Sohn Jason W.;Mansur David B.;Monroe James I.;Drzymala Robert E.;Jin Ho-Sang;Suh Tae-Suk;Dempsey James F.;Klein Eric E.
Progress in Medical Physics
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v.17
no.1
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pp.24-31
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2006
Automated analysis software was developed to measure the magnitude of the intrafractional and interfractional errors during breast radiation treatments. Error analysis results are important for determining suitable planning target volumes (PTV) prior to Implementing breast-conserving 3-D conformal radiation treatment (CRT). The electrical portal imaging device (EPID) used for this study was a Portal Vision LC250 liquid-filled ionization detector (fast frame-averaging mode, 1.4 frames per second, 256X256 pixels). Twelve patients were imaged for a minimum of 7 treatment days. During each treatment day, an average of 8 to 9 images per field were acquired (dose rate of 400 MU/minute). We developed automated image analysis software to quantitatively analyze 2,931 images (encompassing 720 measurements). Standard deviations ($\sigma$) of intrafractional (breathing motion) and intefractional (setup uncertainty) errors were calculated. The PTV margin to include the clinical target volume (CTV) with 95% confidence level was calculated as $2\;(1.96\;{\sigma})$. To compensate for intra-fractional error (mainly due to breathing motion) the required PTV margin ranged from 2 mm to 4 mm. However, PTV margins compensating for intefractional error ranged from 7 mm to 31 mm. The total average error observed for 12 patients was 17 mm. The intefractional setup error ranged from 2 to 15 times larger than intrafractional errors associated with breathing motion. Prior to 3-D conformal radiation treatment or IMRT breast treatment, the magnitude of setup errors must be measured and properly incorporated into the PTV. To reduce large PTVs for breast IMRT or 3-D CRT, an image-guided system would be extremely valuable, if not required. EPID systems should incorporate automated analysis software as described in this report to process and take advantage of the large numbers of EPID images available for error analysis which will help Individual clinics arrive at an appropriate PTV for their practice. Such systems can also provide valuable patient monitoring information with minimal effort.
Purpose : To reveal clinical usefulness of functional MRI (fMRI) using sensorymotor and language stimuli for demonstrating anatomic relationship between sensorimotor or language cortices and lesions in the planning of brain tumor surgery. Materials and Methods : This study included 12 right-handed patients with brain tumors in or around sensorimotor or language cortices. Eleven patients were evaluated with primary motor and sensory stimuli. Of these patients, six patients were also evaluated with language stimuli. One patient was evaluated with language stimuli only. For fMR imaging, a 1.5T scanner was used and the EPI BOLD technique was employed. For postprocessing image, the SPM99 program and a program made by our department was utilized. We evaluated whether sensorimotor and language stimuli activate sensorimotor and language cortices. And also, clinical efficacy of revealing anatomic relationship between cerebral cortices and lesions for planning neurosurgical operation were evaluated. Finally, we compared post-operative neurologic function with pre-operative neurologic function in same patients. Results : The fMRI examination was successful in identifying the functional cortices and depicting anatomic relationship between functional cortices and lesions in all patients. In nine patients of 11 patients with identified sensorimotor cortices, postoperative grade of manual motor test was not changed, compared with preoperative grade. Whereas postoperative improved than preoperative grade in one patient of remaining two patients, postoperative aggravated than preoperative grade in the other. This result was due to atherosclerotic lacunar infarction, regardless of tumor resection. Postoperative deficit of language function was not found in seven patients with identified language cortices. Conclusion : fMRI could be a helpful method for determining the best approach to neurosurgical treatment in patients with brain tumors in or around sensorimotor or language cortices.
Lee, Eunsol;Chae, Eun Jin;Kang, Sunji;Yeom, Yoo Kyeong;Lee, Hyun Joo;Park, Jong Chun;Shin, So Youn;Choi, Yoon Young;Choi, Joon Ho;Do, Kyung-Hyun
Investigative Magnetic Resonance Imaging
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v.17
no.3
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pp.232-238
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2013
Purpose : We investigated the possible added value of magnetic resonance imaging (MR) in staging of malignant pleural mesothelioma (MPM) compared to computed tomography (CT). Materials and Methods: We retrospectively enrolled 20 patients (M;F = 14:6; mean age, 53.5 yrs) who diagnosed as MPM by histology and underwent CT and MR at initial evaluation from Jan 1997 to Dec 2012. Two radiologists performed clinical staging by using CT alone or MR alone in consensus. In patients underwent surgery (n = 13), we evaluated the diagnostic accuracy of CT and MR in terms of staging compared to surgical staging. In all patients, we compared clinical staging of CT only and CT with MR. Results: The diagnostic accuracy for T staging of CT only was 23.1% (3/13) and that of combined CT and MR was 38.5% (5/13), respectively. Among 13 patients underwent surgery, surgical stage was higher than combined CT and MR stage in 5 patients, but lower in 3 patients. CT only and combined CT and MR agreed in 85.0% (17/ 20). In cases of disagree (15.0%, 3/20), combined CT and MR showed higher stage than CT only. Conclusion: Combined CT and MR increases the diagnostic accuracy in staging of MPM compared to CT only and is important in determining the appropriate treatment in patients being considered for surgery.
