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Analysis of the Inter- and Intra-treatment Isocenter Deviations in Pelvic Radiotherapy With Small Bowel Displacement System (Small Bowel Displacement System을 이용한 골반부 방사선조사에서 치료간 및 치료중 중심점 위치변동에 관한 분석)

  • Kim Moon Kyung;Kim Dae Yong;Ahn Yong Chan;Huh Seung Jae;Lim Do Hun;Shin Kyung Hwan;Lee Kyu Chan
    • Radiation Oncology Journal
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    • v.18 no.2
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    • pp.114-119
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    • 2000
  • Purpose : To evaluate the e지ent and frequency of the inter- and intra-treatment isocenter deviations of the whole pelvis radiation field in using small bowel displacement system (SBDS). Methods and Materials : Using electronic portal imaging device (EPID), 302 postero-anterior 232 lateral portal images were prospectively collected from 11 patients who received pelvic radiation therapy (7 with cervix cancer and 4 with rectal cancer). All patients were treated in prone position with SBDS under the lower abdomen. Five metallic fiducial markers were placed on the image detection unit for the recognition of the isocenter and magnification. After aligning the bony landmarks of the EPID images on those of the reference image, the deviations of the isocenter were measured in right-left (RL), cranio-caudal (CC), and PA directions. Results : The mean inter-treatment deviation of the isocenter in each RL, CC, and PA direction was 1.2 mm ($\pm$ 1.6 mm), 1.0 mm ($\pm$3.0 mm), and 0.9 mm ($\pm$4.4 mm), respectively. Inter-treatment isocenter deviations over 5 mm and 10 mm in RL, CC, and PA direction were 2, 12, 24$\%$, and 0, 0, 5$\%$, respectively. Maximal deviation was detected in PA direction, and was 11.5 mm. The mean intratreatment deviation of the isocenter in RL, CC, and PA direction was 0 mm ($\pm$0.9 mm), 0.1 mm ($\pm$ 1.9mm), and 0 mm ($\pm$1.6 mm), respectively. All intra-treatment isocenter deviations over 5 mm in each direction were 0, 1, 1$\pm$, respectively. Conclusions : As the greatest and the most frequent inter-treatment deviation of the isocenter was along the PA direction, it is recommended to put more generous safety margin toward the PA direction on the lateral fields if clinically acceptable in pelvic radiotherapy with SBDD.

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Dynamic Characteristic Analysis Procedure of Helicopter-mounted Electronic Equipment (헬기 탑재용 전자장비의 동특성 분석 절차)

  • Lee, Jong-Hak;Kwon, Byunghyun;Park, No-Cheol;Park, Young-Pil
    • Transactions of the Korean Society for Noise and Vibration Engineering
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    • v.23 no.8
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    • pp.759-769
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    • 2013
  • Electronic equipment has been applied to virtually every area associated with commercial, industrial, and military applications. Specifically, electronics have been incorporated into avionics components installed in aircraft. This equipment is exposed to dynamic loads such as vibration, shock, and acceleration. Especially, avionics components installed in a helicopter are subjected to simultaneous sine and random base excitations. These are denoted as sine on random vibrations according to MIL-STD-810F, Method 514.5. In the past, isolators have been applied to avionics components to reduce vibration and shock. However, an isolator applied to an avionics component installed in a helicopter can amplify the vibration magnitude, and damage the chassis, circuit card assembly, and the isolator itself via resonance at low-frequency sinusoidal vibrations. The objective of this study is to investigate the dynamic characteristics of an avionics component installed in a helicopter and the structural dynamic modification of its tray plate without an isolator using both a finite element analysis and experiments. The structure is optimized by dynamic loads that are selected by comparing the vibration, shock, and acceleration loads using vibration and shock response spectra. A finite element model(FEM) was constructed using a simplified geometry and valid element types that reflect the dynamic characteristics. The FEM was verified by an experimental modal analysis. Design parameters were extracted and selected to modify the structural dynamics using topology optimization, and design of experiments(DOE). A prototype of a modified model was constructed and its feasibility was evaluated using an FEM and a performance test.

