• Title/Summary/Keyword: 프로토콜분석

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Efficacy and Accuracy of Patient Specific Customize Bolus Using a 3-Dimensional Printer for Electron Beam Therapy (전자선 빔 치료 시 삼차원프린터를 이용하여 제작한 환자맞춤형 볼루스의 유용성 및 선량 정확도 평가)

  • Choi, Woo Keun;Chun, Jun Chul;Ju, Sang Gyu;Min, Byung Jun;Park, Su Yeon;Nam, Hee Rim;Hong, Chae-Seon;Kim, MinKyu;Koo, Bum Yong;Lim, Do Hoon
    • Progress in Medical Physics
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    • v.27 no.2
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    • pp.64-71
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    • 2016
  • We develop a manufacture procedure for the production of a patient specific customized bolus (PSCB) using a 3D printer (3DP). The dosimetric accuracy of the 3D-PSCB is evaluated for electron beam therapy. In order to cover the required planning target volume (PTV), we select the proper electron beam energy and the field size through initial dose calculation using a treatment planning system. The PSCB is delineated based on the initial dose distribution. The dose calculation is repeated after applying the PSCB. We iteratively fine-tune the PSCB shape until the plan quality is sufficient to meet the required clinical criteria. Then the contour data of the PSCB is transferred to an in-house conversion software through the DICOMRT protocol. This contour data is converted into the 3DP data format, STereoLithography data format and then printed using a 3DP. Two virtual patients, having concave and convex shapes, were generated with a virtual PTV and an organ at risk (OAR). Then, two corresponding electron treatment plans with and without a PSCB were generated to evaluate the dosimetric effect of the PSCB. The dosimetric characteristics and dose volume histograms for the PTV and OAR are compared in both plans. Film dosimetry is performed to verify the dosimetric accuracy of the 3D-PSCB. The calculated planar dose distribution is compared to that measured using film dosimetry taken from the beam central axis. We compare the percent depth dose curve and gamma analysis (the dose difference is 3%, and the distance to agreement is 3 mm) results. No significant difference in the PTV dose is observed in the plan with the PSCB compared to that without the PSCB. The maximum, minimum, and mean doses of the OAR in the plan with the PSCB were significantly reduced by 9.7%, 36.6%, and 28.3%, respectively, compared to those in the plan without the PSCB. By applying the PSCB, the OAR volumes receiving 90% and 80% of the prescribed dose were reduced from $14.40cm^3$ to $0.1cm^3$ and from $42.6cm^3$ to $3.7cm^3$, respectively, in comparison to that without using the PSCB. The gamma pass rates of the concave and convex plans were 95% and 98%, respectively. A new procedure of the fabrication of a PSCB is developed using a 3DP. We confirm the usefulness and dosimetric accuracy of the 3D-PSCB for the clinical use. Thus, rapidly advancing 3DP technology is able to ease and expand clinical implementation of the PSCB.

A Study of the Elementary School Teachers' Perception of Science Writing (초등학교 교사들의 과학 글쓰기에 대한 인식 연구)

  • Song, Yun-Mi;Yang, Il-Ho;Kim, Ju-Yeon;Choi, Hyun-Dong
    • Journal of The Korean Association For Science Education
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    • v.31 no.5
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    • pp.788-800
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    • 2011
  • The purpose of this study was to investigate the elementary school teachers' perception of science writing. In this study, 10 elementary school teachers who have taught in the 3rd or 4th grade science lesson in 2010 were selected. Researchers constructed interview guide in three parts including the teachers' understanding of science writing, the status of science writing teaching and the difficulties of science writing in their classes. For the investigation, semi-structured in-depth interviews with 10 elementary school teachers were conducted individually. The results showed that the elementary school teachers were unfamiliar with the word ‘science writing’ and considered science writing as a writing using science learning contents. Also, they think that teaching science writing in their science lessons was not needed and didn't assess and provide detailed feedback with the students' written works. Most teachers needed teaching materials and assessment tools for science writing. To develop elementary teachers' understanding of the value and use of writing for learning in science, they will need to participate in science writing programs for in-service teachers and various teaching materials and assessment tools should also be developed.

