Mechanical Check용 Spherical Device의 제작 및 특성 평가

이병구,김건오,권영호,Lee, Byung-Koo,Kim, Gun-Oh,Kweon, Young-Ho 대한방사선치료학회 2007 대한방사선치료학회지 Vol.19 No.1

Purpose: Digital medical image commenced with an introduction of PACS has become more popular today in the radiation diagnosis and medical treatment and made great progress, in particular, for medical testing field, whereas it has made slow progress for radiation therapy area. In order to accommodate the current trend of digital from analog, a spherical type mechanical check device (SMCD) that is form of spherical differing from the existing form of flat or cube has been designed and tested its practicability to replace the part in mechanical check with digital image from QA operation. Materials and Methods: If the distance maintains constant between source(target) and image detector with constant distance to the center of spherical type mechanical check device(SMCD), the size will be shown as a constant image at all times regardless of its direction exposed. For the test, two accurate hemispheres are made and put together which results in a sphere of the equilateral circle. Results: It enables a variety of implementation of the existing mechanical check using digital image as follows: congruity level of radiation field and light field, size accuracy of radiation field and collimation field, gantry rotation isocenter check, collimation rotation isocenter check, room laser accuracy check, collimation rotation angle check, couch rotation angle check, and more. Conclusion: It has proved its practicability in checking isocenter congruity level as real time at the time of simultaneous rotation between gantry and couch that is applied to the non-coplanar field, which had been hard to apply as a device formed of existing flat or cube.

GafChromic RTQA Film을 이용한 광역학적 치료용 레이저의 선질 측정

이병구,임현수,네클라 커나르,Lee, Byung Koo,Lim, Hyun Soo,Kenar, Necla 대한의용생체공학회 2013 의공학회지 Vol.34 No.2

Purpose: The purposes of this study were to measure the dose distribution of Photodynamic therapy(PDT) laser with 635 nm wavelength using GafChromic film. Method & Result: We made each output 300 J by changing mW and sec using the laser beam radiation mode such as C.W(Continuous Wave) mode, Pulse mode and Burst Pulse mode and measured the does at 0 mm and 5 mm of distance from optic fiber catheter end to the film, and at 5 mm distance by changing the angle of the end of the optic fiber catheter as $0^{\circ}$ and $0.5^{\circ}$. The radiated film was scanned and OD(Optical Density) was compared. And two-dimensional isodose curves were obtained and the consistency of shapes was compared. It was confirmed that there was consistency between optic density and the dose radiated on the film when we radiated GafChromic film by changing distance and angle of 300 J output in each radiation mode coordinating mW and sec. Conclusion: In this study, we could identify the stability according to changes in laser beam modes, changes in output according to distance, changes in uniformity according to angle, and beam profiles using GafChromic film, and we could also get two-dimensional isodose curve. It was found that small change in the distance and angle that is made when optic fiber catheter was contacted on the treatment area did not make big effects on the output of beam and the uniformity of dose, and it was also found that GafChromic film could be utilized for the purpose of QA of PDT laser beam.

저 선량 베타선의 조사에 의한 식물의 생장에 미치는 영향

이병구(Byung-Koo Lee),임인철(In-Chul Im),김종언(Jong-Eon Kim) 대한방사선과학회(구 대한방사선기술학회) 2010 방사선기술과학 Vol.33 No.2

