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Evaluating efficiency of Split VMAT plan for prostate cancer radiotherapy involving pelvic lymph nodes (골반 림프선을 포함한 전립선암 치료 시 Split VMAT plan의 유용성 평가)

  • Mun, Jun Ki;Son, Sang Jun;Kim, Dae Ho;Seo, Seok Jin
    • The Journal of Korean Society for Radiation Therapy
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    • v.27 no.2
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    • pp.145-156
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    • 2015
  • Purpose : The purpose of this study is to evaluate the efficiency of Split VMAT planning(Contouring rectum divided into an upper and a lower for reduce rectum dose) compare to Conventional VMAT planning(Contouring whole rectum) for prostate cancer radiotherapy involving pelvic lymph nodes. Materials and Methods : A total of 9 cases were enrolled. Each case received radiotherapy with Split VMAT planning to the prostate involving pelvic lymph nodes. Treatment was delivered using TrueBeam STX(Varian Medical Systems, USA) and planned on Eclipse(Ver. 10.0.42, Varian, USA), PRO3(Progressive Resolution Optimizer 10.0.28), AAA(Anisotropic Analytic Algorithm Ver. 10.0.28). Lower rectum contour was defined as starting 1cm superior and ending 1cm inferior to the prostate PTV, upper rectum is a part, except lower rectum from the whole rectum. Split VMAT plan parameters consisted of 10MV coplanar $360^{\circ}$ arcs. Each arc had $30^{\circ}$ and $30^{\circ}$ collimator angle, respectively. An SIB(Simultaneous Integrated Boost) treatment prescription was employed delivering 50.4Gy to pelvic lymph nodes and 63~70Gy to the prostate in 28 fractions. $D_{mean}$ of whole rectum on Split VMAT plan was applied for DVC(Dose Volume Constraint) of the whole rectum for Conventional VMAT plan. In addition, all parameters were set to be the same of existing treatment plans. To minimize the dose difference that shows up randomly on optimizing, all plans were optimized and calculated twice respectively using a 0.2cm grid. All plans were normalized to the prostate $PTV_{100%}$ = 90% or 95%. A comparison of $D_{mean}$ of whole rectum, upperr ectum, lower rectum, and bladder, $V_{50%}$ of upper rectum, total MU and H.I.(Homogeneity Index) and C.I.(Conformity Index) of the PTV was used for technique evaluation. All Split VMAT plans were verified by gamma test with portal dosimetry using EPID. Results : Using DVH analysis, a difference between the Conventional and the Split VMAT plans was demonstrated. The Split VMAT plan demonstrated better in the $D_{mean}$ of whole rectum, Up to 134.4 cGy, at least 43.5 cGy, the average difference was 75.6 cGy and in the $D_{mean}$ of upper rectum, Up to 1113.5 cGy, at least 87.2 cGy, the average difference was 550.5 cGy and in the $D_{mean}$ of lower rectum, Up to 100.5 cGy, at least -34.6 cGy, the average difference was 34.3 cGy and in the $D_{mean}$ of bladder, Up to 271 cGy, at least -55.5 cGy, the average difference was 117.8 cGy and in $V_{50%}$ of upper rectum, Up to 63.4%, at least 3.2%, the average difference was 23.2%. There was no significant difference on H.I., and C.I. of the PTV among two plans. The Split VMAT plan is average 77 MU more than another. All IMRT verification gamma test results for the Split VMAT plan passed over 90.0% at 2 mm / 2%. Conclusion : As a result, the Split VMAT plan appeared to be more favorable in most cases than the Conventional VMAT plan for prostate cancer radiotherapy involving pelvic lymph nodes. By using the split VMAT planning technique it was possible to reduce the upper rectum dose, thus reducing whole rectal dose when compared to conventional VMAT planning. Also using the split VMAT planning technique increase the treatment efficiency.

