Since patients with strokes occupy a high priority among patients for home nursing, the development of guidelines for such nursing is required and the needs of these patients should be reflected in the guidelines. Therefore, this study was done to identify the content and levels of home nursing for patients with strokes and to utilize the data in developing the most effective home nursing guidelines for these patients. The level of A, D. L. and the ability to control upper extremities were measured, and through a questionnaire. the needs for home nursing and related variables were also evaluated. The subjects for the study were 121 patients, 58 inpatients and 63 home care patients who had had a Stroke. Data collection was done from September 1996 to January 1997. The collected data were analyzed utilizing SPSS /PC, and the results are as follows : 1. Home nursing need of inpatients The priority order of home nursing needs for inpatients was : "Training in emergency treatments and how to cope with a stroke"(2.28+1.06), next, "Explanation of diets as limited or recommended", and last, "Nursing care for sleeping Problems". 2. Home nursing need home of patients The priority order of home nursing needs for home patients was : "Care for the paralyzed side" (2, 89+.34), next, "Maintenance of right posture and how to change position" (2.87+.34), and last, "Counseling on sex". 3. Comparison of the levels of home nursing needs between in patients and home patients The results of analyses of home nursing needs according to causes were grouped into seven categories : and t-tests of the seven categories showed significant differences between the two groups in all categories, that is, the level of home nursing needs were significantly higher for home patients than for inpatients in all categories of home nursing. 4. Level of home nursing needs by characteristics The variables that have affected the level of home nursing needs for these patients were sex, profession, level of education, accompanying diseases, paralyzed position. A.D.L. levels and ability levels in coordinating upper extremities. There variables, displayed a reverse correlation with the level of home nursing needs, and the degree of correlation was high. In conclusion, the above results, show there were differences in the priority order of home nursing needs between inpatients and home patients : but the content of home nursing needs wanted by these patients was similar. Meanwhile, the levels of demand for home nursing was exceptionally higher on the part of home patients than inpatients. Although it is realized that nursing guidelines for home nursing needs in all items need to be developed, there is also a necessity to guidelines in accordance with priority orders, and with consideration of the factors that affect the level of home nursing needs. of the factors that affect the level of home nursing needs.
KSCE Journal of Civil and Environmental Engineering Research
/
v.26
no.3D
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pp.453-459
/
2006
This paper presents an experimental evaluation of wandering effect on asphalt concrete pavement responses. A laser-based wandering system has been developed and its performance is verified under various field conditions. The portable wandering system composed of two laser sensors with Position Sensitive Devices can allow one to measure the distance between laser sensors and tire edges of moving vehicle. Therefore, lateral position of each wheel on the pavement can be determined in a real time manner. Pavement responses due to different loading paths are investigated using a roll over test which is carried out on one of asphalt surfaced pavements in the Korea Highway Corporation test road. The pavement section (A5) consists of 5 cm thick surface course; 7 cm intermediate course; and 18 mm base course, and is heavily instrumented with strain gauges, vertical soil pressure cells and thermo-couples. From the center of wheel paths, seven equally-spaced lateral loading paths are carefully selected over an 140 cm wandering zone. Test results show that lateral horizontal strains in both surface and intermediate courses are mostly compressive right under the loading path and tensile strains start to develop as the loading offset becomes 40 cm from the wheel path. The development of the vertical stresses in the top layers of subbase and anti-frost is found to be minimal once the loading offset becomes 50 cm.