본 연구는 저 선량 베타선의 장기간(31일) 조사에 의한 춘향이 열무와 알타리 무의 생장에 미치는 영향을 분석하는데 목적이 있다. 실험은 알타리 무와 춘향이 열무에 대하여 각각 1개 샘플의 대조군과 11개 샘플의 실험군으로 구성하였다. 대조군과 실험군의 종자들은 각각의 샘플에서 8개씩 선택되어 같은 조건의 배양토에 파종하였다. 실험군 샘플의 누적선량은 31일 동안 매일 같은 시간에 측정하였다. 생장과정과 발아율은 매주 2회 같은 시간에 측정하였다. 잎사귀 수, 초장의 길이와 생체중은 파종 후 20일과 25일에 각각 측정하여 평균값을 얻었다. 25일 동안 측정된 실험군의 결과에서, 알타리 무의 길이와 무게는 누적선량 0.01 Gy에서 대조군보다 각각 5%와 36%로 증가하였다. 또한 춘향이 열무에서 길이는 누적선량 0.01~0.08 Gy와 0.3 Gy에서 대조군보다 각각 13~17%와 1%, 무게는 누적선량 0.05 Gy와 0.23 Gy에서 대조군보다 각각 36%와 2%로 증가하였다. 잎 수에 대하여, 알타리 무는 누적선량 0.01~0.32 Gy에서 대조군보다 0~50%로 증가하였다. 그리고 춘향이 열무는 0.01~0.0.62 Gy에서 대조군보다 0~67%로 증가하였다. 이 결과로부터, 알타리 무와 춘향이 열무는 대체적으로 낮은 누적선량영역(0.01~0.2 Gy)에서 길이와 무게 그리고 잎 수가 증가하였다. 그리고 실험군의 세포의 크기,핵의 위치와 세포의 조밀도는 대조군과 거의 유사하게 현미경으로 관찰되었다. 결론적으로, 베타선에 조사된 알타리 무와 춘향이 열무는 방사선 호메시스 이론과 부합되어 낮은 누적선량영역에서 더 많은 생장을 한 것으로 추정된다. 추후 연구에서 방사선 호메시스와 식물생장의 관련성을 확증하기 위한 추가적인 실험이 필요할 것으로 생각된다. This study is to analyze effects of the growth of Chunhyang Young Radish (CYR) and Altari Radish (AR) according to the exposure for 31 days at low dose β-rays. This test has one contrast sample and eleven test samples each as to AR and CYR. The seeds from contrast and test sample were planted in the culture soil after 8 seeds were chosen from each with identical condition. The accumulated dose of test samples has been measured at consistent time on a daily basis for 31 days. The growing process and germination have been measured twice at consistent time in each week. The number of leaves, length of first leave and weight have been acquired average value by measuring for 20 and 25 days, respectively after being planted. The result of test sample in case of 25 days shows that 5% increase in length and 36% increase in weight for AR each at accumulated dose 0.01 Gy compared to the contrast sample. And the length of CYR has increased by 13~17% and 1% at accumulated dose 0.01~0.08 Gy and 0.3 Gy compared to the contrast sample. For the weight at accumulated dose 0.05 Gy and 0.23 Gy has increased by 36% and 2% compared to contrast sample. As to the number of leaves, AR has increased by 0~50% at accumulated dose 0.01-0.32 Gy compared to contrast sample. It also shows that the CYR has increased to 0~67% at accumulated dose 0.01-0.62 Gy compared to contrast sample. As a result of this study, it indicates that both AR and CYR has generally increased in their length, weight, and the number of leaves at low level accumulated dose part 0.01~0.2 Gy. The size of cell, area of nucleus and density of cell for test sample has been observed quite similar to the ones from contrast sample through microscope. In conclusion, AR and CYR irradiated by β-rays have estimated that they are achieved a rapid growth at low level accumulated dose region corresponding to its radiation hormesis theory. Further studies need to confirm the correlation between the radiation hormesis and the growth of the plants.

Mechanical Check용 Spherical device의 제작 및 특성 평가

이병구(Byung-Koo Lee),양대식(Dae-Sik Yang),권영호(Young-Ho Kweon),한동균(Dong-Kyoon Han),고신관(Shin-Gwan Ko) 대한방사선과학회(구 대한방사선기술학회) 2007 방사선기술과학 Vol.30 No.2

