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Evaluation of the Usefulness of the Respiratory Guidance System in the Respiratory Gating Radiation Therapy (호흡동조 방사선치료 시 호흡유도시스템의 유용성 평가)

  • Lee, Yeong-Cheol;Kim, Sun-Myung;Do, Gyeong-Min;Park, Geun-Yong;Kim, Gun-Oh;Kim, Young-Bum
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.2
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    • pp.167-174
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    • 2012
  • Purpose: The respiration is one of the most important factors in respiratory gating radiation therapy (RGRT). We have developed an unique respiratory guidance system using an audio-visual system in order to support and stabilize individual patient's respiration and evaluated the usefulness of this system. Materials and Methods: Seven patients received the RGRT at our clinic from June 2011 to April 2012. After breathing exercise with the audio-visual system, we measured their spontaneous respiration and their respiration with the audio-visual system respectively. With the measured data, we yielded standard deviations by the superficial contents of respiratory cycles and functions, and analyzed them to examine changes in their breathing before and after the therapy. Results: The PTP (peak to peak) of the standard deviations of the free breathing, the audio guidance system, and the respiratory guidance system were 0.343, 0.148, and 0.078 respectively. The respiratory cycles were 0.645, 0.345, and 0.171 respectively and the superficial contents of the respiratory functions were 2.591, 1.008, and 0.877 respectively. The average values of the differences in the standard deviations among the whole patients at the CT room and therapy room were 0.425 for the PTP, 1.566 for the respiratory cycles, and 3.671 for the respiratory superficial contents. As for the standard deviations before and after the application of the PTP respiratory guidance system, that of the PTP was 0.265, that of the respiratory cycles was 0.474, and that of the respiratory superficial contents. The results of t-test of the values before and after free breathing and the audio-visual guidance system showed that the P-value of the PTP was 0.035, that of the cycles 0.009, and that of the respiratory superficial contents 0.010. Conclusion: The respiratory control could be one of the most important factors in the RGRT which determines the success or failure of a treatment. We were able to get more stable breathing with the audio-visual respiratory guidance system than free breathing or breathing with auditory guidance alone. In particular, the above system was excellent at the reproduction of respiratory cycles in care units. Such a system enables to reduce time due to unstable breathing and to perform more precise and detailed treatment.

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Evaluation on the Accuracy of the PPS in the Proton Therapy System, Which Uses the Self Made QA Phantom (자체 제작한 QA Phantom을 이용한 양성자 PPS (Patient Positioning System)의 정확성 평가)

  • Lee, Ji-Eun;Kim, Jae-Won;Kang, Dong-Yoon;Choi, Jae-Hyeok;Yeom, Du-Seok
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.2
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    • pp.115-121
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    • 2012
  • Purpose: The process of the proton treatment is done by comparing the DRR and DIPS anatomic structure to find the correction factor and use the PPS to use this factor in the treatment. For the accuracy of the patient set up, the PPS uses a 6 axis system to move. Therefore, there needs to be an evaluation for the accuracy between the PPS moving materialization and DIPS correction factor. In order to do this, we will use a self made PPS QA Phantom to measure the accuracy of the PPS. Materials and Methods: We set up a PPS QA Phantom at the center to which a lead marker is attached, which will act instead of the patient anatomic structure. We will use random values to create the 6 axis motions and move the PPS QA Phantom. Then we attain a DIPS image and compare with the DRR image in order to evaluate the accuracy of the correction factor. Results: The average correction factor, after moving the PPS QA Phantom's X, Y, Z axis coordinates together from 1~5 cm, 1 cm at a time, and coming back to the center, are 0.04 cm, 0.026 cm, 0.022 cm, $0.22^{\circ}$, $0.24^{\circ}$, $0^{\circ}$ on the PPS 6 axis. The average correction rate when moving the 6way movement coordinates all from 1 to 2 were 0.06 cm, 0.01 cm, 0.02 cm, $0.1^{\circ}$, $0.3^{\circ}$, $0^{\circ}$ when moved 1 and 0.02 cm, 0.04 cm, 0.01 cm, $0.3^{\circ}$, $0.5^{\circ}$, $0^{\circ}$ when moved 2. Conclusion: After evaluating the correction rates when they come back to the center, we could tell that the Lateral, Longitudinal, Vertical were all in the acceptable scope of 0.5 cm and Rotation, Pitch, Roll were all in the acceptable scope of $1^{\circ}$. Still, for a more accurate proton therapy treatment, we must try to further enhance the image of the DIPS matching system, and exercise regular QA on the equipment to reduce the current rate of mechanical errors.