Background: The purpose of this study was to assess the feasibility of deep inspiration breath-hold (DIBH) based volumetric modulated arc therapy (VMAT) for locally advanced left sided breast cancer patients undergoing radical mastectomy. DIBH immobilizes the tumor bed providing dosimetric benefits over free breathing (FB). Materials and Methods: Ten left sided post mastectomy patients were immobilized in a supine position with both the arms lifted above the head on a hemi-body vaclock. Two thermoplastic masks were prepared for each patient, one for normal free breathing and a second made with breath-hold to maintain reproducibility. DIBH CT scans were performed in the prospective mode of the Varian real time position management (RPM) system. The planning target volume (PTV) included the left chest wall and supraclavicular nodes and PTV prescription dose was 5000cGy in 25 fractions. DIBH-3DCRT planning was performed with the single iso-centre technique using a 6MV photon beam and the field-in-field technique. VMAT plans for FB and DIBH contained two partial arcs ($179^{\circ}-300^{\circ}CCW/CW$). Dose volume histograms of PTV and OAR's were analyzed for DIBH-VMAT, FB-VMAT and DIBH-3DCRT. In DIBH mode daily orthogonal ($0^{\circ}$ and $90^{\circ}$) KV images were taken to determine the setup variability and weekly twice CBCT to verify gating threshold level reproducibility. Results: DIBH-VMAT reduced the lung and heart dose compared to FB-VMAT, while maintaining similar PTV coverage. The mean heart $V_{30Gy}$ was $2.3%{\pm}2.7$, $5.1%{\pm}3.2$ and $3.3%{\pm}7.2$ and for left lung $V_{20Gy}$ was $18.57%{\pm}2.9$, $21.7%{\pm}3.9$ and $23.5%{\pm}5.1$ for DIBH-VMAT, FB-VMAT and DIBH-3DCRT respectively. Conclusions: DIBH-VMAT significantly reduced the heart and lung dose for left side chest wall patients compared to FB-VMAT. PTV conformity index, homogeneity index, ipsilateral lung dose and heart dose were better for DIBH-VMAT compared to DIBH-3DCRT. However, contralateral lung and breast volumes exposed to low doses were increased with DIBH-VMAT.
The purpose of the study is to give basic data for the improvement of the skill and to show an exemplary position for squash club members or trainers thru a comparative analysis on the kinematics and kinetics variables on the forehand drive motion in playing squash. The objects of the research are divided into two sections, skilled group(n=8) and unskilled group(n=8). The skilled group is composed of professional players currently working and unskilled group is career of six month, both of lives in B city. In this research, to gather the data 3D motion analysis and test result analysis using force platform was used. The variables are duration, position, segment velocity, segment acceleration and etc. in using force platform. The results are as follows: 1. The duration per phase of the skilled is 0.18sec P1(DS) while that of unskilled is 0.32sec. in P2(FT), the duration of the skilled is 0.29sec, that of unskilled is 0.34sec. Average of the duration of the skilled is 0.48sec, while the unskilled, 0.66sec. 2. Regarding positional movements per event, the unskilled has a relatively higher position in center of gravity, shoulder joint, elbow joint compared with that of the skilled. Generally speaking, positions of the unskilled is higher than the skilled. 3. In segment velocity per event, R-shank, R-upper arm, R-forearm and racket. The skilled is faster than the unskilled. we found a big dig difference in shank. 4. In acceleration per event, there was a big difference in upper-arm and fore-arm of the impact. 5. The skilled group on the force platform shows relatively stable and regular changes while the unskilled shows unstable from the touch down to initial 20% the force value of central support period after the impact moment decreases rapidly and the center of gravity is not moved well. 6. The maximum force value of the skilled is 1019.7N. it is found 19.86% of the total duration. That of the unskilled is 639.2N, it is found 20.67% of total duration.
This study was performed to quantitatively assess the normal lung volume and density according to the position by multi-detector computed tomography (MDCT) in dogs. Helical CT of the thorax was performed on 4 different positions with dorsal, left lateral, right lateral and ventral recumbency in 6 Pekingese and 6 Maltese dogs. During CT scanning, dogs were kept hyperventilated. Through the 3-dimensional reconstruction of CT images, the lung parameters were measured as the volume and density of the left, right including accessory lobe, and total lung. 3D images represented the different lung shape between Pekingese and Maltese dogs. Their difference of total lung volume and total lung density was not significant on the each position in both breeds. Right lung volume was significantly higher than left. The difference of left and right volume was $66.91{\pm}25.1$ ml. Linear relationship was shown between body weight and lung volume of ventral recumbency position. The dependent lung had higher density and lower volume than nondependent lung in both breed dogs. The volume of nondependent lung was not changed compared with the volume on ventral or dorsal recumbency. The total lung volume measured with MDCT is correlated with the lung density, and the lung density is useful to predict the normal total lung volume.
