두경부암 환자 치료시 3차원 보상체의 임상 적용에 대한 고찰

홍동기,이정우,이두현,박광호,김정만,Hong, Dong-Ki,Lee, Jeong-Woo,Lee, Koo-Hyun,Park, Kwang-Ho,Kim, Jeong-Man 대한방사선치료학회 1997 大韓放射線治療技術學會誌 Vol.9 No.1

The goal of radiation treatment planning is to deliver the dose to the patient within $5\%$ of that prescribed. We have often encountered the situation that the area which have not only several irregular contours but also tissue heterogeneities should be treated. With conventional devices such as wedges, missing tissue compensator. there are some limitations to achieve the uniform dose distribution in treatment volume. The use of CT simulator, 3-D planning system, computer-controlled milling machine enables it to deliver the dose uniformally. This report includes the whole procedure which have patient data acquisition 3D planning, computer-controlled milling, performance verification of 3D compensator, and TLD evaluation. We applied it for the treatment of head and heck cancer only. In Spite of the irregular contour and different electron density of tessue, we have achieved the uniformity of the dose distribution within ${\pm}3\%$ relatively. Although there are some problems which are not only verification of performance but uncertainties of using the new treatment device, we believe that the improvement of dosimetry will eliminate the uncertainties of that application. so the other lesions besides head and neck can will be ale to use the 3D compensator to achieve the dose uniformity

Customer Acceptance Procedure for Clinac (21EX-Platinum)

홍동기,이우석,권경태,박광호,김정만,Hong, Dong-Ki,Lee, Woo-Seok,Kwon, Kyung-Tae,Park, Kwang-Ho,Kim, Chung-Man 대한방사선치료학회 2004 大韓放射線治療技術學會誌 Vol.16 No.2

