• The Journal of Korean Society for Radiation Therapy
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• v.33
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• pp.89-97
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• 2021

Purpose: The purpose of this study is to compare and evaluate the dose change according to the gas volume variations in the rectum, which was not included in the treatment plan during radiation therapy for cervical cancer. Materials and methods: Static Intensity Modulated Radiation Therapy (S-IMRT) using a 9-field and Volumetric Modulated Arc Therapy (VMAT) using 2 full-arcs were established with treatment planning system on Computed Tomography images of a human phantom. Random gas parameters were included in the Planning Target Volume(PTV) with a maximum change of 2.0 cm in increments of 0.5 cm. Then, the Conformity Index (CI), Homogeneity Index (HI) and PTV D_max for the target volume were calculated, and the minimum dose (D_min), mean dose (D_mean) and Maximum Dose (D_max) were calculated and compared for OAR(organs at risk). For statistical analysis, T-test was performed to obtain a p-value, where the significance level was set to 0.05. Result: The HI coefficients of determination(R²) of S-IMRT and VMAT were 0.9423 and 0.8223, respectively, indicating a relatively clear correlation, and PTV D_max was found to increase up to 2.8% as the volume of a given gas parameter increased. In case of OAR evaluation, the dose in the bladder did not change with gas volume while a significant dose difference of more than D_mean 700 cGy was confirmed in rectum using both treatment plans at gas volumes of 1.0 cm or more. In all values except for D_mean of bladder, p-value was less than 0.05, confirming a statistically significant difference. Conclusion: In the case of gas generation not considered in the reference treatment plan, as the amount of gas increased, the dose difference at PTV and the dose delivered to the rectum increased. Therefore, during radiation therapy, it is necessary to make efforts to minimize the dose transmission error caused by a large amount of gas volumes in the rectum. Further studies will be necessary to evaluate dose transmission by not only varying the gas volume but also where the gas was located in the treatment field.

• Tuberculosis and Respiratory Diseases
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• v.85 no.1
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• pp.56-66
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• 2022

Background: Because the etiologies of bronchiectasis and related diseases vary significantly among different regions and ethnicities, this study aimed to develop a diagnostic bundle for bronchiectasis in South Korea. Methods: A modified Delphi method was used to develop expert consensus statements on a diagnostic bundle for bronchiectasis in South Korea. Initial statements proposed by a core panel, based on international bronchiectasis guidelines, were discussed in an online meeting and two email surveys by a panel of experts (≥70% agreement). Results: The study involved 21 expert participants, and 30 statements regarding a diagnostic bundle for bronchiectasis were classified as recommended, conditional, or not recommended. The consensus statements of the expert panel were as follows: A standardized diagnostic bundle is useful in clinical practice; diagnostic tests for specific diseases, including immunodeficiency and allergic bronchopulmonary aspergillosis, are necessary when clinically suspected; initial diagnostic tests, including sputum microbiology and spirometry, are essential in all patients with bronchiectasis, and patients suspected with rare causes such as primary ciliary dyskinesia should be referred to specialized centers. Conclusion: Based on this Delphi survey, expert consensus statements were generated including specific diagnostic, laboratory, microbiological, and pulmonary function tests required to manage patients with bronchiectasis in South Korea.

• The Journal of Korean Society for Radiation Therapy
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• v.33
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• pp.25-33
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• 2021

Purpose : The purpose of this study is to evaluate the accuracy and usefulness of the Trigger mode for the Respiratory Gated Radiation Therapy (RGRT) Materials and methods : A QUASAR respiratory phantom that inserted a 3 mm fiducial marker (a gold marker) was used to estimate the accuracy of the Trigger mode. And the 20 bpm was used as reference respiration rate in this study. The marker that placed at the center of the phantom was contoured, and the lower threshold of a gating window was fixed at 2.0 mm using an OBI with Truebeam STx^TM. The upper threshold was measured every 0.5 mm from 1.0 mm to 3.0 mm. The respiration rates were changed every 10 bpm from 10 bpm to 60 bpm. We repeatedly measured five times to check the error rate of the trigger mode in the same condition. Result : The differences of a distance from a peak phase to upper threshold, 1.0 to 3.0 mm at a 20 bpm as a reference for 3 days in a row were 0.68±0.05 mm, 0.91±0.03 mm, 1.23±0.03 mm, 1.42±0.04 mm, and 1.66±0.06 mm, respectively. Measurement result of changes in respiratory rate compared to baseline respiratory rate in maximum absolute difference. The coefficient of determination (R2) to estimate the correlation between the respiration velocity and variation of absolute difference was on average 0.838, 0.887, 0.770, 0.850, and 0.906. The p-values of all the variables were below 0.05. Conclusion : Using Trigger mode during respiratory gated radiation therapy (RGRT), accuracy and usefulness of trigger mode at reference breathing rate were confirmed. However, inaccuracies depending on the rate of breathing it could be uncertain in case of respiration rate is faster than 20 bpm as a standard respiration rate compared to slower than 20 bpm. Consequently, when conducting a RGRT using the trigger mode, real time monitoring is required with well educated respiration.