Kim, Dong-Su;Kim, Il-Kyu;Jang, Keum-Soo;Park, Tae-Hwan;Kim, Kyu-Nam;Son, Choong-Yul
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.34
no.2
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pp.166-179
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2008
Excessive concentration of stress which is occurred in occlusion around the implant in case of the implant supported fixed partial denture has been known to be the main cause of the crestal bone destruction. Therefore, it is essential to evaluate the stress analysis on supporting tissue to get higher success rates of implant. The purpose of this study was to evaluate the effects of stress distribution and deformation in 3 different types of three-unit fixed partial denture sup-ported by two implants, using a three dimensional finite element analysis in a three dimensional model of a whole mandible. A mechanical model of an edentulous mandible was generated from 3D scan, assuming two implants were placed in the left premolars area. According to the position of pontic, the experiments groups were divided into three types. Type I had a pontic in the middle position between two implants, type II in the anterior posi-tion, and type III in the posterior position. A 100-N axial load was applied to sites such as the central fossa of anterior and posterior implant abutment, central fossa of pontic, the connector of pontic or the connector between two implants, the mandibular boundary conditions were modeled considering the real geometry of its four-masticatory muscular supporting system. The results obtained from this study were as follows; 1. The mandible deformed in a way that the condyles converged medially in all types under muscular actions. In comparison with types, the deformations in the type II and type III were greater by 2-2.5 times than in the type I regardless of the loading location. 2. The values of von Mises stresses in cortical and cancellous bone were relatively stable in all types, but slightly increased as the loading position was changed more posteriorly. 3. In comparison with type I, the values of von Mises stress in the implant increased by 73% in Type II and by 77% in Type III when the load was applied anterior and posterior respectively, but when the load was applied to the middle, the values were similar in all types. 4. When the load was applied to the centric fossa of pontic, the values of von Mises stress were nearly $30{\sim}35%$ higher in the type III than type I or II in the cortical and cancellous bone. Also, in the implant, the values of von Mises stress of the type II or III were $160{\sim}170%$ higher than in the type I. 5. When the load was applied to the centric fossa of implant abutment, the values of von Mises stress in the cortical and cancellous bone were relatively $20{\sim}25%$ higher in the type III than in the other types, but in the implant they were 40-45% higher in the type I or II than in the type III. According to the results of this study, musculature modeling is important to the finite element analysis for stress distribution and deformation as the muscular action causes stress concentration. And the type I model is the most stable from a view of biomechanics. Type II is also a clinically accept-able design when the implant is stiff sufficiently and mandibular deformation is considered. Considering the high values of von Mises stress in the cortical bone, type III is not thought as an useful design.
The effect of internal and shroud nozzle distributor to bubbling fluidized beds which has the size of $0.3m-ID{\times}2.4m-high$ column was modeled by CPFD (Computational Particle-Fluid Dynamics). Metal-grade silicon particles (MG-Si) were used as bed materials which have $d_p=149{\mu}m$, ${\rho}_p=2,325kg/m^3$ and $U_{mf}=0.02m/s$. Total bed inventory and static bed height were 75 kg and 0.8 m, respectively. Effect of vertical internal on the bubble rising velocity was investigated. Bubbles were split by internal when the axial position of the internal from the distributor, z = 0.45 m. Bed pressure drop and axial solid holdup were not affected by internal. However, in the case that axial distance of internal from distributor was too close to jet penetration length, bubbles were not separated and bypassed internal, and faster than without internal or z = 0.45 m.