목적 : 환자의 치료에 있어서 정확한 장비의 설치와 성능 평가는 치료의 질을 향상시키는데 중요한 요소라고 할 수 있으며 사용자가 장비의 특성과 사용 방법을 숙달하고 업무를 수행하는 것이 매우 중요하다고 생각한다. 그러므로 방사선 치료기를 설치하고 방사선 치료를 하기 전에 사용자가 직접 장비의 설치와 성능 평가에 참여하고 특성을 파악하여 이해하는 것이 필요하다. 본 연구에서는 CAP의 과정과 성능 평가결과를 소개하고자 한다. 대상 및 방법 : 선형가속기 21EX(varian, USA)를 대상으로 설치 시부터 성능 검사까지 전 과정을 평가하였고 성능평가는 크게 radiation survey, mechanical test, radiation isocenter test, beam performance, dosimetry, enhanced dynamic wedge로 구분하여 X-omat film(kodark), 선량 측정 장비(multidata, densitometer, electrometa)를 이용하여 실시하였다. 또한 선형가속기에 부착된 MLC(millenium, 120leaf)와 EPID(portal vision)의 성능 평가는 별도로 실시하였다. 결과 : Survey meter를 이용하여 측정한 leakage는 허용 범위 이하의 선량이 검출되었고 mechanical test에서 collimator, gantey, couch rotation은 1mm 이하였고 육안으로 평가한 angle은 digital이 ${\pm}1^{\circ}$이내에 mechanical은 ${\pm}5^{\circ}$이내였다. 또한 light field와 cross-hair의 직선성 검사도 1mm이내로 평가되었다. (A)symmetrical jaw field는 upper/lower 모두 ${\pm}0.5mm$이내였다. X-omat film을 이용한 radiation isocenter test는 1mm 이하였고 light field와 radiation field 의 일치성 검사는 ${\pm}1mm$ 이내였으며 선량 측정 장비를 이용하여 측정한 $\%DD$는 photon energy는 모두 ${\pm}1\%$ 이내로 electron energy는 $90\%,\;80\%,\;50\%,\;30\%$를 측정한 결과 허용 범위 내에서 평가되었다. photon 과 electron energy의 flateness는 각각 $2.3\%$(기준 $3\%$)이내, $3\%$(기준 $4.5\%$)이내이고 symmetry는 $0.45\%$(기준 $2\%$), $0.3\%$(기준 $2\%$)이내에서 평가 할 수 있었다. 그리고 dosimetry test는 sort term, MU setting, rep rate, dose rate accuracy를 photon과 electron energy 별로 MU와 gantry angle을 바꿔가면서 측정한 결과 허용범위 오차이내에 포함되는 것을 확인 할 수 있었다. EPID(portal vision)의 Exact-Arm의 기계적인 검사는 vertical, lateral, longitudinal은 허용범위 내에서 동작했으며 명암과 해상도 검사도 05.mm의 니크롬선이 선명하게 나타났으며 phantom의 음영도 뚜렷하게 나타났다. Multileaf collimator(MLC)검사는 leaf이 isocenter의 중심에 정확하게 배열되었으며 재현성 검사도 정상적으로 동작하였다. 결론 : Clinac 21EX 장치의 customer acceptance를 통해서 향후의 환자의 치료를 하는데 있어 장치의 안정성을 확인 할 수 있었으며 치료 전의 선형가속기와 주변장치의 특성을 파악 할 수 있어서 장비 사용에 있어서 어려움을 감소시킬 수 있으리라고 생각된다. 또한 사용자가 적극적으로 참여함으로써 앞으로 환자를 치료하는데 있어서도 많은 도움이 되리라 생각한다. Purpose : For qualify improvement in radiotherapy, it is important to set up and evaluate equipment (linac) accurately. In addition, technicians are needed to be fully aware of the equipment's detailed quality and its manual. Therefore, the result of ATP is evaluated and introduced, in order that the technicians are skilled by participating in quality assurance (QA) and understanding the quality of the equipment before clinical use. Method and Material : QA for LINAC 21EX (Varian, US) was done with suppliers its procedure was divided into radiation survey, mechanical test, radiation isocenter test, bean performance, dosimetry, and enhanced dynamic wedge and using X-omat film (Kodak), multidata, densitometer, and electrometer. QA of MLC (Millennium, 120 leaf) attached to LINAC and EPID (Portal vision) were done separately. Result : The leakage dose by survey meter was below the tolerance. In mechanical test, collimater, gantry, and couch rotation were less than 1mm, and the angles were ${\pm}0.1^{\circ}$ for digital and ${\pm}0.5^{\circ}$ for mechanical. The alignment test of the light field and crosshair were evaluated less than 1mm. The (a)symmetrical jaw field was less than ${\pm}0.5mm$. The radiation isocenter test using X-mat film was less than 1mm. The consistency of light field and radiation field was less than ${\pm}0.1mm$. PDD for photon energy was less than ${\pm}1\%$ and for electron energy of $90\%,\;80\%,\;50\%,\;and\;30\%$ were evaluated within the tolerance. Flatness for photon and electron energy was evaluated $2.3\%$ (tolerance $3\%$) and $3\%$ (tolerance $4.5\%$), respectively, and symmetry was $0.45\%$ (tolerance $2\%$) and $0.3\%$ (tolerance $2\%$), respectively. Dosimetry test for short term, MU setting, rep rate, and dose rate accuracy of photon and electron energy was within the tolerance depending on energy, MU, and gantry angle. Conclusion : Accuracy and safety for clinical use of Clinac 21EX was verified through customer acceptance procedure and the quality of the equipment was found out. These can reduce the difficulties in using the equipment. Furthermore, it is useful for clinically treatment of patients by technicians' active participations.

직물전극을 이용한 손목형 ECG 측정 장치에 관한 연구

홍동기(Dong-Ki Hong),김경호(Kyung-Ho Kim) 대한전기학회 2014 정보 및 제어 심포지엄 논문집 Vol.2014 No.4

Sliding mode를 이용한 SCARA 로보트의 궤적 제어에 관한 연구

홍동기(D.G. Hong),남경태(K.T. Nam),이해영(H.Y. Lee),박정일(J.I. Park),이석규(S.G. Lee) 대한전기학회 1995 대한전기학회 학술대회 논문집 Vol.1995 No.7