The Strategic Approach to FTA Governmental Negotiation Method between China (중국과의 FTA 협상방식을 위한 전략적 접근)

  • Na, Seung-Hwa
    • The Journal of Industrial Distribution & Business
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    • v.1 no.1
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    • pp.13-21
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    • 2010
  • Since Korea establish diplomatic ties with China in 1992, korea and China have had rapid progress in most of field as politic, economy, society and culture through basing on cultural commonality and geographical adjacency. Especially, China is the biggest trading partner to korea, and also Korea is third-biggest trading country to China. They become strategic cooperating relation in 2008. Currently, in terms of international trade relation, WTO/DDA negotiation is proceeding in difficulty, but FTA has been growing and extending in the world, and the two country, china and korea, have been competitively trying wide and active FTA negotiation promotion. After Financial crisis in 1997, according to the requirement of local economic cooperation, China has shown the interest to several countries since the conclusion of FTA treaty with ASEAN in 2005. China also makes the active afford to conclude FTA with Korea. Last May 28th, this was mentioned in the meeting between president Lee and Premier Wen Jiabao, so it is anticipated that the negotiation for FTA will be started in the near future. There are many political suggestions and concerns in terms of way of negotiation korea would choose. Some economist said that "'Continuous FTA aimed at long-term protocol should be promoted between korea and China and negotiated includingly'" However, this research claims that commodity exchange, service, and investment areas should be included and it has to be comprehensive package settlement style in negotiation. This research has found out the characteristics of China's negotiation and implications through the China's existed FTA negotiation examples. Currently, China has taken Continuous or a phase-negotiation method to ASEAN, Pakistan, Chile and some other developing country and to advanced countries like New Zealand or Singapore, comprehensive package settlement method is used in FTA negotiation. In consider of the FTA negotiation between Korea and China, Korea has some problems in the commodity change area in agriculture maket's opening. While, for china, the issues would happen in service trade area, especially when encountering finance and communication industries are opened, China's economy could be exposed to some risk. In result, Korea should expand its negotiation range from commodity trade to service trade, in order to exchange both issues, then the negotiation will be concluded more easily. In other word, for FTA, korea should follow comprehensive package settlement way that is similar to New zealand and Singapore case. Through this kind of method, Korea can expect effect of creating trade, conversion of it and preoccupancy of service field in china's market against the advanced countries like Usa, Europe and Japan. Also, to have a successful FTA negotiation, korea should find out china's policy for FTA negotiation. With this information, korea will be able to suggest the way to make a profit. Systematic analysis and comparison about previous negotiation cases of china are needed before the negotiation begin.

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Critical Pathway for Operable Gastric Cancer (위암수술 환자에서의 Critical Pathway의 개발과 적용)

