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Evaluation of Setup Error Correction for Patients Using On Board Imager in Image Guided Radiation Therapy (Image Guided Radiation Therapy (IGRT) 시 On Board Imager를 이용한 환자 Setup Error 보정평가)

  • Kang, Soo-Man
    • The Journal of Korean Society for Radiation Therapy
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    • v.20 no.2
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    • pp.69-81
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    • 2008
  • Purpose: To reduce side effects in image guided radiation therapy (IGRT) and to improve the quality of life of patients, also to meet accurate SETUP condition for patients, the various SETUP correction conditions were compared and evaluated by using on board imager (OBI) during the SETUP. Materials and Methods: Each 30 cases of the head, the neck, the chest, the belly, and the pelvis in 150 cases of IGRT patients was corrected after confirmation by using OBI at every 2∼3 day. Also, the difference of the SETUP through the skin-marker and the anatomic SETUP through the OBI was evaluated. Results: General SETUP errors (Transverse, Coronal, Sagittal) through the OBI at original SETUP position were Head & Neck: 1.3 mm, Brain: 2 mm, Chest: 3 mm, Abdoman: 3.7 mm, Pelvis: 4 mm. The patients with more that 3 mm in the error range were observed in the correction devices and the patient motions by confirming in treatment room. Moreover, in the case of female patients, the result came from the position of hairs during the Head & Neck, Brain tumor. Therefore, after another SETUP in each cases of over 3 mm in the error range, the treatment was carried out. Mean error values of each parts estimated after the correction were 1 mm for the head, 1.2 mm for the neck, 2.5 mm for the chest, 2.5 mm for the belly, and 2.6 mm for the pelvis. Conclusion: The result showed the correction of SETUP for each treatment through OBI is extremely difficult because of the importance of SETUP in radiation treatment. However, by establishing the average standard of the patients from this research result, the better patient satisfaction and treatment results could be obtained.

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Measurements of Setup Error and Physiological Movement of Liver by Using Electronic Portal Imaging Device in Patients with Hepatocellular Carcinoma (간암환자에서 Electronic Portal Imaging Device(EPID)를 이용한 자세 오차 및 종양 이동 거리의 객관적 측정)

  • Keum Ki Chang;Lee Sang-wook;Shin Hyun Soo;Kim Gwi Eon;Sung Jinsil Seong;Lee Chang Geol;Chu Sung Sil;Chang Sei-Kyung;Suh Chang Ok
    • Radiation Oncology Journal
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    • v.18 no.2
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    • pp.107-113
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    • 2000
  • Purpose : The goal of this study 닌as to improve the accuracy of three-dimensional conformal radiotherapy (3-D CRT) by measuring the treatment setup error and physiological movement of liver based on the analysis of images which were obtained by electronic portal imaging device (EPID). Materials and Methods : For 10 patients with hepatocellular carcinoma, 4-7 portal images were obtained by using EPID during the radiotherapy from each patient daiiy. We analyzed the setup error and physiological movement of liver based on the verification data. We also determined the safety margin of the tumor in 3-D CRT through the analysis of physiological movement. Results : The setup errors were measured as 3mm with standard deviation 1.70 mm in x direction and 3.7 mm with standard deviation 1.88 mm in y direction respectively. Hence, deviation were smaller than 5mm from the center of each axis. The measured range of liver movement due to the physiological motion was 8.63 mm on the average. Considering the motion of liver and setup error, the safety margin of tumor was at least 15 mm. Conclusion : EPID is a very useful device for the determination of the optimal margin of the tumor, and thus enhance the accuracy and stability of the 3-D CRT in patients with hepatocellular carcinoma.

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Usefulness of Permeability Map by Perfusion MRI of Brain Tumor the Grade Assessment (뇌종양의 등급분류를 위한 관류 자기공명영상을 이용한 투과성영상(Permeability Map)의 유용성 평가)

  • Bae, Sung-Jin;Lee, Joo-Young;Chang, Hyuk-Won
    • Journal of radiological science and technology
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    • v.32 no.3
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    • pp.325-334
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    • 2009
  • Purpose : This study was conducted to assess how effective the permeability ratio and relative cerebral blood volume ratio are to tumor through perfusion MRI by measuring and reflecting the grade assessment and differential diagnosis and the permeability and relative cerebral blood volume of contrast media plunged from blood vessel into organ due to breakdown of blood-brain barrier in cerebral. Subject and Method : Subject of study was 29 patients whose diagnosis were confirmed by biopsy after surgery and 550 (11 slice$\times$50 image) perfusion MRI were used to make image of relative cerebral blood volume with the program furnished on instrument. The other method was to transmit to private computer and the image analysis was made additionally by making image of relative cerebral blood volume-reformulated singular value decomposition, rCBV-rSVD and permeability using IDL.6.2. In addition, Kruskal-wallis test tonggyein non numerical average by a comparative analysis of brain tumors Results : The rCBV ratio (Functool PF; GE Medical Systems and IDL 6.2 program by analysis) and permeability ratio of tumors were as follows; high grade glioma(n=4), (14.75, 19.25) 13.13. low grade astrocytoma(n=5) (14.80, 15.90) 11.60, glioblastoma(n=5) (10.90, 18.60), 22.00, metastasis(n=6) (11.00, 15.08). 22.33. meningioma(n=6) (18.58, 7.67), 5.58. oliogodendroglioma(n=3) (23.33, 16.33, 15.67. Conclusion : It was not easy to classify the grade with the relative cerebral blood volume ratio measured by using the relative cerebral blood image by type of tumors, however, permeability ratio measured by permeability image revealed that the higher the grade of tumor, the higher the measured permeability ratio, showing the assessment of tumor grade is more effective to differential diagnosis.

