A low iodine diet (LID) for $1{\sim}2$ weeks is recommended for patients who undergoing radioiodine remnant ablation. However, the LID educations for patients are different among centers because there is no concrete recommendation for protocol of LID. In this investigation, we compared two representative types of LID protocols performed in several centers in Korea using urine iodine to creatinine ratio (urine I/Cr). Methods: From 2006, April to June, patients referred to our center for radioiodine remnant ablation of thyroid cancer from several local hospitals which had different LID protocols were included. We divided into two groups, stringent LID for 1week and less stringent LID for 2 weeks, then measured their urine I/Cr ratio with spot urine when patients were admitted to the hospital. Results: Total 27 patients were included in this investigation (M:F=1:26; 13 in one-week stringent LID; 14 in two-week less stringent LID. Average of urine I/Cr ratio was $127.87{\pm}78.52{\mu}g/g$ in stringent LID for 1 week, and $289.75{\pm}188.24{\mu}g/g$ in less stringent LID for 2 weeks. It was significantly lower in stringent LID for 1 week group (p=0.008). The number of patients whose urine I/Cr ratios were below $100{\mu}g/g$ was 6 of 13 in stringent LID for 1 week group, and 3 of 14 in less stringent LID for 2 weeks group. Conclusion: Stringent LID for 1 week resulted in better urinary I/Cr ratio in our investigation compared with the other protocol. However it still resulted in plenty of inadequate range of I/Cr ratio, so more stringent protocol such as stringent LID for 2 weeks is expected more desirable.
Radiation therapy for lung cancer is an effective treatment during monotherapy or combination therapy. Studies have reported that the optimum utilization rate of radiation therapy is estimated at 61% to 74%. Radiation therapy in Korea has been investigated to be low; further studies are needed. This study was intended to assess the appropriateness of the use of radiation and to reveal the use of radiation therapy-related factors by examining radiation therapy in lung cancer patients of Busan and South Gyeongnam Province. This study was aimed at the population diagnosed with lung cancer in Busan and South Gyeongnam Province. To conduct the study, 1036 patients enrolled in two hospitals were collected and 897 appropriate as subjects were selected. We compared the optimum utilization rate and actual rate of radiation therapy, and revealed the adequacy and related factors for use of radiotherapy. Of 897 patients, 503 (56%) were treated with medical therapy and 394 (44%) were given radiotherapy. The radiotherapy utilization rate of all lung cancer patients was 42%. The proportion of non-small cell lung cancer by histologic type was 33% and that of small cell lung cancer was 90%. Factors related to radiation therapy used in cancer were age, histological type, clinical stage, doctor refereed to, and clinical examination. Compared to radiation utilization by region (site), curative chest therapy was 42%; palliative treatment was 26%. In the comparison of histologic types, utilization of small-cell lung cancer is lower; the lowest especially in the stage III. Utilization of radiation therapy in Busan and South Gyeongnam Province was lower than the reasonable one. Utilization difference could be explained by patient factors, tumor factors, and health service factors. To improve utilization,development ofoutreach service programs and activation of the multidisciplinary team are required.
Purpose: To suggest the optimal radiation fields after a surgical resection based on a nationwide survey on the principles of radiotherapy for rectal cancer in the Korean Patterns on Care Study. Materials and method: A consensus committee, composed of radiation oncologists from 18 hospitals in Seoul Metropolitan area, developed a survey format to analyze radiation oncologist's treatment principles for rectal cancer after a surgical resection. The survey format included 19 questions on the principles of defining field margins, and was sent to the radiation oncologists in charge of gastrointestinal malignancies in all korean hospitals (48 hospitals). Thirty three ($69\%$) oncologists replied. On the basis of the replies and literature review, the committee developed guidelines for the optimal radiation fields nor rectal cancer Results: The following guidelines were developed: superior border between the lower tip on the L5 vertebral body and upper sacroiliac joint; inferior border $2\~3$ cm distal to the anastomosis in patient whose sphincter was saved, and $2\~3$ cm distal to the perineal scar In patients whose anal sphincter was sacrificed; anterior margin at the posterior lip of the symphysis pubis or $2\~3$ cm anterior to the vertebral body, to include the internal iliac lymph node and posterior margin $1.5\~2$ cm posterior to the anterior surface of the surface, to include the presacral space with enough margin. Comparison with the guidelines, the replies on the superior margin coincided in 23 cases ($70\%$), the inferior margin after sphincter saving surgery in 13 ($39\%$), the inferior margin after adbominoperineal resection in 32 ($97\%$), the lateral margin in 32 ($97\%$), the posterior margins in 32 ($97\%$) and the anterior margin in 16 ($45\%$). Conclusion: These recommendations should be tailored to each patient according to the clinical characteristics such as tumor location, pathological and operative findings, for the optimal treatment. The adequacy of these guidelines should be proved be following the Korean Patterns of Care Study.
