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두경부암 방사선 치료 시 Set-Up 조정 Head Holder 장치의 개발
심재구,송기원,김진만,박명환,Shim, JaeGoo,Song, KiWon,Kim, JinMan,Park, MyoungHwan 대한방사선치료학회 2014 대한방사선치료학회지 Vol.26 No.1
두경부암 환자의 헤드 홀더를 사용하는 경우 모의 치료 시 환자는 테이블 위에 위치하지만, 방사선 치료를 시행하는 경우 헤드 홀더를 치료 테이블에 걸쳐서 사용하기 때문에 체중 및 여러 가지 요소로 인한 기하학적 불일치로 상, 하, 좌, 우 및 처짐의 현상이 발생할 수 있다. 이러한 환자 Set-Up의 재현성의 불일치를 개선하기 위해 두경부암 전용 헤드 홀더를 자체 고안하여 제작 및 개발하여 유용성을 평가하였다. Alderson Rando Phantom을 이용하여 전산화단층촬영장치(High Advantage, GE, U.S.A)를 통해 이미지를 획득하였고, 광자선 4MV 세기변조 방사선치료(IMRT) 방식을 적용하여 최적화된 치료 계획을 실시하였다. 선형가속기(21EX, Varian, U.S.A)를 이용하여 모의 치료와 동일한 상태에서 환자를 set-up한 후 에 치료기에 장착된 CBCT를 이용하여 각각의 무게(0,15,30Kg)의 차이를 통해 교정 전, 후 X, Y, Z축의 오차를 5회 반복 측정한 결과는 다음과 같다. 0Kg에서 $0.4{\pm}0.8mm$, $0.8{\pm}0.4mm$, 0mm으로 나타났고, 교정 후에는 $0.2{\pm}0.8mm$, $0.4{\pm}0.5mm$, 0으로 나타났다. 15Kg에서 교정 전,후 오차는 $0.2{\pm}0.8mm$, $1.2{\pm}0.4mm$, $2.2{\pm}0.4mm$와 $0.2{\pm}0.4mm$, $0.4{\pm}0.5mm$, $0.4{\pm}0.5mm$로 나타났다. 30Kg에서 교정 전,후 오차는 $0.8{\pm}0.4mm$, $2.4{\pm}0.5mm$, $4.4{\pm}0.8mm$와 $0.6{\pm}0.54mm$, $1{\pm}0mm$, $0.6{\pm}0.5mm$로 나타났다. 각각의 교정 전,후의 통계적으로 분석한 결과 15Kg인 경우 Z축에서 p<0.034, 30Kg인 경우 Y, Z축에서 p<0.038, p<0.041 로 유의한 결과를 나타냈다. 두경부암 전용 방향 조절 장치 헤드 홀더가 환자의 set-up오차를 줄여주는 역할을 해주는 것으로 나타났다. 또한 오차를 줄여줌으로써 환자의 재현성이 향상되어 보다 정밀하고 정확한 방사선 치료를 구현할 수 있을 것으로 사료된다. In case of all patients who receive radiation therapy, a treatment plan is established and all steps of treatment are planned in the same geometrical condition. In case of head and neck cancer patients who undergo simulated treatment through computed tomography (CT), patients are fixed onto a table for planning, but laid on the top of the treatment table in the radiation therapy room. This study excogitated and fabricated an adjustable holder for head and neck cancer patients to fix patient's position and geometrical discrepancies when performing radiation therapy on head and neck cancer patients, and compared the error before and after adjusting the position of patients due to difference in weight to evaluate the correlation between patients' weight and range of error. Computed tomography system(High Advantage, GE, USA) is used for phantom to maintain the supine position to acquire the images of the therapy site for IMRT. IMRT 4MV X-rays was used by applying the LINAC(21EX, Varian, U.S.A). Treatment planning system (Pinnacle, ver. 9.1h, Philips, Madison, USA) was used. The setup accuracy was compared with each measurement was repeated five times for each weight (0, 15, and 30Kg) and CBCT was performed 30 times to find the mean and standard deviation of errors before and after the adjustment of each weight. SPSS ver.19.0(SPSS Inc., Chicago, IL,USA) statistics program was used to perform the Wilcoxon Rank test for significance evaluation and the Spearman analysis was used as the tool to analyze the significance evaluation of the correlation of weight. As a result of measuring the error values from CBCT before and after adjusting the position due to the weight difference, X,Y,Z axis was $0.4{\pm}0.8mm$, $0.8{\pm}0.4mm$, 0 for 0Kg before the adjustment. In 15Kg CBCT before and after adjusting the position