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Pharmacogenetic Impact on Korean Patients Receiving Antiepileptic Drugs (항전간제를 투여받은 한국인 환자에서의 약리유전학적 영향)

  • Kim, Jeong-Oh;Lee, Han-Hee;Shin, Jung-Young;Zhang, Xiang Hua;Oh, Ji-Eun;Kim, Yeong-In;Lee, Jeong-Hyun;Kang, Jin-Hyoung
    • Journal of Life Science
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    • v.22 no.8
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    • pp.1057-1063
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    • 2012
  • Epilepsy is the most prevalent chronic neurological disorder and can be controlled by antiepileptic drugs (AEDs) in up to 70% of patients. We performed an association study between adverse drug reactions and the genetic polymorphisms of CYP2C9, CYP2C19, ABCB1, and SCN1A. The clinical data of 83 epilepsy patients who had received AEDs containing carbamazepine (CBZ) were collected. We extracted genomic DNA from peripheral blood and then genotyped CYP2C9 ($CYP2C9^*2$, $CYP2C9^*3$), CYP2C19 ($CYP2C9^*2$, $CYP2C9^*3$), ABCB1 (C3435T), and SCN1A (IVS5N+5 G>A) using direct sequencing. The allele frequencies of $CYP2C9^*3$, $CYP2C9^*2$, $CYP2C9^*3$, ABCB1 (3435C>T), and SCN1A (IVS5N+5 G>A) were 0.93, 0.72, 0.91, 0.61, and 0.55, respectively. Statistically significant differences were indicated from the data obtained. Patients with SCN1A genotype CC or CT were compared with patients with SCN1A genotype TT while using more than 500mg of carbamazepine. We have associated functional polymorphisms with the dose used in regular clinical practice for Korean epilepsy patients who had received antiepileptic drugs (AEDs) containing carbamazepine. For AEDs, we found that one of the SCN1A genotypes is associated with a 500 mg dose. There was no association found with CNS ADR caused by AEDs.

Measurements of Actual Effective Half-Life in $^{131}I$ Therapy for Graves' Hyperthyroidism (그레이브스 갑상선기능항진증 환자의 방사성옥소($^{131}I$) 치료시 실제 유효반감기의 측정)

  • So, Yong-Seon;Kim, Myung-Seon;Kwon, Ki-Hyun;Kim, Seok-Whan;Kim, Tae-Hyung;Han, Sang-Woong;Kim, Eun-Sil;Kim, Chong-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.30 no.1
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    • pp.77-85
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    • 1996
  • Radioiodine($^{131}I$) has been used for the treatment of Graves' hyperthyroidism since the late 1940's and is now generally regarded as the treatment of choice for Graves' hyperthyroidism who does not remit following a course of antithyroid drugs. But for the dose given, several different protocols have been described by different centers, each attempting to reduce the incidence of long-term hypothyroidism while maintaining an acceptable rate control of Graves' hyperthyroidism. Our goals were to evaluate effective half-life and predict absorbed dose in Graves' hyperthyroidism patients, therefore, to calculate and readminister radioiodine activity needed to achieve aimed radiation dose. Our data showed that the mean effective $^{131}I$ half-life for Graves' disease is 5.3 days(S.D=0.88) and mean biologic half-life is 21 days, range 9.5-67.2 days. The mean admininistered activity and the mean values of absorbed doses were 532 MBq(S.D.=254), 112 Gy (S.D.=50.9), respectively. The mean activity needed to achieve aimed radiation dose were 51MBq and marked differences of $^{131}I$ thyroidal uptake between tracer and therapy ocurred in our study. We are sure that the dose calculation method that uses 5 days thyroidal $^{131}I$ uptake measurements after tracer and therapy dose, provides sufficient data about the effective half-life and absorbed dose of $^{131}I$ in the thyroid and predict the effectiveness of $^{131}I$ treatment in Graves' hyperthyroidism.