Park, Yong Soo;Jang, Jun Yeong;Cho, Gwang Hyeon;Park, Yong Cheol;Choi, Byeong Ki
The Journal of Korean Society for Radiation Therapy
/
v.30
no.1_2
/
pp.35-40
/
2018
Purpose : The range of force differs from the size of proton energy used in our hospital. The compensator enables to change energy size based on distal thickness which also makes changes in dose rate. Therefore, the purpose of this study is to evaluate the effect of changing the thickness of compensator distal on dose range and beam on time. Subject and Methodology : Five low energy patients who have received proton therapy were selected as subjects for this study. Beam on was checked for the selected patients during the existing therapy. After then, the thickness of distal of compensator was increased by 2 cm up to 14 cm through proton therapy plan system(TPS) for comparative analysis. For the evaluation of dose range, the value of the target's conformity index(CI) and the maximum dose of rear side target's organ at risk(OAR) were compared. Furthermore, to evaluate the effect of therapy time, beam on time was compared by making compensator distal in each thickness. Result : The result of homogeneity index and conformity index of the increased compensator distal showed the same level in all patients. The comparison results of OAR of target rear side showed 7 cGy at spine cord of abdomen at maximum, 88 cGy at eyeball's RT lens, 391 cGy at RT lens of nasal cavity 51 cGy at trachea of the mediastinum, and 661 cGy at a small bowl of the pelvis. The comparison results of the beam on time showed a reduction from 126 seconds to 62 seconds for the abdomen, from 105 seconds to 37 seconds for the eyeball, from 187 seconds to 134 seconds for nasal cavity, from 100 seconds to 40 seconds for mediastinum, from 440 seconds to 118 seconds for the pelvis. Conclusion : The research result showed that as the distal thickness of compensator increased, the size of energy increased. In addition, beam on decreased due to the increase of dose rate. It is expected that the result would help reduce the treatment time and increase the convenience of patients if it is applied to liver patients who need respiratorygated therapy and pediatric patients. However, distal penumbra increased as the size energy increased. Therefore, in treating cases where OAR is in the vicinity of the target rear side, the influence of penumbra should be taken into account in adjusting thickness level of the compensator in proton therapy plan.
Journal of Korean Society of Environmental Engineers
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v.39
no.3
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pp.155-163
/
2017
Membrane filtration has become more popular in drinking water treatment recently, since the filtration can control not only particulate matters but also pathogenic microorganisms such as giardia and cryptosporidium very effectively. Pilot-scale ($120m^3/d$ of treatment capacity) and test-bed ($25,000m^3/d$ of treatment capacity) microfiltration experiments were conducted to find optimum operating mode and the critical flux. Optimum operating mode of pilot-test was assessed as inflow 1.0 min, filtration 36.5 min, air backwash 0.9 min, backwash 1.0 min and outflow 1.0 min with 50 LMH ($L/min{\cdot}m3^$) of critical flux. Critical Flux was calculated to be $50L/m^2-h$ (within TMP 0.5 bar) based on the increase formula of the transmembrane pressure difference according to the change of time at Flux 20, 40, 56 and 62 LMH in pilot operation. Chemical cleaning was first acid washed twice, and alkali washing was performed secondarily, and a recovery rate of 95% was obtained in the test-bed plant. The results of operating under these appropriate conditions are as follows. Turbidity of treated water were 0.028, 0.024, 0.026 and 0.028 NTU in spring, summer, autumn and winter time, respectively. Microfiltration has superior treatment capability and performance characteristics in removing suspended solids and colloidal materials, which are the main cause of turbidity and important carrier of metal elements, and it has shown great potential in being an economically substitute to traditional processes (sand filtration).
