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Evaluation of safety by skin dosimetry in Intraoperative Radiotherapy for breast cancer patients (유방암 환자의 수술 중 방사선치료 시 피부선량 측정을 통한 안전성 평가)

  • Jung, In Ho;Kim, Joon Won;Park, Kwang Woo;Ha, Jin Sook;Jeon, Mi Jin;Cho, Yoon Jin;Kim, Sei Joon;Kim, Jong Dae;Shin, Dong Bong
    • The Journal of Korean Society for Radiation Therapy
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    • v.27 no.1
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    • pp.13-22
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    • 2015
  • Purpose : We investigated the safety of Intrabeam$^{TM}$ system, X-ray unit for Intraoperative Radiotheray (IORT) by measuring surface dose using Optically Stimulated Luminescent Dosimeter(OSLD). Materials and Methods : 30 patients were selected, who were in breast cancer patients and had an operation of breast conserving surgery (BCS). At the inner surface of tumor bed, 20 Gy were described, and 5 Gy at 1cm depth from the inner surface. Along the size of tumor bed which could be decided after resection of tumor, the size of applicator were determined. Usual treatment time were from 18 to 40 minutes. For the measurement of surface doses, OSLD were placed at superior(U1,2), inferior(D1,2), lateral(L1,2) and medial(M1,2) directions from the center of applicator. Each direction, two OSLD were placed at 0.5 cm and 1.5 cm from the center. Mean, maximum, and minimum doses were analyzed to be compared. Results : Mean values were U1 $2.23{\pm}0.80Gy$, U2 $1.54{\pm}0.53Gy$, D1 $1.73{\pm}0.63Gy$, D2 $1.25{\pm}0.45Gy$, L1 $1.95{\pm}0.82Gy$, L2 $1.38{\pm}0.42Gy$, M1 $2.03{\pm}0.70Gy$, and M2 $1.51{\pm}0.58Gy$. Maximum values were 4.34 Gy at U1, and Minimum values were 0.45 Gy at M2. 13.3 % of patient (4pts out of 30) were reported that surface dose were over 4 Gy. Conclusion : The fact that skin dose of all patients were less than 5 Gy based on OSLD measurement showed the safety of Intrabeam$^{TM}$ system. In the relatively small breast volume, the tendency that surface dose was increased had been shown, which was analyzed by the data of patients who irradiated over 4Gy at skin surface. Therefore, for appropriate indication for IORT, it is suggested that breast volume as well as the size and position of tumor should be carfully considered.

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Analysis of Risk Factors and Effect of Vancomycin for Sternal Infection after Coronary Artery Bypass Graft (관상동맥우회술 후 흉골감염의 위험인자분석 및 반코마이신의 효과)

  • Baek, Jong-Hyun;Jung, Tae-Eun;Lee, Dong-Hyup;Lee, Jang-Hoon;Kim, Jung-Hee
    • Journal of Chest Surgery
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    • v.43 no.4
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    • pp.381-386
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    • 2010
  • Background: Sternal wound infection (SWI) is an important complication after cardiac surgery. The aim of this study was to investigate the predictors affecting sternal wound infection and preventive factors including short term Vancomycin therapy in patients who underwent coronary artery bypass grafting (CABG). Material and Method: A retrospective study was done using data collected from January 2001 through December 2007. This included 219 patients who had isolated CABG. The definition of SWI was documentation from a microbiological study and a requirement for simple closure or other surgical revision. Result: The overall incidence of SWI was 7.8% (n=17). The causative organisms were methicillin resistant Staphylococcus aureus (MRSA, n=13), methicillin resistant Staphylococcus epidermidis (n=2), Pseudomonas aeruginosa (n=1), and Candida albicans (n=1). Ten cases had deep sternal wound infection with mediastinitis; 7 cases had a superficial wound infection. Infection-related mortality was low (1/17; 6%). Diabetes mellitus (p=0.006) and smoking history (p=0.020) were factors that predicted high risk. Short term use of vancomycin decreased the incidence of MRSA-associated SWI (p=0.009). For treatment, curettage and rewiring or flap were needed in most cases (88%, n=14). Conclusion: Patients who had diabetes mellitus and a smoking history need careful management. Short term use of vancomycin is effective for prevention of SWI with MRSA.