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An Intelligence Support System Research on KTX Rolling Stock Failure Using Case-based Reasoning and Text Mining (사례기반추론과 텍스트마이닝 기법을 활용한 KTX 차량고장 지능형 조치지원시스템 연구)

  • Lee, Hyung Il;Kim, Jong Woo
    • Journal of Intelligence and Information Systems
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    • v.26 no.1
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    • pp.47-73
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    • 2020
  • KTX rolling stocks are a system consisting of several machines, electrical devices, and components. The maintenance of the rolling stocks requires considerable expertise and experience of maintenance workers. In the event of a rolling stock failure, the knowledge and experience of the maintainer will result in a difference in the quality of the time and work to solve the problem. So, the resulting availability of the vehicle will vary. Although problem solving is generally based on fault manuals, experienced and skilled professionals can quickly diagnose and take actions by applying personal know-how. Since this knowledge exists in a tacit form, it is difficult to pass it on completely to a successor, and there have been studies that have developed a case-based rolling stock expert system to turn it into a data-driven one. Nonetheless, research on the most commonly used KTX rolling stock on the main-line or the development of a system that extracts text meanings and searches for similar cases is still lacking. Therefore, this study proposes an intelligence supporting system that provides an action guide for emerging failures by using the know-how of these rolling stocks maintenance experts as an example of problem solving. For this purpose, the case base was constructed by collecting the rolling stocks failure data generated from 2015 to 2017, and the integrated dictionary was constructed separately through the case base to include the essential terminology and failure codes in consideration of the specialty of the railway rolling stock sector. Based on a deployed case base, a new failure was retrieved from past cases and the top three most similar failure cases were extracted to propose the actual actions of these cases as a diagnostic guide. In this study, various dimensionality reduction measures were applied to calculate similarity by taking into account the meaningful relationship of failure details in order to compensate for the limitations of the method of searching cases by keyword matching in rolling stock failure expert system studies using case-based reasoning in the precedent case-based expert system studies, and their usefulness was verified through experiments. Among the various dimensionality reduction techniques, similar cases were retrieved by applying three algorithms: Non-negative Matrix Factorization(NMF), Latent Semantic Analysis(LSA), and Doc2Vec to extract the characteristics of the failure and measure the cosine distance between the vectors. The precision, recall, and F-measure methods were used to assess the performance of the proposed actions. To compare the performance of dimensionality reduction techniques, the analysis of variance confirmed that the performance differences of the five algorithms were statistically significant, with a comparison between the algorithm that randomly extracts failure cases with identical failure codes and the algorithm that applies cosine similarity directly based on words. In addition, optimal techniques were derived for practical application by verifying differences in performance depending on the number of dimensions for dimensionality reduction. The analysis showed that the performance of the cosine similarity was higher than that of the dimension using Non-negative Matrix Factorization(NMF) and Latent Semantic Analysis(LSA) and the performance of algorithm using Doc2Vec was the highest. Furthermore, in terms of dimensionality reduction techniques, the larger the number of dimensions at the appropriate level, the better the performance was found. Through this study, we confirmed the usefulness of effective methods of extracting characteristics of data and converting unstructured data when applying case-based reasoning based on which most of the attributes are texted in the special field of KTX rolling stock. Text mining is a trend where studies are being conducted for use in many areas, but studies using such text data are still lacking in an environment where there are a number of specialized terms and limited access to data, such as the one we want to use in this study. In this regard, it is significant that the study first presented an intelligent diagnostic system that suggested action by searching for a case by applying text mining techniques to extract the characteristics of the failure to complement keyword-based case searches. It is expected that this will provide implications as basic study for developing diagnostic systems that can be used immediately on the site.

