• Radiation Oncology Journal
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• v.16 no.2
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• pp.185-194
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• 1998

Purpose : With the development of stereotactic immobilization systems capable of reliable serial repositioning, fractionated stereotactic radiation therapy (FSRT) offers the Potential for an improved treatment outcome by excellent dose delivery, and dose distribution characteristics with the favorable radiobiological properties of fractionated irradiation. We describe our initial experience using FSRT for the treatment of intracranial benign tumor. Materials and Methods : Between August 1995 and December 1996. 15 patients(7 males and 8 females aged 6-70 years) were treated with FSRT. The patients had the following diagnosis pituitary adenoma(10) including one patient who previously had received radiotherapy, craniopharyngioma (2), acoustic neurinoma (1), meningioma (2). Using the Gill-Thomas-Cosman relocatable head frame and multiple non-coplanar therapy, the daily dose of 2Gy was irradiated at 90% to 100% isodose surface of the isocenter The collimator sizes ranged from 26mm to 70mm. Results : In all patients except one follow-up lost, disease was well-controlled. Acute complication was negligible and no patient experienced cranial nerve neuropathies and radiation necrosis. In overall patient setup with scalp measurements, reproducibility was found to have mean of $1.1{\pm}0.6mm$ from the baseline reading. Conclusion : Relocatable stereotactic system for FSRT is highly reproducible and comfortable. Although the follow-up period was relatively short. FSRT is considered to be a safe and effective radiation technique as the treatment of intracranial tumor. But the fractionation schedule(fraction size, overall treatment time and total dose) still remains to be solved by further clinical trials.

• The Korean Society of Law and Medicine
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• v.17 no.2
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• pp.85-124
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• 2016

The Human gene testing act (GenDG) in Germany starts from the characteristic features of gene testing, i.e. dualisting structure consisted of anlaysis on the one side and the interpretation on the other side. The linguistic distincion of 'testing', 'anlaysis' and 'judgment' in the act is a fine example. Another important basis of the regulation is the ideological purpose of the law, that is information autonomy. The normative texts as such and the founding principle are the basis of the classification of testing types. Especially in the case of gene testing for medical purpose is classified into testing for diagnostic purpose and predictive purpose. However, those two types are not always clearly differentiated because the predictive value of testing is common in both types. In the legal regulation of gene testing it is therefore important to manage the uncertainty and subjectivity which are inherent in the gene-analysis and the judgment. In GenDG the system ensuring the quality of analysis is set up and GEKO(Commity for gene tisting) based on the section 23 of GenDG concretes the criterium of validity through guidelines. It is also very important in the case of gene testing for medical purpose to set up the system for ensurement of procedural rationality of the interpretation. The interpretation of the results of analysis has a wide spectrum because of the consistent development of technology on the one side and different understandings of different subjects who performs gene testings. Therefore the process should include the communication process for patients in oder that he or she could understand the meaning of gene testing and make plans of life. In GenDG the process of genetic counselling and GEKO concretes the regulation very precisely. The regulation as such in GenDG seems to be very suggestive to Korean legal polic concerning the gene testing.

• Journal of Chest Surgery
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• v.35 no.3
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• pp.209-216
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• 2002

Background: Valvular heart disease is still the most common health problem in Korea. By the end of the year 1999, there has been 94,586 cases of open heart surgery since the first case in 1958. Among them, 36,247 cases were acquired heart diseases and 20,704 of those had valvular heart disease. But there was no database system and every surgeon and physician had great difficulties in analysing and utilizing those tremendous medical resources. Therefore, we developed a valve registry database program and utilize it for risk factor analysis and so on. Material and Method: Personal computer-based multiuser database program was created using Microsoft AccessTM. That consisted of relational database structure with fine-tuned compact field variables and server-client architecture. Simple graphic user interface showed easy-to-use accessability and comprehensibility. User-oriented modular structure enabled easier modification through native AccessTM functions. Infinite application of query function aided users to extract, summarize, analyse and report the study result promptly. Result: About three-thousand cases of valve replacement procedure were performed in our hospital from 1968 to 1999. Total number of prosthesis replaced was 3,700. The numbers of cases for mitral, aortic and tricuspid valve replacement were 1600, 584, 76, respectively. Among them, 700 patients received prosthesis in more than two positions. Bioprosthesis or mechanical prosthesis were used in 1,280 and 1,500 patients respectively Redo valve replacements were performed in 460 patients totally and 40 patients annually Conclusion: Database program for registry of valvular heart disease was successfully developed and used in personal computer-based multiuser environment. This revealed promising results and perspectives in database management and utilization system.

