• Title/Summary/Keyword: 결정론적 분석

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Evaluation of Scattered Dose to the Contralateral Breast by Separating Effect of Medial Tangential Field and Lateral Tangential Field: A Comparison of Common Primary Breast Irradiation Techniques (유방암 접선조사 치료 방법에 대한 반대쪽 유방에서의 산란선량 평가)

  • Ban, Tae-Joon;Jeon, Soo-Dong;Kwak, Jung-Won;Baek, Geum-Mun
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.2
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    • pp.183-188
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    • 2012
  • Purpose: The concern of improving the quality of life and reducing side effects related to cancer treatment has been a subject of interest in recent years with advances in cancer treatment techniques and increasing survival time. This study is an analysis of differing scattered dose to the contralateral breast using common different treatment techniques. Materials and Methods: Eclipse 10.0 (Varian, USA) based $30^{\circ}$ EDW (Enhanced dynamic wedge) plan, $15^{\circ}$ wedge plan, $30^{\circ}$ wedge plan, Open beam plan, FiF (field in field) plan were established using CT image of breast phantom which in our hospital. Each treatment plan were designed to exposure 400 cGy using CL-6EX (VARIAN, USA) and we measured scattered dose at 1 cm, 3 cm, 5 cm, 9 cm away from medial side of the phantom at 1 cm depth using ionization chamber (FC 65G, IBA). We carried out measurement by separating effect of medial tangential field and lateral tangential field and analyze. Results: The evaluation of scattered dose to contralateral breast, $30^{\circ}$ EDW plan, $15^{\circ}$ wedge plan, $30^{\circ}$ wedge plan, Open beam plan, FIF plan showed 6.55%, 4.72%, 2.79%, 2.33%, 1.87% about prescription dose of each treatment plan. The result of scattered dose measurement by separating effect of medial tangential field and lateral tangential field results were 4.94%, 3.33%, 1.55%, 1.17%, 0.77% about prescription dose at medial tangential field and 1.61%, 1.40%, 1.24%, 1.16%, 1.10% at lateral tangential field along with measured distance. Conclusion: In our experiment, FiF treatment technique generates minimum of scattered dose to contralateral breast which come from mainly phantom scatter factor. Whereas $30^{\circ}$ wedge plan generates maximum of scattered doses to contralateral breast and 3.3% of them was scattered from gantry head. The description of treatment planning system showed a loss of precision for a relatively low scatter dose region. Scattered dose out of Treatment radiation field is relatively lower than prescription dose but, in decision of radiation therapy, it cannot be ignored that doses to contralateral breast are related with probability of secondary cancer.

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The Effect of Photoneutron Dose in High Energy Radiotherapy (10 MV 이상 고에너지 치료 시 발생되는 광중성자의 영향)

  • Park, Byoung Suk;Ahn, Jong Ho;Kwon, Dong Yeol;Seo, Jeong Min;Song, Ki Weon
    • The Journal of Korean Society for Radiation Therapy
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    • v.25 no.1
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    • pp.9-14
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    • 2013
  • Purpose: High-energy radiotherapy with 10 MV or higher develops photoneutron through photonuclear reaction. Photoneutron has higher radiation weighting factor than X-ray, thus low dose can greatly affect the human body. An accurate dosimetric calculation and consultation are needed. This study compared and analyzed the dose change of photoneutron in terms of space according to the size of photon beam energy and treatment methods. Materials and Methods: To measure the dose change of photoneutron by the size of photon beam energy, patients with the same therapy area were recruited and conventional plans with 10 MV and 15 MV were each made. To measure the difference between the two treatment methods, 10 MV conventional plan and 10 MV IMRT plan was made. A detector was placed at the point which was 100 cm away from the photon beam isocenter, which was placed in the center of $^3He$ proportional counter, and the photoneutron dose was measured. $^3He$ proportional counter was placed 50 cm longitudinally superior to and inferior to the couch with the central point as the standard to measure the dose change by position changes. A commercial program was used for dose change analysis. Results: The average integral dose by energy size was $220.27{\mu}Sv$ and $526.61{\mu}Sv$ in 10 MV and 15 MV conventional RT, respectively. The average dose increased 2.39 times in 15 MV conventional RT. The average photoneutron integral dose in conventional RT and IMRT with the same energy was $220.27{\mu}Sv$ and $308.27{\mu}Sv$ each; the dose in IMRT increased 1.40 times. The average photoneutron integral dose by measurement location resulted significantly higher in point 2 than 3 in conventional RT, 7.1% higher in 10 MV, and 3.0% higher in 15 MV. Conclusion: When high energy radiotherapy, it should consider energy selection, treatment method and patient position to reduce unnecessary dose by photoneutron. Also, the dose data of photoneutron needs to be systematized to find methods to apply computerization programs. This is considered to decrease secondary cancer probabilities and side effects due to radiation therapy and to minimize unnecessary dose for the patients.