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Evaluation of Continuing Education Program to Enhance Competency for Hospice Volunteers: An Exploratory Mixed-Methods Design (호스피스 자원봉사자 역량강화를 위한 지속교육의 효과: 혼합연구방법의 적용)

  • Seo, Minjeong;Cho, Han-A;Han, Sang Mi;Ko, Youngshim;Gil, Cho-Rong
    • Journal of Hospice and Palliative Care
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    • v.22 no.4
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    • pp.185-197
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    • 2019
  • Purpose: Hospice volunteers are serving an invisible yet pivotal role in the hospice and palliative care team. This study investigated how effectively a continuing education program could enhance hospice volunteers' competency. Methods: A total of 20 hours (four hours per week) of training was provided to 30 hospice volunteers who participated in the continuing education for hospice volunteers. Efficiency of the education was analyzed with an exploratory mixed-methods design. For quantitative analysis, the volunteers were asked, before and after the training, about their attitudes towards hospice care, what makes a meaningful life, self-efficacy and satisfaction with their volunteer service. Descriptive statistics, paired t-tests, and Wilcoxon signed-rank test were performed using SPSS Window 20.0. For qualitative research, participants were placed in three groups for a focus group interview, and data were analyzed by content analysis. Results: A quantitative study result shows that this training can significantly affect hospice volunteers' attitudes and improve their self-efficacy. A qualitative study result shows that participants wanted to receive continuous education from the physical/psychosocial/spiritual aspects to better serve end-of-life patients and their family members even though they have to spare significant time for the volunteer service. They wanted to know how to take good care of patients without getting themselves injured and how to provide spiritual care. Conclusion: The continuing education program reflecting volunteers' requests is strongly needed to improve their competency. An effective continuing education requires continuous training and support in areas where hospice volunteers are interested in. A good alternative is to combine web-based and hands-on training, thereby allowing hospice volunteers freely take training that suits their interest.

A Study on Postconventional Christian Education for Intercultural Conflict Resolution (문화 간 갈등해소를 위한 탈인습적 기독교교육에 관한 연구)

  • Kim, Jinyoung
    • Journal of Christian Education in Korea
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    • v.62
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    • pp.257-283
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    • 2020
  • Our current society is experiencing a mass upheaval through globalization: mobility, hybridity, and cultural diversity are part of this world phenomenon. We can say that these changes are a result of people crossing borders due to international travel, immigration, emigration, studying abroad, labor, international marriages, fast and comfortable transportation, and the Internet. According to 2018 UNPD(Untied Nations Population Division)'s data, the international migrants have exceeded 258 million as of 2017. The increased number of migrants signifies that people with various backgrounds move from their own culture to a drastically different one. Interacting with different cultures can give people the chance to experience abundant lifestyles and improve life qualities. During that process, however, the differences between cultures can cause not only misunderstandings, conflicts, and violent collisions, but also xenophobia or radical nationalism. The current society is confronted with a problem: the people cannot stubbornly cling to a homogenous ethnicity anymore, which makes the coexistence between the citizens and immigrants necessary. Through these circumstances, I aim to suggest an educational model and a practical curriculum from a Christian perspective as the aim of this study. It seeks to encourage Christians to flexibly respond to these conflicts and collisions, and to fulfill their social responsibilities faithfully. For this reason, I will explore and seek sharing practical values through both shalom's communality as a theological approach and postconventionality in mature adults as a social-scientific approach. Consequently, I have few requests for the readers. First, approach with openness, understanding, and respect for other culture. Second, see this study as one step of confronting the global problem for coexistence and coprosperity of all social agents in the earth, a limited space. Third, notice that this study uses the interdisciplinary approach (theological and social scientific view) for a shareable, practical value that consistently leads the curriculum of my thesis, and a scientific method to eliminate bias. Lastly, understand that this study will eventually be used in educational practice, and as a result it prioritizes giving thought to the Christian educational environment. This study begins by exploring the conflicts and collisions between diverse cultures of our current society in international and national cases. Afterwards, I will reflect on how we can manage these conflicts and collisions by exploring the social-scientific view, postconventionality in mature adults, the theological view, and shalom's communality as a complement for the postconventionality's personal dimension. In conclusion, I suggest a curriculum that achieves peace as a practical value based on postventionality and shalom's communality for this study's goal.

