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      • KCI등재

        Effects of Geometrical Uncertainties on Whole Breast Radiotherapy: A Comparison of Four Different Techniques

        Naoki Nakamura,Osamu Takahashi,Minobu Kamo,Shogo Hatanaka,Haruna Endo,Norifumi Mizuno,Naoto Shikama,Mami Ogita,Kenji Sekiguchi 한국유방암학회 2014 Journal of breast cancer Vol.17 No.2

        Purpose: The purpose of this study was to quantify the targetcoverage, homogeneity, and robustness of the dose distributionsagainst geometrical uncertainties associated with fourwhole breast radiotherapy techniques. Methods: The study wasbased on the planning-computed tomography-datasets of 20patients who underwent whole breast radiotherapy. A total offour treatment plans (wedge, field-in-field [FIF], hybrid intensitymodulatedradiotherapy [IMRT], and full IMRT) were created foreach patient. The hybrid IMRT plans comprised two opposedtangential open beams plus two IMRT beams. Setup errors weresimulated by moving the beam isocenters by 5 mm in the anterioror posterior direction. Results: With the original plan, thewedge technique yielded a high volume receiving ≥107% of theprescription dose (V107; 7.5%±4.2%), whereas the other threetechniques yielded excellent target coverage and homogeneity. A 5 mm anterior displacement caused a large and significant increasein the V107 (+5.2%±4.1%, p<0.01) with the FIF plan, butnot with the hybrid IMRT (+0.4%±1.2%, p=0.11) or full IMRT(+0.7%±1.8%, p=0.10) plan. A 5-mm posterior displacementcaused a large decrease in the V95 with the hybrid IMRT (-2.5%±3.7%, p<0.01) and full IMRT (-4.3%±5.1%, p<0.01) plans, butnot with the FIF plan (+0.1%±0.7%, p=0.74). The decrease inV95 was significantly smaller with the hybrid IMRT plan than withthe full IMRT plan (p<0.01). Conclusion: The FIF, hybrid IMRT,and full IMRT plans offered excellent target coverage and homogeneity. Hybrid IMRT provided better robustness against geometricaluncertainties than full IMRT, whereas FIF provided comparablerobustness to that of hybrid IMRT

      • KCI등재

        Postoperative Radiographic Early-Onset Adjacent Segment Degeneration after Single-Level L4–L5 Posterior Lumbar Interbody Fusion in Patients without Preoperative Severe Sagittal Spinal Imbalance

        Yuji Matsuoka,Kenji Endo,Hidekazu Suzuki,Yasunobu Sawaji,Hirosuke Nishimura,Taichiro Takamatsu,Osamu Kojima,Kazuma Murata,Takeshi Seki,Shinji Horie,Takamitsu Konishi,Kengo Yamamoto 대한척추외과학회 2018 Asian Spine Journal Vol.12 No.4

        Study Design: Retrospective study. Purpose: To investigate the relationship between preoperative total spinal sagittal alignment and the early onset of adjacent segment degeneration (ASD) after single-level posterior lumbar interbody fusion (PLIF) in patients with normal sagittal spinal alignment. Overview of Literature: Postoperative early-onset ASD is one of the complications after L4–L5 PLIF, a common surgical procedure for lumbar degenerative disease in patents without severe sagittal imbalance. A better understanding of the preoperative characteristics of total spinal sagittal alignment associated with early-onset ASD could help prevent the condition. Methods: The study included 70 consecutive patients diagnosed with lumbar degenerative disease who underwent single-level L4–L5 PLIF between 2011 and 2015. They were divided into two groups based on the radiographic progression of L3–L4 degeneration after 1-year follow-up: the ASD and the non-ASD (NASD) group. The following radiographic parameters were preoperatively and postoperatively measured: sagittal vertebral axis (SVA), thoracic kyphosis (TK), lumbar lordosis, pelvic tilt, and pelvic incidence (PI). Results: Eight of the 70 patients (11%) experienced ASD after PLIF (three males and five females; age, 64.4±7.7 years). The NASD group comprised 20 males and 42 females (age, 67.7±9.3 years). Six patients of the ASD group showed decreased L3–L4 disc height, one had L3–L4 local kyphosis, and one showed both changes. Preoperative SVA, PI, and TK were significantly smaller in the ASD group than in the NASD group (p<0.05). Conclusions: A preoperative small SVA and TK with small PI were the characteristic alignments for the risk of early-onset ASD in patients without preoperative severe sagittal spinal imbalance undergoing L4–L5 single-level PLIF.