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Soil Loss and Pollutant Load Estimation in Sacheon River Watershed using a Geographic Information System (GIS를 이용한 동해안 하천유역의 토양유실량과 오염부하량 평가 -사천천을 중심으로-)

  • Cho, Jae-Heon;Yeon, Je-Chul
    • Journal of Korean Society of Environmental Engineers
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    • v.22 no.7
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    • pp.1331-1343
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    • 2000
  • Through the integration of USLE and GIS, the methodology to estimate the soil loss was developed, and applicated to the Sacheon river in Gangrung. Using GIS, spatial analysis such as watershed boundary determination, flow routing. slope steepness calculation was done. Spatial information from the GIS application was given for each grid. With soil and land use map, information about soil classification and land use was given for each grid too. Based upon these data, thematic maps about the factors of USLE were made. We estimated the soil loss by overlaying the thematic maps. In this manner, we can assess the degree of soil loss for each grid using GIS. Annual average soil loss of Sacheon river watershed is 1.36 ton/ha/yr. Soil loss in forest, dry field, and paddy field is 0.15 ton/ha/yr, 27.04 ton/ha/yr, 0.78 ton/ha/yr respectively. The area of dry field, which is 4% of total area, is $2.4km^2$. But total soil loss of dry field is 6561 ton/yr, and it occupies 84.9 % of total soil loss eroded in Sacheon river watershed. Comparing with the 11.2 ton/ha/yr of an average soil loss tolerance for cropland, provision for the soil loss in dry field is necessary. Run-off and water quality of Sacheon river were measured two times in flood season: from July 24, 1998 to July 28 and from September 29 to October 1. As the run-off of the river increased, SS, TN, TP concentrations and pollutant loadings increased. SS, TN, TP loads of Sacheon river discharged during the 2 heavy rains were 21%, 39%, and 19% of the total pollutant loadings generated in the Sacheon river watershed for one year. We can see that much pollutants are discharged in short period of flood season.

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The Spatial Characteristics of Real-time Population Distribution in Seoul based on the Media Users' Time-space Information for The Activity Spaces (미디어 이용자의 활동공간 시.공간 정보를 활용한 서울의 실시간 인구 분포 분석)

  • Lee, Keumsook;Kim, Ho Sung;Lee, Soo Young
    • Journal of the Economic Geographical Society of Korea
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    • v.18 no.1
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    • pp.87-102
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    • 2015
  • This study attempts to introduce the methodology for accounting real-time population distribution in the urban areas. For the purpose, we utilize the media user's time-space information from the media users' media diaries in the media panel survey databases. We analyze the space-time population rate for each activity space related with everyday urban lifes. Seoul has been selected as a case study area, since space-time information are relatively rich there, and thus the comparisons are available. The space-time population rates have been verified by the comparative analysis with the T-card results. We propose a real time population measurement method by combination of the space-time population rate with geographical data. The real time population of each activity space at each dong in Seoul has been calculated by multiplying the space-time population rates to the numbers of employer of three categories of activity spaces(residential, working, and commercial). By utilizing GIS, we visualize the results of two time points (3AM and 3PM) and then analyze the spacio-temporal characteristics of real time population distribution in Seoul. The Day time population distribution pattern shows strong relationships with the distribution of business and commercial activities, while the night time population distribution pattern can be explained by resident population distribution almost perfectly.