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A Study on the Relationship of Learning, Innovation Capability and Innovation Outcome (학습, 혁신역량과 혁신성과 간의 관계에 관한 연구)

  • Kim, Kui-Won
    • Journal of Korea Technology Innovation Society
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    • v.17 no.2
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    • pp.380-420
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    • 2014
  • We increasingly see the importance of employees acquiring enough expert capability or innovation capability to prepare for ever growing uncertainties in their operation domains. However, despite the above circumstances, there have not been an enough number of researches on how operational input components for employees' innovation outcome, innovation activities such as acquisition, exercise and promotion effort of employee's innovation capability, and their resulting innovation outcome interact with each other. This trend is believed to have been resulted because most of the current researches on innovation focus on the units of country, industry and corporate entity levels but not on an individual corporation's innovation input components, innovation outcome and innovation activities themselves. Therefore, this study intends to avoid the currently prevalent study frames and views on innovation and focus more on the strategic policies required for the enhancement of an organization's innovation capabilities by quantitatively analyzing employees' innovation outcomes and their most suggested relevant innovation activities. The research model that this study deploys offers both linear and structural model on the trio of learning, innovation capability and innovation outcome, and then suggests the 4 relevant hypotheses which are quantitatively tested and analyzed as follows: Hypothesis 1] The different levels of innovation capability produce different innovation outcomes (accepted, p-value = 0.000<0.05). Hypothesis 2] The different amounts of learning time produce different innovation capabilities (rejected, p-value = 0.199, 0.220>0.05). Hypothesis 3] The different amounts of learning time produce different innovation outcomes. (accepted, p-value = 0.000<0.05). Hypothesis 4] the innovation capability acts as a significant parameter in the relationship of the amount of learning time and innovation outcome (structural modeling test). This structural model after the t-tests on Hypotheses 1 through 4 proves that irregular on-the-job training and e-learning directly affects the learning time factor while job experience level, employment period and capability level measurement also directly impacts on the innovation capability factor. Also this hypothesis gets further supported by the fact that the patent time absolutely and directly affects the innovation capability factor rather than the learning time factor. Through the 4 hypotheses, this study proposes as measures to maximize an organization's innovation outcome. firstly, frequent irregular on-the-job training that is based on an e-learning system, secondly, efficient innovation management of employment period, job skill levels, etc through active sponsorship and energization community of practice (CoP) as a form of irregular learning, and thirdly a model of Yί=f(e, i, s, t, w)+${\varepsilon}$ as an innovation outcome function that is soundly based on a smart system of capability level measurement. The innovation outcome function is what this study considers the most appropriate and important reference model.

The College Students' Attitude toward Terminal Care and Euthanasia (대학생들의 임종진료에 대한 태도 - 안락사를 중심으로 -)

  • Choi, Youn-Seon;Shin, Jong-Min;Lee, Young-Mee;Lee, Tai-Ho;Hong, Myung-Ho;Kim, Jun-Suk;Yeom, Chang-Hwan
    • Journal of Hospice and Palliative Care
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    • v.2 no.1
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    • pp.16-22
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    • 1999
  • Purpose : Today, people usually die in hospitals and institution-sterile and strange, and equipped with a complex range of technology capable of supporting and prolonging life, frequently only biological one, when a return to health and vitality is no longer possible. Consequently, 'dying with dignity' has become a slogan of opposition to useless and degrading prolongation of life when a patient's organ, though still minimally functional, can no longer support or permit the exercise of self-fulfilling personal control over life's events. Dying with dignity, however, means entirely different things to different people. This study is to investigate the college students' attitude on terminal care and passive euthanasia. Methods : During June 1997, 337 college students participated in this study by responding to the pre-made questionnaire. It deft with the attitude to passive euthanasia, hospice, the most suffering fear facing the death, the preferred place and person to be with if dying. Results : 63.2% of subjects agreed to passive euthanasia. Only 14.2.% of college students can explain the concept of hospice, exactly They got the information about hospice by TV(43%), book(33.5%), religious group(12%) in order. The preferred death place was home(76.6%) and hospital(11.9%) in order. The Most suffering fear facing the death were about unknown(41.5%), loosing colleague(13.6%), pain(11%), isolation(6.5%) in order. Conclusion : About two-thirds of college students agreed to passive euthanasia. But euthanasia is dangerous and unnecessary. We should vigorously promote programmes of education in hospice and palliative medicine and care.