A study of the difference of Dongeui-Suse-Bowon and past Oriental-Medicine appeared in the argument of Interior-overheating-sympton of the Tae-Eum-In caused by liver's receiving heat (태음인(太陰人) 간수열(肝受熱) 이열병론(裡熱病論)을 통해 살펴본 과거의학(過去醫學)과 동의수세보원(東醫壽世保元)의 음양관(陰陽觀)의 차이(差異))

  • Kim, Jong-Weon
    • Journal of Sasang Constitutional Medicine
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    • v.9 no.1
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    • pp.127-153
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    • 1997
  • Sasang-Medicine can classify all sympton with more simple classifying system than past Oriental-Medicine, because Sasang Byeon-Zeung(=classifying system of the sympton) separate by four clearly. The merit of this Sasang Byeon-Zeung can be seen more clearly on the part of the pathology of the expiratory-scattering and inspiratory-gathering of the Tae-Eum and Tae-Yang. On this view point, this thesis discussed the following subjects. 1. Investigate the theory of raising-falling and scattering-gathering developed in the Dongeui-Suse-Bowon. 2. Investigate the changes of the recognition of the Yang-Dog sympton and Jo-Yeol sympton argued as Interior-overheating-sympton of the Tae-Eum-In caused by liver's receiving heat. 3. Investigate the Yi-Je-Ma's view on the Eum-Yang in the argument of interior-overheating-sympton of the Tae-Eum-In caused by liver's receiving heat. As a result, the following conclusions were led to. 1. Dongeui-Suse-Bowon considers Spleen-Kidney has the couple motion of the raising Yang and falling Eum, and Liver-Lung has the couple motion of the expiratory-scattering and inspiratory-gathering. This theory of raising-falling and scattering-gathering is same as in the concept with the gathering. This theory of raising-falling and scattering-gathering is same as in the concept with the theory of raising-falling and floating-sinking of past Oriental-Medicine, but more consistently systematized in the pathology and prescription. 2. Dongeui-Suse-Bowon considers the Yang-Dog sympton and Jo-Yeol sympton as the interior-overheating-sympton of the Tae-Eum-In. As following the book, the fire of desire weeken the expiratory-scattering power of the lung, and deepen the shortage of the expiratory-scattering power comparison to the inspiratory-gathering power. Therfore the sympton can be treated by releasing ourselves from the desire and taking medicine strengthening the expiratory-scattering power. 3. In the early stage of the orintal medicine, they used prescriptions composed of So-Yang medicine and Tae-Eum medicine which can cool heat. Galgeun, Mawhang and Seungma were used in the age of Sanghanron, thereafter Jugoing's Jojung-Tang and Gongsin's Galgeunhaegi-Tang were developed as prescriptions of the interior-overheating-sympton of the Tae-Eum-In, and finally Tea-Uem-In Galgeunhaegi-Tang was settled by Yi-Je-Ma.

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Moderating Effect of Lifestyle on Consumer Behavior of Loungewear with Korean Traditional Fashion Design Elements (소비자대함유한국전통시상설계원소적편복적소비행위지우생활방식적조절작용(消费者对含有韩国传统时尚设计元素的便服的消费行为之于生活方式的调节作用))

