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Quantitative Evaluation of Gated Radiation Therapy Using Gamma Index Analysis (감마지표 분석을 통한 호흡연동방사선치료의 정량적 평가)

  • Ma, Sun Young;Choi, Ji Hoon;Jeung, Tae Sig;Lim, Sangwook
    • Progress in Medical Physics
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    • v.24 no.3
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    • pp.198-203
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    • 2013
  • Generally, to evaluate gated radiation therapy, moving phantoms are used to simulate organ motion. Since the target moves in every direction, we need to take into account motion in each direction. This study proposes methods to evaluate gated radiation therapy using gamma index analysis and to visualize adequate gating window sizes according to motion ranges. The moving phantom was fabricated to simulate motion in the craniocaudal direction. This phantom consisted of a moving platform, the I'm MatriXX, and solid water phantoms. A 6 MV photon filed with a field size of $4{\times}4cm^2$ was delivered to the phantom using the gating system, while the phantom moved in the 1-, 2-, 3-, 4-, and 5-cm motion ranges. The gating windows were set at 40~60%, 30~40%, and 0~90%, respectively. The I'm MatriXX acquired the dose distributions for each scenario and the dose distributions were compared with a $4{\times}4cm^2$ static filed. The tolerance of the gamma index was set at 3%/3 mm. The greater the gating window, the lower the pass rate, and the greater the motion range, the lower the pass rate in this study. In case treatment without gated radiation therapy for the target with motion of 2 cm, the pass rate was less than 96%. But it was greater than 99% when gated radiation therapy was used. However gated radiation therapy was used for the target with motion greater than 4 cm, the pass rate could not be greater than 97% when gating window was set as 30~70%. But when the gating window set as 40~60%, the pass rate was greater than 99%.

Experimental study on the relaxation zone depending on the width and distance of the weak zone existing ahead of tunnel face (터널 굴진면 전방에 위치한 연약대 폭과 이격거리에 따른 이완영역에 대한 실험적 연구)

  • Ham, Hyeon Su;Lee, Sang Duk
    • Journal of Korean Tunnelling and Underground Space Association
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    • v.20 no.5
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    • pp.855-867
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    • 2018
  • When a weak zone exists ahead of tunnel face, the stress in the adjacent area would increase due to the longitudinal arching effect and the stability of the tunnel is affected. Therefore, it is critical to prepare a countermeasure through the investigation of the frontal weakness zone of the excavated face. Although there are several researches to predict the existence of weak zone ahead of tunnel face, such as geophysical exploration, numerical analysis and tunnel support, lack of studies on the relaxation zone depending on the width or distance from the vulnerable area. In this study, the impact of the weak zone on the formation of the relaxation zone was investigated. For this purpose, a series of laboratory test were carried out varying the width of the weak zone and the separation distance between tunnel face and weak zone. In the model test, sand with a water content of 3.8% was used to form a model ground. The model weak zone was constructed with dry sand curtains. The tunnel face was adjusted to allow a sequential excavation of upper and lower half part. load cells were installed on the bottom of the foundation and the tunnel face and measuring instruments for displacement were installed on the surface of the model ground to measure the vertical stress and surface displacements due to tunnel excavation respectively. The test results show that the width of weak zone did not affect the ground settlement while the ground subsidence drastically increased within 0.25D. The vertical stress and horizontal stress increased from 0.5D or less. In addition, the longitudinal arching effect is likely within the 1.0D zone ahead of the tunnel face, which may reduce the vertical stress in the ground following tunneling direction.

Optimal Incentives for Customer Satisfaction in Multi-channel Setting (멀티채널에서의 고객만족제고 인센티브 연구)