Hepatoprotective Effect of Alnus japonica and Portulaca oleracea Complex on Alcohol-induced Liver Injury Mice Models by Anti-oxidation Activity

홍동기(Dong ki Hong),박수동(Soodong Park),김주연(Jooyun Kim),심재정(Jaejung Shim),이정률(Junglyoul Lee) 한국자원식물학회 2023 한국자원식물학회지 Vol.36 No.3

직물전극을 이용한 심전도 측정에 관한 연구

홍동기(Dong-Ki Hong),정인복(In-Bok Jung),김경호(Kyung-Ho Kim) 대한전기학회 2013 대한전기학회 학술대회 논문집 Vol.2013 No.7

기화주제(企畵主題)(민사절차법의 문제점과 그 해결방안 ; 부실등기 방지를 위한 등기신청절차의 개선방안 -등기원인증서의 공증제와 자격대리인의 본인확인의무를 중심으로-

홍동기 ( Dong Ki Hong ) 경성대학교 법학연구소 2013 경성법학 Vol.22 No.-

Real estate registration is a national level notarization behavior that aims to protect citizens`` private properties and to pursue after stable transaction by accurately notifying the changes pertaining ti the relationship of real estate rights. In other words, real estate registration is a means for posting up the real right in an official manner. Thus, if there is confusion or defect when it comes to the registration, this I bound to cause immense confusion regarding citizens`` real right. Accordingly, registration system aims to contribute to the stability and effective control of real estate transactions by posting up the changes of the actual real right accurately and rapidly. Moreover. Korea takes on the orientation pertaining to the requirements for validity(formalism) when it comes to real estate real right change. Thus, in order for the registration system to fulfill its inherent role which is real estate transaction safety, it is required that the real estate``s actual state should be reflecter accurately on the register, and it is also required that the process of change when it comes to the relationship of rights that are registered for a certain real estate is listed on the register accurately without omission. Accordingly, in order to realize the deals of the registration system which are the accurate official posting of real right change and protection of transaction safety, it is necessary to prevent poor registration to ensure accurate official posting of the real right change above anything. Meanwhile, it is also necessary to pursue after the measures to ensure transaction safety by laying down the means for handing poor registration legally and by developing the system for the protection of the entrusting party against poor registration with the assumption that poor registration cannot be completely eliminated despite these efforts. The ultimate goal of the registration system of the entrusting day is to carry out official posting accurately and promptly while ensuring harmony between the real estate transaction safety and effective control. Until recently, discussions were being held about the following in Korea in order to prevent poor registration and to increase registration``s reliability level; adoption of the notarization system for the deed of grounds for registration. securing of registration officials`` actual right to review. unification of general register ledger, registration compulsory, and strengthening of the self authentication procedure for the agent applying fir registration. There is no doubt that all these systems can serve as a means to improve registration``s reliability. However, even when these systems as a means to improve registration``s reliability. However, even when these systems are measures that can prevent poor registration and? increase registration``s reliability level on a logical level. it is necessary to factor in the reality of Korea such as the current status concerning application for registration and progress on the operation of the registration system before making the decision on whether to adopt them or not. If not. adoption of a certain system a be realize the goal which was intended in the beginning due to the realistic limitations. Instead, this system could in fact increase burden on the citizens or impede promptness of the registration procedure. Meanwhile, even when the legislation and realities of each of the advanced nations of the West are examined, it appear as if poor registration cannot be eliminated despite the adoption of numerous systems and despite the extensive effort made to increase registration``s reliability level. This demonstrates that there is need to pursue after the measures to protect the party that trusts poor registration and formed relationship of transaction while making the effort to prevent poor registration. To these, this research reviewed all these system level measures which were being discussed in the past to prevent poor registration by utilizing the experiences of the`` working level registration official by focusing on practical value and feasibility of adopting. Meanwhile, this research clearly disclosed all the measures for the rational handing of poor registration if it occurs and for the protection of entrusting party through the interpretation of the existing laws. Meanwhile, this research seeks to contribute to the development of the registration system that suits our reality by unfolding the legislation for the recognition of registration``s public confidence. Towards this end, there is a need to carry out the following. CD In relation to the question of adopting the notarization system for the deed of grounds for registration. it is important to note that the share of poor registration that is related to the notarization of the deed of grounds for registration is not very high. Moreover, even when the deed of grounds for registration notarization system is adopted. the effect on the prevention of poor registration may not be high when compared to the additional social and economic costs that citizens have to assume. Given all these., it may be possible to complement through the strengthening of the qualification agent``s self authentication procedure sunce an agent is in charge of applying for registration in most cases instead of merely relying on the adoption of deed of grounds for registration notarization system. (2)In order to adopt the system in which registration official carries out the review in actuality. in a complete manner. it is necessary to factor in the reality in which the number of registration officials is very short. compared to the number of registration applications. Thus. it is necessary to review the possibility of adopting the system in parts for some of the registration, ® Moreover. it is necessary to alleviate mis match for marking of real estate by linking the register and general ledger via IT system. @ As for the registration regarding marking. there is a need to modify and to complement the system level measures to suit our reality before adopting so that they. would including measures to prevent poor registration by making registration compulsory. Moreover, the following measures are needed to protect the entrusting party of the poor registration resulting despite this and to pursue after transaction safety. CDAs for the present time when the registration``s public confidence is not recognized, it is necessary to protect the entrusting party of the poor registration in case there is a need to withstand the sacrifice of the genuine right holder by providing the root causes of poor registration through the rational interpretation of the existing laws. (2) Ultimately. it is necessary to recognize public confidence when it comes to the registration to review legislative solution with the prerequisite of pursuing after systematic measures to third party``s safety.