      • KCI등재

        Hip Extensor Strength Influences Dynamic Postural Changes during Gait in Patients with Adult Spinal Deformity: A Cross-Sectional Study Using Three-Dimensional Motion Analysis

        Sato Keita,Tominaga Ryoji,Endo Tatsuya,Miura Takuya,Iwabuchi Masumi,Ito Toshikazu,Shirado Osamu 대한척추외과학회 2022 Asian Spine Journal Vol.16 No.5

        Study Design: Single-hospital cross-sectional study.Purpose: The aim of the present study was to investigate the physical functions influencing dynamic postural change in patients with adult spinal deformity (ASD).Overview of Literature: Dynamic postural change leading to increased forward lean during gait is a problem in patients with ASD; however, the relationship between this change and trunk and hip extensor strength is unclear.Methods: Thirty patients with ASD aged ≥50 years who were admitted to our hospital between July 2016 and September 2019 were included in this study. X-ray parameters (i.e., sagittal vertical axis, pelvic tilt, and pelvic incidence minus lumbar lordosis) were evaluated from the full-length standing radiographs of the subjects. Trunk and hip extensor strength was evaluated using a hand-held dynamometer. Dynamic postural changes (i.e., sagittal trunk shift during standing, sagittal trunk shift during gait, and delta sagittal trunk shift) were assessed using a three-dimensional motion analysis system. The relationships between dynamic postural change and various X-ray parameters, as well as trunk and hip extensor strength, were examined using multivariable analysis.Results: Multivariable analysis showed that hip extensor strength is the factor most strongly associated with dynamic postural change among the X-ray parameters and physical functions assessed in this study (<i>β</i>=−0.41, <i>R<sup>2</sup></i>=0.12).Conclusions: We demonstrated the association between dynamic postural change and hip extensor strength in patients with ASD. Our results may be useful to healthcare providers treating patients with ASD. Interventions for dynamic postural change in patients with ASD should focus on hip extensor strength.

      • KCI등재

        Relationship between Lower Limb Pain Intensity and Dynamic Lumbopelvic-Hip Alignment in Patients with Degenerative Lumbar Spinal Canal Stenosis: A Cross-Sectional Study

        Miura Takuya,Tominaga Ryoji,Sato Keita,Endo Tatsuya,Iwabuchi Masumi,Ito Toshikazu,Shirado Osamu 대한척추외과학회 2022 Asian Spine Journal Vol.16 No.6

        Study Design: This cross-sectional study was conducted in a single hospital.Purpose: To clarify the relationship between lower limb pain intensity and dynamic lumbopelvic-hip alignment in patients with lumbar spinal canal stenosis (LSS), using a three-dimensional (3D) motion analysis system.Overview of Literature: Although it is well known that leg symptoms have a close relationship with posture in patients with LSS, the relationship under dynamic conditions, such as gait, remain unclear.Methods: Thirty patients with LSS scheduled for spine surgery participated in this study. Lower limb pain was assessed using the Visual Analog Scale (VAS), and the patients were divided into two groups based on the mean scores (patients with scores above and below the mean were classified as the high-VAS and low-VAS groups, respectively). The kinematics of the spine, pelvis, and hip joints during gait were then measured using a 3D motion analysis system. Student paired t -tests were used to compare the angles of the spine, pelvis, and hip during gait between the two groups.Results: Compared to those in the low-VAS group, the spine was significantly extended and bent toward the more painful lower limb side, and the pelvis was significantly anteriorly tilted among individuals in the high-VAS group.Conclusions: Patients with LSS experiencing severe pain in their lower limb tend to keep the spine in a more extended position, bend laterally toward the painful side, and have an anteriorly tilted pelvic posture. The dynamic spinal and pelvic alignment was closely related to the intensity of the lower limb pain.