• Tuberculosis and Respiratory Diseases
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• v.85 no.2
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• pp.185-194
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• 2022

Background: The Korea Interstitial Lung Disease Study Group has made a new nationwide idiopathic pulmonary fibrosis (IPF) registry because the routine clinical practice has changed due to new guidelines and newly developed antifibrotic agents in the recent decade. The aim of this study was to describe recent clinical characteristics of Korean IPF patients. Methods: Both newly diagnosed and following IPF patients diagnosed after the previous registry in 2008 were enrolled. Survival analysis was only conducted for patients diagnosed with IPF after 2016 because antifibrotic agents started to be covered by medical insurance of Korea in October 2015. Results: A total of 2,139 patients were analyzed. Their mean age at diagnosis was 67.4±9.3 years. Of these patients, 76.1% were males, 71.0% were ever-smokers, 14.4% were asymptomatic at the time of diagnosis, and 56.9% were at gender-age-physiology stage I. Occupational toxic material exposure was reported in 534 patients. The mean forced vital capacity was 74.6% and the diffusing capacity for carbon monoxide was 63.6%. Treatment with pirfenidone was increased over time: 62.4% of IPF patients were treated with pirfenidone initially. And 79.2% of patients were treated with antifiboritics for more than three months during the course of the disease since 2016. Old age, acute exacerbation, treatment without antifibrotics, and exposure to wood and stone dust were associated with higher mortality. Conclusion: In the recent Korean IPF registry, the percentage of IPF patients treated with antifibrotics was increased compared to that in the previous IPF registry. Old age, acute exacerbation, treatment without antifibrotics, and exposure to wood and stone dust were associated with higher mortality.

• The Journal of Korean Society for Radiation Therapy
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• v.33
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• pp.47-54
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• 2021

Purpose : In order to evaluate the usefulness of clinical application of the Pause & Resume methods by comparing and analyzing the data stability and dose reduction effect when repeat scan assuming irregular breathing and using the Pause & Resume method during chest 4D CT using Quasar^TM Phantom. Materials and Methods : Using the Quasar^TM Phantom, set the breathing rate per minute to 15 BPM and 7.5 BPM, and set the S15 point as an irregular breathing section, and then placed OSLD to this point and use the Pause & Resume method to measure the dose of S15. CTDIvol, DLP, and ALARA-CT were used for comparative analysis of radiation dose between Pause & Resume method and Repeat-scan. In order to evaluate the stability and usability of the data applying the Pause & Resume method, the captured images were sorted by Advanced Workstation Volume Share7 and then sent to Eclipse^TM, the diameter and volume were analyzed by forming a contour on the iron ball in the Quasar^TM Phantom Results : When using Pause & Resume, the dose of OSLD measurement increased by 1.97 times in the section of S15. As a result of image evaluation, the average value of all volumes measured with and without the Pause & Resume method at 15 BPM and 7.5 BPM was 15.2 cm3±0.5%.Allthemeasuredvaluesfor the radius of iron ball were 3.1 cm regardless of whether Pause & Resume method was used or not. In the case of using Pause & Resume, 33% decreased from the lowest DLP value and 38% decreased from the highest DLP value of repeat scan, and the effective dose also decreased 32.1% from the minimum value and 37.6% from the maximum value. Conclusion: Irradiation dose was increased by Pause & Resume method because of the repeat scan on the S15 site where assuming irregular breathing occurred, However Pause & Resume method led to a significant reduction in dose on overall scan range. It also proved the usefulness of clinical application of the Pause & Resume method as a result of similar diameters and volumes of iron ball measurement.