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A study on the infant daycare center teacher practicing infant's rights respect in care giving daycare center's daily work (어린이집의 하루일과에서 영아반 보육교사가 실행하는 영아권리존중보육에 관한 연구)

  • Youn, Jin-Ju
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.6
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    • pp.407-417
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    • 2017
  • This study examined the extent to which childcare methods of infant classroom childcare teachers who respect infant rights in the everyday teaching curriculum at day-care centers occurs. To achieve these objectives, a questionnaire survey was conducted on 210 infant classroom childcare teachers who were in charge of the day-care center classrooms located in [G] city of [J] province. The results of the research confirmed that first there were no statistically significant differences when verifying the extent to which childcare methods of infant classroom childcare teachers who respect infant rights in the everyday teaching curriculum at day-care centers according to the final education level, professional experience, age, and education major of the infant classroom childcare teacher. On the other hand, the results confirmed that when analyzing for arrival time for infant classroom childcare instruction at the day-care center and for the time spent taking the infant to and from the bathroom, the infant classroom childcare teachers who had graduated from 2 year colleges showed more respect for infant rights compared to that of infant classroom childcare teachers who had graduated from 4 year universities, and for the arrival time for infant classroom childcare instruction at the day-care center and nap times, the infant classroom childcare teachers who were above 50 years of age showed more respect for infant rights compared to that of infant classroom childcare teachers who were in their 30s and 40s. The results of the research confirmed that there were statistically significant differences for both the age and education major of the infant classroom childcare teachers. When examining each of the sub-factor, the age of the infant classroom childcare teachers, respect for the infant's opinion, respect for individuality, and for information provision, infant classroom childcare teachers older than 50 years of age were shown to exercise a higher level of respect for the infant according to the rule of prioritizing the infant compared to infant classroom childcare teachers in their 30s and 40s, and infant classroom childcare teachers who majored in infant education-related majors exercised a higher level of respect for the infant for respecting freedom and autonomy compared to that of infant classroom childcare teachers who majored in welfare and childcare-related fields. The results of the research confirmed a statistically significant static correlation between the two related variables. Therefore, this suggests that the more childcare methods of infant classroom childcare teachers who respect infant rights in the everyday teaching curriculum at day-care centers, the more childcare methods of infant classroom childcare teachers who respect infant rights occurred according to the rule of prioritizing the infant. These results can be used to establish both quantitatively and qualitatively an excellent and balanced respect for infant rights.

Clinical Characteristics of Type 2 Diabetes in Children and Adolescents (소아 및 청소년 2형 당뇨병의 임상적 특징)

  • Lee, Seong Yong;Shin, Choong Ho;Yang, Sei Won
    • Clinical and Experimental Pediatrics
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    • v.45 no.6
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    • pp.754-763
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    • 2002
  • Purpose : The incidence of type 2 diabetes in children and adolescents has been reported to increase recently. The aim of this study is to investigate the clinical features of type 2 diabetes developing during childhood and adolescent period. Methods : The medical records of 33 patients with type 2 diabetes were reviewed. We analysed clinical manifestations, demographic data, and modes and responses of treatment. Results : Age at diagnosis was $13.4{\pm}1.8$ years. Seventy percent of patients revealed pubertal signs at diagnosis. Half of the patients had BMI more than $25kg/m^2$. Seventy-three percent of patients had family history of type 2 diabetes. Acanthosis nigricans were found in 18% of patients. Nineteen(57.6%) patients were diagnosed incidentally by random urine or blood glucose test without any typical diabetic symptom or sign. The modes of therapy to control hyperglycemia were insulin alone(75.8%), oral hypoglycemic agents alone(9.1%), insulin and oral hypoglycemia agents(9.1%), and only diet with exercise(6%). At the time of investigation, 45.5% of patients were not using insulin. The typical diabetic symptoms at diagnosis were more prevalent in patients who required insulin for more than two years than patients who did not(P<0.05). Conclusion : The development of type 2 diabetes in children and adolescents is possibly related to puberty, obesity, family history, and defects in insulin secretion rather than insulin resistance. Many children and adolescents with type 2 diabetes required insulin initially and some of them could discontinue. More than half of the patients were diagnosed as diabetes without any typical symptom or sign, which might be one of the predictive factors of the prolonged insulin requirement.