  • Song, Kyo-Young;Kim, Seung-Nam;Park, Cho-Hyun
    • Journal of Gastric Cancer
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    • v.5 no.2
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    • pp.95-100
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    • 2005
  • Purpose: Critical pathways (CP), also known as clinical pathways, are management plans that display goals for patients and have led to improved outcomes for many disease entities. This study was aimed at developing a critical pathway for the surgical treatment of gastric cancer patients and evaluating its usefulness. Materials and Methods: A CP was developed and implemented by a team of surgeons, nurses, nutritionists, and administrative officials. Among the 117 patients who received curative gastrectomies for gastric cancer at Kangnam St. Mary's Hospital, The Catholic University of Korea, between October 2003 and August 2004, 26 patients were treated according to the CP. We evaluated its usefulness by comparing the clinical characterisctics, postoperative progress, hospital stays, and costs between the CP and the non-CP groups. Patient satisfaction was also surveyed with questionnaires. Results: Of the initial 26 patients in the CP group, two were excluded from the final evaluation; one patient had a duodenal stump leakage, and the other had a gastric stasis postoperatively. In 8 patients, protocol violation occurred; six patients refused to be discharged on the $7^{th}$ postoperative day, one patient who had an gastric staisis postoperatively stayed for 2 additional days, and one patient who needed ICU care stayed for 4 additional days. The drop-out rate was $7.7\%$ (2/26), and the variance rate was $30.8\%$ (8/26). The mean hospital stay was 11.3 days ($10\~15$ days) for the CP group compared with 17.5 days ($9\∼68$ days) for the non-CP group, resulting in a difference of about 6 days (P<0.05). The mean hospital stays after surgery were 10.3 days ($7\∼68$ days) and 8.3 days ($7\∼12$ days) for the non-CP and the CP groups, respectively, but the difference was statistically not significant (P>0.05). The mean charge during the hospital stay was higher in the non-CP group ( $\\$ 6,292,200) than in the CP group ( $\\$ 4,863,685). The charge per hospital day was higher in the CP group ( $\\$ 430,414) than in the non-CP group ( $\\$ 359,554). Patient satisfaction was higher in the CP group than in the non-CP group. Conclusion: By developing and applying a critical pathway in the surgical treatment of stomach cancer patients, we could reduce the length of hospital stay as well as the cost. A multi-centered prospective study to establish a standard treatment pathway and to demonstrate its effectiveness is needed in the future.

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Pediatric Renal Transplantation in Asia (아시아 소아 신장이식 현황)

  • Kim Ji-Hong;Choi Yong;Kim Pyung-Kil
    • Childhood Kidney Diseases
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    • v.6 no.2
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    • pp.131-141
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    • 2002
  • Purpose : Renal transplantation which allows children normal growth and development and a return to normal life. is now proven to be the best modality for children with ESRD Up to Recently, the number of renal transplantations in Asia has rapidly increased and the outcome has also improved. This investigation was planned to estimate the current status of pediatric renal transplantation in Asia and to find the keys for better improvement of outcome in pediatric renal allograft in Asian countries. Material and methods : The participating countries and institutions for this investigation were China, Hong Kong, India, Indonesia, Japan, Malaysia, Pakistan, Philippines, Singapore, Thailand, Korea, KSPN (Korean Society of Pediatric Nephrology), KONOS (Korean Network for Organ Sharing). Results : Many countries in Asia still do not have a well organized nation wide renal transplantation registration system independently in the pediatric field. So it's very difficult to evaluate the real state of pediatric transplantation among Asian countries. According to the estimation with fragmented data from each countries, in the front running countries of pediatric renal transplantation in Asia, about 40 or more transplants were performed in each country per year and the five year actuarial renal allograft survival was around 80% which is similar to that of western countries. But there were large gaps among the behind groups. Conclusion : Vigorous attempts to perform renal transplantation for children especially younger than 5 years old would be encouraged as well as organ donation from brain dead donor and non heart beating cadaveric donor also should be activated to cope effectively with the shortage of living donor supply. Large number of recent reports shows the favorable outcome of pre-emptive renal transplantation, we should make more efforts toward pre-emptive renal transplantation. First of all, in order to improve the outcome and to narrow the gap between Asian countries in pediatric renal transplantation, effective and continuous efforts to establish nationwide pediatric renal transplantation registration program as well as official, nation-to-nation data sharing program should be needed.

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The Extended Site Assessment Procedure Based on Knowledge of Biodegradability to Evaluate the Applicability of Intrinsic Remediation (자연내재복원기술(Intrinsic Remediation)적용을 위한 오염지역 평가과정 개발)