Baik Yong Hae;Lee Soon Jin;Lee Ji Yun;Noh Jae Hyung;Sohn Tae Sung;Kim Sung;Kim Yong Il
Journal of Gastric Cancer
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v.3
no.4
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pp.195-200
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2003
Purpose: Advancement of computed tomography (CT) hardware and software has allowed thin section scanning and reconstruction of fascinating 2-dimentional (2D) and 3- dimentional (3D) images. Especially, the reconstruction of 3D images of gastrointestinal tract has been used in the detection and diagnosis of pre-malignant and malignant diseases. To compare the efficacy of CT gastrography with conventional upper gastrointenstinal series (UGIs) in gastric cancer patients. Materials and Methods: During Nov. 2002 and Mar. 2003, twenty-seven patients who had gastric cancer received both double contrast upper GI series and CT gastrography prior to radical surgery. Among these patients, nineteen had early gastric cancer (EGC) and 8 had advanced gastric cancer (AGC). Fifteen patients were male and 12 were female. The mean age was 54 yrs (range, $27\∼75$ yrs). The patients were placed on NPO and Stomach was distended with gas in fasting state prior to CT scanning. Double contrast upper GI series were performed as routine manual. CT scan was conducted in all patients using 8 or 16-channel multidetector CT in this study. The collimation and reconstruction for CT scanning were set at 2.5 mm and 1.25 mm, respectively. CT scanning was performed in the supine position. For image processing, CT gastrography, in which raysum and surface rendering images were constructed, virtual and 2D image in coronal and sagittal images were performed. The detectability of gastric cancer was assessed between UGIs and CT gastrography. Results: In AGCs, the detection rate of cancer using CT gastrography and virtual gastroscopy was higher than EGC cases. However, CT gastrography and virtual gastroscopy showed less favorable results than UGIs. Even though only a small number of cases had been studied, we might conclude that CT gastrography and virtual gastroscopy could replace UGIs in the detection of AGC cases. Conclusion: The detection rate used with CT gastrography and Virtual gastroscopy is not better than that of UGIs in early gastric cancer, however, in advanced gastric cancer cases, it is nearly equal to that of UGIs.
The difference between three-dimensional (3D) and four-dimensional (4D) dose could be affected by factors such as tumor size and motion. To quantitatively analyze the effects of these factors, a phantom that can independently control each factor is required. The purpose of this study is to develop a deformable lung phantom with the above attributes and evaluate the characteristics. A phantom was designed to simulate diaphragm motion with amplitude in the range 1~7 cm and period up to ${\geq}2s$ of regular breathing. To simulate different tumors sizes, custom molds were created using a 3D printer and filled with liquid silicone. The accuracy of the phantom diaphragm motion was assessed by comparing measured motion with predicted motion. Because the phantom diaphragm motion is not identical to the tumor motion, the correlation between the diaphragm and tumor motions was calculated by a curve fitting method to emulate user-intended tumor motion. Tumors of different sizes were located at same position, and tumor set-up positions were evaluated. The accuracy of phantom diaphragm motion was better than 1 mm. The diaphragm-tumor correlation showed that the tumor motion in the superior-inferior direction increased with increasing diaphragm motion. The tumor motion was larger in the $10cm^3$ tumor than in the $90cm^3$ tumor. The range of difference between the tumor set-up positions was 0 to 0.45 cm. This phantom showed independently adjusting factors such as tumor size and motion to facilitate quantitative analysis of the dosimetric impact of respiratory motion according to these factors.
Single crystals of sodium thiosulfate $(Na_2S_2O_3) have been grown from the saturated solution by the evaporation method at the optimum condition. Radiation damages in the crystal by ${\gamma}$-irradiation of $20{\times}10^6$ Rontgen have given rise to paramagnetic centers. The anisotropic spectra of each paramagnetic species have been obtained with the X-band EPR spectrometer at room temperature. When an isotropic D.P.P.H. at g value of 2.0036 is based on. ESR Spectra of the single crystal are recorded for each rotation about the perpendicular a, b and c axis with intervals of $10^{\circ}$ from $0^{\circ}$to $180^{\circ}$ in order to find out the properties of the crystal for anglar variation of the anisotropic peaks. The g values are calculated from the line position between the anisotropic peaks and the isotropic peaks of D.P.P.H. and then principal g values and their direction cosines of the species is obtained by the diagonalization of 9 matrix elements of the corresponding g values. From the analysis of the characteristic principal g values and direction cosines for ${\gamma}$-irradiated $Na_2S_2O_3$ crystal, anisotropic peaks corresponding to $SO_2^+, SO_2^- $are identified and the existences of unidentified and unstable paramagnetic defects are verified.
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