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The Status of Nursing Ethics Education in Korea 4-year-College of Nursing (간호윤리 교육현황 - 4년제 대학교육을 중심으로 -)

  • Han Sung-Suk;Kim Yong-Soon;Um Young-Rhan;Ahn Sung-Hee
    • The Journal of Korean Academic Society of Nursing Education
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    • v.5 no.2
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    • pp.376-387
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    • 1999
  • Purpose : To provide fundamental data to present further direction of education on Nursing Ethics by investigating the status of Nursing Ethics education performed at 4-year-Colleges of Nursing. Korea. Methods : A descriptive survey study The data collected from 28 universities through a questionnaire to examine the status of Nursing Ethics education in Korea. Results : I. Teaching Nursing Ethics class as a independent subject-6(21.4%) universities. 1) The average of 23.67 hours(2 credits) in the total educational hours. 2) Teaching method-theoretical class, discussion of case study, discussion of related issues, presentation of video tapes and discussion, team education, role play, and submission of reports. 3) Education contents-Nursing profession and ethics, the dignity of human life, necessity of bioethics, ethical theory and refutation, code for nurses, ethical issues between nurses and patients, nurses and co-workers, and nurses and nurses 6 universities 4) 5 universities-Included ethical decision making, artificial insemination, external insemination, artificial abortion, organ transplantation, brain death, human subject of study suicide, and euthanasia. II. Teaching Nursing Ethics as an inclusive theme in other subjects-22 (78.57%) universities. 1) Educated in Introduction of Nursing (14 universities), Nursing Management, Nursing Ethics and Philosophy, Special Nursing, Nursing and Law, and Professional Nursing. 2) Educational course-Taught in freshman level at 14 universities, average 9.32 education hours. Conclusion: Showed not only that universities, not operating Nursing Ethics as a independent class, unreasonably operate and assign too many contents in comparing with its education hours and are likely to become only a cramming education but also professors whose major is not Nursing Ethics presently in charge need to take a chance to supplement their knowledge and teaching method.

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Risk Factors for the Failure of Non-operative Reduction of Intussusceptions (장중첩증에서 비수술적 정복의 실패 위험인자)

  • Ko, Kwang-Min;Song, Young-Wooh;Je, Bo-Kyung;Han, Jae-Joon;Woo, Chan-Wook;Choi, Byung-Min;Lee, Jung-Hwa
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.11 no.2
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    • pp.110-115
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    • 2008
  • Purpose: Intussusceptions are one of the most common causes of intestinal obstruction in infants and young children. Although it is easily treated by non-operative reduction using barium, water or air, this treatment is very stressful for young patients and may cause bowel perforation, peritonitis and shock. In this study, we identified the risk factors associated with the failure of non-operative reduction, to identify a group of children that would benefit from the procedure and those who would not. Methods: We reviewed the medical records of patients with intussusception who were treated at the Korea University Medical Center Ansan hospital from March 1998 to July 2006. Three hundred fourteen children with intussusception were identified. Among them, non-operative reductions were performed in three hundred. Clinical and radiological variables were compared according to the failure or success of the non-operative reduction. Results: Non-operative reductions were successful in 243 (81%) and failed in 57 (19%). The group that had failed procedures had a younger age (12.3${\pm}$17.2 months vs. 18.0${\pm}$15.8 months, p=0.03), longer symptom duration before reduction (33.6${\pm}$29.0 hr vs. 21.5${\pm}$20.3 hr, p<0.01), more vomiting and lethargy (p<0.01), but less abdominal pain and irritability (p<0.01), compared with the group that had a successful procedure. Logistic regression analysis showed that the factors associated with the failure of non-operative reductions were a younger age, less than 6 months of age (odds ratio: 2.5, 95% confidence interval: 1.2~5.2, p=0.01), duration of symptoms, longer than 24 hrs before reduction (odds ratio: 2.1, 95% confidence interval: 1.2~4.2, p=0.03), bloody stool (odds ratio: 4.8, 95% confidence interval: 1.9~12.2, p<0.01), lethargy (odds ratio: 3.4, 95% confidence interval: 1.1~10.4, p=0.04), and abdominal pain or irritability (odds ratio: 0.2, 95% confidence interval: 0.1~0.4, p<0.01). Conclusion: For children with intussusception, an age younger than 6 months, and duration of symptoms more than 24 hrs before reduction, as well as the presence of bloody stools, lethargy and abdominal pain or irritability were variables associated with failure of a non-operative reduction. Knowledge of these variables should be considered in making clinical decisions for therapeutic interventions.