  • ;Robert M. Cowan
    • Journal of Korea Soil Environment Society
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    • v.2 no.3
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    • pp.3-21
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    • 1997
  • The remediation of contamiated sites using currently available remediation technologies requires long term treatment and huge costs, and it is uncertain to achieve the remediation goal to drop contamination level to either back-ground or health-based standards by using such technologies. Intrinsic remediation technology is the remediation technology that relies on the mechanisms of natural attenuation for the containment and elimination of contaminants in subsurface environments. Initial costs for the intrinsic remediation may be higher than conventional treatment technologies because the most comprehensive site assessment for intrinsic remediation is required. Total remediation cost, however may be the lowest among the presently employed technologies. The applicability of intrinsic remediation in the contaminated sites should be theroughly investigated to achieve the remedial goal of the technology. This paper provides the frame of the extended site assessment procedure based on knowledge of biodegradability to evaluate the applicability of intrinsic remediation. This site assessment procedure is composed of 5 steps such as preliminary site screening, assessment of the current knowledge of biodegradability, selecting the appropriate approach, analyzing the contaminant fate and transport and planning the monitoring schedule. In the step 1, followings are to be decided 1) whether to go on the the detailed assessment or not based on the rules of thumb concerning the biodegradability of organic compounds, 2) which protocol document is selected to follow for detailed site assessment according to the site characteristics, contaminants and the relative distance between the contamination and potential receptors. In the step 2, the database for biodegradability are searched and evaluated. In the step 3, the appropriate biodegradability pathways for the contaminated site is selected. In the step 4, the fate and transport of the contaminants at the site are analyzed through modeling. In the step 5, the monitoring schedule is planned according to the result of the modeling. Through this procedure, users may able to have the rational and systematic informations for the application of intrinsic remediation. Also the collected data and informations can be used as the basic to re-select the other remediation technology if it reaches a conclusion not to applicate intrinsic remediation technology at the site from the site assessment procedure.

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Quality Assurance Program of Electron Beams Using Thermoluminescence Dosimetry (열형광선량계를 이용한 전자선 품질보증 프로그램에 관한 연구)

  • Rah Jeong-Eun;Kim Gwe-Ya;Jeong Hee-Kyo;Shin Dong-Oh;Suh Tae-Suk
    • Progress in Medical Physics
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    • v.16 no.2
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    • pp.62-69
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    • 2005
  • The purpose of this study has been performed to investigate the possibility of external audit program using thermoluminescence dosimetry for electron beam in korea. The TLD system consists of LiF powder, type TLD-700 read with a PCL 3 reader. In order to determine a calibration coefficient of the TLD system, the reference dosimeters are irradiated to 2 Gy in a $^{60}CO$ beam at the KFDA The irradiation is performed under reference conditions is water phantom using the IAEA standard holder for TLD of electron beam. The energy correction factor is determined for LiF powder irradiated of dose to water 2 Gy in electron beams of 6, 9, 12, 16 and 20 MeV (Varian CL 2100C). The dose is determined according to the IAEA TRS-398 and by measurement with a PTW Roos type plane-parallel chamber. The TLD for each electron energy are positioned in water at reference depth. In this study, to verify of the accuracy of dose determination by the TLD system are performed through a 'blind' TLD irradiation. The results of blind test are $2.98\%,\;3.39\%\;and\;0.01\%(1\sigma)$ at 9, 16, 20 MeV, respectively. The value generally agrees within the acceptance level of $5\%$ for electron beam. The results of this study prove the possibility of the TLD quality assurance program for electron beams. It has contributed to the improvement of clinical electron dosimetry in radiotherapy centers.

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Effect of Multidisciplinary Emergency Consultation System for Drug Intoxicated Patients (응급실을 내원한 약물중독 환자에 대한 다학제 응급협진체계의 효과 검증)