Influence of bearing surface angle of abutment screw on mechanical stability of joint in the conical seal design implant system (내부 원추형 연결형태 임플란트에서 지대주 나사머리의 좌면각도가 연결부 기계적 안정성에 미치는 영향)

  • Kim, Joo-Hyeun;Huh, Jung-Bo;Yun, Mi-Jung;Kang, Eun-Sook;Heo, Jae-Chan;Jeong, Chang-Mo
    • Journal of Dental Rehabilitation and Applied Science
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    • v.30 no.3
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    • pp.206-214
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    • 2014
  • This study is to evaluate how different bearing surface angles of abutment screw affect the mechanical stability of the joint in the conical seal design implant system. Materials and Methods: Internal connection type regular implants, two-piece cemented type abutments and tungsten carbide/carbon-coated titanium alloy abutment screws were selected. Titanium alloy screws with conical ($45^{\circ}$) and flat ($90^{\circ}$) head designs which fit on to abutment were fabricated. The abutments were tightened to implants with 30 Ncm by digital torque gauge. The loading was applied once to the central axis of abutment. The mean axial displacement was measured using micrometer before and after the tightening and loading (n = 5). The abutment was tightened to implants with 30 Ncm and T-shape stainless steel crown was cemented. Then the change in the amount of reverse-torque was measured after the repeated loading to the central axis, and the place 5 mm away from the central axis. Compressive bending and fatigue strength were measured at the place 5 mm away from the central axis (n = 5). Results: Both groups showed the largest axial displacement when abutment screw tightening and total displacement was greater in the flat head group compared to conical head group (P < 0.05). However, there were no significant differences in reverse torque value, compressive bending and fatigue strength (P > 0.05). Conclusion: Within the limitations of this study, the abutment screw head design had no effect on two groups regarding the joint stability, however the conical head design affected the settlement of abutment resulting in the reduced total displacement.

An Evaluation of the Use of Statistical Methods in the Journal of Tuberculosis and Respiratory Diseases ([결핵 및 호흡기질환] 게재 논문의 통계적 기법 활용에 대한 평가)

  • Koh, Won-Jung;Lee, Seung-Joon;Kang, Min Jong;Lee, Hun Jae
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.2
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    • pp.168-179
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    • 2004
  • Background : The statistical analysis is an essential procedure ensuring that the results of researches are based on evidences rather than opinion. The purpose of this study is to evaluate which statistical techniques are used and whether these statistical methods are used appropriately or not in the journal of Tuberculosis and Respiratory Diseases. Materials and Methods : We reviewed 185 articles reported in the journal of Tuberculosis and Respiratory Diseases in 1999. We evaluated the validity of used statistical methods based upon the checklist that was developed on the basis of the guideline for statistical reporting in articles for medical journals by International Committee of Medical Journal Editors. Results : Among 185 articles, original articles and case reports were 110 (59.5%) and 61 (33.0%) respectively. In 112 articles excluding case reports and reviews, statistical techniques were used in 107 articles (95.5%). In 94 articles (83.9%) descriptive and inferential methods were used, while in 13 (11.6%) articles only descriptive methods were used. With the types of inferential statistical techniques, comparison of means was most commonly used (64/94, 68.1%), followed by contingency table (43/94, 45.7%) and correlation or regression (18/94, 19.1%). Among the articles in which descriptive methods were used, 83.2% (89/107) showed inappropriate central tendency and dispersion. In the articles in which inferential methods were used, improper methods were applied in 88.8% (79/89) and the most frequent misuse of statistical methods was inappropriate use of parametric methods (35/89, 39.3%). Only 14 articles (13.1%) were satisfactory in utilization of statistical methodology. Conclusion : Most of the statistical errors found in the journal were misuses of statistical methods related to basic statistics. This study suggests that researchers should be more careful when they describe and apply statistical methods and more extensive statistical refereeing system would be needed.

