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- 저자 : 임상욱 ( San (검색결과 2 건)
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허현도,최상현,김우철,김헌정,김성훈,조삼주,민철기,조광환,이상훈,최진호,임상욱,신동오,Huh, Hyun-Do,Choi, Sang-Hyoun,Kim, Woo-Chul,Kim, Hun-Jeong,Kim, Seong-Hoon,Cho, Sam-Ju,Min, Chul-Ki,Cho, Kwang-Hwan,Lee, Sang-Hoon,Choi, Jin-Ho,Lim, San 한국의학물리학회 2009 의학물리 Vol.20 No.3
사이버나이프 로봇 방사선 수술 시스템은 환자를 치료하는 동안 환자의 내부 기준 마커를 이용하여 종양의 위치를 실시간으로 추적 할 수 있는 시스템이다. 최근 폐종양 치료의 경우 기준 마커의 삽입 없이 폐종양의 밀도 차이를 이용하여 실시간 종양 추적을 할 수 있는 폐종양추적시스템이 개발되어 치료에 적용되고 있다. 최근 개발되어 국내 최초 도입된 폐종양 추적치료시스템의 위치 추적 정확도의 분석은 동적흉부 팬톰과 GafChromic film을 이용하였다. 폐종양추적시스템을 이용하여 종양의 위치 추적 정확도는 평균 오차 $0.85{\pm}0.22$ mm로 분석되었다. 기준마커 삽입 없이 폐종양추적시스템을 이용하여 폐종양 치료에 매우 유용한 것으로 판단되었다. To track moving tumor in real time, CyberKnife system imports a technique of the synchrony respiratory tracking system. The fiducial marker which are detectable in X-ray images were demand in CyberKnife Robotic radiosurgery system. It issued as reference markers to locate and track tumor location during patient alignment and treatment delivery. Fiducial marker implantation is an invasive surgical operation that carries a relatively high risk of pneumothorax. Most recently, it was developed a direct lung tumor registration method that does not require the use of fiducials. The purpose of this study is to measure the accuracy of target applying X-sight lung tracking using the Gafchromic film in dynamic moving thorax phantom. The X-sight Lung Tracking quality assurance motion phantom simulates simple respiratory motion of a lung tumor and provides Gafchromic dosimetry film-based test capability at locations inside the phantom corresponding to a typical lung tumor. The total average error for the X-sight Lung Tracking System with a moving target was $0.85{\pm}0.22$ mm. The results were considered reliable and applicable for lung tumor treatment in CyberKnife radiosurgery system. Clinically, breathing patterns of patients may vary during radiation therapy. Therefore, additional studies with a set real patient data are necessary to evaluate the target accuracy for the X-sight Lung Tracking system.
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정상 심기능을 보이는 노인 환자에서 정형외과 수술 전 NT-proBNP의 역할
고은정 ( Eun Jung Ko ),문재연 ( Jae Youn Moon ),임영민 ( Yeong Min Lim ),홍원정 ( Won Jung Hong ),신석표 ( Suk Pyo Shin ),김상훈 ( Sang Hoon Kim ),양우인 ( Woo In Yang ),성정훈 ( Jung Hoon Sung ),김인재 ( In Jai Kim ),임상욱 ( San 대한내과학회 2014 대한내과학회지 Vol.87 No.3
Background/Aims: Preoperative N-terminal pro-brain natriuretic peptide (NT-proBNP) is a useful predictor of postoperative cardiovascular complications. The present study investigated whether blood NT-proBNP values are suitable for predicting postoperative cardiovascular complications after non-cardiac surgery in elderly patients showing normal left ventricular (LV) function on preoperative echocardiograms. Methods: This study was performed by analyzing the medical records of elderly patients referred to the cardiology department for the purpose of assessing their cardiac function before orthopedic surgery. Of the patients who underwent echocardiography and NT- proBNP assessment simultaneously, 275 patients aged ≥ 70 years and with an LV ejection fraction of ≥ 55% were included in the study. Results: Major adverse cardiac and cerebrovascular events (MACCEs) occurred in 33 (12%) of the 275 patients, and the NT-proBNP concentration was higher in patients with complications than in those without complications (1,904.20 ± 2,300.23 vs. 530.58 ± 882.27 pg/mL, p < 0.01). The ROC area under the curve was 0.756 (95% confidence interval 0.701-0.805, p < 0.001) with an optimal cutoff of 416.3 pg/mL (69.7% sensitivity, 67.36% specificity). A multivariate analysis showed that a preoperative age of > 80 years (odds ratio, 2.313; p = 0.047) and an increased blood NT-proBNP concentration (odds ratio, 3.189; p = 0.009) were independent risk factors for the prediction of MACCEs. Conclusions: Although elderly patients scheduled to undergo non-cardiac surgery may show normal LV systolic function on echocardiography, measurement of their preoperative blood NT-proBNP concentration is useful for predicting MACCEs occurring after non-cardiac surgery. (Korean J Med 2014;87:302-310)
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