The Spiritual Well-Being and the Spiritual Nursing Care of Nurses for Cancer Patients (암 환자를 돌보는 간호사의 영적안녕과 영적간호수행)

  • Yoon, Me-Ok
    • Journal of Hospice and Palliative Care
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    • v.12 no.2
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    • pp.72-79
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    • 2009
  • Purpose: The purpose of this study was to test the correlation between the levels of spiritual well-being and spiritual nursing care of nurses for cancer patients and to provide baseline data for spiritual nursing care. Methods: In the study, there were 209 nurses involved who cared for cancer patients, and they were from Christian General Hospital in a city, Jeonju. Data were collected from September 17 to 30 in 2008 using structured questionnaires. The data were analyzed using research methods, including descriptive statistics, t-test, ANOVA, Duncan test, and Pearson correlation coefficients. Results: The mean score of spiritual well-being of nurses was $63.41{\pm}10.32$ (range $20{\sim}80$) and that of spiritual nursing care was $26.96{\pm}7.05$ (range $15{\sim}60$). There was a significant positive correlation between the spiritual well-being of nurses and their spiritual nursing care (r=.353, P=.000). Conclusion: The spiritual well-being and spiritual nursing care have a positive correlation. The level of spiritual well-being of nurses was relatively significant, whereas that of spiritual nursing care was relatively low. Therefore, it is recommended, for spiritual nursing care that nurses responsible for cancer patients should pursue more spiritual growth, attend church services regularly, and should further be educated in their care and responsibility.

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Market Segmentation of Converging New Media Advertising: The Interpretative Approach Based on Consumer Subjectivity (융합형 뉴미디어 광고의 시장세분화 연구: 소비자 주관성에 근거한 해석적 관점에서)

  • Seo, Kyoung-Jin;Hwang, Jin-Ha;Jeung, Jang-Hun;Kim, Ki-Youn
    • Journal of Internet Computing and Services
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    • v.15 no.4
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    • pp.91-102
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    • 2014
  • The purpose of this research is to perform the consumer typological study of integrated emerging digital advertisement, where IT and advertisement industry were fused, and to propose the theoretical definition about consumer characteristic which is in need for collection of related market subdivision strategy in perspective of business marketing. For this, the Q methodology, the 'subjectivity' research of qualitative perspective, which discovers new theory by interpreting subjective system of thinking, preference, opinion, and recognition of inner side of respondents, was applied and analyzed. Compared to previous quantitative research that pursues hypothesis verification, this Q methodology is not dependent on operational definition proposed by researcher but pursues for analytic study completely reflecting objective testimony of respondents. For this reason, Q study analyzes in-depth the actual consumer type, which can be found at the initial market formation stage of new service, therefore this study is applicable for theorizing the consumer character as a mean of advanced research. This study extracted thirty 'IT integrated digital advertisement type (Q sample)' from thorough literature research and interviews, and eventually discovered a total four consumer types from analyzing each Q sorting research data of 40 respondents (P sample). Moreover, by interpreting subdivided intrinsic characteristic of each group, the four types were named as 'multi-channel digital advertisement pursuit type', 'emotional advertisement pursuit type', 'new media advertisement pursuit type', and Web 2.0 advertisement pursuit type'. The analysis result of this study is being expected for its value of usage as advanced research of academic and industrial research with the emerging digital advertisement industry as a subject, and as basic research in the field of R&D, Marketing program and the field of designing the advertisement creative strategy and related policy.

Actual Condition of Quality Control of X-ray Imaging System in Primary Care Institution: focused on Gwangju Metropolitan City (1차 의료기관의 엑스선 발생장치 정도관리에 관한 현황조사:광주광역시 지역을 중심으로)

  • Dong, Kyung-Rae;Lee, Seun-Joo;Kweon, Dae-Cheol;Goo, Eun-Hoe;Jung, Jae-Eun;Lee, Kyu-Su
    • Journal of Radiation Protection and Research
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    • v.35 no.1
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    • pp.34-42
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    • 2010
  • With the expanded use of radiation in modern medical practices, the most important issue in regards to efforts to reduce individual exposure dose is quality assurance. Therefore in order to study the present condition of quality assurance, the Gwangju Metropolitan City area was divided into five districts each containing ten hospitals. Four experiments were conducted: a reproducibility experiment for kVp, mA, and examination time (sec) intensity of illumination; half-value layer (HVL) measurement; and beam perpendicularity test matching experiment. The tube voltage reproducibility experiment for all fifty hospitals resulted in a 95.33% passing rate and mA and examination time both resulted in a 77.0% passing rate. The passing rate for intensity of illumination was 86.0% and 52.0% for HVL, which was the lowest passing rate of all four factors. For the beam perpendicularity test matching experiment, generally the central flux is matched to within $1.5^{\circ}$. Of all fifty hospitals 30.0% were beyond $3^{\circ}$. The results of the survey showed that 58% responded that they knew about quality assurance cycle. All fifty respondents stated that they have not received any training in regards to quality assurance at their current place of employment. Although quality assurance is making relative progress, the most urgent issue is awareness of the importance of quality assurance. Therefore, the implementation of professional training focusing on safety management and accurate quality assurance of radiation will reduce the exposure to radiation for radiologists and patients and higher quality imaging using less dosage will also be possible.