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Adenovirus Pneumonia with Respiratory Failure in Pediatric Patients (소아에서 발생한 호흡부전이 동반된 아데노 바이러스 폐렴)

  • Do, Sung Suk;Ma, Sang Hyeok;Park, Jae Sun;Lee, Young Ho;Lee, Hwan Jong;Lee, Gyu Man
    • Pediatric Infection and Vaccine
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    • v.5 no.2
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    • pp.258-266
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    • 1998
  • Purpose : Cases of adenoviral penumonia with rapidly progressive clinical course were experienced. We reviewed these patients in viewpoint of clinical manifestation and adenoviral serotypes. Methods : Culture and indirect immunofluorescence for respiratory viruses including respiratory syncytial virus, influenza virus, parainfluenza virus, adenovirus was done with nasopharyngeal aspirates from patients who admitted due to respiratory infections in Fatima Hospital, Masan from Nov. 1996 to Jul. 1997. Cultured adenovirus was serotyped by both neutralization and hemagglutination inhibition test. Medical records were reviewed for 5 patients with respiratory failure from adenovirus was isolated and serotyped. Results : The total number of examined patients was 460 patients. We isolated respiratory viruses in 143(30.9%) patients. Adenovirus was isolated from 66 out of 143(46.2%) patients. During Jan 1997 to May 1997, five patients with ages of 18 days to 11 months who were infected by adenovirus and had high fever with dyspnea and required assisted mechanical ventilation. One patients discharged against doctor's advice then died. Two of four patients had complications of disseminated intravascular coagulation; two had bronchiolitis obliterans. Two isolates were serotype 7, and one was serotype 5, and two were untyped. Conclusion : Severe pneumonia caused by serotype 7 continued to occur in 1997 following the epidemic in 1996, and severe pneumonia may also be caused by serotype 5 and other serotypes.

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TACT Productivity Management for Finish Works of Residential Buildings using Productivity Achievement Ratio (PAR) (공동주택 마감공사 TACT 기법 생산성 관리 - Productivity Achievement Ratio를 활용한 생산성 관리 -)

  • Joo, Seonu;Park, Moonseo;Lee, Hyun-Soo;Lee, Kwang-Pyo
    • Korean Journal of Construction Engineering and Management
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    • v.16 no.3
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    • pp.36-48
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    • 2015
  • To complete various types of finish works with higher quality in much less time, TACT, which was mostly used for high-rise buildings, has been adapted to meet the needs for systematic schedule management in construction sites. However, the effectiveness of adapting TACT has not been shown as expected due to the different perspectives on productivity from both general contractor and subcontractors based on unforeseen conditions according to the types of site. Furthermore, not enough theoretical backgrounds, empirical data, and systematic approaches to solve the fundamental problems caused by each participants' different views on productivity has produced obstacles for establishing effective solutions. Therefore, this research aims to analyze the possible main reasons for having different point of views regarding productivity among various participants of residential building sites using TACT based on literature review, site survey, and interviews. Also, case study was conducted to propose obtainable productivity (OP) regression equation and productivity achievement ratio (PAR) with reduction factors (RFs) and actual productivity (AP) data from an actual construction site. The proposed outcome may assist general contractors converting output management with PPC to productivity management with actual data using PAR. On the other hand, subcontractors would be able to estimate theory-based maximum productivity of construction sites with TACT by using OP. The PAR will enhance the communication between general and sub-contractors for their decision making process. Finally, the main RFs derived from PAR could be used as essential keys for productivity management to increase the economical and operational effectiveness of the construction project.