MLC leakage를 이용할 Verification의 효용성 고찰

윤인하,홍동기,정왕권,서동린,윤화룡,김정만,Yun InHa,Hong DongGi,Jung WangKwon,Seo DongRin,Yun HwaRyeong,Kim JungMan 대한방사선치료학회 2004 大韓放射線治療技術學會誌 Vol.16 No.1

Purpose : Verification within 5mm is one of the important QA process of IMRP and SRS. Therefore, we improve accuracy of patients set-up using scale point. Materials and Methods : We compare MLC scale pointer with customerized port film graticule for patients who was underwent IMRT and SRS. Results : Scale pointer using MLC showed accurate location of patients landmark including divergency of beam, and any point of patient could be certified by means of cross of MLC. Conclusion : MLC scale pointer is effective and convenient method in verification of patients set-up using L-gram. 서론 및 목적 : 세기변조 방사선치료와 전신 정위적 방사선치료에서 5mm이내의 위치 정확성확인 (L-gram)은 환자치료 목적 달성을 위한 중요한 QA과정의 하나이다. 이에 본원에서 제작한 scale point를 이용하여 L-gram 영상을 얻어 환자치료의 정확성을 향상시키고자 한다. 대상 및 방법 : 본원의 MLC 부착장비인 CL2100C/D, CL21EX에서 치료중인 IMRT, SRS환자를 대상으로 기존의 상품화된 port film graticule과 본원에서 제작한 MLC scale pointer를 비교 분석하였다. 결과 : MLC를 이용한 scale pointer는 beam의 확산까지 고려한 정확한 위치를 나타내었고 MLC의 교차로 생기는 pixel 모양의 형성을 통해 어떠한 위치에서도 정확한 확인이 가능했다. 결론 및 고찰 : L-gram 확인시 약간의 시간적 투자($1{\sim}2$분)로서 정확한 위치를 나타냄으로서 L-gram 확인시간 단축과 치료부위의 정확한 위치 확인을 할 수 있었다.