due to the weight difference, X,Y,Z axis was $0.2{\pm}0.8mm$, $1.2{\pm}0.4mm$, $2.0{\pm}0.4mm$. After adjusting position was X,Y,Z axis was $0.2{\pm}0.4mm$, $0.4{\pm}0.5mm$, $0.4{\pm}0.5mm$. In 30Kg CBCT before and after adjusting the position due to the weight difference, X,Y,Z axis was $0.8{\pm}0.4mm$, $2.4{\pm}0.5mm$, $4.4{\pm}0.8mm$. After adjusting position was X,Y,Z axis was $0.6{\pm}0.5mm$, $1.0{\pm}0mm$, $0.6{\pm}0.5mm$. When the holder for the head and neck cancer was used to adjust the ab.0ove error value, the error values from CBCT were $0.2{\pm}0.8mm$ for the X axis, $0.40{\pm}0.54mm$ for Y axis, and 0 for Z axis. As a result of statistically analyzing each value before and after the adjustment the value was significant with p<0.034 at the Z axis with 15Kg of weight and with p<0.038 and p<0.041 at the Y and Z axes respectively with 30Kg of weight. There was a significant difference with p<0.008 when the analysis was performed through Kruscal-Wallis in terms of the difference in the adjusted values of the three weight groups. As it could reduce the errors, patients' reproduction could be improved for more precise and accurate radiation therapy. Development of an adjustable device for head and neck cancer patients is significant because it improves the reproduction of existing equipment by reducing the errors in patients' position.
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치환기 특성에 따른 아민흡수제와 CO<sub>2</sub>의 반응특성 평가
심재구,이정현,정진규,곽노상,Shim, Jae-Goo,Lee, Junghyun,Jung, Jin-Kyu,Kwak, No-Sang 한국전력공사 2020 KEPCO Journal on electric power and energy Vol.6 No.3
The reaction of carbon dioxide with the amine-based absorbents which have various substituents in the molecule was described. In the case of MEA which is a representative primary amine, the absorption reaction was proceeded very fast while the regeneration reaction was took place slowly due to the strong bond strength between the absorbent and carbon dioxide. The more substituents on N atom of the absorbent, the slower the absorption reaction between carbon dioxide and the absorbent, which in turn causes faster the regeneration rate from the reaction intermediate, carbamate.
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방사선치료 시 체질량지수와 직장암 환자의 자세 오차 분석
심재구(Jae-Goo Shim),정홍량(Hong-Ryang Jung),서정민(Jung-Min Seo),박병석(Byong-Suk Park),장준영(Joon-Young Jang),임청환(Cheong-Hwan Lim) 한국콘텐츠학회 2013 한국콘텐츠학회논문지 Vol.13 No.10
직장암 환자 방사선 치료 시 체질량지수와 belly board 사용 유?무에 따른 자세 오차 연구를 위해 2012년 1월부터 2013년 3월까지 114명을 대상으로 후향적 연구를 실시하였다. 환자의 평균 나이는 58세(29-83세), 평균 체질량 지수는 23.35 kg/m2(16.55-31.15kg/m2), belly board를 사용한 환자는 31명, 사용하지 않은 환자는 83명이었으며, 치료 확인 촬영 영상 AP&LAT(전, 후측) 총 527장의 X, Y, Z축에 대한 각각의 평균 및 표준 편차는 1.66±1.55mm, 1.64±1.56mm, 1.99±1.75mm의 값으로 나타났다. 체질량지수 24이상을 기준으로 하였을 경우 24미만일 경우보다 Z축에서 2mm이상의 오차 발생 위험도가 4.8배 높게 나타났고 (p<0.001), belly board를 사용하지 않은 경우 체질량 지수가 24이상인 경우 Z축에서 2mm이상의 오차 발생 위험도가 3.6배 높게 나타났다(p<0.011). 