The vibratory energy introduced into the external ear canal is changed by the mechanical factors of eardrum itself, the motility of ossicles, and the air cushion of tympanic cavity and the like. This study was designed to investigate the volume of middle ear cavity and mastoid air cell system as a factor of determining the accoustic impedance of middle ear system. The author studied how the increase in air volume of middle ear cavity effects on the acoustic impedance of middle ear system with dogs' ears and researched the correlation between the degree of pneumatization of temporal bones and the acoustic impedance of middle ear system by comparing the radiological findings of pneumatization (Law's and Towne's projection) with the acoustic impedance measurements with Madsen ZO 70. The result is as follows: 1 The tympanometric findings in control state revealed the curves of type A, and did not change in its configuration by the increase in the air volume of dogs middle ear system. 2. The static compliance of middle ear revealed a distinct and linear increase in proportion to the increase in air volume of middle ear system; the rate of increase was $0.05{\pm}0.02$ cc of static compliance per cc of air volume. 3. Authenticated in the above result and the tendency to increase in static compliance in proportion to the increase in the degree of pneumatization of temporal bones, there was significant regression equation between the degree of pneumatization of temporal bones (x variable) and the static compliance of middle ear system; $y=0.19x{\pm}0.16{\pm}0.05$ It is suggested that the difference in volume of middle ear system plays an important role in the change of the static compliance of middle ear, and the author concludes that the measurement of static compliance of middle ear has clinical value as diagnostic means of evaluating the degree of pneumatization of temporal bones along with some radiological examination.
The proportion of people who contacted pulmonary T.B. in Korea has drastically decreased as a result of the incessant effort of the Korean government which adopted a policy of“drive out T.B.”as its foremost health policy. However, the proportion still remains relatively high com-pared with that of developed countries. This study attempts to find some means for guiding and educating college students who have T.B. in their health care by (1) first determining the effect if their self-concept and health beliefs on their behavior in regard to their disease and (2) then predicting the level of compliance of the new patients to the treatment suggested by the health specialist, before the commencement of the treatment. The subjects of this study consisted of 88 mald and female students at Y University who were diagnosed as minimal pulmonary T.B. patients and registered at the health clinic of Y University during the period between September 1, 1981 and March 31, 1953. Data were collected from them by means of questionnaire and interview. The instruments used for this study were (1) a part of Junghoon Choi's“Perceptual Orientation ,Scale”for measuring self-perception of patients and (2) Rosenberg's questionnaire for measuring patients' evaluation of self-esteem, and (3) an instrument for measuring patients' health beliefs which was developed by this researcher utilizing information available from references. The collected data were analyzed using descriptive statistics, chisquare test, Pearson correlation coefficient and t-test. The findings were as follows: 3. Test of hypotheses 1) Hypothesis 1: Patients with high self-concept will be high in health beliefs. For testing this hypothesis a calculation of Pearson correlation coefficient (r) between the patients' self-concept and their health beliefs was carried out. The result of this test was -. 0756 which was not significant at α=.05 and hence hypothesis 1 was not supported. 2) Hypothesis 2: Patients with a high self-concept will tend to be high in compliance with the suggested treatment. Again a Pearson correlaton coefficient was calculated between the two variaibles in the hypothesis. The calculated coefficient r was .1558 which was not significant at α=.05. Hence hypothesis 2 was rejected. 3) Hypothesis 3: Patients with high susceptibility will have a high compliance level. The correlation coefficient between the two variables was -.1975, which was significant at α=.05 but due to the negative sign hypothesis 3 could not be accepted. 4) Hypothesis 4: Patients who take their disease seriously will have a higher compliance level. The calculated correlation coefficient between the variables in this hypothesis was .1642 which was not significant at α=.05 and hence hypothesis 4 was rejected. 5) Hypothesis 5: Patients with a high sense of the benefit of treatment will have a high level of compliance. The computed correlation coefficient was .3129 which was significant at α=.05 and hence hypothesis 5 was acepted. 2. Findings from the correlation analysis were as follows: 1) Patients' susceptibility and their compliance to treatment was negatively correlated (r= -. 1975) which was significant at α= .05. This implies that as the patients' level of susceptibility increases their compliance level decreases. 2) Patients' susceptibility and their self-concept were negatively correlated (r= -. 1790) which was again singnificant at α=.05. The implication of this is that as the patients’self concept increases their susceptibility to disease decreases. 3) Patients' self-concept and their sense of benefit derieved from the treatment was positively correlated (r=.1970) which was significant at α=.05. That is, patients with a high self-concept perceived a great sense of benefit from the treatment. To summarize, patients who are low in susceptibility have a high level of compliance and self-concept.