Study on the Characteristics of Heart Rate Variability, Body component analysis and accompanying symptoms in 175 Insomnia Patients (불면환자 175명의 심박변이도, 체성분 분석 및 동반증상의 특징에 관한 연구)

  • Ha, Ji-Won;Kim, Bo-Kyung
    • Journal of Oriental Neuropsychiatry
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    • v.21 no.4
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    • pp.21-39
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    • 2010
  • Objectives : This study was to investigate the characteristics of the heart rate variability(HRV), types of insomnia and accompanying symptoms of 175 insomnia patients. Methods : For this study we carried out HRV, Inbody of 175 patients with insomnia who have come to Dongeui oriental hospital of Dongeui university from the period of Janaury 2008 to September 2010. We studied the association of the insomnia patients' age and gender with HRV, accompanying symptoms and the types of insomnia. The information of the accompanying symptoms and types of insomnia was based on each patients' progress note. Results : l. There was no significant differences in the characteristics of HRV between male and female. 2. The most frequent symptom shown among the insmonia patents' was headache(41.14%). 3. Comparing the symptoms between the gender, female patients had more dry mouth, alternative periodic chill and fever, and hot flush symptoms than the male patients. 4. Comparing the symptoms between the age groups(divided in two), the lower age group (20~59) had more dizziness and constipation symptoms than the higher age group (over 60). 5. Comparing the types of insomma between the age group, the higher age group (over 60) had more termination insomnia. 6. The types of insomnia of the entire insomnia patients were onset insomnia (73.1%), maintenance insomnia(20.6%), termination insomma(l7.1 %), shallow sleep (52.6%), listed by order of frequency. 7. The patients who takes hypnotics had more anorexia symptoms than the patients who doesn't take hypnotics. 8. There was no visible differences of the average fractal portrait between male and female. The age group of 20~30yrs. had the highest average fractal portrait, and the age group of 30~59yrs. the second highest, and the age group over 60yrs. the lowest. 9. The average of the regulation reserves of the autonomic nervous system(B2) - was lower than the regulation level of the ANS at the present (Bl). 10. When compared the priority of the function of the ANS, it showed that the proportion of HF($38.61{\pm}29.19%$)was the most, and than VLF($30.65{\pm}23.36%$), LF($20.04{\pm}19.13%$) the least. 11. The average of the compensation level of the central nervous system at present(Cl) - was lower than the compensation reserves of the CNS(C2). 12. The average of the control reserves of the cerebrum(D2) - was lower than the control level of the cerebrum at the present (Dl). 13. There was no visible differences between different sexes and ages in pulse rate. 14. The abdomen fat ratio above the line of the insomnia patients was 77.97% in male and 93.1% in female. Both sexes showed that insomnia patients had more abdomen fat that the standard, and female patients had more abd. fat than male patients. Conclusions : This study shows that the HRV of insomnia patients had no significant differences between gender. Fractal portrait, HF, LF and VLF of the insomnia patients are in inverse proportion to the age. The study of the Body Component Analysis showed that female had more abdomen fat than male, and both gender showed more abdomen fat than the standard. When looked into the accompanying symptoms of the insomnia patients, the symptoms show differences according to gender, age and hypnotics taking, as shown as below. In the entire patients, Headache was the most accompanying symptom. Female had more dry mouth, alternative periodic chill and fever, and hot flush symptoms than male. Higher age groups had more dizziness and constipation as accompanying symptoms than lower age groups. Patients who takes hypnotics had more anorexia than those who dont.

Clinical Features of Infectious Ileocecitis in Children (소아 감염성 회장맹장염의 임상적 고찰)

  • Lee, Tae-Ho;Hong, Yoo-Rha;Yeon, Gyu-Min;Lee, Jun-Woo;Park, Jae-Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.13 no.1
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    • pp.30-35
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    • 2010
  • Purpose: Infectious ileocecitis is an infection confined to the ileocecal area and one of the most common causes of pediatric abdominal pain. This study was performed to demonstrate the clinical features of infectious ileocecitis in children. Methods: The medical records and radiologic findings of 37 patients with ileocecitis diagnosed by ultrasonography and/or computed tomography, who were admitted to Pusan National University Hospital from January 2004 and July 2008, were reviewed retrospectively. Viral gastroenteritis and secondary ileocecitis were excluded. Results: The mean age of the patients was 4.8${\pm}$3.4 years. One-half of the patients were preschool children. The chief complaint was abdominal pain (75.7%), diarrhea (10.8%), and vomiting (8.1%). Accompanying symptoms were fever (56.8%), vomiting (21.6%), and diarrhea (16.2%). The mean duration of abdominal pain, fever, diarrhea, and vomiting was 3.8${\pm}$2.1, 3.0${\pm}$1.9, 3.4${\pm}$1.9, and 2.4${\pm}$2.3 days, respectively. The frequency of diarrhea and vomiting was 5.8${\pm}$2.2 and 4.0${\pm}$2.8 per day, respectively. Diagnosis was made by abdominal ultrasonography in 22 patients (59.5%), abdominal CT in 2 patients (5.4%), and both modalities in 13 patients (35.1%). Besides the radiologic finding of thickening of the bowel wall, mesenteric lymphadenitis (59.5%), ascites (5.4%), and both mesenteric lymphadenitis and ascites (16.2%) were revealed. The mean duration of illness was 7.5${\pm}$5.0 days. There were no specific laboratory findings, and culture studies with stool or blood were negative. All of the patients recovered completely without specific treatment. Conclusion: Infectious ileocecitis has acute appendicitis-mimicking symptoms, but is self-limited within a few days, thus unnecessary treatment and work-up is avoided. However, distinguishing infectious ileocecitis from appendicitis, inflammatory bowel disease, and mesenteric lymphadenitis is important.