• Journal of Chest Surgery
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• v.30 no.8
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• pp.752-759
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• 1997

Profound hypothermia protects . cerebral function during total circulatory arrest(TCA) in the surgical treatment of a variety of cardiac and aortic diseases. Despite its importance, there is no ideal technique to monitor the brain injury from ischemia. Since 1994, we have developed compressed spectral array(CSA) of electroencephalography(EEG) and monitored cerebral activity to reduce ischemic injury. The purposes of this study are to analyse the efficacy of CSA and to establish objective criteria to consistently identify the safe level of temperature and arrest time. We studied 6 patients with aortic dissection(AD, n=3) or aortic arch aneurysm(n=3, ruptured in 2). Body temperatures from rectum and esophagus and the EEG were monitored continuously during cooling and rewarming period. TCA with cerebral ischemia was performed in 3 patients and TCA with selective cerebral perfusion was performed in 3 patients. Total ischemic time was 30, 36 and 56 minutes respectively for TCA group and selective perfusion time was 41, 56 and 92 minutes respectively for selective perfusion group. The rectal temperatures for flat EEG were between 16.1 and 22. $1^{\circ}C$ (mean: 18.4 $\pm$ 2.0): the esophageal temperatures between 12.7 and $16.4^{\circ}C$ (mean $14.7\pm1.6).$ The temperatures at which EEG reappeared $5~15.4^{\circ}C$ for esophagus. There was no neurological defic t and no surgical mortality in this series. In summary, the electrical cerebral activity Teappeared within 23 minutes at the temperature less than $16^{\circ}C$ for rectum. It seemed that $15^{\circ}C$ of esophageal temperature was not safe for 20 minutes of TCA and continuous monitoring the EEG with CSA to identify the electrocerebral silence was useful.

• The Korean Journal of Nuclear Medicine Technology
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• v.18 no.1
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• pp.26-32
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• 2014

Purpose: As PET-MRI which has excellent soft tissue contrast is developed as integration system, many researches about clinical application are being conducted by comparing with existing display equipments. Because PET-MRI is actively used for head and neck cancer diagnosis in our hospital, lymph node metastasis before the patient's surgery was diagnosed and clinical usefulness of head and neck cancer PET-MRI scan was evaluated using pathological opinions and idiopathy surrounding tissue metastasis evaluation method. Materials and Methods: Targeting 100 head and neck cancer patients in SNUH from January to August in 2013. $^{18}F-FDG$ (5.18 MBq/kg) was intravenous injected and after 60 min of rest, torso (body TIM coil, Vibe-Dixon) and dedication (head-neck TIM coil, UTE, Dotarem injection) scans were conducted using $Bio-graph^{TM}$ mMR 3T (SIEMENS, Munich). Data were reorganized using iterative reconstruction and lymph node metastasis was read with Syngo.Via workstation. Subsequently, pathological observations and diagnosis before-and-after surgery were examined with integrated medical information system (EMR, best-care) in SNUH. Patient's diagnostic information was entered in each category of $2{\times}2$ decision matrix and was classified into true positive (TP), true negative (TN), false positive (FP) and false negative (FN). Based on these classified test results, sensitivity, specificity, accuracy, false negative and false positive rate were calculated. Results: In PET-MRI scan results of head and neck cancer patients, positive and negative cases of lymph node metastasis were 49 and 51 cases respectively and positive and negative lymph node metastasis through before-and-after surgery pathological results were 46 and 54 cases respectively. In both tests, TP which received positive lymph node metastasis were analyzed as 34 cases, FP which received positive lymph node metastasis in PET-MRI scan but received negative lymph node metastasis in pathological test were 4 cases, FN which received negative lymph node metastasis but received positive lymph node metastasis in pathological test was 1 case, and TN which received negative lymph node metastasis in both two tests were 50 cases. Based on these data, sensitivity in PET-MRI scan of head and neck cancer patient was identified to be 97.8%, specificity was 92.5%, accuracy was 95%, FN rate was 2.1% and FP rate was 7.00% respectively. Conclusion: PET-MRI which can apply the acquired functional information using high tissue contrast and various sequences was considered to be useful in determining the weapons before-and-after surgery in head and neck cancer diagnosis or in the evaluation of recurrence and remote detection of metastasis and uncertain idiopathy cervical lymph node metastasis. Additionally, clinical usefulness of PET-MRI through pathological test and integrated diagnosis and follow-up scan was considered to be sufficient as a standard diagnosis scan of head and neck cancer, and additional researches about the development of optimum MR sequence and clinical application are required.

