• Title/Summary/Keyword: Adverse effects

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Dosimetric Comparison of One Arc & Two Arc VMAT Plan for Prostate cancer patients (Prostate Cancer 환자에 대한 One Arc와 Two Arc VMAT Plan의 선량 측정 비교 분석)

  • Kim, Byoung Chan;Kim, Jong Deok;Kim, Hyo Jung;Park, Ho Chun;Baek, Jeong Ok
    • The Journal of Korean Society for Radiation Therapy
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    • v.30 no.1_2
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    • pp.107-116
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    • 2018
  • Purpose : Intensity-modulated radiation therapy(IMRT) has been widely used for radiation therapy of Prostate Cancer because it can reduce radiation adverse effects on normal tissues and deliver more dose to the Prostate than 3D radiation therapy. Volumetric modulated arc therapy(VMAT) has been widely used due to recent advances in equipment and treatment techniques. VMAT can reduce treatment time by up to 55 % compared to IMRT, minimizing motion error during treatment. Materials and Methods : In this study, compared the MU and DVH values of 10 patients with prostate cancer by classifying them into 4 groups with 5 LN-Prostate groups and 5 Only-Prostate. And DQA measurements were performed using ArcCHECK and MapCHECK. Results : The results of Target and OAR dose distribution of Prostate patients are as follows. $D_{max}$ was in the range of 100~110 % in 4 groups, and more than 110 % of hot spot was not seen. Only-Prostate ($P_1$, $P_2$) without LN had a satisfactory dose distribution for the target dose, but slightly better for 2 arc plan($P_2$) than 1 arc plan($P_1$). The target dose $D_{98%}$ distribution in the LN-Prostate ($P_{L1}$, $P_{L2}$) group showed better 2 arc plan($P_{L2}$) than 1 arc plan($P_{L1}$), But in the case of 1 arc plan($P_{L1}$), the target dose $D_{98%}$ value was not enough. In OAR, the dose distribution of 1 Arc($P_1$) Plan and 2 Arc($P_2$) Plan in the Only-Prostate ($P_1$, $P_2$) Group satisfied the prescribed dose value. But, The dose distribution of 1 arc($P_1$) was slightly higher. In LN-Prostate OAR, 1 Arc($P_{L1}$) Plan showed higher dose than the prescribed dose. The Gamma evaluation pass rate of ArcCHECK and MapCHECK calculated from the DQA measurements was slightly higher than 99 % and the mean error range of the point dose measurements using the CC04 ion chamber was less than 1 %. Conclusion : In this study, Only-Prostate ($P_1$, $P_2$) group, the dose of 2 Arc plan was better. However, considering the treatment time and MU value, 1 Arc treatment method was more suitable. In the LN-Prostate ($P_{L1}$, $P_{L2}$) group, 2 Arc($P_{L2}$) treatment method showed better results and satisfied with Target $D_{98%}$ and OAR prescription dose.

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The Impact of Justice of Layoff on Management Trust, Job Satisfaction and Organizational Commitment in the Hotel Corporations (호텔기업에 있어 구조조정상의 공정성 지각이 경영진의 신뢰, 직무만족 및 조직몰입에 미치는 영향)