  • Kim, Hyun-Sik
    • Journal of Distribution Research
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    • v.15 no.1
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    • pp.25-47
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    • 2010
  • CS is one of the major concerns of managers in the world because it is well known to be a key medium construct for firms' superior outcome. One of the major agents for CS management is retailers. Firms try to manage not only employees but also retailers to promote CS behaviors. And so diverse incentives are used to promote their CS behaviors under diverse channel setting such as multi-channel. However in spite of the rising needs there has been scarce studies on the optimal incentive structure for a manufacturer to offer competing retailers at the multi-channel. In this paper, we try to find better way for a manufacturer to promote the competing retailers' CS behaviors. We investigated how to promote the retailers' CS behavior via game-theoretic modeling. Especially, we focus on the possible incentive, CS bonus type reward introduced in the studies of Hauser, Simester, and Wernerfelt(1994) and Chu and Desai(1995). We build up a multi stage complete information game and derive a subgame perfect equilibrium using backward induction. Stages of the game are as following. (Stage 1) Manufacturer sets wholesale price(w) and CS bonus($\eta$). (Stage 2) Both retailers in competition set CS effort level($e_i$) and retail price($p_i$) simultaneously. (Stage 3) Consumers make purchasing decisions based on the manufacturer's initial reputation and retailers' CS efforts.

    Structure of the Model We investigated four issues about the topic as following: (1) How much total incentive is adequate for a firm of a specific level of reputation to promote retailers' CS behavior under multi-channel setting ?, (2) How much total incentive is adequate under diverse level of complimentary externalities between the retailers' CS efforts to promote retailers' CS behavior?, (3) How much total incentive is adequate under diverse level of cost to make CS efforts to promote retailers' CS behavior?, (4) How much total incentive is adequate under diverse level of competition between retailers to promote retailers' CS behavior? Our findings are as following. (1) The higher reputation has the manufacturer, the higher incentives for retailers at multi-channel are required in the equilibrium.
    shows the increasing pattern of optimal incentive level along the manufacturer's reputation level(a) under some parameter conditions(b=1/2;c=0;$\beta$=1/2). (2) The bigger complimentary externalities exists between the retailers' CS efforts, the higher incentives are required in the equilibrium.
    shows the increasing pattern of optimal incentive level along the complimentary externalities level($\beta$) under some parameter conditions(a=1;b=1/2;c=0). (3) The higher is the retailers' cost, the lower incentives are required in the equilibrium.
    shows the decreasing pattern of optimal incentive level along the cost level(c) under some parameter conditions(a=1;b=1/2;$\beta$=1/2). (4) The more competitive gets those two retailers, the higher incentives for retailers at multi-channel are required in the equilibrium.
    shows the increasing pattern of optimal incentive level along the competition level(b) under some parameter conditions(c=0;a=1;$\beta$=1/2). One of the major contribution points of this study is the fact that this study is the first to investigate the optimal CS incentive system under multi-channel setting.

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Repetition of Apoptosis Induced by Amiloride Derivatives in Human Umbilical Vein Endothelial Cells (제대정맥 내피세포에서 Amiloride 유도체에 의한 Apoptosis 반복)

  • Park, Kyu Chang;Park, Kyu Sang;Moon, Soo Jee
    • Clinical and Experimental Pediatrics
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    • v.46 no.1
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    • pp.56-66
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    • 2003
  • Purpose : Human umbilical vein endothelial cells(HUVECs) play an important role in regulating blood flow by releasing vasoactive substances. It has been reported that endothelial impairment and dysfunction might be a primary cause of placental vascular disease, which is manifested clinically as preeclampsia in mother and intrauterine growth restriction in fetus. Furthermore, the frequency of apoptotic changes is increased in umbilical and placental tissues from growth-restricted pregnancies. However, the various mechanisms of umbilical endothelial cell apoptosis have not been broadly proposed. We investigate the effects of amiloride derivatives on apoptotic death of HUVECs and identify their ionic mechanism. Methods : HUVECs were purchased from Clonetics, and cultured on endothelial cell growth medium. MTT assay and flow cytometry were used for assessing cytotoxic effect and confirming the apoptosis. Changes in intracellular ion concentrations were measured with specific fluorescent dyes and fluorescence imaging analysis system. Results : Amiloride derivatives elicited cytotoxic effects on HUVECs with dose-dependent manners and the rank order of potency is HMA($IC_{50}\;11.2{\mu}M$), MIA>EIPA>>amiloride. HMA-induced cytotoxicity is dependent on extra- and intracellular pH, that is, increase extra- and intracellular pH augmented the cytotoxic effects of HMA. HMA dose-dependently reduced intracellular major ions, such as $K^+$ and $Cl^-$. Interestingly, the depletion of intracellular ions induced by HMA was also significantly enhanced at alkaline extracellular pH. Conclusion : Amiloride derivatives induce apoptosis of HUVECs with dose and pH dependent manners. They reduce intracellular $K^+$ and $Cl^-$ concentration, which is also extracellular pH dependent.