Establishment of Miniaturized Cultivation Method for Large and Rapid Screening of High-yielding Monascus Mutants, and Enhanced Production of Monacolin-K through Statistical Optimization of Production Medium (Monascus 균사체의 소규모 배양을 통한 고생산성 균주의 대규모 선별방법 확립과 통계적 생산배지 최적화를 통한 Monacolin-K 생산성 향상)

  • Lee, Mi-Jin;Jeong, Yong-Seob;Kim, Pyeung-Hyeun;Chun, Gie-Taek
    • KSBB Journal
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    • v.22 no.5
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    • pp.305-312
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    • 2007
  • It is crucial to develop a miniaturized cultivation method for large and rapid screening of high-yielding mutants of monacolin-K, a powerful anti-hypercholesterolemic secondary metabolite biosynthesized by the fungal cells of Monascus ruber. In order to investigate as many strains as possible in a short time, a miniaturized fermentation method especially suitable for the cultivation of the filamentous Monascus mutants was developed using $50m{\ell}$ culture-tube ($7m{\ell}$ of working volume) instead of the traditional $250m{\ell}$ flask ($50m{\ell}$ of working volume). Generally, in filamentous fungal cell fermentations, morphologies in growth and production cultures should be maintained as thick filamentous and compact-pelleted (usually less than 1 mm in diameter) forms, respectively, for enhanced production of secondary metabolites in final production cultures. In this study, we intended to induce the respective optimal morphologies in the miniaturized culture system for the purpose of rapid screening of overproducers. Miniaturized growth culture system was successfully developed due to the mass production of spores in the statistically optimized solid medium. When large amounts of spores were inoculated into the growth cultures, and brown rice flour (20 g/L) was also supplemented to the growth medium, dense filamentous morphologies were successfully induced in the growth cultures performed with the 50 ml culture tubes. It was implied that the amounts of spores inoculated into the growth tube-cultures and the growth medium components should be the key factors for the induction of the filamentous forms in the growth fermentations. Furthermore, in order to statistically optimize production medium, multiple experiments based on Plackett-Burman design and response surface method (RSM) were carried out, resulting in more than 2 fold enhanced production of monacolin-K in the final production cultures with the optimized production medium. Notably, under the production culture conditions with the statistically optimized medium, optimal pellet sizes below 1 mm in diameter were reproducibly induced, in contrast to the thick and viscous filamentous morphologies observed in the previous production cultures.

A survey on the habit of dieting and food constrained by superstition (식습관(食習慣)과 금기식(禁忌食)에 관(關)한 조사(調査))

  • Lee, Geum-Yeong;Suh, Myung-Sook
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.2 no.1
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    • pp.73-80
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    • 1973
  • 1. Generally speaking, our people have been carrying out the government policy of using grains other than rice comparatively well. But it is desirable that the government heirs the whole nation as well as the farmers to understand better the scientific meaning of using foods made from the flour of various grains. This will greatly improve the nation's eating habits, for it will make people discard the habit of eating only boiled-rice, which will not only improve our national health but will also increase the national income. 2. For the purpose of improving health and developing intellectual faculties of our mind, we had better, if possible, get much protein from plants(especially beans) which we can obtain more readily than from animals. However if we must use animal protein, we should dependonly on livestock. Pregnant women and new-born children must not be in ill health because of malnutrition caused by following groundless superstitions about foods: for example, some religions forbid the use very healthful foods or some traditional conventions do the blend of certain foods together with other victuals. 3. It is good that we conquer the difficulty of living in the season of spring poverty by having other substitute for regular victuals. But it requires us to pay a careful attention to the food and to do research on many foods problems such as food pollution. Farmers should cooperate with each other and help those who have very little arable land, or even those who have no place for cultivating, to grow miscellaneous cereals on the land which other farmers don't use that year. 4. On the whole, farmers have a good appetite for any, food, whatever it is. Neverthless, because they aren't econmically well-off, they generally eat hot meals only for breakfast and supper in the busy faming season. They eat a tepid lunch which, they think saves time and cooking fuel. In conclution, I feel sorry that many village farmers still steeped in conventional thought and superstition are inclined to have an unbalanced diet of boiled-rice and that they continue not to use the floor from other grains all the year round. when these unscientific dieting customs mentioned above are discarded, we will be able to enjoy good health, better knowledge or intellegence, and higher income. Then we will ba able to make our present lives more self-reliant and self-supporting.