폐암 환자의 전신 정위적 방사선 수술시 정확한 SET UP에 대한 고찰

서동린,홍동기,권경태,박광호,김정만,Seo, Dong-Rin,Hong, Dong-Gi,Kwon, Kyung-Tea,Park, Kwang-Ho,Kim, Jung-Man 대한방사선치료학회 2004 大韓放射線治療技術學會誌 Vol.16 No.2

목적 : 전신 정위적 방사선 수술환자 치료 시 환자의 set up을 정확히 확인하고 평가하는 것은 치료 성적을 좌우 하는데 중요한 요소이다. 특히 폐암 환자의 경우 호흡 등에 의한 종양의 움직임으로 인해서 L-gram이나 EPID를 이용하여 정확한 위치를 확인하는데는 여러 가지 어려움이 있다. 이러한 문제점들에 대하여 verification system(exactrac)을 이용하여 set up의 정확성을 확인해 보고자 한다. 대상 및 방법 : Body frame(elekta, sweden)을 이용하여 전신 정위적 방사선 수술을 받는 폐암 환자 6명을 대상으로 (ABC tool을 사용한 환자 5명과 사용 안한 환자1명) 기존의 L-gram과 EPIDs로 image를 획득하여 Ant, Lat image를 비교하여 환자의 set-up을 확인하고 CT에서 얻은 DRR image와 Verification system(exactrac)의 X-ray image를 얻어서 두image를 3차원적으로 fusion하여 그 좌표 값(vertical, longitudinal, lateral)을 분석하고 기존의 방법과의 차이를 확인하였다. 결과 : L-gram과 EPIDs로는 정확한 좌표 값보다는 주관적으로 Set up의 정확성 여부를 판단하여 치료할 수 있었지만 Verification system(exactrac)을 이용하여 확인한 결과 치료환자의 Set up 전, 후의 좌표 값(vertical, longitudinal, lateral)이 0.5cm이내에 포함되는 것을 볼 수 있었고 좌표 값의 차이를 시각적이고 객관적으로 평가할 수 있어서 Set up의 정확성을 판단하는 데 유용했다. 결론 : Verification system(exactrac)을 사용하면 환자의 Set up이 정확한 지 치료 전 또는 중간에도 시각적인 확인이 가능한 장점이 있지만 기존의 방법보단 확인과정이 조금 복잡하고 CT scan 시 3mm 이내로 해야 하며 X-ray image가 선명하게 나타나야 된다는 단점이 있다. 이러한 문제점만 해결된다면 Set up의 정확성을 쉽게 확인할 수 있어서 치료 시 많은 도움이 되리라고 생각된다. Purpose : What confirm a patient's set-up precisely is an important factor in stereotactic radiosurgery Especially, the tumor is moved by respiration in case of lung cancer. So it is difficult to confirm a exact location by L-gram or EPID. I will verify a exact patient's set-up about this sort of problem by verification system(exactrac 3.0) Materials and Methods : The patient that had lung cancer operated on stereotactic radiosurgery is composed of 6 people. The 5 patients use an ABC tool and 1 patient doesn't use it. I got such a patient's L-gram and EPID image by Body frame(elekta, sweden), compared Ant. image with Lat. one, and then confirmed a set-up. I fused DRR image of CT and X-ray image of Verification system(exactrac 3.0) 3 dimensional, analyzed the coordinate value(vertical, longitudinal, lateral), and then confirmed a difference of existing method. Results : In case of L-gram and EPID, we judge an exact of the patient's set-up subjectively, and on we could treat the patient with radiation. As a result of using Verification system(exactrac 3.0), coordinate value(vertical, longitudinal, lateral) of patient's set-up was comprised within 5mm. We could estimate a difference of the coordinate value visually and objectively. Consequently, Verification system(exactrac 3.0) was useful in judging an exact patient's set-up. Conclusion : In case of Verification system(exactrac 3.0), we can confirm an exact patient's set-up at any time whenever, However, there are several kinds of the demerit. First, it is a complex process of confirmation than the existing process. Second, thickness of CT scan slice is within 3mm. The last, X-ray image has to have shown itself clearly. If we solve this problem. stereotactic radiosurgery will be useful in treating patients why we can confirm an exact patient's positioning easily.