      • Monitoring of Hydrogen Sulfide from an Industrial Waste Landfill in Japan

        ( Noppharit Sutthasil ),( Tomonori Ishigaki ),( Yuka Ogata ),( Kazuto Endo ),( Masato Yamada ),( Masanao Nagamori ),( Osamu Oishi ),( Yoshinori Yabuki ),( Tanaka Hirokazu ) 한국폐기물자원순환학회(구 한국폐기물학회) 2018 한국폐기물자원순환학회 심포지움 Vol.2018 No.1

        Landfill management in Japan was developed more than Centuries. At industrial rapid growth era, numbers of waste were disposed with less control, such as co-disposal of Construction and Demolition waste (C&D waste) and organic Municipal Solid Wastes (MSW). Generally, Hydrogen sulfide (H<sub>2</sub>S) is detectable in ppm by human as odor, but more seriously it causes toxic effect in hundreds ppm. H<sub>2</sub>S is often generated in landfill containing sulfate source (such as gypsum board) and organic waste thorough the activity of the Sulfate Reducing Bacteria (SRB). This study was carried out to investigate the emission behavior and environmental parameters related to H<sub>2</sub>S generation in a landfill under aftercare phase, which has been disposed of C&D waste, and to develop the methodology to assess the environmental situation in landfills to be monitored. This survey was also involved in the project that aim to develop the methodology of appropriate management of the landfills. The objected landfill was located nearby the river and was operated by private sector. After the “standard of landfill disposal” regulation was enforced in Japan, this landfill was closed and started to monitoring. Figure 1 shows schematic of geological section of landfill, the area of dumping was mountainous, North and Eastern side of landfill was mounted to the hill called ‘Upper Zone’. South and Western side called ‘Lower Zone’. The slope of landfill surface was from upper to lower part. The approximate landfill surface is 4000 m<sup>2</sup>. Landfill investigation was conducted on October 2017. The location for measurement of surface gas emission by static chamber method was selected by grid placing. Soil gas concentration was measured by a gas analyzer and gas detecting tube. Water quality from landfill layer in monitoring well was analyzed in laboratory. The results show H<sub>2</sub>S gas was detected 5 out of 29 grid points from 0.7 m beneath cover soil in range 0.2-800 ppm. These H<sub>2</sub>S gas concentrations were related to surface H<sub>2</sub>S emissions which emitted in range 0.3-37.7 l/m<sup>2</sup>/d. The detected H<sub>2</sub>S emitted points were located at the lower zone of this landfill. In the same area, CH<sub>4</sub> emission were found in 10 out of 29 points in range 0.1-62.7 l/m<sup>2</sup>/d. H<sub>2</sub>S emission and CH<sub>4</sub> emission were negatively correlated. In contrast to the lower zone, CH<sub>4</sub> emission was detected at few points and no H<sub>2</sub>S gas was found at the upper zone. It is widely known that SRB and Methane Generating Bacteria inhabited or competitive of carbon source under anaerobic condition. Landfill gas results indicated that anaerobic degradation was comparably active in lower zone due to the existing of organic matter inside waste body. To compare biogas generation from lower and upper zone, CH<sub>4</sub> and CO<sub>2</sub> emissions from lower zone was about 10.1 and 3.2 times higher than that from upper zone, respectively. The higher degradation rate explain by the different amount of organic matter from upper to lower zone. Quality of inner water of landfill layer in the monitoring wells which located in lower zone were analyzed. The SO<sub>4</sub> concentration were in range 110-710 mg/l. Low concentration of dissolved oxygen (0.68 mg/l) and remaining of organic carbon (33.7 mg/l) were confirmed in inner water of landfill. These would possibly provide condition of H<sub>2</sub>S generation. From the result, landfill gas emission still active even the landfill already close for several years. It could suggest that the intensive and log-term monitoring program for this landfill must be necessary. It was also shown that the integration of monitoring of behavior of gas emission and dissolved component must be necessary to identify the practical situation of landfills, and to apply for future investigation in terms of improving the accuracy and simplification of methodology.

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