  • Ko, Eun-Ju;Lee, Jee-Hyun;Kim, Angella Ji-Young;Burns, Leslie Davis
    • Journal of Global Scholars of Marketing Science
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    • v.20 no.1
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    • pp.15-26
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    • 2010
  • Due to the globalization across various industries and cultural trade among many countries, oriental concepts have been attracting world’s attentions. In fashion industry, one's traditional culture is often developed as fashion theme for designers' creation and became strong strategies to stand out among competitors. Because of the increase of preferences for oriental images, opportunities abound to introduce traditional fashion goods and expand culture based business to global fashion markets. However, global fashion brands that include Korean traditional culture are yet to be developed. In order to develop a global fashion brand with Korean taste, it is very important for native citizen to accept their own culture in domestic apparel market prior to expansion into foreign market. Loungewear is evaluated to be appropriate for adopting Korean traditional details into clothing since this wardrobe category embraces various purposes which will easily lead to natural adaptation and wide spread use. Also, this market is seeing an increased demand for multipurpose wardrobes and fashionable underwear (Park et al. 2009). Despite rapid growth in the loungewear market, specific studies of loungewear is rare; and among research on developing modernized-traditional clothing, fashion items and brands do not always include the loungewear category. Therefore, this study investigated the Korean loungewear market and studied consumer evaluation toward loungewear with Korean traditional fashion design elements. Relationship among antecedents of purchase intention for Korean traditional fashion design elements were analyzed and compared between lifestyle groups for consumer targeting purposes. Product quality, retail service quality, perceived value, and preference on loungewear with Korean traditional design elements were chosen as antecedents of purchase intention and a structural equation model was designed to examine their relationship as well as their influence on purchase intention. Product quality and retail service quality among marketing mixes were employed as factors affecting preference and perceived value of loungewear with Korean traditional fashion design elements. Also effects of preference and perceived value on purchase intention were examined through the same model. A total of 357 self-administered questionnaires were completed by female consumers via web survey system. A questionnaire was developed to measure samples' lifestyle, product and retail service quality as purchasing criteria, perceived value, preference and purchase intention of loungewear with Korean traditional fashion design elements. Also, loungewear purchasing and usage behavior were asked as well in order to examine Korean loungewear market status. Data was analyzed through descriptive analysis, factor analysis, cluster analysis, ANOVA and structural equation model was tested via AMOS 7.0. As for the result of Korean loungewear market status investigation, loungewear was purchased by most of the consumers in our sample. Loungewear is currently recognized as clothes that are worn at home and consumers are showing comparably low involvement toward loungewear. Most of consumers in this study purchase loungewear only two to three times a year and they spend less than US$10. A total of 12 items and four factors of loungewear consumer lifestyle were found: traditional value oriented lifestyle, brand-affected lifestyle, pursuit of leisure lifestyle, and health oriented lifestyle. Drawing on lifestyle factors, loungewear consumers were classified into two groups; Well-being and Conservative. Relationships among constructs of purchasing behavior related to loungewear with Korean traditional fashion design elements were estimated. Preference and perceived value of loungewear were affected by both product quality and retail service quality. This study proved that high qualities in product and retail service develop positive preference toward loungewear. Perceived value and preference of loungewear positively influenced purchase intention. The results indicated that high preference and perceived value of loungewear with Korean traditional fashion design elements strengthen purchase intention and proved importance of developing preference and elevate perceived value in order to make sales. In a model comparison between two lifestyle groups: Well-being and Conservative lifestyle groups, results showed that product quality and retail service quality had positive influences on both preference and perceived value in case of Well-being group. However, for Conservative group, only retail service quality had a positive effect on preference and its influence to purchase intention. Since Well-being group showed more significant influence on purchase intention, loungewear brands with Korean traditional fashion design elements may want to focus on characteristics of Well-being group. However, Conservative group's relationship between preference and purchase intention of loungewear with Korean traditional fashion design elements was stronger, so that loungewear brands with Korean traditional fashion design elements should focus on creating conservative consumers' positive preference toward loungewear. The results offered information on Korean loungewear consumers' lifestyle and provided useful information for fashion brands that are planning to enter Korean loungewear market, particularly targeting female consumers similar to the sample of the present study. This study offers strategic and marketing insight for loungewear brands and also for fashion brands that are planning to create highly value-added fashion brands with Korean traditional fashion design elements. Considering different types of lifestyle groups that are associated with loungewear or traditional fashion goods, brand managers and marketers can use the results of this paper as a reference to positioning, targeting and marketing strategy buildings.

Comparison of Property Changes of Black Jujube and Zizyphus jujube Extracts during Lactic Acid Fermentation (흑대추와 일반 건조대추의 추출 및 유산발효과정 중 특성 변화)