Analytical Anisotropic Algorithm을 사용한 폐암 치료 시 MU 검증 프로그램 적용에 관한 고찰

김종민,김대섭,홍동기,백금문,곽정원,Kim, Jong-Min,Kim, Dae-Sup,Hong, Dong-Ki,Back, Geum-Mun,Kwak, Jung-Won 대한방사선치료학회 2012 대한방사선치료학회지 Vol.24 No.1

목 적: Analytical Anisotropic Algorithm (AAA)을 사용하여 계산된 폐 부위 방사선치료계획은 Pencil Beam Convolution (PBC) Algorithm 기반의 MU 검증 프로그램을 이용하였을 때 MU의 오차가 발생하여 MU 검증 프로그램 사용에 어려움이 있다. 본원에서는 AAA를 사용하여 계산된 치료계획을 검증할 방법에 대하여 연구하였다. 대상 및 방법: Eclipse treatment planning system (Version 8.9, Varian, USA)을 사용하여 폐 부위 정위적체부방사선치료(Stereotactic Body Radiation Therapy, SBRT) 7건에서의 총 57개 조사야(Field) 각각에 대하여 선량계산 알고리즘으로 PBC와 AAA를 사용하여 계산하였다. 수립된 치료계획의 MU를 자체 개발하여 사용 중인 MU 검증 프로그램의 MU와 비교 분석하였다. PBC 알고리즘과 AAA에서 발생한 오차에 영향을 미칠 수 있는 조사야크기(Field size), 방사선이 폐 조직을 통과한 거리, 방사선이 종양 조직을 통과한 거리, 유효깊이(Effective depth) 등 4가지 변수에 대하여 오차와의 상관관계를 상용 프로그램을 이용하여 분석하였다. 결 과: PBC 알고리즘의 오차는 $0.2{\pm}1.0%$로 나타났으며 AAA의 오차는 $3.5{\pm}2.8%$로 나타났다. 또한, 오차에 영향을 미칠 수 있는 4가지 변수에 대해 분석한 결과, 방사선이 폐 조직을 통과한 거리와 MU의 오차와의 관계에서 상관계수 0.648 (P=0.000)로 유의하게 증가하였고, ${\Delta}_{AAA}$=L.P 0.00903+0.02048이라는 MU 보정인자를 산출해 낼 수 있었으며 MU 보정인자를 MU 검증 프로그램에 적용한 결과, 적용 전 $3.5{\pm}2.8%$의 오차는 $0.4{\pm}2.0%$ 이내로 줄어들었다. 결 론: 본 연구에서는 방사선이 폐 조직을 통과한 거리가 커질수록 MU 검증 프로그램과의 오차가 커짐을 알아냈으며, MU보정인자라는 간단한 방법을 통해 AAA 알고리즘의 MU를 검증할 수 있게 되었다. Purpose: There was a problem with using MU verification programs for the reasons that there were errors of MU when using MU verification programs based on Pencil Beam Convolution (PBC) Algorithm with radiation treatment plans around lung using Analytical Anisotropic Algorithm (AAA). On this study, we studied the methods that can verify the calculated treatment plans using AAA. Materials and Methods: Using Eclipse treatment planning system (Version 8.9, Varian, USA), for each 57 fields of 7 cases of Lung Stereotactic Body Radiation Therapy (SBRT), we have calculated using PBC and AAA with dose calculation algorithm. By developing MU of established plans, we compared and analyzed with MU of manual calculation programs. We have analyzed relationship between errors and 4 variables such as field size, lung path distance of radiation, Tumor path distance of radiation, effective depth that can affect on errors created from PBC algorithm and AAA using commonly used programs. Results: Errors of PBC algorithm have showned $0.2{\pm}1.0%$ and errors of AAA have showned $3.5{\pm}2.8%$. Moreover, as a result of analyzing 4 variables that can affect on errors, relationship in errors between lung path distance and MU, connection coefficient 0.648 (P=0.000) has been increased and we could calculate MU correction factor that is A.E=L.P 0.00903+0.02048 and as a result of replying for manual calculation program, errors of $3.5{\pm}2.8%$ before the application has been decreased within $0.4{\pm}2.0%$. Conclusion: On this study, we have learned that errors from manual calculation program have been increased as lung path distance of radiation increases and we could verified MU of AAA with a simple method that is called MU correction factor.