  PACS의 도입에 발맞추어 시작된 digital 의료영상은 현재 방사선 진단 및 치료 영역에서 일반화되었으며 특히 진단영역에서는 눈부신 발전을 거듭하고 있다. 치료영역에서의 digital image 구현은 상대적으로 느린 성장과정을 거쳐 오늘에 이르고 있다.<BR>  본 논문은 이러한 analog에서 digital로 변화하는 흐름을 인식하여 정도관리(Quality Assurance) 업무 중 mechanical check 부분을 digital image base 업무로 대체하여 수행하고, 기존의 육면체 또는 사각형틀의 개념을 탈피한 구형(球形)의 Spherical mechanical check device(SMCD) 고안하여 그 실용성을 실험하였다.<BR>  Source(target)에서 image detecter 간의 거리가 항상 일정하고, Spherical mechanical check device(SMCD)의 중심까지 거리가 일정하다면 어느 방향에서 SMCD를 exposure하더라도 그 크기는 항상 일정하게 영상으로 표현 될 것이다. 이를 위해 정확한 반구(半球)를 2개 정밀 제작하여 그것을 합쳤을 때 정원(正圓)의 구(球)가 되도록 하였다. 이를 이용하여 radiation field와 light field의 일치도, radiation field 크기의 정확도(5×5, 10×10, 15×15㎝), Collimator field 크기의 정확도(5×5, 10×10, 15×15㎝), Gantry rotation isocenter check, Collimator rotation isocenter check, Room laser accuracy check, Collimator rotation angle check와 Couch rotation angle check 등 기존의 mechanical check를 digital image를 이용하여 실행할 수 있었으며, 기존의 Flat 또는 정육면체 형태의 mechanical check device로는 쉽게 하기 힘든 non-coplanar field에 적용되는 Gantry와 Couch가 동시에 rotation되었을 때 그 isocenter의 일치도를 real time으로 확인할 수 있었다.   Digital medical image commenced with an introduction of PACS has become more popular today in the radiation diagnosis and radiation treatment and made great progress, in particular, for medical testing field, whereas it has made slow progress for radiation treatment field.<BR>  In order to accommodate the current trend of digital from analog, a spherical mechanical check device (SMCD) that is the form of spherical differing from the existing form of flat or cube has been designed and tested its practicability to replace the part in mechanical check with digital image from QA operation. <BR>  If the distance maintains constance between source(target) and image detector with constant distance to the center of spherical mechanical check device(SMCD), the size will be shown as a constant image at all times regardless of its direction exposed. For the test, two accurate hemispheres are made and put together which results in a sphere of the equilateral circle.<BR>  It enables a variety of implementation of the existing mechanical check using digital image as follows: congruity level of radiation field and light field, size accuracy of radiation field and collimation field, gantry rotation isocenter check, collimation rotation isocenter check, room laser accuracy check, collimation rotation angle check, couch rotation angle check, and more. In addition, it has proved its practicability in checking isocenter congruity level as real time at the time of simultaneous rotation between gantry and couch that is applied to the non-coplanar field, which had been hard to apply as a device formed of existing flat or cube.