Clinical Analysis of Recurrent Intussusception and the Pathologic Lead Point in a Single Center (단일 병원에서의 재발성 장중첩증과 병적 선두에 대한 임상적 고찰)

  • Lee, Kun-Song;Park, Yun-Joon
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.2
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    • pp.163-170
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    • 2009
  • Purpose: Intussusception is the most common cause of intestinal obstruction in young children. Although intussusceptions are easily treated, some intussusceptions with or without a pathologic lead point (PLP) often recur. In this study, we analyzed the clinical characteristics and prognosis of recurrent intussusceptions (RI), the frequency of the PLP, and correlation between RI with PLP. Methods: The medical records of 144 patients, among 590 patients with intussusceptions who had been admitted to the Department of Pediatrics and Pediatric Surgery of Dankook University Hospital between May 1994 and June 2009 were reviewed retrospectively. Results: The overall recurrence rate of intussusceptions in this study was 9.2%. The mean interval between the initial occurrence and the first recurrent attack was 130${\pm}$175 days (range, 12 hours to 3 years). There was no statistically significant difference in the recurrence rate among patients who underwent air, barium, and manual reduction (p=0.131). Eighty-seven cases (92.6%) of RI had a successful reduction by the use of non-operative techniques. A PLP was present in 18 patients (3.0%). The most common PLP was intestinal lymphoid hyperplasia, followed by Meckel's diverticulum, duplication cyst, intestinal polyp, and adenomyoma. The mean number of intussusceptions was 4.7${\pm}$1.9 in 7 patients with PLP, which was significantly higher than (2.4${\pm}$0.9) patients without a PLP (p=0.023). The mean duration of recurrences was 17.4${\pm}$19.8 months (range, 2 days to 72 months). Conclusion: A careful search for a PLP should be performed to prevent recurrence of intussusception, especially when intussusception has recurred more than three times.

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Seasonal Distribution of T Serotyping and emm Genotyping of Group A Streptococci Obtained from Children with Streptococcal Infections in Masan, Korea, 2003~2004 (2003~2004년 경남 마산 지역에서 분리된 A군 연쇄구균의 T 혈청형과 emm 유전자형의 계절별 분포)

  • Jeon, Ho-Sang;Park, Hwa-Jin;Lee, Hee-Joo;Ma, Sang-Hyuk;Cha, Sung-Ho
    • Pediatric Infection and Vaccine
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    • v.12 no.1
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    • pp.52-60
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    • 2005
  • Purpose : The aim of this study is to know seasonal distribution of group A streptococci obtained from one center using emm genotyping and T serotyping in Masan from 2003 through 2004. Methods : Among children who visited the Changwon Fatima Hospital at Masan, Korea from June 2003 through February 2004, 100 patients who had clinical findings of acute pharyngitis, scarlet fever, and cellulitis were confirmed as GAS by culture, and were enrolled in our study. All obtained GAS were sent to the WHO Collaborative Center for Reference and Research on Streptococci, University of Minnesota, Minneapolis for T serotyping and emm genotyping. We classified these results again according to seasonal and disease's entities. Results : 19 different T serotypes was typed. T4(27.5%), T1(17.6%), T6(13.7%), and T12(13.7%) serotypes were relatively common in summer, while T4(28.3%), T12(15.2%), and T12/B3264(8.7%) were common in winter. T4 and T12 were persistent all year around. Distribution of T serotypes in 89 patients with pharyngotonsillitis were T4(26.7%), T12(14.0%), T1(12.8%), and T6(11.6%) in order of frequency. 15 different emm genotypes was typed. The number of emm 1, emm 6, emm 9, and emm 44 genotypes decreased or disappeared in winter, and the number of emm 3, emm 12, and emm 89 genotypes increased or reappeared in winter. Conclusion : Because T serotyping and emm genotyping are useful tools for evaluating epidemiology and pathogenesis of group A streptococci, we should monitor these strains every year, and should serotype and genotype GAS obtained from the invasive streptococcal infections.