직장암 환자의 방사선 치료 시 장루를 착용한 경우에만 Belly Board사용 뿐 만 아니라 체질량 지수가 높은 환자에게도 적용한다면 자세 오차를 줄이는데 효과적일 것이라 사료된다. To study the positioning error according to the use of belly board and body mass index (BMI) for rectal cancer radiotherapy, a retrospective study was conducted on 114 patients from January 2012 to March 2013. The median age of the patients was 58 (29-83 years), mean BMI was 23.35 kg/m2 (16.55-31.15kg/m2), 31 patients used belly board and 83 did not use belly board. There were a total of 527 AP & LAT images of treatment (EPID), and the mean and standard deviation of each X, Y, Z axis were 1.66±1.55mm, 1.64±1.56mm, and 1.99±1.75mm, respectively. Based on the BMI of 24 or higher, error occurrence risk of higher or equal to 2mm on Z axis was 4.8 times higher compared to BMI of 24 or lower (p<0.001), and when BMI was 24 or higher in case the belly board was not used, the error occurrence risk of higher or equal to 2mm on the z-axis was 3.6 times higher (p<0.011). Radiation therapy for rectal cancer patients, using Belly Board for both the ones wearing fistula and with high BMI may be effective in decreasing the positioning errors.
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Factor Analysis of Decreased Score on Coronary Artery Calcium Score
심재구(Jae Goo Shim),김연민(Yon Min Kim),김진우(Jin Woo Kim) 한국방사선학회 2016 한국방사선학회 논문지 Vol.10 No.4
이 연구는 관상동맥 CT 석회화점수 검사를 2회 이상 받은 자 중에서, 이전에 비하여 점수가 낮아진 원인을 후향적으로 분석하였다. 건강검자 환자 100명(남자 85명 60.6±6.9세, 여자 15명 67.2±7.3세)을 대상으로 하였다. 석회화점수 감소가 발생한 경우를 Agatston의 분류 방법에 따라 minimal (1-10), mild(11-100), moderate(101-400), severe (400< ) 4개 그룹으로 분류하였다. Mild 그룹에서 49명으로 가장 많았으며, minimal 그룹에서 감소율 변동이 가장 크게 나타났다. 석회화점수 감소 요인은 Scan location 불일치 51%, Motion artifact 26%, 장비변동 14%, 작업자의 실수 5%, 입력 miss 2%, Image loss 1%, 부정맥 1% 로 나타났다. Scan location의 불일치는 scan된 석회화의 slice 위치에 따른 부분체적 효과로 생각되며, 관상동맥 석회화 점수가 작은 100 이하 그룹에서는 높은 변화폭(19.7%)이 나타났고 100 이상의 그룹에서는 낮은 변화폭(2.2%)을 보여 석회화 점수에 따라 허용될 수 있는 변화폭이 달라진다는 것을 알 수 있었다. Motion artifact 요인은 26%로 나타났으며, 이는 높은 심박동에 의한 것으로 심박동이 높거나 검사 전 폐기능, 운동부하 등 심박동에 영향을 미치는 선행검사와 밀접한 관련이 있었다. The purpose of our study was to retrospectively evaluate the cause of a decreased calcium score of follow-up studies on coronary artery calcium scores (CACs) computed tomography (CT). The subjects were healthy 100 people(85 males 60.6±6.9 years, 15 females 67.2±7.3 years). The subjects decreased CACs were divided into 4 subgroups depending on Agatston classification, minimal (1-10), mild (11-100), moderate (101-400), severe (400<). As a result of decreased CACs were scan location disagreement 51%, motion artifact 26%, equipment changes 14%, operator mistakes 5%, input miss 2%, image loss 1%, arrhythmia 1%. In the mild group, the most common decreased CACs were 49 people. In the minimal group, the most significant variation reduction has occurred to 6 people. Scan location disagreement was considered a partial volume effects due to the scan starting position. It showed less than 100 CACs a high variation (19.7%) in more than 100 CACs, a lower variation (2.2%), these could be seen that the variation range is different that can be tolerated according to the calcification score. Motion artifact factor was found in 26%, which is so closely related to the preceding tests that affect the higher heart rate like this pulmonary function test, exercise stress test.