A Study on Perception and Attitudes of Examinees of Health Screening Center towards Health Examination (종합건강진단 수진자들의 건강진단에 대한 인식 및 태도에 관한 연구)

  • Bae, Seong-Wook;Lee, Kyeong-Soo;Kang, Pock-Soo
    • Journal of Yeungnam Medical Science
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    • v.13 no.1
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    • pp.59-77
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    • 1996
  • A survey was conducted to study perception and attitudes of examinees of health screening center towards items, cost and procedures of health examination and degree of satisfaction with health examination, from March 2 to May 31, 1995. The study population was 468 examinees received health examination at Health Screening & Diagnosis Center of Yeungnam University Hospital. A questionnaire method was used to collect data. The followings are summaries of findings : Examinees were predominantly male(77.4%); had college education(68.6%), and held white-collar workers(57.8%). Statistical significance of association between frequency of periodic health examination and other variables were tested by chi-square test. Examinees who have higher degree of concern regarding health and those who practice more exercise for health maintenance received health examination more frequently. The majority expressed that health examination is very beneficial and effective in terms of prevention and early detection of diseases. Also the majority revealed that they are satisfied with health examination. The majority expressed that procedures and time spent for health examination are adequate; interval of health examination is one year; and additional examination items are cerebral examination, neurological examination and gastrofibercope. The majority revealed that they want more information about chronic degenerative diseases and health maintenance and promotion. In conclusion, the study revealed that examinees seemed to have more positive perceptions and attitudes towards health examination.

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Job Satisfaction and Its Related Factors among 119 Rescue Workers (119 구급대원의 직무만족도와 그의 관련요인)

  • Park, Ho-Jin;Yoon, Seok-Han;Cho, Young-Chae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.7
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    • pp.46-57
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    • 2017
  • This study examined the level of job satisfaction of rescue workers in accordance with the sociodemographic and health related characteristics, as well as job-related factors. Moreover, this study aimed to know the relationship between job satisfaction and violence experience, job stress, and burn-out. A total of 1,240 rescue workers, who works in 14 fire stations across the country, were surveyed. The survey was conducted by self-administered questionnaires during the period between March 1st and April 30, 2016. As a result, the score of job satisfaction according to the sociodemographic and health related characteristics were significantly lower in the younger-aged group, unmarried group, no-regular exercise group, and poor group of subjective sleep evaluation, unhealthy group of subjective health status than their respective counterparts. From the perspective of job-related characteristics, the job satisfaction scores were significantly lower in the groups of lower rank, lower job career, lower monthly income, hard group of physical burden of work, dissatisfaction group of sense of satisfaction in work, unfit group of the job, without group of consider quitting the job than their respective counterparts. The score of job satisfaction, in accordance with violence experience, job stress, and burn-out were significantly lower in groups with higher scores of violence experience, job stress, and burn-out. In a logistic regression analysis, the adjusted odds ratio of the low-risk job satisfaction were significantly increased in the very high group than in the low group of violence experience, in middle, high and very high group than in low group of job stress, in very high group than in low group of burn-out. The results suggest that the job satisfaction of rescue workers is significantly influenced by various factors, including socio-demographic characteristics, health-related behaviors, job-related characteristics, violence experience, job stress, and burn-out.