Korean water quality standards for the protection of agricultural water uses were originally derived based on management of public water resource. They were not prepared to protect crop plants from contaminants, and therefore required water parameters in agricultural uses were excluded in current water quality standards. Korean water standards in river and lake have five levels, and level IV is correspondent to agricultural water uses. Currently, there is no Korean guidelines to protect crop plants from contaminants contained in agricultural water. In Canada, agricultural water guidelines are provided to protect crops from contaminants. In this study, agricultural water quality standards in Korea were compared with them in developed countries to evaluate the adequacy of Korean water quality standards for the protection of agricultural water uses. Additional water quality parameters in agricultural uses were also proposed. Suggested parameters include electric conductivity, sodium, chloride, boron, copper, iron, zinc, and microbiological quality, They are the required parameters to protect crop plants as well as human health. Current water quality standards in agricultural uses was not considered to be appropriate in terms of crop protection. Additional water parameters should be included in agricultural water quality standards.
Changes in business environment caused by globalization of the world economy and the beginning of the knowledge society forced hospitals to equip with tools for the enhanced competitiveness. In other words, hospitals must aim three targets such as acquisition of advanced medical skills and equipments, improvement of service level for patients, and achievement of superior managerial performance simultaneously. This study has been done to suggest a way to reduce the possibility of hospital bill claim reduction as an alternative for the achievement of superior managerial performance. If the reduction rate of hospital bill claim is high, it will put negative impact on the hospital's revenue stream and hospital's reliability. Thus, if they want to stay competitive, hospitals need to device ways to cut the reduction rate as much as possible. In this study, a prototype system has been developed and implemented to check the possibility to cut the reduction rate through deep analysis of causes of reduction. The prototype first developed utilizing data mining techniques and the relation rules algorithm. Then the prototype was tested its performance using the D hospital's live data.
Journal of the Korea Academia-Industrial cooperation Society
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v.20
no.12
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pp.167-175
/
2019
Recently, health examination centers have been changing from auxiliary medical facilities to key and independent medical facilities. However, it is not easy to improve medical facilities, including health examination centers, due to the variable characteristics of the relationship between humans and space. Therefore, this study was done to develop a pedestrian-based discrete event simulation analysis program to examine the problems and develop methods for improvement. The program was developed to analyze five evaluation indices and the density of examinees. The problems were derived by analyzing the required time, capacity, and queue size for each examination through simulations. We reduced the examination time and moving distance, increased the capacity, and distributed the queues by adjusting the medical services and relocating the examination rooms. The results were then quantitatively verified by simulations.
Wang, Mee-Suk;Lee, In Deok;Kang, M.S.;Cha, Eun-Kwang;Choi, Dae-Ho;Jeong, Hyeon-Cheol
Journal of the Korea Academia-Industrial cooperation Society
/
v.15
no.5
/
pp.3014-3024
/
2014
This study is to provide basic data for the improvement of nursing services. A survey was done of 135 patients over the age of 65 in a general ward and an attended ward of a hospital in Seoul from December 5 to December 31, 2014 in order to assess their satisfaction with the nursing services. It was found that appropriately staffed nursing services as in attended wards showed greater patients' satisfaction than ordinarily staffed nursing services in general wards(t=3.45, p=.001). Significantly higher satisfaction levels were shown with the nursing services of the attended wards in the subcategories: professional technic(t=2.96, p=.004), training(t=.30, p=.001), and confidence(t=3.79, p<.001). Among the subcategories, confidence was the highest satisfaction factor followed by professional technic and education. The results suggest the need of securing an appropriate number of nursing staff in a ward to enhance patients' satisfaction.
This study is to confirm the range of tube voltage for Chest X-ray in DR system by comparing with dose area product (DAP) and effective dose in efficient detector exposure index (DEI) range. GE definium 8000 was used to for the phantom study. The range of tube voltage is 60~130 kVp and of mAs is 2.5~40 mAs. The acquired images were classified into efficient DEI groups, then calculated effective dose with DAP by using a PC-Based Monte Carlo Program 2.0. The signal to noise ratio (SNR) was measured at 4 regions, including the thoracic spine, the lung area with the ribs, the lung area without the ribs, and the liver by using Picture Archiving and Communication System. The significance of the group for each tube voltage was verified by performing the kruskal-wallis test and the mann-whitney test as a post-test. When set to 4 groups dependned on the tube voltage, DAP showed significant differences; 60 kVp and 80 kVp, and 60 kVp and 90 kVp (p= 0.034, 0.021). Effective dose exhibited no statistically significant differences from the all of the group (p>0.05). SNR exhibited statistically significant differences from the all of the group in the liver except compared to 80 kVp and 90 kVp (p<0.05). Therefore, high tube voltages of 100 kVp or more need to be reconsidered in terms of patient dose and imaging in order to represent an appropriate chest X-ray image in a digital system.
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