  • Kang, Jino;Kim, Hye Ri;Min, Kyungjoon;Kim, Na Ryoung;Heo, Yoon Kyung;Kim, Sun Mi
    • Korean Journal of Psychosomatic Medicine
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    • v.27 no.2
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    • pp.130-137
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    • 2019
  • Objectives : When a patient who attempts suicide visits the emergency room, it is important that the departments of emergency medicine, internal medicine, and psychiatry communicate with each other and prioritize treatment. This study was conducted to verify the effectiveness of the multidisciplinary emergency consultation system (ECS) for drug intoxicated patients. Methods : We retrospectively analyzed the data from medical records prior to the ECS, from July 2017 to May 2018, and after the ECS, from July 2018 to May 2019, to verify the effectiveness of the system. Results : After the ECS, admission to open wards was significantly higher than to the intensive care units (χ2=8.567, p=0.014). In addition, the proportion of consultations to the department of psychiatry among patients admitted to other departments tended to increase (χ2=4.202, p=0.053), and the time required for consultation response decreased (Z=-2.031, p=0.042). As a result of the consultation, the proportion of the patients who had been transferred to the department of psychiatry was increased (χ2=4.692, p=0.043), and the time spent to transfer tended to decrease (Z=-1.941, p=0.052). Conclusions : After implementing the ECS for drug intoxicated patients, unnecessary intensive care unit admissions, consultation response time, and the time spent to transfer were reduced, and the rate of consultation referrals and transfer rates increased. This means that the multidisciplinary consultation system rapidly provided essential medical services to patients at lower medical costs.

Development of a Dose Calibration Program for Various Dosimetry Protocols in High Energy Photon Beams (고 에너지 광자선의 표준측정법에 대한 선량 교정 프로그램 개발)

  • Shin Dong Oh;Park Sung Yong;Ji Young Hoon;Lee Chang Geon;Suh Tae Suk;Kwon Soo IL;Ahn Hee Kyung;Kang Jin Oh;Hong Seong Eon
    • Radiation Oncology Journal
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    • v.20 no.4
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    • pp.381-390
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    • 2002
  • Purpose : To develop a dose calibration program for the IAEA TRS-277 and AAPM TG-21, based on the air kerma calibration factor (or the cavity-gas calibration factor), as well as for the IAEA TRS-398 and the AAPM TG-51, based on the absorbed dose to water calibration factor, so as to avoid the unwanted error associated with these calculation procedures. Materials and Methods : Currently, the most widely used dosimetry Protocols of high energy photon beams are the air kerma calibration factor based on the IAEA TRS-277 and the AAPM TG-21. However, this has somewhat complex formalism and limitations for the improvement of the accuracy due to uncertainties of the physical quantities. Recently, the IAEA and the AAPM published the absorbed dose to water calibration factor based, on the IAEA TRS-398 and the AAPM TG-51. The formalism and physical parameters were strictly applied to these four dose calibration programs. The tables and graphs of physical data and the information for ion chambers were numericalized for their incorporation into a database. These programs were developed user to be friendly, with the Visual $C^{++}$ language for their ease of use in a Windows environment according to the recommendation of each protocols. Results : The dose calibration programs for the high energy photon beams, developed for the four protocols, allow the input of informations about a dosimetry system, the characteristics of the beam quality, the measurement conditions and dosimetry results, to enable the minimization of any inter-user variations and errors, during the calculation procedure. Also, it was possible to compare the absorbed dose to water data of the four different protocols at a single reference points. Conclusion : Since this program expressed information in numerical and data-based forms for the physical parameter tables, graphs and of the ion chambers, the error associated with the procedures and different user could be solved. It was possible to analyze and compare the major difference for each dosimetry protocol, since the program was designed to be user friendly and to accurately calculate the correction factors and absorbed dose. It is expected that accurate dose calculations in high energy photon beams can be made by the users for selecting and performing the appropriate dosimetry protocol.

Handover Functional Architecture for Next Generation Wireless Networks (차세대 무선 네트워크를 위한 핸드오버 기능 구조 제안)