• Korea Journal of Hospital Management
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• v.27 no.2
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• pp.53-66
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• 2022

Aim : The purpose of this study is to investigate the influence of the awareness level of the mandatory employment system for the disabled and the help of the employment increase on the health status of the disabled. Based on this, the purpose of this study is to raise awareness of the compulsory employment system for the disabled and to suggest a way to improve the health of the disabled. Methods : In this study, the first data of the second wave of the 2016-2018 Employment Panel Survey for the Disabled was used to analyze the participation of the disabled in economic activities. a total of 1,648 subjects were analyzed using the chi-square test and generalized estimating equation (GEE). Results : Compared to the group knowing about the compulsory employment system for the disabled, in the group who did not know about the compulsory employment system, the cognitive level was significantly higher for subjective health status (Odds Ratio [OR]: 1.573, 95% Confidence Interval [CI]: 1.252-1.977) and chronic diseases (OR: 1.407, 95% CI: 1.091-1.816), Compared to the group that the compulsory employment system for the disabled is helpful in increasing employment, the group that said it was not helpful at all had depression feel (OR: 2.330, 95% CI: 1.219-4.452) and subjective health status (OR: 2.052, 95% CI: 1.232. -3.416) significantly affected. Conclusion : It was found that the lower the level of awareness and help of the compulsory employment system for the disabled, the negative impact on their health status. Therefore, it is necessary to promote employment growth by raising awareness of the employment system for the disabled. Furthermore, in order to improve the health of the disabled, public relations plans to increase the understanding of the disabled on the system and policies to protect the disabled people who lose their will to work due to difficulties in accessing employment were enacted, and Changes to a disability-friendly working environment should be activated so that participants can participate.

• Korean Journal of Remote Sensing
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• v.38 no.6_2
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• pp.1691-1707
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• 2022

Cheonji Lake, the caldera of Baekdu Mountain, located on the border of the Korean Peninsula and China, alternates between melting and freezing seasonally. There is a magma chamber beneath Cheonji, and variations in the magma chamber cause volcanic antecedents such as changes in the temperature and water pressure of hot spring water. Consequently, there is an abnormal region in Cheonji where ice melts quicker than in other areas, freezes late even during the freezing period, and has a high-temperature water surface. The abnormal area is a discharge region for hot spring water, and its ice gradient may be used to monitor volcanic activity. However, due to geographical, political and spatial issues, periodic observation of abnormal regions of Cheonji is limited. In this study, the degree of ice change in the optimal region was quantified using a Landsat -5/-7/-8 optical satellite image and a Modified U-Net regression model. From January 22, 1985 to December 8, 2020, the Visible and Near Infrared (VNIR) band of 83 Landsat images including anomalous regions was utilized. Using the relative spectral reflectance of water and ice in the VNIR band, unique data were generated for quantitative ice variability monitoring. To preserve as much information as possible from the visible and near-infrared bands, ice gradient was noticed by applying it to U-Net with two encoders, achieving good prediction accuracy with a Root Mean Square Error (RMSE) of 140 and a correlation value of 0.9968. Since the ice change value can be seen with high precision from Landsat images using Modified U-Net in the future may be utilized as one of the methods to monitor Baekdu Mountain's volcanic activity, and a more specific volcano monitoring system can be built.

• Journal of the Korean earth science society
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• v.43 no.5
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• pp.618-638
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• 2022

The Middle Jurassic granite dike swarm intruding into the Paleoproterozoic banded gneiss is pervasively observed in Ueumdo, Hwaseong City, mid-western Gyeonggi Massif. Based on their cross-cutting relationships in a representative outcrop, there are four dikes (UE-A, UE-C, UE-D, UE-E), and depending on the direction, there are three granite dike groups, which are NW- (UE-A dike), NW to WNW- (UE-C dike), and NE-trending (UE-D and UE-E dikes). These granite dikes are massive, medium-to coarse-grained biotite granites, and their relative ages observed in outcrops are in the order of UE-A, UE-D (=UE-E), and UE-C. The geometric analysis of the dikes indicates that the UE-A and UE-C dikes intrude under approximately NE-SW trending horizontal minimum stress fields. The UE-A dike, which showed a relatively low average SiO2 content by major element analysis, is a product of early magma differentiation compared to other dikes; therefore, it is consistent with the relative age of each dike. The ²⁰⁶Pb/²³⁸U weighted mean ages for each dike obtained from SHRIMP zircon U-Pb dating were calculated to be 167 Ma (UE-A), 164 Ma (UE-C), 167 Ma (UE-D), and 167 Ma (UE-E), respectively. The samples of the UE-A, UE-D, and UE-E dikes showed very similar ages. The UE-C dike shows the youngest age, which is consistent with the results of the relative age in the outcrops and major element analysis. Therefore, the granite dikes intruded into the Middle Jurassic (approximately 167 and 164 Ma), coinciding with those of the Gyeonggi Massif, where the Middle Jurassic plutons are geographically widely distributed. This result indicates that the wide occurrence of the Middle Jurassic plutons on the Gyeonggi Massif was formed as a result of igneous activity moving in the northwest direction with the shallower subduction angle of the subducting oceanic plate during the Jurassic.