The Effects of Comprehensive Health Care Program for Living Alone Older People on Blood Pressure, Fasting Glucose, Body Composition, Depression at a Senior Welfare Center (일개 노인복지관 통합건강케어프로그램이 독거노인의 혈압, 혈당, 체중, 체성분, 우울감에 미치는 영향)

  • Jang, Ae Sun;Hwang, Eun Jeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.11
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    • pp.526-535
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    • 2017
  • This study was conducted to identify the effects of a comprehensive health care program for elderly living alone on blood pressure, fasting glucose, body composition, and depression at a senior welfare center in M city. The study employed a one-group, pre-posttest design. The comprehensive health care program lasted for three months, from March to June in 2015, and consisted of open health education, exercise class, health consulting and personal education, nutritional consultation, and a self-support group. The sample elements of this study were individuals over 65-years-old with hypertension or diabetes mellitus, living near a welfare center in M city. A total of 34 participants were initially selected, but five subjects who were attended less than five times were excluded; therefore, a total of 29 individuals were included. The t-test and Pearson's correlation were used to analyze the data. The characteristics of subjects were 19 male(65.52%) and 10 female(34.48%). The most common age was 70 (16 subjects;55.17%). Additionally, 14 subjects were suffering from hypertension and diabetes mellitus (48.27%), which were occupied in the largest number in this study. The average attendance number of health programs was 10.28 times(${\pm}4.17$). In this study of subjects were significantly lower systolic blood pressure(t=3.275, p=0.004), body weight(t=3.878, p=0.001), depression(t=3.308, p=0.004) compared to pre-test. As the elderly population has increased, the number of individuals living alone has also increased. Accordingly, then need for physical and psycho-social health programs targeting the elderly is greater.

A Preliminary Study on Emotion, Self-Esteem and Quality of Life in the Patients with Chest Pain (흉통 환자에서의 정서, 자존감 및 삶의 질에 대한 예비 연구)

  • Park, Sook Hyun;Jae, Young Myo;Lee, Dae Su;Jang, Saeheon;Choi, Jin Hyuk;Lee, Han Cheol
    • Korean Journal of Psychosomatic Medicine
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    • v.20 no.2
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    • pp.120-126
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    • 2012
  • Objectives : The objective of this study is to measure and to compare the rate of depression, anxiety, self-es-teem and the quality of life of the patients with chest pain. Based on the result of this study, the necessity of the psychiatric assessment and treatment of the patients with chest pain is emphasized. This study is a preliminary research for a larger scale investigation to be carried out in the future. Methods : Thirty nine patients with chest pain who visited Cardiovascular Division of Dept. of Internal Medicine Pusan National University Hospital and fourty normal control group(NC) were included in this study. The patients were classified into typical chest pain group(TCP, N=19) and atypical chest pain group(ACP, N=20) based on the cause of the pain. The cause was determined by cardiac computed tomography, exercise stress test, coronary angiography, and questionaires by a cardiology specialist. The patients were assessed with Beck Depression Inventory(BDI), State-Trait Anxiety Inventory(STAI), Rosenberg Self-Esteem Scale(RSES) and Korean version of the Smith Klein Beecham 'Quality of Life' scale(KvSBQOL). Results : 1) When the risk factors of cardiac disease is compared, most of the factors(Hypertension, Diabetes, Hyperlipidemia, Cerebral infarction) did not differ significantly among the two chest pain groups, except for the family history, for which TCP group showed higher risk than ACP group did. 2) As for the self-report questionaires scores, BDI score, which indicates the rate of depression, of both ACP group and TCP group was significantly higher than that of NC group in BDI for depression. STAI score, which measures anxiety, was also significantly high in both groups. Especially, STAI score was significantly higher in ACP group than TCP group. 3) In the aspect of self-esteem and quality of life, ACP group scored significantly lower than TCP group and NC group. The scores for TCP group and NC group did not differ significantly. Conclusions : The patients with chest pain showed more depression and anxiety than normal control group, regardless of the cause of the pain. However, TCP group did not show significantly larger drop in self-esteem and quality of life than ACP group did. This result implies that early psychiatric assessment and treatment is needed for the patients with such chest pain, since it is highly likely that the pain would lead to lower quality of life of the patients.

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