  • Auh, Mi Sun;Kim, Yi Seul;Ahn, Seung Joon;Ahn, Jun Bae;Kim, Kwang Yup
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.41 no.10
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    • pp.1346-1355
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    • 2012
  • This study was carried out to investigate the characteristics of black jujube and Zizyphus jujube extracts during lactic acid fermentation. Both extracts were fermented using Lactobacillus fermentum YL-3. As a result, viable cell number rapidly increased until 24 hours, after which it gradually decreased. Before lactic acid fermentation, the $IC_{50}$ of black jujube, which was 0.014 mg/mL, was lower than that of Zizyphus jujube. Further, black jujube showed stronger antioxidant activity (374.21 mg AA eq/g) than Zizyphus jujube. Contents of total polyphenolics in both extracts were 15.46 mg/g and 13.61 mg/g, respectively, whereas contents of total flavonoids were 374.21 ${\mu}g/g$ and 64.25 ${\mu}g/g$. After lactic acid fermentation, there was no significant increase in DPPH or ABTS free radical scavenging activity. Total polyphenolic content of Zizyphus jujube decreased to 12.39 mg/g upon fermentation, whereas flavonoid content significantly increased to 291.58 ${\mu}g/g$. Further, polyphenolic and flavonoid contents of black jujube increased from 15.46 mg/g to 17.46 mg/g and from 374.21 ${\mu}g/g$ to 1,135.29 ${\mu}g/g$, respectively. These results demonstrate that 9-Times Steamed and Dried increased functional components. Especially, lactic acid fermented black jujube showed remarkably high antioxidant activity. These results confirm the potential use of lactic acid fermented black jujube as a valuable resource for the development of functional foods.

Automatic Quality Evaluation with Completeness and Succinctness for Text Summarization (완전성과 간결성을 고려한 텍스트 요약 품질의 자동 평가 기법)

  • Ko, Eunjung;Kim, Namgyu
    • Journal of Intelligence and Information Systems
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    • v.24 no.2
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    • pp.125-148
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    • 2018
  • Recently, as the demand for big data analysis increases, cases of analyzing unstructured data and using the results are also increasing. Among the various types of unstructured data, text is used as a means of communicating information in almost all fields. In addition, many analysts are interested in the amount of data is very large and relatively easy to collect compared to other unstructured and structured data. Among the various text analysis applications, document classification which classifies documents into predetermined categories, topic modeling which extracts major topics from a large number of documents, sentimental analysis or opinion mining that identifies emotions or opinions contained in texts, and Text Summarization which summarize the main contents from one document or several documents have been actively studied. Especially, the text summarization technique is actively applied in the business through the news summary service, the privacy policy summary service, ect. In addition, much research has been done in academia in accordance with the extraction approach which provides the main elements of the document selectively and the abstraction approach which extracts the elements of the document and composes new sentences by combining them. However, the technique of evaluating the quality of automatically summarized documents has not made much progress compared to the technique of automatic text summarization. Most of existing studies dealing with the quality evaluation of summarization were carried out manual summarization of document, using them as reference documents, and measuring the similarity between the automatic summary and reference document. Specifically, automatic summarization is performed through various techniques from full text, and comparison with reference document, which is an ideal summary document, is performed for measuring the quality of automatic summarization. Reference documents are provided in two major ways, the most common way is manual summarization, in which a person creates an ideal summary by hand. Since this method requires human intervention in the process of preparing the summary, it takes a lot of time and cost to write the summary, and there is a limitation that the evaluation result may be different depending on the subject of the summarizer. Therefore, in order to overcome these limitations, attempts have been made to measure the quality of summary documents without human intervention. On the other hand, as a representative attempt to overcome these limitations, a method has been recently devised to reduce the size of the full text and to measure the similarity of the reduced full text and the automatic summary. In this method, the more frequent term in the full text appears in the summary, the better the quality of the summary. However, since summarization essentially means minimizing a lot of content while minimizing content omissions, it is unreasonable to say that a "good summary" based on only frequency always means a "good summary" in its essential meaning. In order to overcome the limitations of this previous study of summarization evaluation, this study proposes an automatic quality evaluation for text summarization method based on the essential meaning of summarization. Specifically, the concept of succinctness is defined as an element indicating how few duplicated contents among the sentences of the summary, and completeness is defined as an element that indicating how few of the contents are not included in the summary. In this paper, we propose a method for automatic quality evaluation of text summarization based on the concepts of succinctness and completeness. In order to evaluate the practical applicability of the proposed methodology, 29,671 sentences were extracted from TripAdvisor 's hotel reviews, summarized the reviews by each hotel and presented the results of the experiments conducted on evaluation of the quality of summaries in accordance to the proposed methodology. It also provides a way to integrate the completeness and succinctness in the trade-off relationship into the F-Score, and propose a method to perform the optimal summarization by changing the threshold of the sentence similarity.