• Journal of Food Hygiene and Safety
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• v.37 no.5
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• pp.323-327
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• 2022

The mineral content of Tricholoma matsutake was evaluated for comparison of mineral contents according to the area of cultivation. Ten domestic and thirty Chinese (10 Yanji, 10 Yunnan and 10 Tibet) T. matsutake specimens were assessed using an atomic absorption spectrophotometer (AAS) and inductively coupled plasma mass spectrometer (ICP-MS). The Na, Mg, K, and Ca contents of domestic T. matsutake were 128.12±85.25 mg/kg, 218.52±105.35 mg/kg, 7,534.58±2,691.52 mg/kg, and 17.69±7.14 mg/kg, respectively, while those of Yanji T. matsutake were 124.89±57.24 mg/kg, 64.07±27.52 mg/kg, 1,439.18±311.04 mg/kg, and 10.88±4.52 mg/kg, respectively. The Na, Mg, K, and Ca contents of Yunnan T. matsutake were 90.78±23.23 mg/kg, 77.40±28.36 mg/kg, 1,446.29±126.33 mg/kg, and 28.42±5.18 mg/kg respectively, while those of Tibet T. matsutake were 143.50±41.54 mg/kg, 124.64±50.18 mg/kg, 3,530.95±2,714.99 mg/kg, and 21.05±8.71 mg/kg, respectively. The Cu contents of domestic, Yanji, Yunnan, and Tibet T. matsutake were 105.43±32.97 mg/kg, 19.92±8.95 mg/kg, 54.51±16.91 mg/kg, and 64.80±23.01 mg/kg, respectively. Both domestic and Chinese T. matsutake samples showed significantly different K, Mg, and Cu levels in this study. Therefore, a comparative evaluation of the K, Mg, and Cu contents of multiple domestic and Chinese T. matsutake varieties is needed to determine the appropriate area of cultivation in the future.

• Journal of the Korean Orthopaedic Association
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• v.55 no.5
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• pp.405-410
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• 2020

Purpose: Pedicle screw insertion has been traditionally used as a surgical treatment for degenerative lumbar spine disease. As an alternative, the cortical-bone trajectory screw allows less invasive posterior lumbar fixation and excellent mechanical stability, as reported in several biomechanical studies. This study evaluated the clinical and radiological results of a case of early failure of cortical-bone screw fixation in posterior fixation and union after posterior decompression. Materials and Methods: This study examined 311 patients who underwent surgical treatment from 2013 to 2018 using cortical orbital screws as an alternative to traditional pedicle screw fixation for degenerative spinal stenosis and anterior spine dislocation of the lumbar spine. Early fixation failure after surgery was defined as fixation failure, such as loosening, pull-out, and breakage of the screw on computed tomography (CT) and radiographs at a follow-up of six months. Results: Early fixation failure occurred in 46 out of 311 cases (14.8%), screw loosening in 46 cases (14.8%), pull-out in 12 cases (3.9%), and breakage in four cases (1.3%). An analysis of the site where the fixation failure occurred revealed the following, L1 in seven cases (15.2%), L2 in three cases (6.5%), L3 in four cases (8.7%), L4 in four cases (8.7%), L5 in four cases (8.7%), and S1 in 24 cases (52.2%). Among the distal cortical bone screws, fixation failures such as loosening, pull-out, and breakage occurred mainly in the S1 screws. Conclusion: Cortical-bone trajectory screw fixation may be an alternative with comparable clinical outcomes or fewer complications compared to conventional pedicle screw fixation. On the other hand, in case with osteoporosis and no anterior support structure particularly at L5-S1 fusion sites were observed to have result of premature fixation failures such as relaxation, pull-out, and breakage.