Clinical characteristics and progress of Kawasaki disease patients who had early treatment with intravenous immune globulin (가와사끼병에서 면역글로불린 조기 투여군의 임상적 특성 및 치료 경과)

  • Park, So-Yoon;Lee, Young Hwan
    • Clinical and Experimental Pediatrics
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    • v.50 no.10
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    • pp.1005-1010
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    • 2007
  • Purpose : To determine the optimal time of high dose intravenous immune globulin (IVIG) treatment, we analysed the clinical characteristics and progress of a group of Kawasaki disease patients who had early treatment with IVIG. Method : A retrospective study was conducted of 188 patients with Kawasaki disease who were admitted to Yeungnam University Medical Center from January 2000 to December 2005. All patients were treated with a high dose IVIG and high dose aspirin for the initial acute phase treatment. The early treatment group consisted of 94 patients who received treatment before 5 days of fever, and the conventional group consisted of 94 patients who were treated on or after day 5. The patients' sex, age, laboratory findings, total duration of fever, duration of fever after initial IVIG, need for additional IVIG and coronary artery status were noted. Result : There were no significant differences between the two groups in sex ratio and age. No significant differences were noted in the level of WBC count, ESR, CRP, serum albumin, LDH, total duration of fever and coronary abnormality. But the value of ALT($151.8{\pm}17.3$ vs. $81.9{\pm}13.4$, P=0.002), duration of fever after initial IVIG ($3.8{\pm}0.5days$ vs. $2.1{\pm}0.2days$, P=0.003), and rate of additional IVIG (15.9% vs. 6.3%, P=0.037) were significantly higher in the early treatment group. There was no significant difference in initial dose of IVIG, but dosage of aspirin was lower in early treatment group (P=0.037). Conclusion : There is no evidence that early treatment of IVIG has greater efficacy in preventing cardiac sequelae than conventional treatment. In addition, early treatment is likely to result in a greater requirement for additional IVIG treatment.

How to Determine the Moving Target Exactly Considering Target Size and Respiratory Motion: A Phantom Study (종양의 움직임과 호흡주기에 따른 체적 변화에 대한 연구: 팬텀 Study)

  • Kim, Min-Su;Back, Geum-Mun;Kim, Dae-Sup;Kang, Tae-Yeong;Hong, Dong-Ki;Kwon, Kyung-Tae
    • The Journal of Korean Society for Radiation Therapy
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    • v.22 no.2
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    • pp.145-153
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    • 2010
  • Purpose: To accurately define internal target volume (ITV) for treatment of moving target considering tumor size and respiratory motion, we quantitatively investigated volume of target volume delineated on CT images from helical CT and 4D CT scans. Materials and Methods: CT images for a 1D moving phantom with diameters of 1.5, 3, and 6 cm, acryl spheres were acquired using a LightSpeed $RT^{16}CT$ simulator. To analyze effect of tumor motion on target delineation, the CT image of the phantoms with various moving distances of 1~4 cm, and respiratory periods of 3~6 seconds, were acquired. For investigating the accuracy of the target trajectory, volume ratio of the target volumes delineated on CT images to expected volumes calculated with diameters of spherical phantom and moving distance were compared. Results: Ratio$_{helical}$ for the diameter of 1, 5, 3, and 6 cm targets were $32{\pm}14%$, $45{\pm}14%$, and $58{\pm}13%$, respectively, in the all cases. As to 4DCT, RatioMIP were $98{\pm}8%$, $97{\pm}5%$, and $95{\pm}1%$, respectively. Conclusion: The target volumes delineated on MIP images well represented the target trajectory, in comparison to those from helical CT. Target volume delineation on MIP images might be reasonable especially for treatment of early stage lung cancer, with meticulous attention to small size target, large respiratory motion, and fast breathing.

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