Correlation between Angiographic Vasospasm and Clinical Vasospasm following Aneurysmal Subarachnoid Hemorrhage (뇌동맥류 파열에 의한 뇌지주막하 출혈후 혈관 조영상 혈관연축과 임상적 혈관연축의 상관관계)

  • Suh, Dong-Sang;Kim, Bum-Tae;Im, Soo-Bin;Cho, Sung-Jin;Shin, Won-Han;Choi, Soon-Kwan;Byun, Bark-Jang
    • Journal of Korean Neurosurgical Society
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    • v.29 no.12
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    • pp.1563-1569
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    • 2000
  • Objective : Delayed ischemic neurologic deficit(DIND) is one of the major complications following aneurysmal subarachnoid hemorrhage(SAH). However, the correlation between angiographic vasospasm(AV) and DIND after SAH is not precisely known. The authors investigated the timing, incidence, characteristics of DIND, and analyzed correlation between AV and DIND. Patients and Methods : A series of 126 patients with SAH and performed cerebral angiography which, confirmed anterior circulation aneurysm, admitted to between January 1996 to December 1998, were studied retrospectively. A comparative analysis between group 1(G1) in which AV patients presented with DIND, and group 2(G2) patients did not DIND, were done. AV was graded according to location, distribution and degree. Location of vasospasm was classified as basal type(BT), distal type(DT). BT was involved horizontally and include the bilateral carotid systems, proximal middle cerebral artery(MCA) and proximal anterior cerebral artery(ACA). DT was involved vertically and include the MCA branches as they become vertically or posteriorly oriented and the ACA distal to the anterior communicating artery. BT and DT all defined ether as localized type(LT) or combined type(CT). Distribution of vasospasm was classified as type I, type II and type III. Type I represents the involvement of bilateral carotid systems and bilateral anterior cerebral artery, type II was designed as one carotid system without involving anterior cerebral artery, and type III when only some portions of the anterior cerebral artery were involved, bilaterally. Degree of vasospasm was classified as mild(less than 25%), moderate(between 25-50%), severe(greater than 50%), and those were determined by comparing the caliber of the artery in vasospasm to that of the nearest area of apparently normal vessel. Results : The incidence of AV & DIND was 57/126(45.2%), 29/126(23.0%), and timing of DIND was 9 days(${\pm}4.1$) after initial hemorrhage. As for the location, BT was seen in 12 cases(40.0%), DT 11 cases(36.7%) and CT 7 cases (23.3%), respectively. Where as G1, BT was seen 5 cases(18.5%), DT 5 cases(18.5%) and CT 17 cases(63.0%), respectively in G2. CT AV was more correlated with DIND than LT AV(p<0.05). For distribution, type I was seen in 16 cases(59.2%), type II 4 cases(14.8%), type III 7 cases(25.9%) in G1 where as type I was seen in 7 cases(23.3%), type II 10 cases(33.3%), type III 13(43.3%) in G2. Type I AV was well correlated with DIND unlike to type II or type III(p<0.05). As for the degree, mild was seen in 4 cases(14.8%), moderate 14 cases(51.9%), severe 9 cases (33.3%) in G1, and mild 16 cases(18.5%), moderate 11 cases(36.7%) and severe 3 cases(10.0%) in G2. Moderate to severe type AV was well correlated with DIND(p<0.05). Conclusion : These results indicate that it may be possible to predict DIND according to careful analysis of location, distribution, degree of AV in patients with aneurysmal SAH.