GET Imaging Evaluation of Patients with Esophageal Cancer (식도암 환자의 GET 영상 평가)

  • Moon, Jong Wun;Lee, Chung Wun;Seo, Young Deok;Yun, Sang Hyeok;Kim, Yong Keun;Won, Woo Jae
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.2
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    • pp.31-36
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    • 2013
  • Purpose: Measure gastric emptying time (GET: Gastric Emptying Time) is a non-invasive and quantitative evaluation methods, mainly by endoscopic or radiological examination confirmed no mechanical obstruction in patients with symptoms of congestion is checked. Such tests are not common gastric emptying time measured esophageal cancer patients (who underwent esophagectomy) patients after surgery for gastric emptying time was measured test. And the period of time for more than one year after the gastric emptying time measurement was performed. By comparing the two kinds of tests in the chest cavity after surgery as the evaluation of gastrointestinal function tests evaluate the usefulness of GET, and will evaluate the characteristics of the image. Materials and Methods: 93 patients who underwent esophagectomy with gastric emptying time measurement of subject tests immediately after surgery and after 1 year or longer were twice. Preparation of the patient before the test is more than 12 hours of overnight fasting is important, in addition to the medicine or to stop smoking, and diabetes insulin injections should be early in the morning is ideal to test. Generally labeled with $^{99m}Tc-DTPA$ resin which is used to make steamed egg, seaweed and fermented milk with a high viscosity after eating, three hours in the standing position was measured. Evaluation of gastric emptying curves on the way intragastric radioactivity level by 50% the time (half-time [T1/2]) was calculated, based on the half-life was divided into three steps: over 180 minutes was defined as delayed gastric emptying, within 180minutes was defined as intermediate gastric emptying and when all the radioisotopes were dumped into the jejunum as soon as swallowed, was defined as rapid gastric emptying. Results: Gastric emptying time of a typical images stomach of antrum and fundus additional images appear stronger over time move on to the small intestine. but esophageal cancer who underwent esophagectomy side of the thoracic cavity showed a strong image. Immediately after surgery, the half-time (T1/2) of rapid gastric emptying appeared to 12.9%, intermediate gastric emptying appeared to 52.7%, delay gastric emptying appeared to 34.4%. After more than a year the results of the half-life after surgery, 67% of rapid gastric emptying to intermediate gastric emptying was changed, 69% of delay gastric emptying to intermediate gastric emptying changed. Intermediate gastric emptying worse in patients rapid gastric emptying and the delay gastric emptying is 24% in the case. Conclusion: Esophagectomy for esophageal cancer who underwent half-time measurement test (T1/2) rapid gastric emptying and delay gastric emptying are the result of the comparison over time, changes were observed intermediate gastric emptying. Mainly seeing of gastric emptying time measurement in the esophagus instead of thoracic cavity to check the evaluation of gastrointestinal function can be useful even means. And segmentation criteria and narrow time interval of checking if more accurate information and analysis of the clinical diagnosis and evaluation seems to be done.

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Effect of the Suicide Prevention Program to the Impulsive Psychology of the Elementary School Student (자살예방 프로그램이 초등학교 충동심리에 미치는 영향)