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스마트 학습법이 보건 계열 학생들에게 성취목표지향성 및 학업적 자기 효능감이 미치는 효과
심재구(Jae-Goo Shim),박수진(Soo-Jin Park) 한국방사선학회 2017 한국방사선학회 논문지 Vol.11 No.4
스마트 학습법을 적용한 학생과 적용하지 않은 학생들을 대상으로 자기주도적 학습능력 및 학업적 자기 효능감이 효과적으로 적용되었는지 알아보고 향 후 보건 계열 방사선과 전공과목에 스마트 학습법을 적용한 효과에 대해 논의 및 향 후 발전적인 방향에 대해 제언하고자 한다. 2016년 3월부터 6월까지 한 학기동안 스마트 학습법으로 강의를 받은 학생과 스마트 학습법을 적용하지 않은 학생 두 분류로 나누었고 자료 수집방법은 자가 보고형 질문지 방식으로 진행하였다. 스마트 학습법으로 강의를 받은 교육군이 비교육군에 비해 자기주도 학습능력를 검정한 결과, 5점 만점에 교육군이 3.46점, 비교육군이 2.63점으로 통계적으로 유의한 차이가 있는 것으로 나타났고(t=9.721, p=.000), 성취목표지향성을 검정한 결과, 교육군이 3.12점, 비교육군이 2.92점으로 통계적으로 유의한 차이가 있는 것으로 나타났다(t=4.544, p=.000). 위의 결과로 스마트학습법이 자기주도학습, 학업적 자기효능감 및 학습 만족도에 대해 긍정적인 영향을 보여줬으며, 향후 보건 계열 학과에서도 교수자는 학습자와 쌍방향 커뮤니케이션을 통해 강의의 질적 향상을 위해 학습 변화가 필요하다. The purpose of this was to study and analyze smart learning the self directed learning, self efficacy, learning satisfaction about department of radiology in a college. For this study total students 74 in 2classes were surveyed at the end of semester. Compared to use smartphones one group and not use smartphones one group for study in a class. The research data was analyzed using SPSS also self directed learning ,self learning efficacy, learning satisfaction analyzed t-test, general character was analyzed two group(one : Used smart learning other : not Used smart learning) χ2-test. First, Used smart learning group is more higher than not Used smart learning group in a self learning efficacy, self directed learning, learning satisfaction. Second, during the smart learning classes a students appeared a positive response. Suggest to change a paradigm in a radiology classes so we have to improve a teaching skills this solution recommend is two way communication. In conclusion, smart learning applied for classes of college is meaningful as a new teaching, which can be change gradually learning satisfaction by teaching methods.
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방사선과 학생을 위한 가상현실 교육콘텐츠 개발 및 적용을 통한 학습효과 분석
심재구(Shim Jae-Goo),권순무(Kwon Soon-Moo) 대한방사선과학회(구 대한방사선기술학회) 2020 방사선기술과학 Vol.43 No.6
This study developed radiation therapy contents based on virtual reality technology and applied them to radiation students. A survey was conducted to analyze the relationship between learning effects and learning satisfaction to students who used virtual reality education videos to analyze their learning performance. 71 students radiology department were classified into two groups one that experienced virtual reality and the other that did not experienced virtual reality. We surveyed between the two groups analyzed self-directed learning, self-learning efficacy and learning satisfaction. As a result, the comparison between the two groups showed no difference between self-directed learning and self-learning efficacy. But the learning satisfaction was significant from 2.64±0.83 to 3.20±0.88 in the problem solving process for groups applying virtual reality contents. Therefore, learning satisfaction has improved experienced group virtual reality content and the materials for virtual reality education can be applied more efficiently in non-face-to-face lectures.
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