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On Pattern of Birth and Death in Seoul City (서울시인구(市人口)의 출생(出生).사망(死亡) 양상(樣相)에 관(關)한 연구(硏究))

  • Kwon, E-Hyock;Kim, Tae-Ryong;Park, Hyung-Jong;Koo, Do-Suo;Lee, Yong-Wook;Park, Soon-Young
    • Journal of Preventive Medicine and Public Health
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    • v.1 no.1
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    • pp.9-23
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    • 1968
  • A survey was conducted by the staff of the College of Medicine and School of Public Health, Seoul National University in cooperation with Seoul Special City from 1 December 1967 through 28 February 1968, on such events as delivery, death, abortion and pregnancy. The survey directed to a total population of 47,811 residing in 9,157 households led us to the following findings: 1. Two year averages of crude birth rate, crude death rate and natural increase rate were 30.1, 5.6 and 24.5, respectively. 2. Of all deliveries, home and hospital deliveries constituted 61.1 per cent and 35.5 per cent, respectively. 3. Deliveries other than hospital deliveries were found to be attended more often by mother-in-laws (26.5 per cent) than by doctors or midwives(23.4 per cent). 4. About 51 per cent of all women having experiences in pregnancy during the last two years had an experience of consulting a doctor at least one time throughout whole period of pregnancy. 5. In most cases scissors were used to cut umbilical cords, of which 71.0 per cent were not sterilized and only 20.3 per cent sterilized. 6. In many cases placenta was incinerated(48.2 per cent) and on many other occasions it was thrown away into water(28.3 per cent). 7. Cement bags(37.4 per cent), gauze and absorbent cotton(29.8 per cent) were found to be most frequently used to receive new-born babies. 8. In 1966 8. 8 per cent of the women had at least one abortion induced and in 1967 the percentage was 9.2 per cent. 9. Nearly all(95.8 per cent) of the induced abortions reportedly were done at doctor's clinics. 10. Of all the abortions induced 65.3 per cent were done by specialists in obstetrics, 30.3 per cent by general practitioners and 2.7 per cent by midwives. 11. Those who experienced spontaneous abortions were 1.9 per cent of all women both in 1966 and 1967. 12. About 9.2 per cent of women investigated were found to be currently pregnant. 13. Age specific death rate turned out to be highest among those under 1 year of age. 14. Ten major causes of death in their order of frequency were: 15. Places of death can be classified into homes(75.3 per cent) and hospitals(13.2 per cent). 16. Method of disposing of corpses comprised burials(54.2 per cent) and cremations(44.6 per cent). 17. Infant, neonatal and hebdomadal mortality rates have been computed at 32.2, 18.9 and 13.7, respectively. 18. Infants were found to have died either at homes(81.5 per cent) or at hospitals(18.5 per cent). 19. Birth registrations had been done for about 18.5 per cent of the dead infants.

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Epidemiologic Investigation of an Outbreak of Shigellosis in Kyongju, Korea (1998년 경주시 한 초등학교 학생과 인근 주민에서 발생한 세균성이질)

  • Jung, Cheol;Bae, Geun-Ryang;Hur, Yeong-Joo;Lee, Sang-Won;Jeong, Eun-Kyeong;Lim, Hyun-Sul
    • Journal of Preventive Medicine and Public Health
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    • v.33 no.1
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    • pp.1-9
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    • 2000
  • Objectives : This study was carried out to investigate the sources of infection and modes of transmission of an outbreak of shigellosis that occurred among pupils of 'M' primary school and residents near the school in Kyongju from Sept. 24 to Oct. 24, 1998. Methods : The subjects who completed a questionnaire and a rectal swab for microbiologic examinations were 1,534 persons (781 males, 753 females), including 469 pupils of 'M' primary school (268 males, 201 females). Bacteriological examinations of underground water and simple piped water were done. Results : The attack rate of diarrhea was 28.7% in the subjects from Sept.24 to Oct. 24, 1958. There was no difference in attack rate of diarrhea by gender, but it was significantly higher in the pupils of 'M' primary school than others (p<0.01). The attack rate of diarrhea by resident areas was no different to the pupils of 'M' primary school, but was significantly higher in the residents of Mohwa 2 Ri except pupils that 'M' primary school is located in (p<0.01). The distribution of date of onset revealed the exposure date to be Sept, 22 and 23 in consideration of incubation periods and common source outbreak followed propagative spread in the epidemic curve. The major characteristics of diarrhea were watery (89.1%) in nature, $1\sim3$ days (72.5%) in duration, $2\sim3$ times (63.9%) in frequency. The clinical symptoms among the diarrheal cases included abdominal pain (74.1%), fever (56.4%), headache (55.9%), chill (40.4%) and tenesmus (31.4%). Conclusions : The source of infection was estimated to be contaminated underground water and simple piped water caused by leakage from the cess pool. It is highly necessary that the management of drinking water and cess fools should be done thoroughly.