• Journal of Wetlands Research
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• v.16 no.4
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• pp.303-318
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• 2014

Baseflow gives a significant contribution to stream function in the regions where climatic characteristics are seasonally distinct. In this regard, variable baseflow can make it difficult to maintain a stable water supply, as well as causing disruption to the stream ecosystem. Changes in land use can affect both the direct flow and baseflow of a stream, and consequently, most other components of the hydrologic cycle. Baseflow estimation depends on the observed streamflow in gauge watersheds, but accurate predictions of streamflow through modeling can be useful in determining baseflow data for ungauged watersheds. Accordingly, the objectives of this study are to 1) improve predictions of SWAT by applying the alpha factor estimated using RECESS for calibration; 2) estimate baseflow in an ungauged watershed using the WHAT system; and 3) evaluate the effects of changes in land use on baseflow characteristics. These objectives were implemented in the Gapcheon watershed, as an ungauged watershed in South Korea. The results show that the alpha factor estimated using RECESS in SWAT calibration improves the prediction for streamflow, and, in particular, recessions in the baseflow. Also, the changes in land use in the Gapcheon watershed leads to no significant difference in annual baseflow between comparable periods, regardless of precipitation, but does lead to differences in the seasonal characteristics observed for the temporal distribution of baseflow. Therefore, the Guem River, into which the stream from the Gapcheon watershed flows, requires strategic seasonal variability predictions of baseflow due to changes in land use within the region.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.8 no.1
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• pp.49-55
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• 2005

Purpose: The purpose of this study was to evaluate the quality and problems of Web sites for management of childhood and adolescent obesity. Methods: We evaluated 203 Web sites identified from the search engine, Korean Yahoo, using the word of 'childhood and adolescent obesity'. 203 Web sites were classified according to medical institutions, health information Web sites, beauty shops. etc. We surveyed whether childhood and adolescent obesity distinguished with adult obesity was considered, or not. and researched the unique managements of childhood and adolescent obesity including the cardinal treatment. Results: Of the 203 Web sites, 157(77.3%) provided detailed information about treatment of obesity, 46(22.7%) provided only simple information about one. The sites providing detailed information were composed of 52.2% of oriental medicine clinics, 35.0% of clinic & hospitals including pediatric hospitals. Distribution of the sites about management of childhood and adolescent obesity distinguished with adult's one was only 23% of oriental medicine clinics, but 93% of childrens hospitals. Conclusion: Without considering the speciality of childhood obesity, inaccurate information are distributing on internet web sites. It is necessary for concern and development of advertizing system on the internet distributing accurate information about treatment of childhood obesity.