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Forest Law and Forest Resources in Five Northeast Asian Countries - R.O.K., D.P.R.K., Japan, China and Taiwan - (동북(東北)아시아 5개국(個國)(한국(韓國), 북한(北韓), 일본(日本), 중국(中國), 대만(臺灣))의 산림법(山林法)과 산림자원(山林資源))

  • Yoo, Byoung Il
    • Journal of Korean Society of Forest Science
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    • v.84 no.1
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    • pp.10-21
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    • 1995
  • This study was conducted to compare the changes in the forest resources and the process of establishment and characteristics of the Forest Law in five Northeast Asian Countries, who share the Chinese culture as a common background. The effect of Forest Law on forest resources of each countries is also compared. This study shows that the forest management scheme and the modernistic forest law in the five Northeast Countries were influenced by Japan around the early 20th century. The Forest Laws of the five countries were reestablished after the end of World War II, and now the five countries have their own Forest Law. At present, the five countries are depending on the import of foreign timber for timber supply because of the shortage of domestic timber resources. The Forest Laws of the five countries have a lot of similarities reflecting same cultural background, whereas there are differences originated from social and economic discrepancies. Currently R.O.K. is worst in forest resources compared to the other countries. The Forest Law of R.O.K. has too many articles, which has little direct relationship with forest resources management. Therefore it is recommended to consolidate the law system in the field of forest and forestry in R.O.K. including the amendment of Forest Law directing to sustainable forest and maintaining the efficiency of forest resources management.

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Analysis of Cancer Incidence in Zhejiang Cancer Registry in China during 2000 to 2009

  • Du, Ling-Bin;Li, Hui-Zhang;Wang, Xiang-Hui;Zhu, Chen;Liu, Qing-Min;Li, Qi-Long;Li, Xue-Qin;Shen, Yong-Zhou;Zhang, Xin-Pei;Ying, Jiang-Wei;Yu, Chuan-Ding;Mao, Wei-Min
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.14
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    • pp.5839-5843
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    • 2014
  • Objective: The Zhejiang Provincial Cancer Prevention and Control Office collected cancer registration data during 2000 to 2009 from 6 cancer registries in Zhejiang province of China in order to analyze the cancer incidence. Methods: Descriptive analysis included cancer incidence stratified by sex, age and cancer site group. The proportions and cumulative rates of 10 common cancers in different groups were also calculated. Chinese population census in 1982 and Segi's population were used for calculating age-standardized incidence rates. The log-linear model was used for fitting to calculate the incidence trends. Results: The 6 cancer registries in Zhejiang province in China covered a total of 60,087,888 person-years during 2000 to 2009 (males 30,445,904, females 29,641,984). The total number of new cancer cases were 163,104 (males 92,982, females 70,122). The morphology verified cases accounted for 69.7%, and the new cases verified only by information from death certification accounted for 1.23%. The crude incidence rate in Zhejiang cancer registration areas was $271.5/10^5$ during 2000 to 2009 (male $305.41/10^5$, female $236.58/10^5$), age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) were $147.1/10^5$ and $188.2/10^5$, the cumulative incidence rate (aged from 0 to 74) being 21.7%. The crude incidence rate was $209.6/10^5$ in 2000, and it increased to $320.20/10^5$ in 2009 (52.8%), with an annual percent change (APC) of 4.51% (95% confidence interval, 3.25%-5.79%). Age-specific incidence rate of 80-84 age group was achieved at the highest point of the incidence curve. Overall with different age groups, the cancer incidences differed, the incidence of liver cancer being highest in 15-44 age group in males; the incidence of breast cancer was the highest in 15-64 age group in females; the incidences of lung cancer were the highest in both males and females over the age of 65 years. Conclusions: Lung cancer, digestive system malignancies and breast cancer are the most common cancers in Zhejiang province in China requiring an especial focus. The incidences of thyroid cancer, prostate cancer, cervical cancer and lymphoma have increased rapidly. Prevention and control measures should be implemented for these cancers.

MRI Findings of the Repaired Anterior Cruciate Ligament (전방 십자 인대의 일차 봉합술 후 MRI 소견)