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The Effect of Human Albumin Infusion on the Clinical Course of Steroid Sensitive Nephrotic Syndrome (인알부민 투여가 스테로이드 반응성 신증후군의 임상경과에 미치는 영향)

  • Lee Soo Jin;Jeong Ji A;Hwang Soo Ja;Lee Seung Joo
    • Childhood Kidney Diseases
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    • v.4 no.2
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    • pp.102-110
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    • 2000
  • Purpose : Intravenous infusion of albumin has been widely und to relieve severe nephrotic edema in spite of beneficial or harmful effects. The purpose of this study is to examine the harmful effect of albumin on the clinical course of steroid sensitive nephrotic syndrome(SSNS). Method : We prospectively randomized the patients with nephrotic syndrome(biopsy proven or clinically compatible to minimal change nephrotic syndrome) into the albumin group(20$\%$ albumin 1 g/kg) or control group(5$\%$ D/W) between March 1997 and September 1999 at Ewha University Mokdong Hospital. We compared the clinical course of the albumin group(n=13) with the control group(n=13). Results : 1. The duration of steroid therapy until complete remission in the albumin group was significantly longer than the control group($13.7{\pm}6.4\;days\;vs\;7.5{\pm}2.8\;days$)(P<0.05). 2. The remission duration to the first relapse was significantly shorter in the albumin group ($94{\pm}63.5$ days) than the control group($190{\pm}106.4$ days)(P< 0.05). There was no significant difference in the relapse rate within 1 year after complete remission[77$\%$ (10/13) vs 46$\%$ (6/13)](P>0.05) and the relapse frequency per year($1.9{\pm}0.8\;vs\;1.5{\pm}0.5$) between the albumin and control groups. 3. Spot urine protein/creatinine ratio significantly increased in the albumin group at post-albumin 2, 4 days(P<0.05). There was no significant difference in the change of the daily percent weight loss, blood pressure, serum Na, K concentration between the albumin and control groups. Conclusion : Albumin infusion in SSNS delayed the response to steroid and shortened the remission duration to the first relapse. Albumin should be carefully used in nephrotic edema.

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Chronic Kidney Disease-mineral Bone Disorder and Active Vitamin D Analogs for Treating Severe Hyperparathyroidism in Children Receiving Chronic Peritoneal Dialysis (소아복막투석환자에서 CKD-MBD와 중증 부갑상샘 기능항진증에서 비타민 D 치료)

  • Kang, Eun Gu;Lee, Joo Hoon;Park, Young Seo
    • Childhood Kidney Diseases
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    • v.18 no.2
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    • pp.64-70
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    • 2014
  • Purpose: The aims of this study were to assess the clinical and laboratory profiles of chronic kidney disease-mineral bone disorder (CKD-MBD) and to assess the effects of treatment of active vitamin D analogs on severe hyperparathyroidism (SHPT) in pediatric patients on chronic peritoneal dialysis. Methods: This is a retrospective study included 53 patients who had been undergoing dialysis for more than 1 year, between January 2003 and December 2012. Results: Even after treatment with phosphate binders and active vitamin D analogs, the $mean{\pm}standard$ deviation of the percentage of time during peritoneal dialysis that the patients' serum concentrations of phosphorus, corrected total calcium, and parathyroid hormone (PTH) fell within the Kidney Disease Outcomes Quality Initiative recommended ranges was $25.06{\pm}17.47%$, $53.30{\pm}23.03%$, and $11.52{\pm}9.51%$, respectively. Clinical symptoms or radiological signs of CKD-MBD were observed in 10 patients (18.9%). There were significant differences in percentage of time that the serum intact PTH concentration was outside of the recommended range between patients with and without symptoms or signs of CKD-MBD (below recommended range, $11.74{\pm}7.37%$ vs. $40.77{\pm}25.39%$, P <0.001; above the recommended range, $63.79{\pm}27.86%$ vs. $37.09{\pm}27.76%$, P =0.022). Of the 25 patients with SHPT, high-dose alfacalcidol treatment was required in 13 patients that controlled SHPT in 7 of these patients, without marked complications. Conclusion: Despite our efforts to manage CKD-MBD, patients' met the recommended ranges from relevant guidelines at a low frequency. The treatment of high-dose active vitamin D analogs was required in about half of the patients with SHPT and effective in about half of them.