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The Process of the Quickening and Development of Science-Technology- Society Education in the United Kingdom (I) - Between the Beginning of the 19th Century and the Middle of the 20th Century - (영국에서의 과학-기술-사회 교육의 태동과 발전 과정( I )-19세기 초반에서 20세기 중반까지를 중심으로-)

  • Song, Jin-Woong
    • Journal of The Korean Association For Science Education
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    • v.19 no.3
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    • pp.409-427
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    • 1999
  • The aim of this study was to illustrate how STS-related ideas in science education have been developed historically in the context of British education, particularly focused on the period of the 19th century and the first half of the 20th century. It has been hardly considered that the basic ideas of the STS education, one of the two paradigms of current science education together with constructivism, can be traced back to the beginning of the school science education itself. far beyond some of the programs which are largely regarded as the first-developed STS programs in Britain, such as Science in Society and SISCON. The movement of Mechanics' Institute during the first half of the 19th century would be the first systematic attempt to bridge the gap between the knowledge of pure science and its practical applications, although the main target was working-class adults rather than school pupils. At the end of the first half of the 19th century, this application-focused approach of science teaching was echoed in the elementary schools by Richard Dawes, one of the early experimenters of school science. The second half of the century was in large the period of the establishment of science as one of the core elements of school curriculum, mainly by emphasizing the aspect of pure science as a means for mental training. During this period, the elements of STS education-related appeared in the subject called 'Object Lesson' in elementary schools which was practically a separate subject from those of science. After the turn of the century, triggered by the experience of World War I, the growing appreciation of the impacts of science upon society and of the necessity of the teaching of science for wider audience gave a great impact towards two new main movements, i.e. for General Science and Citizen Science. The later illustrates a typical example of the STS movement in school science during the first half of the 20th century, particularly driven by the socialistic ideas towards the relation between science and society.

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pT1N3 Gastric Cancer (pT1N3 위암)

  • Ahn, Dae-Ho;Kwon, Sung-Joon;Yun, Hyo-Yung;Song, Young-Jin;Mok, Young-Jae;Han, Sang-Uk;Kim, Wook
    • Journal of Gastric Cancer
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    • v.6 no.2
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    • pp.109-113
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    • 2006
  • Purpose: Various minimally invasive surgical techniques, such as an endoscopic mucosal resection and a laparoscopic gastrectomy, are becoming common practice for some cases of early gastric cancer (EGC) defined in terms of the depth of invasion being limited to the mucosa or submucosa. However, there are rare cases of early gastric cancer with massive lymph-node metastasis. Materials and Methods: From 6 university hospitals of Korea, 2,772 EGC cases were resected during the various period of analysis (1,432 cases of mucosal cancer and 1,340 of submucosal cancer). Results: As control data, we used the data from a single institute, CHA University Hospital. There were nine cases of early gastric cancer (9/2,772, 0.32%) with N3 lymph node metastasis defined by more than 15 lymph nodes being metastasized according to the UICC-TNM classification (pT1N3, stage IV). Two cases were mucosal cancer (2/1,432, 0.1 4%), and seven cases were submucosal cancer (7/1,340, 0.52%). Metastasized lymph nodes varied in number from 18 to 52. There were three male and six female patients with a mean age of 57. This is a totally reversed sex ratio compared to the usual gastric cancer or EGC. Among the total of 9 EGC patients, there were 5 who had superficial spreading carcinomas with surface areas larger than $25\;cm^2$. This is a significantly higher proportion compared to the general EGC population. When we compared the tumor size according to the LN status, the N3 group was definitely larger than the other groups. 78% of the pT1N3 cases showed lymphatic invasion, which is very high compared to the 4.7% in general EGC cases. Among the 9 cases, 6 patients had too short a follow-up period to evaluate the correct prognosis, but there was one patient with a non-curative resection and two patients with early recurrence. Although the sample size is small and the follow-up period is short, we can expect a very poor prognosis when we consider the common prognosis of EGC that is widely known and accepted. Conclusion: From these results, we can a conclude that the risk factors for pT1N3 gastric cancer are female patients, submucosal invasion, larger tumor size, and lymphatic invasion. However rare, the existence of pT1N3 gastric cancer needs to be taken into consideration, especially during the diagnosis. Furthermore, minimally invasive treatment for EGC needs to be chosen with great precaution. Since the prognosis of pT1N3 gastric cancer is expected to be poor, aggressive adjuvant chemotherapy may be necessary. (J Korean Gastric Cancer Assoc 2006;6:109-113)