Journal of agricultural medicine and community health
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v.36
no.3
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pp.179-190
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2011
Objectives: This study was performed to understand pregnancy, delivery, and infant rearing knowledge and educational need of marriage immigrant women to be utilized as a basic data for developing a suitable educational program. Methods: The subject of the study was composed of one hundred twenty two married immigrant women who live in South Korea. The method used in determining the population was the convenience sampling method. The data were gathered by means of personal interviews using questionnaires. Results: The mean score of pregnancy and delivery knowledge was 3.35, educational need was 3.64 out of 5, and infant rearing knowledge was 3.16, educational need was 3.66 out of 5. The pregnancy and delivery knowledge of the subject showed significant differences based on their present residential location and presence of children and their educational need varies according to their country of origin. The infant rearing knowledge on the other hand, showed notable differences according to presence of children while homeland and existence of children were the two major factors that greatly influenced the significant variation for educational need. Conclusions: The score of pregnancy, delivery and infant educational need were higher than knowledge. The score of pregnancy, delivery, and infant rearing educational need garnered similar results. Thus it is suggested that further researches should be conducted for the development, application, and verification of pregnancy, delivery, and infant rearing education programs that consider knowledge and educational need of immigrant married women in South Korea.
Kim, Hae-Gyoung;Bhang, Hyung-Suk;Park, Gwang-Soo;Wang, Mi-Rhan;Min, Seong-Ho;Park, Ki-Chang;Ahn, Joung-Sook
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.10
no.2
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pp.212-219
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1999
Objective:This study is designed to get clinical guidelines for management of children with TBI by examining neuropsychiatric sequelae of TBI, determining whether the severity of TBI, type of treatment, and enviornmental factors are related to those sequelae, and defining the adequacy of public psychological tests as evaluating tools for them. Method:This is chart review of 47 children, aged 5 to 14 years, referred to a psychiatric outpatient clinic for neuropsychiatric evaluation at least 6 months after TBI. Data on the initial GCS score, associated injury, treatment type, and duration of hospital stay are obtained from medical records. EEG, MRI, intelligent test, and several psychological tests are administrated at the point of assessment. Results:1) Cognitive symptoms outnumber externalizing behavioral, emotional, and somatic symptoms, with no significant differences of frequencies of those 4 categorical symptoms between mild injury group and moderate to severe group. 2) Children treated with non-surgical method(p<0.01) complain more cognitive symptoms than the others. 3) Behavioral symptoms are related to younger age(p<0.05), and to anticonvulsant medication(p<0.05). 4) Children with associated injury complain emotional symptoms more frequently(p<0.05). 5) More somatic symptoms are presented by children with no medication(p<0.05), and with higher I.Q(p<0.05). 6) Low I.Q is correlated to low GCS score (p<0.05). Cognitive impairment is confirmed in 25 in 42 children complaining cognitive symptoms though I.Q test and BGT, whose hospital stay is longer than the others(p<0.05). 7) emotional disturbance is confirmed in 22 in 25 children showing emotional problems through psychological tests, who complain cognitive symptoms more frequently(p<0.05). Conclusion:This findings suggest that even mild TBI children need to be followed-up and treated as complaining neuropsychiatric symptoms over 6 months after injury, and shorter hospital stay is recommended for cognitive and emotional status of children, and for better evaluation of neuropsychiatric sequelae of TBI, more specific tests should be included in neuropsychological test tools.