  • Kim, Jung-Man;Koh, In-Jun;Lee, Dong-Yeob;Lee, Yoon-Min
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.1
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    • pp.14-21
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    • 2009
  • Purpose: To investigate MRI findings of the repaired anterior cruciate ligament (ACL). Materials and Methods: Seventeen of arthroscopic ACL primary repair with sutures pull-out technique were followed for 21.4 months (range: 12 to 60 months). Stability was assessed with physical examination and KT-1000 arthrometer (MED metric, San Diego, CA) and postoperative MRI checked with time. The patients were divided into 2 groups according to the location of tear which was defined with the location of remained synovial sleeve. Group I (11 patients) comprised that the tear was located within proximal 1/3 of ACL substance and group II (6 patients) comprised below proximal 1/3. MRI findings of the repaired ACL were evaluated by its course, sharpness, thickness and signal intensity using 3 grade system and correlated with its location of tear. Results: In all cases, Lachman test and flexion-rotation drawer test were negative, pivot-shift test was less than grade 1 and the mean side-to-side difference by use of KT-1000 arthrometer was 1.4 mm (range: -1.0 to 2.5 mm). The overall continuity of the repaired ACL was well maintained in all cases. However, mild sagging was observed in 10 cases(58.8%), mild obscure contour in 6 cases (35.3%), increased thickness in 8 cases (47.1%) and slight increased signal intensity in 5 cases (29.5%). There was no statistical significance in all parameters between 2 groups. And a focal defect at the femoral attachment site in sagittal image was observed in 7 cases (41.2%) of all patients which comprised 2 cases (18.2%) of group I and 5 cases (83.3%) of group II. It was observed more frequently in group II with statistical significance (p=0.035). Conclusion: Some abnormal MRI findings such as mild sagged course, obscure contour, increased thickness and signal intensity, the focal defect at femoral attachment site could be observed even though the stability was well maintained clinically. We thought that the focal defect was affected by the location of tear of ACL.

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A Study on the Strategic Use of an IMC Planning Model for the Distribution Industry (유통업 IMC 기획모델의 전략적 활용에 관한 연구)

  • Mo, Sun-Jong;Song, In-Am
    • Journal of Global Scholars of Marketing Science
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    • v.18 no.2
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    • pp.113-145
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    • 2008
  • Marketing for the distribution industry is making an ongoing progress in the changes of customers, the competitive environment, and the internal marketing environment. Integrated marketing communication activities are required for the enhancement of efficiency in the market.oriented activities. In this study, IMC is defined as "a notion that a market oriented business integrated marketing communication means, conducting and evaluating marketing activities with consistent messages in order to communicate with customers based on databases." In this study, an IMC planning model for the improvement of marketing efficiency in the distribution industry was derived from a pilot study. This model may be broken down into the following phases: IMC goals setting, situational analysis (customer analysis, competition analysis and company analysis), customer data analysis, contact management, budgeting, the establishment of an IMC strategy, the IMC mix and execution, an evaluation system, and feedback. In consideration of the characteristics of the distribution industry, this study was accompanied by a vocational study on IMC means employed by, in particular, department stores and other distributors such as: advertising, sales promotion, sales promotion advertising, direct marketing, public relations, personal selling, the Internet, mobile, visual merchandising, words of mouth. In addition, this study also covered the correlation among variables such as IMC activities of distributors, the process of forming customer's brand attitudes, brand loyalty and repurchase intention. This research would enhance the utilization of IMC. The analysis on customer's brand attitudes toward the IMC activities of distributors requires the simultaneous consideration of how they are linked to purchase as well as their attitudes toward both distributors and stores. The formation of brand loyalty and repurchase intention is related to the integration of marketing communication and the maintenance of consistency in contents, which requires integrated brand communication (IBC) strategies. IBC is a concept of using IMC means to manage the brand in a continuing and consistent manner and measuring their effect, which is a process to establish enterprise.level brand identity and maximize brand loyalty and repurchase intention by integrating IMC means. For an empirical analysis in this study, an online questionnaire survey was conducted among those department store customers from 20's to 50's who reside either in the Seoul and Gyeonggi areas and have made purchase at department stores. In this study, the research model consisted of four theoretical variables: IMC activities, IMC attitudes, brand loyalty, and repurchase intention, on which variables a pilot study was conducted. A number of hypotheses were constructed on the relations between IMC activities and IMC attitudes, between IMC attitudes and repurchase intention, and between brand loyalty and repurchase intention. The test of the hypotheses may be summarized as follows: Firstly, the test of the hypothesis concerning the relation between IMC attitudes and IMC activities - advertising, sales promotion, direct marketing, public relations, personal selling, the Web, mobile, visual merchandising, and word of mouth - indicates that advertising, sales promotion, direct marketing, public relations, personal selling, mobile, visual merchandising, and word of mouth have significant impact on IMC activities. In addition to the result similar to those of previous studies that such marketing communication means as word of mouth, advertising, personal selling and sales promotion, in particular, play very important roles, a notable finding of this study is that visual merchandising performed by department stores is shown to have very significant impact on IMC activities. On a separate note, it is also noteworthy that Internet marketing activities engaged by department stores are not shown to have significant impact on IMC attitudes. Secondly, the test of the hypothesis on the relation between IMC attitudes and brand loyalty attests that IMC attitudes for the distribution industry significantly affect brand loyalty. Thirdly, the test of the hypothesis concerning the relation between IMC attitudes and repurchase intention confirms that IMC attitudes for the distribution industry significantly affect repurchase intention. Fourthly, the test of the hypothesis concerning the relation between brand loyalty and repurchase intention indicates that brand loyalty significantly affect repurchase intention. A comprehensive view of these findings points to the conclusion that the IMC activities for the distribution industry do affect IMC attitudes, brand loyalty, and repurchase intention.