  • Baek, Joo-Young;Kim, Dong-Wook;Kim, Hyun-Jin;Choi, Yoon-Hee;Kim, Duk-Jin;Kim, Woo-Jae;Suh, Young-Joo;Kang, Suk-Yang;Kim, Kyung-Suk;Shin, Kyung-Chul
    • Proceedings of the Korean Information Science Society Conference
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    • 2006.10d
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    • pp.268-273
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    • 2006
  • 차세대 무선 네트워크 (4G)는 새로운 무선 접속 기술의 개발과 함께 많은 연구가 필요한 분야이다. 그 중에서 특히 단말의 끊김없는 이동성을 제공해 주기 위한 핸드오버 기술이 가장 중요하다고 할 수 있다. 차세대 무선 네트워크는 새로운 무선 접속 기술과 함께 기존의 무선랜이나 이동통신망 등과 같이 사용될 것으로 예상되며, 네트워크 계층에서의 이동성 지원을 위하여 Mobile IPv6를 사용할 것으로 예상되는 네트워크이다. 이러한 네트워크에서 끊김없는 이동성을 제공해 주기 위해서는 현재까지 연구된 핸드오버 기능 및 구조에 대한 연구와 함께 보다 다양해진 네트워크 환경과 QoS 등을 고려한 종합적인 핸드오버 기능에 대한 연구가 필요하다. 본 논문에서는 차세대 무선 네트워크에서 단말의 끊김없는 핸드오버를 제공해 주기 위하여 필요한 기능들을 도출하고, 이들간의 유기적인 연관관계를 정의하여 다양한 네트워크 환경과 사용자의 우선순위, 어플리케이션의 QoS 요구 조건 등을 고려한 종합적인 핸드오버 기능 구조를 제안하고자 한다. 제안하는 핸드오버 구조는 Monitoring, Triggering, Handover의 세 가지 module로 나뉘어져 있으며, 각각은 필요에 따라 sub-module로 다시 세분화된다. 제안하는 핸드오버 구조의 가장 큰 특징은 핸드오버를 유발시킬 수 있는 여러 가지 요소를 종합적으로 고려하며 이들간의 수평적인 비교가 아닌 다단계 비교를 수행하여 보다 정확한 triggering이 가능하도록 한다. 또한 단말의 QoS 요구 사항을 보장하고 네트워크의 혼잡도(congestion) 및 부하 조절 (load balancing)을 위한 기능을 핸드오버 기능에 추가하여 효율적인 네트워크의 자원 사용이 가능하도록 설계하였다.서버로 분산처리하게 함으로써 성능에 대한 신뢰성을 향상 시킬 수 있는 Load Balancing System을 제안한다.할 때 가장 효과적인 라우팅 프로토콜이라고 할 수 있다.iRNA 상의 의존관계를 분석할 수 있었다.수안보 등 지역에서 나타난다 이러한 이상대 주변에는 대개 온천이 발달되어 있었거나 새로 개발되어 있는 곳이다. 온천에 이용하고 있는 시추공의 자료는 배제하였으나 온천이응으로 직접적으로 영향을 받지 않은 시추공의 자료는 사용하였다 이러한 온천 주변 지역이라 하더라도 실제는 온천의 pumping 으로 인한 대류현상으로 주변 일대의 온도를 올려놓았기 때문에 비교적 높은 지열류량 값을 보인다. 한편 한반도 남동부 일대는 이번 추가된 자료에 의해 새로운 지열류량 분포 변화가 나타났다 강원 북부 오색온천지역 부근에서 높은 지열류량 분포를 보이며 또한 우리나라 대단층 중의 하나인 양산단층과 같은 방향으로 발달한 밀양단층, 모량단층, 동래단층 등 주변부로 NNE-SSW 방향의 지열류량 이상대가 발달한다. 이것으로 볼 때 지열류량은 지질구조와 무관하지 않음을 파악할 수 있다. 특히 이러한 단층대 주변은 지열수의 순환이 깊은 심도까지 가능하므로 이러한 대류현상으로 지표부근까지 높은 지온 전달이 되어 나타나는 것으로 판단된다.의 안정된 방사성표지효율을 보였다. $^{99m}Tc$-transferrin을 이용한 감염영상을 성공적으로 얻을 수 있었으며, $^{67}Ga$-citrate 영상과 비교하여 더 빠른 시간 안에 우수한 영상을 얻을 수 있었다. 그러므로 $^{99m}Tc$-transierrin이 감염 병소의 영상진단에 사용될 수 있을 것으로 기대된다.리를 정량화 하였다. 특히 선

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