굴곡이 있는 전리함 집전극에 기인한 선량 변화

이병구(Byung-Koo Lee),김정남(Jung-Nam Kim) 한국콘텐츠학회 2008 한국콘텐츠학회논문지 Vol.8 No.11

방사선 치료분야에서 인체에 조사되는 방사선 양은 수 ~ 수 십 Gy로 매우 높기 때문에 항상 정확히 다루어져야 한다. 본 논문의 실험을 위해 전리함(ionization chamber)이 사용되었다. 품질관리프로토콜(quality assurance protocol) 없이 사용되는 전리함의 상태를 파악하고, 전리함의 본래 기하학적 구조가 변형되었을 때 변화된 값을 측정하였다. 지두형 전리함의 집전극 휨 정도를 알아내기 위해 방사선 투시장치와 CT 3차원 영상으로 재구성하여 휨 정도를 정량화 하였다. 그리고 기하학적 구조가 정상적인 전리함과 측정값을 비교하여 그 값의 왜곡정도를 알아보았고, 선량측정은 4㎹, 10㎹ photon 두 종류를 같은 선량과 선량율로 하였다. 집전극이 휘어진 전리함의 흡수선량의 왜곡정도는 대략 5.5~7.2% 정도 값 이었으며 에너지에 대한 차이는 거의 없었다. 본 연구를 통해 전리함의 기하학적 구조가 시간 경과, 장비의 취급 부주위 등에 따라 변형 될 수 있고, 특히 집전극의 휨 현상이 발생할 수 있다는 것을 알았다. 또한 평소에 인지하지 못하는 곳에서도 많은 왜곡과 오차를 만들어 낼 수 있다는 것을 확인 할 수 있었다. Nowadays the risk of radiation is getting more serious, so we must know the exact dose that was irradiated, Because very high radiation dose is used in radiation therapy field. We used the ionization chamber which measure the radiation dose in this study. We tried to know the incorrect result from the distortion of geometric structure of ionization chamber and we studied how to find the distortion of geometric structure of ionization chamber. We used a radio fluoroscopy to find the wound degree of electrode of ionization chamber and a reconstructed 3D CT image to analyze the wound degree of electrode quantitatively. we measured degree of distortion by comparing with absorbed dose of normal electrode and wound electrode. The comparative result is not absolute dosimetry at specific point but relative dosimetry between thats. We measured 4 ㎹ ,10㎹ photon with same absorbed dose and dose rate. The degree of distortion of wound electrode was totally 5.5 ~7.2%, and there was no difference between two energies. The variation induced from radiation dose to be irradiated and dose rate, and the degree of distortion from wound direction also was almost similar value. We could find that the geometric structure of ionization chamber that can influence a basic measurement of radiation dose can be changed by old usage and inattention of management in this study, especially winding of electrode can be happened, in radiation therapy field, It is very important to keep precise radiation dose quantitatively.

EPID 영상을 이용한 유방암 접선조사의 정확성 평가

이병구(Byung-Koo Lee),강수만(Soo-Man Kang) 대한방사선과학회(구 대한방사선기술학회) 2012 방사선기술과학 Vol.35 No.3

본 논문은 유방암 환자의 접선 조사 시, 치료 전 수행하는 electronic portal image와 치료 계획용 2-D reconstruction image를 비교하는 방법으로 자세의 정확성을 평가하고자 한다. 방사선 치료 중 접선조사(tangential breast treatment)만을 받는 22명의 유방암 환자를 대상으로 자세 정렬의 정확성을 확인 하였다. electronic portal image와 치료 계획용 2-D reconstruction image의 해부학적 기준 매개 변수를 비교하여 그 오차 도를 평가 하였다. 접선조사 환자의 44매 2-D reconstruction image와 110매의 EPID image 상의 비교 기준 매개 변수는 치료 조사면 중심부(field center)의 폐 길이, CLD(central lung distance), 치료 조사면 중심부의 연부조직 길이, CSTD(central soft tissue distance), 상부 총 폐 길이, ALD (above lung distance), 하부 총 폐 길이, BLD (below lung distance)이며, 내측 접선조사면(medial tangential field)에서 각 매개 변수의 오차 평균값은 1.0, -6.4, -2.1, 2.0, 각각의 표준편차(σ)는 1.5, 2.3, 4.1, 1.1 이다. 외측 접선조사면(lateral tangential field)의 각 매개 변수 오차 평균값은 –1.5, -4.3, -2.7, –1.3 이며, 각각의 표준편차(σ)는 3.3, 2.1, 2.9, 그리고 2.5로 나타났다. 접선조사 치료를 받는 유방암 환자의 EPID image 상에서 CLD, CSTD, ALD 그리고 BLD의 인식은 매우용이하며 이를 근거로 자세 정렬 오차를 판단하는 것이 시간과 숙련도의 단축을 이끌어 낼 수 있다고 사료된다. The aim of this study was to investigate the setup accuracy for tangential breast treatment patients using electronic portal image and 2-D reconstruction image. Twenty two patients undergoing tangential breast treatment. To explore the setup accuracy, distances between chosen landmarks were taken as reference parameters. The difference between measured reference parameters on simulation films and electronic portal images (EPIs) was calculated as the setup error. A total of 22 simulation films and 110 EPIs were evaluated. In the tangential fields, the calculated reference parameters were the central lung distance (CLD), central soft-tissue distance (CSTD), and above lung distance (ALD), below lung distance (BLD). In the medial tangential field, the average difference values for these parameters were 1.0, -6.4, -2.1 and 2.0, respectively; and the σ values were 1.5, 2.3, 4.1 and 1.1, respectively. In the lateral tangential field, the average difference values for these parameters were –1.5, -4.3, -2.7 and –1.3, respectively; and the σ values were 3.3, 2.1, 2.9 and 2.5, respectively. CLD, CSTD, ALD and BLD in the tangential fields are easily identifiable and are helpful for detecting setup errors using EPIs in patients undergoing tangential breast radiotherapy treatment.