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A Study on Curriculum Development For Community Health Practitioners (보건진료원 직무교육 교과과정 개선을 위한 일 연구)

  • 조원정;이경자
    • Journal of Korean Academy of Nursing
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    • v.22 no.2
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    • pp.207-226
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    • 1992
  • This study was designed to develop a conceptual framework for the curriculum and develop the details of the learning content for the education of Community Health Practitioners (CHPs). Since education programs for CHPs started 10 years ago, concepts related to CHP services have changed because of changes in society. The objectives of the study were as follows : 1) to analyse the usefulness of the present education program for CHPs, 2) to analyse the Job performance and self -confidence of the CHPs, 3) to identify the health needs of the clients served by the CHPs and the community problems related to health. 4) to develop a conceptual framework for the curriculum, for the education of CHPs, 5) to develops details for the learning content of the education program for CHPs. Phase I of the study was conducted by questionnaires to 150 CHPs who have worked in remote rural areas for more than 2 years. Among them, 147 responded. Data was collected from August 16, to August 25, 1990. In order to identify the health needs of the community people, research within the last five years was reviewed and analyzed. The data on 1, 842 communities gathered by the WHO Nursing Collaborations Center of the College of Nursing, Yonsei University was utilized to identify community problems related to health and the self - confidence in job performance of the CHPs. Psase II of the study consisted of a workshop with 13 professionals including Community Health Practitioners to evaluate the existing education program and a conceptual framework of the curriculum for the job education of CHPs. The results of the study are Summariged below : 1. The only 26 among 45 content items of the education program related to job skills was used by 80% of the responding CHPs. The knowledge of $\ulcorner$Networking community organization$\lrcorner$ was used by only 53.7% of the respondents. Educational content about $\ulcorner$Mental disease$\lrcorner$ was used by less than 50% of CHPs because of a knowledge deficit. 2. The CHPs reported that their activities concentrated on clinical services during the last six months. The survey showed that they seemed to neglect the activities for health promotion and disease prevention. Thus, $\ulcorner$Education for community loaders$\lrcorner$(15.9%), $\ulcorner$Activity for eavironmental health$\lrcorner$(16.3%) and $\ulcorner$Social work for needey people$\lrcorner$(23.3%) were done by less than 30% of CHPs. 3. More than 90% of CHPs reported being self - confident for the activities of $\ulcorner$Health education and counselling$\lrcorner$, $\ulcorner$Medicine prescription$\lrcorner$ and $\ulcorner$Immunization$\lrcorner$. But 50% of CHPs reported that they were not have self - confident in $\ulcorner$Management of water and environmental health$\lrcorner$ and only 25.6% of CHPs could insert an IUD independently. 4. It was identified that respiratory diseases and the gastrointestinal diseases were most common problems for the community people, followed by musculoskeletal and skin problems. 5. The community problems were classified into eight categories : physical environmental problems, environmental hygiene, health problems, health behavior, social problem, lack of resources, financial problem and the problems of the cultural and value system. 6. The conceptual framework consisted of the target population and their health status, nursing process working site and primary health care services such as health promotion, disease prevention, treatment and rehabilitation. 7. The contents of curriculum of education program for CHPs were formulated from the results of this study.

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