• Journal of the Mineralogical Society of Korea
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• v.16 no.4
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• pp.283-293
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• 2003

Domestic water treatment plants operate the rapid and slow filtering system using the filtering sands. Most of them are composed of beach sands, which have less sorption capacity of heavy metals as well as organic contaminants. Therefore, the development of fortified functional filtering materials with high removal capacity of organic and inorganic contaminants is needed to prevent the unexpected load of contaminated source water. This study aims to test the hydrochemical change and the removing capacity of heavy metals such as Cd, Cu, and Pb on the Jumunjin sand, feldspathic sand(weathering product of Jecheon granite), feldspathic mixing sand I(feldspathic sand mixed with 10 wt% zeolite), and feldspathic mixing sand II (feldspathic sand mixed with 20 wt% zeolite). Feldspathic mixing sand I and II showed the eruption of higher amounts of cations and anions compared with the Jumunjin sand and feldspathic sand. They also showed higher eruption of Si, Ca, $SO_4$ ions than that of Al, $NO_3$, Fe, K, Mg, and P. Feldspathic mixing sand II caused higher eruption of some cations of Na, Ca, Al than feldspathic mixing sud I, which is the result controlled by the dissolution of zeolite. Jumunjin sand and feldspathic sand showed very weak sorption of Cd, Cu and Pb. In contrast to this, feldspathic mixing sand I and II showed the high sorption and removal capacity of the increasing order of Cd, Cu and Pb. Feldspathic mixing sand II including 20% zeolite showed a fortified removal capacity of some heavy metals. Therefore, feldspathic mixing sand mixed with some contents of zeolite could be used as the fortified filtering materials for the water filtering and purification in the domestic water treatment plants.

• Korean Journal of Environmental Agriculture
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• v.22 no.2
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• pp.148-152
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• 2003

The phosphorus(P) adsorption capacities of various filter media were investigated in relation to the size and types of fitter media to screen the optimum condition. The objective of this study was to evaluate the constructed wetland longevity by improving P adsorption capacity. The maximum P adsorption capacities of filter media A($4{\sim}10\;mm$), B($2{\sim}4\;mm$) and C($0.1{\sim}2\;mm$) were 8, 10 and 22 mg/kg, respectively, showing those increased as the filter media size decreased. Among the experimental media, the optimum filter media size was $0.1{\sim}2\;mm$. When the filter Medium was supplemented with organic materials which were piled up and decayed in the constructed wetland, the P adsorption capacity was significantly enhanced Under the conditions of optimum fitter media size, the respective Maximum P adsorption capacities of filter media C when supplemented with Ca, Mg, Al and Fe were higher than that of filter media C. However the addition of Ca, Mg, Al and Fe to constructed wetland were not recommended because of the possibility of their secondary pollution. The maximum P adsorption capacity of filter media C was 22 mg/kg, but this was increased to 36 mg/kg when filter media C was supplemented with 2% oyster shell.

• Journal of Korean Society of Coastal and Ocean Engineers
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• v.24 no.4
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• pp.257-268
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• 2012

The EFDC model with find grid resolution system connecting the Gyeong-Gi bay and Han River estuary was constructed to study on spring-neap variability of net volume transport at each channel of the Han River estuary. The simulation time of numerical model is 124 days from May to August, 2009 with freshwater discharge at Han, Imjin and Yeseong River. The calibration and verification of model results was confirmed using harmonic components of water level and tidal current. The net volume transport was calculated during 30 days with normal freshwater conditions at Seokmo channel and Yeomha channel around Ganghwado. The ebbing net volume transport of 44% and 56% is drained into Gyeong-Gi bay through Yeomha and Seokmo channel, respectively. The ebbing net volume transport nearby Seodo at Yeomha channel convergence flooding net volume transport at Incheon harbor, and drain (westward direction) through channel of tidal flat between Ganghwado and Yeongjongdo to the Gyeong-Gi bay. The averaged net volume transport during 4 tidal cycles was compared to variation of spring-neap periods of the Yeomha channel. The convergence position is moved up- and down-ward according to spring-neap variability. The movement of the convergence zone is appeared because 1) increasing of discharged rate tidal flat channel between Ganghwado and Yeongjongdo at the spring period, 2) The growth of barotropic forcing with downward direction at the spring tide, and 3) The strength of the baroclinic pressure gradient is greater than spring with mixing processes.