근접치료동위원소의 Activity Check

김건오,이병구,권영호,Kim, Gun-Oh,Lee, Byung-Koo,Kwon, Young-Ho 대한방사선치료학회 2004 大韓放射線治療技術學會誌 Vol.16 No.1

목적 : 근접치료에 사용하는 동위원소인 Ir-192는 전량 수입에 의존하고 있으며, 그 Activity는 Welltype Chamber를 이용하여 측정하거나 제조업체의 선원 강도 인증서를 믿고 의존하는 방법, 또는 Farmer Chamber를 이용한 in-air dosimetry 등이 있다. 본 논문에서는 좀더 간단하고 단순한 Farmer Chamber를 이용한 방법을 소개하고자 한다. 대상 및 방법 : Farmer Chamber와 Source Calibration jig를 이용하여 Ir-192 동위원소의 Activity를 측정하고 그 값을 제조사의 선원강도 인증서의 값과 비교하여 선원의 Activity를 check한다. 결과 : 측정결과 제조사의 값과 비교하여 ${\pm}2.1\%$로, AAPM 권고 값인 ${\pm}5\%$ 안의 오차범위에 들어가는 차이로서 임상에서의 사용이 가능하다. 결론 : 근접치료장치의 사용증가와 그에 따른 선원의 수입 증가는 불가결하다. 그리고 선원의 정확한 Activity Check는 필수이다. 선원의 Act check를 위해 Well type chamber의 추가 구입 없이 Farmer Chamber와 Source Calibration jig를 이용하여 정확한 선량 측정이 가능하였다. An isotope Ir-192, which is used in brachytherapy depends on import in whole quantities. There are a few ways for its activity. measurement using Welltype chamber or the way to rely on authentic decay table of manufacturer. In-air dosimetry using Farmer Chamber, etc. In this paper, let me introduce the way using Farmer chamber which is easier and simple. With the Farmer chamber and source calibration jig, take a measurement the activity of an isotope Ir-192 and compare the value with the value from decay table of manufacturer and check the activity of source. The result of measurement, compared the value from decay table, by ${\pm}2.1\%$. (which belongs to recommendable value for AAPM ${\pm}5\%$ as difference of error range) It is possible to use on clinical medicine. With the increase in use of brachytherapy, the increase of import is essential. And an accurate activity check of source is compulsory. For the activity check of source, it was possible to use Farmer chamber and source calibration jig without additional purchase of Well type chamber.

Unit Dose Drug Distribution System의 도입을 통한 투약시스템의 질 향상 평가

이인향,이순실,이병구,최원자,홍성선,Lee, In Hyang,Lee, Soonsil,Lee, Byung Koo,Choi, Won Ja,Hong, Sung Sun 한국의료질향상학회 2001 한국의료질향상학회지 Vol.8 No.2