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Implication of Quantitative Culture of Bronchoalveolar Lavage Fluid in the Diagnosis of Ventilator Associated Pneumonia in Patients with Antimicrobial Therapy (항생제 사용 중 발생한 기계 호흡기 관련 폐렴에서 기관지 세포 세척술의 진단적 의미)

  • Chang, Yoon-Soo;Ahn, Chul-Min;Chung, Byung-Chun;Kim, Hyung-Jung;Kim, Seong-Kyu;Lee, Won-Yong;Shin, Jeung-Su
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.1
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    • pp.72-81
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    • 2000
  • Backgrounds : Authors evaluated the quantitative culture of bronchoalveolar lavage fluid(BALF) in patients who were being treated with antimicrobial agents and the characteristics of isolated microorganism. Method : A prospective study was done with 25 patients under mechanical ventilation and antimicrobial treatment in ICU and NCU of Yongdong Severance Hospital from Apr. to Sep. 1999. Patients were classified into two groups: control group (n=5) and patients with VAP (n=20). The threshold of quantitative culture of BAL fluid in the diagnosis of VAP was $10^4$ cfu/ml. Results : 1) In gram staining of BALF, one patient in the control group and four in the VAP group showed positive results. Quantitative culture of BALF showed no organisms in the patients in the control group and in 9 VAP patients. Therefore the overall sensitivity was 43.8%. 2) Frequency of isolated organisms cultured above diagnostic threshold was in the following order: E. cloaclae, S. aureus, K. pneumoniae, and A. baumani. S. aureus and Staphylococcus coagulase(-) were a11 resistant to oxacillin. Seven out of 10 isolated G (-) organisms were suspected to be organisms producing extended spectrum $\beta$-lactamase (ESBL). 3) The concurrence between gram staining of sputum aspiration and that of BALF was only in 1 case. And the concurrence of culture results was observed in 3 cases. Conclusion : The sensitivity of gram staining and quantitative culture of BALF from patients under antibiotic therapy and the concordance rate between conventional tracheal aspiration and BAL were low, facts which were important in interpretation the data. Since the frequency of drug resistance organisms was not different from that of foreign data, antibiotics must be prudently selected and used.

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A Clinical Observation on Children with Transient Small Bowel Intussusception (일과성 소장형 장중첩증의 임상적 고찰)

  • Hur, Nam-Jin;Ryu, Min-Hyuk;Lee, Dong-Jin;Kwon, Jung-Hyeok
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.3 no.2
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    • pp.160-168
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    • 2000
  • Purpose: The purpose of this study was to evaluate the clinical and abdominal ultrasonogra- phic(US) features of spontaneously reduced transient small bowel intussusception in chlidren. Methods: We retrospectively reviewed the clinical and US findings of 98 children with intussusception who were admitted to the Pediatric Department of Ulsan Dong-Kang General Hospital from Mar. 1999 to Feb. 2000. Results: 1) Among 98 cases, there were 12 cases (12.3%) of transient small bowel intussusception(TSBI) and 86 cases (87.7%) of classic intussusception (CI). 2) The peak incidence of age in TSBI was over 3 years, which was older than that in CI. With regard to sex distribution, male predominated in both type. 3) Clinical symptoms and signs including cyclic irritability, vomiting, bloody stool, and abdominal mass in TSBI group were less common than those in CI group (41.7%, 33.4%, 0.0%, 0.0% vs 91.9%, 59.3%, 41.9%, 26.7%, respectively) but persistent abdominal pain was more common in TSBI group than in CI group (58.5% vs 11.2%). 4) The size of total target sign and surrounding peripheral hypoechoic rim of TSBI group on US were smaller than those of CI group ($11.95{\pm}2.61$ mm, $2.08{\pm}1.15$ mm vs $26.91{\pm}5.98$ mm, $7.86{\pm}2.77$ mm, respectively). 5) Concomittant illness was found more frequently in TSBI group than in CI group (66.7% vs 26.7%). 6) All case of TSBI group were reduced spontaneouly, which were confirmed by US, but none of CI group. Conclusion: Transient small bowel intussusception is probably more common than generally thought and its clinical and US findings is quite different from classical obstructing intussus-ception. Because all of our cases resulted in spontaneous reduction, we recommend careful observation and repeat examination rather than an immediate operation in transient small bowel intussusception.

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