  • Kim, Young-Soon;Ahn, Dae-Hee
    • Journal of Global Scholars of Marketing Science
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    • v.18 no.1
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    • pp.115-139
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    • 2008
  • Since financial crisis of IMF resulted in intensive competitiveness and adverse management environment, many hotel industries have responded it with restructuring. Since this restructuring is accompanied by reduction of employees, hence comes the recognition of justice in the procedure of restructuring. When the surviving employees in the restructuring process recognize unfairness in the procedure and practical operations, organization effectiveness can not be maintained due to losing trust of their employers. In this paper I will examine the relationship between validity of restructuring and compensatory programs for layoffs and surviving employees' trust of the employers. Also I will find out the relationship between remaining employees' trust of the employers and their job satisfaction and organization commitment. Through this relationship, we can prepare an alternative to reduce negative effect of restructuring. The hypotheses of this study are proposed as follows: H1: The higher surviving employees' recognition of procedural justice in restructuring process is, the higher their trust with a manager of the company is. H2: The higher surviving employees' recognition of distributive justice in restructuring process is, the higher their trust with a manager of the company is. H3: The higher surviving employees' recognition of procedural justice in restructuring process is, the higher their job satisfaction is. H4: The higher surviving employees' recognition of distributive justice in restructuring process is, the higher their job satisfaction is. H5: The higher surviving employees' recognition of procedural justice in restructuring process is, the higher their organization commitment is. H6: The higher surviving employees' recognition of distributive justice in restructuring process is, the higher their organization commitment is. H7: The higher surviving employees' trust with a manager of the company in restructuring process is, the higher their job satisfaction is. H8: The higher surviving employees' trust with a manager of the company in restructuring process is, the higher their organization commitment is. For the purposes of this study, employees working in luxury hotels located in Seoul were targeted. Self-administered questionnaires were distributed to those who consented with the investigation after explaining the purpose of the survey. A total of 500 questionnaires were distributed and 450 questionnaire were returned to the researcher for analysis. 430 of the returned questionnaires were used for analysis. As for the education for this survey, 250 junior college graduates or under (58.1%), 143 college graduates (33.3%) and 37 graduate school graduates (8.6%). As for the marital status, 315 persons (73.3%) are single and 115 are married (26.7%). As for the monthly income, 49 people (11.48%) are less than 2 million won, 148 (34.4%) are between 2 million and less than 2.5 million won, 153 (35.6%) are between 2.5 million to less than 3 million won, 80 (18.6%) are more than 3 million won. As for the workplace, 293 people (68.1%) work for the F&B department, 73 (17.0%) for rooms department, 41 (9.5%) for operation/ marketing department, 23 (5.3%) for account/ general affair department. As for the period of employment, 85 people (19.8%) are less than 5 years, 150 (34.9%) are between 6 to 9 years, 143 (33.3%) are between 10 to 14 years. and 52 (3.%) are more than 15 years. An exploratory factor analysis was used to survey validity and reliability of calculating tool on perceived values. This study used correlation between individual items and whole items and Cronbach's alpha value of multiple-item scale which is usually used to assess scale and reliability. Reliability of conceptual sub-dimension was assessed by basing on repeated procedure of correlation between individual items and whole items and factor loading. 1. Verification of correlation between validity of restructuring and trust This research showed that procedural and distributive justice of restructuring affects trust positively. The path coefficient between procedural justice of restructuring and trust is 0.719(t=10.135, p=0.000), and thereby the higher procedural justice results in higher trust. The path coefficient between distributive justice of restructuring and trust is 0.160(t=3.291, p=0.001), and thereby the higher distributive justice results in higher trust. Hence H1 and H2 are accepted. 2. Verification of correlation between validity of restructuring and job satisfaction The path coefficient between procedural justice of restructuring and job satisfaction is 0.179(t=2.202, p=0.028), and thereby the higher procedural justice results in higher job satisfaction. The path coefficient between distributive justice of restructuring and job satisfaction is 0.074(t=1.620, p=0.105), and thereby distributive justice of restructuring has no relationship with job satisfaction. Hence H3 is accepted, but H4 is removed. 3. Verification of correlation between validity of restructuring and organization commitment The path coefficient between procedural justice of restructuring and organization commitment is 0.188(t=2.466, p=0.014), and thereby the higher procedural justice results in higher organization commitment. The path coefficient between distributive justice of restructuring and organization commitment is 0.118(t=2.720, p=0.007), and thereby the higher distributive justice results in higher organization commitment. Hence H5 and H6 are accepted. 4. Verification of correlation between trust and job satisfaction The path coefficient between trust and job satisfaction is 0.610(t=6.736, p=0.000), and thereby the correlation has a meaningful result. Since the higher trust of the employer results in higher job satisfaction, H7 is accepted. 5. Verification of correlation between trust and organization commitment The path coefficient between procedural justice of restructuring and job satisfaction is 0.446(t=5.547 p=0.000), and thereby the higher trust of the employer results in higher organization commitment. Hence H8 is accepted. This research aimed to help the employers of hotel industries by analyzing the effects of validity of restructuring on employees' trust, job satisfaction and organization commitment. The research found that employer's validity of restructuring has significant affects on the degree of employee's trust with a manager, thereby reducing the negative effects of restructuring and enhancing organization commitment and job satisfaction. The principal purpose of this research is to confirm the correlation between employees' perceived validity of restructuring and their trust with a manager. Also whether this correlation results in competitive edge of the company is also investigated. It is also pointed out that employees had to participated the procedure of restructuring, sharing the philosophy and reason of restructuring. This participation and furthermore compensatory methods can reduce employees' anxiety of organization operations. Variable of trust appeared to have impact on intermediation effect between perceived variable of validity and job satisfaction, organization commitment, so that increase of trust with a manager plays an crucial role in increasing organization effectiveness. Since this research did not cover whole hotel industries which underwent restructuring, it showed a limit. Unlike previous studies which dealt with validity and trust of superior bosses, this research focussed on employers. Also the organization citizenship which is not considered in this study will be dealt with in the future study.

