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근긴장이상 환자에서 저빈도 반복 경두개자기자극의 효과 1예
김영범,김연희,이강우,장원혁 대한근전도전기진단의학회 2011 대한근전도 전기진단의학회지 Vol.13 No.1
We here reported the suppression of dystonia after the low frequency rTMS in a patient with the pediatric stroke. A 21-year old woman with infarction in the left basal ganglia and corona radiata showed the dystonia on right extremities since 4 years old. The Movement score and the Disability score of Burke-Fahn-Mardsen Dystonia Rating Scale (BFMDRS) was 28.0 and 5. She received a 20 minutes treatment session with 1 Hz rTMS on the left premotor cortex three times per week for 2 weeks. After treatment, the Movement score and the Disability score of BFMDRS scale were improved to 17.5 and 4, respectively. These rTMS effects were maintained for about 2~4 hours after each session. In this case, we observed that lowfrequency rTMS improved specific motor symptom of severe dystonia. We also observed that excessive corticospinal drive could be suppressed by low-frequency rTMS on the premotor cortex.
전자선 조사야 결합부분의 선량분포 개선을 위한 Acrylic Electron Wedge의 제작 및 사용
김영범,권영호,황웅구,김유현,Kim Young Bum,Kwon Young Ho,Whang Woong Ku,Kim You Hyun 대한방사선치료학회 1998 大韓放射線治療技術學會誌 Vol.10 No.1
Treatment of a large diseased area with electron often requires the use of two or more adjoining fields. In such cases, not only electron beam divergence and lateral scattering but also fields overlapping and separation may lead to significant dose inhomogeneities(${\pm}20\%$) at the field junction area. In this study, we made Acrylic Electron Wedges to improve dose homogeneities(${\pm}5\%$) in these junction areas and considered application it to clinical practices. All measurements were made using 6, 9, 12, 16, 20MeV Electron beams from a linear accelerator for a $10{\times}10cm$ field at 100cm SSD. Adding a 1 mm sheet of acryl gradually from 1 mm to 15 mm, We acquired central axis depth dose beam profile and isodose curves in water phantom. As a result, for all energies, the practical range was reduced by approximately the same distance as the thickness of the acryl insert, e.g. a 1 mm thick acryl insert reduce the practical range by approximately 1 mm. For every mm thickness of acryl inserted, the beam energy was reduced by approximately 0.2MeV. These effects were almost independent of beam energy and field size. The use of Acrylic Electron Wedges produced a small increase $(less\;than\;3\%)\;in\;the\;surface\;dose\;and\;a\;small\;Increase(less\;than\;1\%)$ in X-ray contamination. For acryl inserts, thickness of 3 mm or greater, the penumbra width increased nearly linear for all energies and isodose curves near the beam edge were nearly parallel with the incident beam direction, and penumbra width was $35\;mm{\sim}40\;mm$. We decide heel thickness and angle of the wedge at this point. These data provide the information necessary to design Acrylic Electron Wedge which can be use to improve dose uniformity at electron field junctions and it will be effectively applicated in clinical practices.
4MV X-선을 이용한 조직보상체 두께비 연구 및 응용
김영범,정희영,권영호,김유현,Kim Young-Bum,Jung Hee-Young,Kweon Young-Ho,Kim You-Hyun 대한방사선치료학회 1996 大韓放射線治療技術學會誌 Vol.8 No.1
A radiation beam incident on irregular or sloping surface produces an inhomogeneity of absorbed dose. The use of a tissue compensator can partially correct this dose inhomogeneity. The tissue compensator should be made based on experimentally measured thickness ratio. The thickness ratio depends on beam energy, distance from the tissue compensator to the surface of patient, field size, treatment depth, tissue deficit and other factors. In this study, the thickness ratio was measured for various field size of $5cm{\times}5cm,\;10cm{\times}10cm,\;15cm{\times}15cm,\;20cm{\times}20cm$ for 4MV X-ray beams. The distance to the compensator from the X-ray target was fixed, 49cm, and measurement depth was 3, 5, 7, 9 cm. For each measurement depth, the tissue deficit was changed from 0 to(measurement depth-1)cm by 1cm increment. As a result, thickness ratio was decreased according to field size and tissue deficit was increased. Use of a representative thickness ratio for tissue compensator, there was $10\%$ difference of absorbed dose but use of a experimentally measured thickness ratio for tissue compensator, there was $2\%$ difference of absorbed dose. Therefore, it can be concluded that the tissue compensator made by experimentally measured thickness ratio can produce good distribution with acceptable inhomogeneity and such tissue compensator can be effectively applied to clinical radiotherapy.