  • Kang, Soo Jin;Kang, Ho Jung;Cho, Won Cheol;Lee, Tae Shik
    • Journal of Korean Society of Disaster and Security
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    • v.6 no.1
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    • pp.65-72
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    • 2013
  • In this study, the early suicide prevention program was applied to the elementary school students and compared the prior & post effect of the program, and verified the status of psychology change like emotional status, or temptation to take a suicide, and presented the possibility as a suicide prevention program. The period of adolescence is the very unstable period in the process of growth being cognitively immature, emotionally impulsive period. It is the period emotionally unstable and unpredictable possible to select the method of suicide as an extreme method to escape the reality, or impulsive problem solving against small conflict or dispute situation. Many stress of the student such as recent nuclear family, expectation of parents to their children, education problem, socio-environmental elements, individual psychological factor lead students to the extreme activity of suicide in recent days. In this study, the scope of stress experienced in the elementary school as well as idea and degree of temptation regarding suicide by the suicide prevention program were identified, and through prevention program such as meditation training, breath training and through experience of anger control, emotion-expression, self overcome and establish positive self-identity and make understanding Self-control, Self-esteem & preciousness of life based on which the effect to suicide prevention was analyzed. The study was made targeting 51 students of 2 classes of 6th grade of elementary school of Goyang-si and processed 30 minutes every morning focused on through experience & activity of the principle & method of brain science. The data was collected for 20 times before starting morning class by using Suicide Probability Scale(herein SPS-A) designed to predict effectively suicide Probability, suicide risk prediction scale, surveyed by 7 areas such as Positive outlook, Within the family closeness, Impulsivity, Interpersonal hostility, Hopelessness, Hopelessness syndrome, suicide accident. Analytical methods and validation was used the Wilcoxon's signed rank test using SPSS Program. Though the process of program in short period, but there was a effective and positive results in the 7 areas in the average comparison. But in the t-test result, there was a different outcome. It indicated changes in the 3 questionnaires (No.7, No.14, No.19) out of 31 SPS-A questionnaires, and there was a no change to the rest item. It also indicated more changes of the students in the class A than class B. And in case of the class A students, psychological changes were verified in the areas of Hopelessness syndrome, suicide accident among 7 areas after the program was processed. Through this study, it could be verified that different results could be derived depending on the Student tendency, program professional(teacher in charge, processing lecturer). The suicide prevention program presented in this article can be a help in learning and suicide prevention with consistent systematization, activation through emotion and impulse control based on emotional stress relief and positive self-identity recovery, stabilization of brain waves, and let the short period program not to be died out but to be continued connecting from childhood to adolescence capable to make surrounding environment for spiritual, physical healthy growth for which this could be an effective program for suicide prevention of the social problem.

Ischemic Preconditioning and Its Relation to Glycogen Depletion (허혈성 전처치와 당원 결핍과의 관계)

  • 장대영;김대중;원경준;조대윤;손동섭;양기민;라봉진;김호덕
    • Journal of Chest Surgery
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    • v.33 no.7
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    • pp.531-540
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    • 2000
  • Baclgrpimd; Recent studies have suggested that the cardioprotective effect of ischemic preconditioning(IP) is closely related to glycogen depletion and attenuation of intracellular acidosis. In the present study, the authors tested this hypothesis by perfusion isolated rabbit hearts with glucose(G) is closely related to glycogen depletion and attenuation of intracellular acidosis. In the present study, the authors tested this hypothesis by perfusion isolated rabbit hearts with glucose(G)-free perfusate. Material and Method; Hearts isolated from New Zealand white rabbits(1.5~2.0 kg body weight) were perfused with Tyrode solution by Langendorff technique. After stabilization of baseline hemodynamics, the hearts were subjected to 45 min global ischemia followed by 120 min reperfusion with IP(IP group, n=13) or without IP(ischemic control group, n=10). IP was induced by single episode of 5 min global ischemia and 10 min reperfusion. In the G-free preconditioned group(n=12), G depletion was induced by perfusionwith G-free Tyrode solution for 5 min and then perfused with G-containing Tyrode solution for 10 min; and 45 min ischemia and 120 min reperfusion. Left ventricular functionincluding developed pressure(LVDP), dP/dt, heart rate, left ventricular end-distolic pressure(LVEDP) and coronary flow (CF) were measured. Myocardial cytosolic and membrane PKC activities were measured by 32P-${\gamma}$-ATP incorporation into PKC-specific peptide and PKC isozymes were analyzed by Western blot with monoclonal antibodies. Infarct size was determined by staining with TTC(tetrazolium salt) and planimetry. Data were analyzed by one-way analysis of variance (ANOVA) and Turkey's post-hoc test. Result ; In comparison with the ischemic control group, IP significantly enhanced functional recovery of the left ventricle; in contrast, functional significantly enhanced functional recovery of the left ventricle; in contrast, functional recovery were not significantly different between the G-free preconditioned and the ischemic control groups. However, the infarct size was significantly reduced by IP or G-free preconditioning(39$\pm$2.7% in the ischemic control, 19$\pm$1.2% in the IP, and 15$\pm$3.9% in the G-free preconditioned, p<0.05). Membrane PKC activities were increased significantly after IP (119%), IP and 45 min ischemia(145%), G-free [recpmdotopmomg (150%), and G-free preconditioning and 45 min ischemia(127%); expression of membrane PKC isozymes, $\alpha$ and $\varepsilon$, tended to be increased after IP or G-free preconditioning. Conclusion; These results suggest that in isolated Langendorff-perfused rabbit heart model, G-free preconditioning (induced by single episode of 5 min G depletion and 10 min repletion) colud not improve post-ischemic contractile dysfunction(after 45-minute global ischemia); however, it has an infarct size-limiting effect.