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The Respiratory and Hemodynamic Effects of Prone Position According to the Level of PEEP in a Dog Acute Lung Injury Model (잡종견 급성폐손상 모델에서 Prone position 시행시 PEEP 수준에 따른 호흡 및 혈류역학적 효과)

  • Lim, Chae-Man;Chin, Jae-Yong;Koh, Youn-Suck;Shim, Tae-Sun;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.1
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    • pp.140-152
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    • 1998
  • Background: Prone position improves oxygenation in patients with ARDS probably by reducing shunt Reduction of shunt in prone position is thought to be effected by lowering of the critical opening pressure (COP) of the dorsal lung because the pleural pressure becomes less positive in prone position compared to supine position. It can then be assumed that prone position would bring about greater improvement in oxygenation when PEEP applied in supine position is just beneath COP than when PEEP is above COP. Hemodynamically, prone position is expected to attenuate the lifting of cardiac fossa induced by PEEP. Based on these backgrounds, we investigated whether the effect of prone position on oxygenation differs in magnitude according to the level of PEEP applied in supine position, and whether impaired cardiac output in supine position by PEEP can be restored in prone position. Methods: In seven mongrel dogs, $PaO_2/F_1O_2$(P/F) was measured in supine position and at prone position 30 min. Cardiac output (CO), stroke volume (SV), pulse rate (PR), and pulmonary artery occlusion pressure (PAOP) were measured in supine position, at prone position 5 min, and at prone position 30 min. After ARDS was established with warmed saline lavage(P/F ratio $134{\pm}72$ mm Hg), inflection point was measured by constant flow method($6.6{\pm}1.4cm$ $H_2O$), and the above variables were measured in supine and prone positions under the application of Low PEEP($5.0{\pm}1.2cm$ $H_2O$), and Optimal PEEP($9.0{\pm}1.2cm$ $H_2O$)(2 cm $H_2O$ below and above the inflection point, respectively) consecutively. Results : P/F ratio in supine position was $195{\pm}112$ mm Hg at Low PEEP and $466{\pm}63$ mm Hg at Optimal PEEP(p=0.003). Net increase of P/F ratio at prone position 30 min, however, was far greater at Low PEEP($205{\pm}90$ mm Hg) than at Optimal PEEP($33{\pm}33$ mm Hg)(p=0.009). Compared to CO in supine position at Optimal PEEP($2.4{\pm}0.5$ L/min), CO in prone improved to $3.4{\pm}0.6$ L/min at prone position 5 min (p=0.0180) and $3.6{\pm}0.7$ L/min at prone position 30 min (p=0.0180). Improvement in CO was attributable to the increase in SV: $14{\pm}2$ ml in supine position, $20{\pm}2$ ml at prone position 5 min (p=0.0180), and $21{\pm}2$ ml at prone position 30 min (p=0.0180), but not to change in PR or PAOP. When the dogs were turned to supine position again, MAP ($92{\pm}23$ mm Hg, p=0.009), CO ($2.4{\pm}0.5$ L/min, p=0.0277) and SV ($14{\pm}1$ ml, p=0.0277) were all decreased compared to prone position 30 min. Conclusion: Prone position in a dog with saline-lavaged acute lung injury appeared to augment the effect of relatively low PEEP on oxygenation, and also attenuate the adverse hemodynamic effect of relatively high PEEP. These findings suggest that a PEEP lower than Optimal PEEP can be adopted in prone position to achieve the goal of alveolar recruitment in ARDS avoiding the hemodynamic complications of a higher PEEP at the same time.

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