Background : A study comparing unit dose drug distribution system(UDS) versus traditional drug distribution system(TDS) was conducted in Seoul National University Hospital. The objectives of this study were to identify safer drug distribution system and to measure the efficiency of both systems in utilizing nursing and pharmacist's time. Methods : The study was designed to compare the data on medication errors, nursing time and pharmacists' time before and after implementation of the UDS in the internal medicine and otorhinolaryngology care units. The data on actual medications administered to patients were obtained by a disguised observer during the study period. The data collected were then compared with the physicians' orders to determine the rate of medication errors. In addition, using ten-minute interval work-sampling method nursing and pharmacists' time were measured. Results : About 6% of medications were administered incorrectly in the TDS, in comparison to 1.6% in the UDS. The rate of medication error decreased significantly in the UDS compared with the TDS. Mean times spent on medication-related activities by nurses were 34.1% in the TDS and 28.5% in the UDS. In the internal medicine care unit, nursing time associated with medications decreased significantly after the implementation of the UDS, but the reduction in medication-related nursing time in the otorhinolaryngology care unit was not significant. Pharmacist's medication-related work activities, increased from 2% in the TDS to 20% in the UDS. Pharmacist's time spent on therapy-related activities increased significantly. Conclusion : The rate of medication errors in the UDS decreased significantly compared with the TDS. Time spent on medication-related activities decreased for nurses while it increased for pharmacists. In summary, the UDS was estimated to be safer and to utilize of pharmacists' and nursing time more efficiently than the TDS.

방사모드에 따른 레이저 치료 효과

최덕수,임현수,이병구,네클라 커나르,Choi, Deog Su,Lim, Hyun Soo,Lee, Byung Koo,Kenar, Necla 대한의용생체공학회 2016 의공학회지 Vol.37 No.4

US Food and Drug Administration (FDA) approved as a innovative cure for cancer, 1996. The effect is death of cancer cells through necrosis, apoptosis. Mainly the Continuous Wave mode (CW) use for PDT Laser. It sting, the question including itch, and etc. Reportedly, the increase of temperature with the perforated edema, ulcer, necrosis. The Thermal relaxation time and Oxygen recovery time is necessary. To give a normal oxygen recovery time of the cell, used Pulse mode. Progress, it was Burst Pulse mode when easing the thermal wake, the simplicity was secured, the PDT effect is good. Excepted in control group CW, Pulse, Burst pulse mode were incubated with various concentrations of 5-aminolevulinic acid hydrochloride (ALA-5). The tumor size reduction CW mode (44%), Pulse mode (48%), Burst pulse mode (53%) at 4 week after PDT with 0.3, 0.3, 0.3 mg/ml of ALA-5. After 4 hours, investigation of 100, 100, $100J/cm^2$ laser irradiation. The pulse mode was superior in expirimental data analysis. And it was the Burst pulse mode edge head of a family effect.

정맥 영양을 시행한 위장관암 수술 환자에서 영양집중지원팀의 중재 효과

이현정 ( Hyun Jung Lee ),김정태 ( Jung Tae Kim ),이병구 ( Byung Koo Lee ) 한국정맥경장영양학회 2014 한국정맥경장영양학회지 Vol.6 No.2

Purpose: Cancer patients are frequently malnourished, and malnutrition can increase morbidity and mortality. Postoperative malnutrition can cause poor wound healing and failure of the immune response. Administration of parenteral nutrition (PN) after surgery may decrease complication and hospital length of stay. Intervention of a Nutrition Support Team (NST) improves patient outcomes through nutritional assessment and proper nutrition support. In this study we investigated effects of NST intervention with PN on gastrointestinal cancer patients who underwent surgery. Methods: This retrospective study was conducted at Kyung Hee University Hospital at Gangdong from 2012 January to 2013 December. This study reviewed gastrointestinal cancer patients who were administered PN for more than seven days. The patients were divided into two groups: NST group versus non-NST group. Results: In this study, 53 patients with malnutrition were administered PN for more than seven days. Nutrition support between the NST group and non-NST group was not statistically significant, except multivitamin and trace element. Changes in nutritional index were not statistically significant. No difference in incidence of complication,monitoring performance rate was observed between the two groups. Conclusion: Due to a small number of patients and lack of severity of disease in this study, no significant difference in improvement of nutritional index was observed between the NST group and non-NST group. For safe and effective PN, conduct of additional study is necessary in order to determine the effects of NST.