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20 Years Surgical Experiences for Ebstein's Anomaly (엡스타인 기형의 20년 수술 치험)

  • Lee, Sak;Park, Han-Ki;Lee, Chang-Young;Chang, Byung-Chul;Park, Young-Hwan
    • Journal of Chest Surgery
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    • v.40 no.4 s.273
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    • pp.280-287
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    • 2007
  • Background: We retrospectively evaluated the clinical results of surgically managing patients with Ebstein's anomaly. Material and Method: Between Feb. f 984 and June 2006, 50 patients who underwent surgical treatment for Ebstein's anomaly at Yonsei Cardiovascular Center were retrospectively reviewed. The mean age of the patients was 26.9 years and 19 patients were male, Associated anomalies included atrial septal defect (33), patent ductus arteriosus (2), ventricular septal defect (1), and pulmonary stenosis (4), and 90%, (45/50) of the patients had more than a moderate degree of tricuspid regurgitation. Carpentier type A was present in 6 patients, type B in 26, type C in 14 and type D in 4. Ten patients were associated with WPW syndrome. Conservative surgery was possible in 31 patients (tricuspid annuloplasty, plication of the atrialized RV), Fontan's operation was peformed in 4 patients, tricuspid valve replacement was done in 12 and palliative surgery was done in 2 patients. Thirteen patients were associated with hi-directional cavopulmonary shunt (BCPS: one and a half ventricular repairs): 10 patients with WPW syndrome and 4 patients with atrial fibrillation underwent concomitant ablation. Result: The postoperative median NYHA functional class $(3{\rightarrow}1)$ and the mean cardio-thoracic ratio $(0.65{\rightarrow}0.59)$ were decreased significantly (p<0.001, p=0.014). The mean oxygen saturation $(86.6{\rightarrow}94.1%)$, and median TR grade $(4{\rightarrow}1)$ were also significantly improved (p=0.004, p<0.001). For comparison of BCPS and conservative surgery, the preoperative right ventricular pressure (33.0 vs. 41.3 mmHg), the ICU stay (2.80 vs. 1.89 days), the hospital say (10.6 vs. 16.8 days), and the left ventricular ejection fraction (64.3 vs. 72.8%) were statistically different. Postoperative mortality occurred in 3 patients (6%) due to biventricular failure in 2 patients and sepsis in the other patient. The mean follow up duration was 101.5 months, and one patient died of Fontan failure and 6 patients required reoperation (bioprosthetic degenerative change (2) and Fontan conversion (4)). The overall survival rate at 10 years was 90.2%, the freedom from reoperation rate and rate of cardiac related events were 78.9% and 49.2%, respectively. Conclusion: Surgical management of Ebstein's anomaly can be performed safely, and the associated BCPS may be helpful for high-risk patients. Adequate application of surgical management may increase the long-term survival with a reduced rate of reoperation.