Kim, Yihyun;Hong, Sukyoung;Lee, Kyungdo;Jang, Soyeong
Korean Journal of Soil Science and Fertilizer
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v.46
no.1
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pp.23-31
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2013
Microwave remote sensing can help monitor the land surface water cycle and crop growth. This type of remote sensing has great potential over conventional remote sensing using the visible and infrared regions due to its all-weather day-and-night imaging capabilities. In this paper, a ground-based multi-frequency (L-, C-, and X-band) polarimetric scatterometer system capable of making observations every 10 min was developed. This system was used to monitor the wheat over an entire growth cycle. The polarimetric scatterometer components were installed inside an air-conditioned shelter to maintain constant temperature and humidity during the data acquisition period. Backscattering coefficients for the crop growing season were compared with biophysical measurements. Backscattering coefficients for all frequencies and polarizations increased until dat of year 137 and then decreased along with fresh weight, dry weight, plant height, and vegetation water content (VWC). The range of backscatter for X-band was lower than for L- and C-band. We examined the relationship between the backscattering coefficients of each band (frequency/polarization) and the various wheat growth parameters. The correlation between the different vegetation parameters and backscatter decreased with increasing frequency. L-band HH-polarization (L-HH) is best suited for the monitoring of fresh weight (r=0.98), dry weight (r=0.96), VWC (r=0.98), and plant height (r=0.96). The correlation coefficients were highest for L-band observations and lowest for X-band. Also, HH-polarization had the highest correlations among the polarization channels (HH, VV and HV). Based on the correlation analysis between backscattering coefficients in each band and wheat growth parameters, we developed prediction equations using the L-HH based on the observed relationships between L-HH and fresh weight, dry weight, VWC and plant height. The results of these analyses will be useful in determining the optimum microwave frequency and polarizations necessary for estimating vegetation parameters in the wheat.
This study aims to provide policy suggestions by examining the perception and attitude of Koreans toward the welfare rights. The study was done through a telephone survey conducted by an opinion research institute on 2,050 respondents in 16 cities and provinces. The results are as follows. First, a majority of Koreans responded that the primary responsibility for welfare rests with the government and perceived their welfare receipt rights in a positive way. Respondents also showed an assertive attitude toward exercising their rights by stating that they intend to file a demurrer or participate in civic activities. Second, in terms of duty performance, most respondents showed different positions concerning tax hike and insurance rate increase, although they showed a stronger opposition to an increase in insurance fee. In addition, 90% of the respondents were in favor of building welfare institutions in the residential area and an overwhelming proportion of the respondents indicated that they would take an active part in welfare development by regularly paying taxes and volunteering. Third, the respondents gave a very negative rating to Koreas welfare system and its overall level. That is, people thought that the level of Koreas welfare system is on a par with that in developing or underdeveloped countries, and that the welfare system benefits no one or only the rich. People generally felt that there was not one proper welfare institution. In conclusion, the study found that Koreans have keen awareness of their welfare rights and proactive attitude toward welfare development, whereas negative viewpoint toward tax and insurance fee increases. This may stem from peoples distrust of government welfare policies and the existing welfare system. This study suggests that welfare policy is an important factor in determining peoples political attitude. Therefore, government authorities must recognize people not as passive receivers of welfare benefit but as active policy partners, and establish policies that reflect peoples high welfare rights perception and willingness to take part in welfare development.
Background: Accurate staging of bronchogenic carcinoma is important in determining resectability and metastasis of tumor to the subcarinal nodes is generally believed to indicate poor prognosis. The technique of Transbronchial needle aspiration (TBNA) has offered a safe & effective way to asscess mediastinal lymph node involvement in the staging of lung cancer. We performed TBNA in patients who were suspected lung cancer to evaluate the clinical usefulness of the TBNA. Method: TBNA of the subcarinal lymph node was performed at the time of initial diagnostic bronchoscopy in 60 patients with suspected lung cancer, and 42 cases of histologically proved bronchogenic cancer were analized. Results: The frequency of adequate samples by transbronchial needle aspiration (TBNA) was 81% and the positive rate of malignant cells by TBNA was 14.7%. There were no differences in positive rates by tumor cell types. In patients with thickened carina on bronchoscopy, the TBNA was positive in 33.3% as compared to 5.3% of normal carina on bronchoscopy, and the difference was statistically significant (p<0.05). In patients with enlarged subcarinal lymph node on chest CT, the positive rate of malignant cells (50.0%) was higher than that of normal sized subcarinal lymph node on chest CT (4.8%) (p<0.01). There were no specific complications in the TBNA procedure. Conclusion: TBNA is a relatively safe procedure and it offers the possibility of avoiding the cost and morbidity of surgical staging in patients especially whose carina is thickened on bronchoscopy and whose subcarinal LN was enlarged on chest CT.
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