 4 rivers exceeded the target water quality due to both point and non-point pollutant sources. Among the rivers that exceeded the target water quality due to point pollutant sources, which included domestic sewage of the untreated population, there is a need to reduce the influx of polluted loads by the untreated population. The use of eco-friendly fertilizers is recommended for rivers with a relatively high farmland ratio among rivers exceeding the target water quality due to non-point pollutant sources, and installation of boiling point reduction facilities that can reduce the amount of polluted load introduced during rainfall or manage water shores. In rivers with a large number of livestock breeding heads, the livestock houses located in these rivers need to be preferentially transferred to livestock manure treatment plants. Due to the high ratio of land area because of urbanization, initial rainwater treatment facilities are required to reduce the amount of pollutant load flowing into the river through the impermeable layer during rainfall.