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The Effect of Photoneutron Dose in High Energy Radiotherapy (10 MV 이상 고에너지 치료 시 발생되는 광중성자의 영향)

  • Park, Byoung Suk;Ahn, Jong Ho;Kwon, Dong Yeol;Seo, Jeong Min;Song, Ki Weon
    • The Journal of Korean Society for Radiation Therapy
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    • v.25 no.1
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    • pp.9-14
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    • 2013
  • Purpose: High-energy radiotherapy with 10 MV or higher develops photoneutron through photonuclear reaction. Photoneutron has higher radiation weighting factor than X-ray, thus low dose can greatly affect the human body. An accurate dosimetric calculation and consultation are needed. This study compared and analyzed the dose change of photoneutron in terms of space according to the size of photon beam energy and treatment methods. Materials and Methods: To measure the dose change of photoneutron by the size of photon beam energy, patients with the same therapy area were recruited and conventional plans with 10 MV and 15 MV were each made. To measure the difference between the two treatment methods, 10 MV conventional plan and 10 MV IMRT plan was made. A detector was placed at the point which was 100 cm away from the photon beam isocenter, which was placed in the center of $^3He$ proportional counter, and the photoneutron dose was measured. $^3He$ proportional counter was placed 50 cm longitudinally superior to and inferior to the couch with the central point as the standard to measure the dose change by position changes. A commercial program was used for dose change analysis. Results: The average integral dose by energy size was $220.27{\mu}Sv$ and $526.61{\mu}Sv$ in 10 MV and 15 MV conventional RT, respectively. The average dose increased 2.39 times in 15 MV conventional RT. The average photoneutron integral dose in conventional RT and IMRT with the same energy was $220.27{\mu}Sv$ and $308.27{\mu}Sv$ each; the dose in IMRT increased 1.40 times. The average photoneutron integral dose by measurement location resulted significantly higher in point 2 than 3 in conventional RT, 7.1% higher in 10 MV, and 3.0% higher in 15 MV. Conclusion: When high energy radiotherapy, it should consider energy selection, treatment method and patient position to reduce unnecessary dose by photoneutron. Also, the dose data of photoneutron needs to be systematized to find methods to apply computerization programs. This is considered to decrease secondary cancer probabilities and side effects due to radiation therapy and to minimize unnecessary dose for the patients.

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The Study of Reliability and Validity of Attention Deficit Disorder Evaluation Scale-School Version(ADDES-SV) (주의력결핍 과잉운동장애 아동 평가척도의 교사 평가판에 대한 신뢰도 및 타당도 연구)

  • Bae, Jin-Woo;Cheung, Seung-Douk;Lee, Jong-Bum;Park, Hyung-Bae;Kim, Jin-Seung;Song, Chang-Jin
    • Journal of Yeungnam Medical Science
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    • v.14 no.2
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    • pp.415-429
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    • 1997
  • The purpose of this study was to examine the reliability and validity of attention deficit disorder evaluation scale-school version(ADDES-SV). Between October 1996 and November 1996, ADDES-SV was administered to 263 elementary school students in the second grade and between Jun 1996 and October 1996, 28 attention deficit hyperactivity disorder patients. In the reliability test, the test-retest reliability coefficient was significantly high and that of inattention was 0.88, that of impulsivity was 0.80, that of hyperactivity was 0.83 and total score was 0.83. In the reliability test by internal consistancy, the Cronbach $\alpha$ coefficient was significantly high and that of inattention was 0.98, that of impulsivity was 0.87, that of hyperactivity was 0.87(p<0.05). The half-sprit reliability coefficient by first-second half method showed high correlation and that of inattention was part 1: 0.96, part 2: 0.96 impulsivity was part 1: 0.95, part 2: 0.93, hyperactivity was part 1: 0.92, part 2: 0.94(p<0.05). Inter-rater reliability by pearson correlation coefficient was significantly high and that of inattention was 0.92, that of impulsivity was 0.87, that of hyperactivity was 0.89 and total score was 0.89. The concurrent validity between ADDES-SV and CAP scale was 0.85 in attention deficit hyperactivity disorder patient group and 0.79 in normal control group(p<0.05). In discriminant validity test between attention deficit hyperactivity disorder patient group and normal control group, the patient group showed higher score(p<0.05). The total discriminant capacity of the patient group in ADDES-SV was 94.6%. In this point of view, ADDES-SV scale showed high reliability and validity in applying to Korean subjects and was proved to be the useful screening test tool for attention deficit hyperactivity disorder research.

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Comparison of Anterior Cruciate Ligament Reconstruction using Autogenous Patellar Tendon versus Quadruple Hamstring Tendon (자가 슬개건과 네 겹 슬괵건을 이용한 전방 십자 인대 재건술의 비교)

  • Kim, Seok-Jung;Kwon, Oh-Soo;Choi, Dong-Won;Song, Ho-Wook;Kang, Hyun-Taek;In, Yong
    • Journal of the Korean Arthroscopy Society
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    • v.8 no.1
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    • pp.19-25
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    • 2004
  • Purpose: To compare the results of two different autografts used to reconstruct the anterior cruciate ligament(ACL): bone-patellar tendon-bone and quadruple hamstring tendon. Materials and Methods: Forty one cases (20 bone-patellar tendon-bone cases and 21 quadruple hamstring tendon cases) were followed up more than 2 years postoperatively. Patellar tendons were fixed with interference screws and hamstring tendons were fixed with cross pins and intrafix sheaths and screws. Follow-up results were evaluated with KT-2000 arthrometer, International knee Documentation Committee(IKDC) evaluation form and follow up X-ray Donor site morbidity was analysed. Results: Final IKDC) scores more than B grade and side to side differences of manual maximum test using KT-2000 arthrometer showed insignificant differences(p>) between the two groups. Plain radiographs of hamstring group showed marked widening of the femoral and tibial tunnels at postoperative 2 years. Patellar tendon group showed 30% rate of anterior knee complications. Conclusion: ACL reconstruction using autogenous hamstring graft with new fixation method showed comparable clinical results to using autogenous patellar tendon graft with fewer anterior knee symptoms.

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The Effect of Meniscectomy on Clinical Result After ACL Reconstruction (전방십자인대 재건술에서 반월상 연골 절제술의 영향)

  • Cho, Hyung-Jun;Lee, Jung-Hwan;Bae, Dae-Kyung;Song, Sang-Jun;Yoon, Kyoung-Ho
    • Journal of the Korean Arthroscopy Society
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    • v.14 no.1
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    • pp.7-12
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    • 2010
  • Purpose: To evaluate the effects of total or subtotal meniscectomy on anterior cruciate ligament reconstruction. Materials and Methods: We reviewed the 455 cases of arthroscopic ACLR (anterior cruciate ligament reconstruction) from February, 2003 to February, 2007 and followed-up more than 1 year. The 93 cases were enrolled. The 45 cases who underwent only ACLR were included and the 48 cases who underwent ACLR with total or subtotal meniscectomy were included in this study except grade 3 or 4 chondral lesion, partial meniscetomy or meniscal repair. We divided the patient into 4 groups which were isolated ACLR group (group I, 45cases), ACLR with lateral meniscectomy group (group II, 10cases), ACLR with medial meniscectomy group (group III, 28cases) and ACLR with both medial and lateral meniscectomy group (group IV, 10cases). The clinical evaluation was done by range of motion (ROM), IKDC subjective score, Lysholm score, anterior drawer test, Lachman test, Pivot shift test and KT-1000 arthrometer. Results: At final follow up, group IV was inferior than group I in IKDC subjective score and Lysholm score, and inferior than group II in IKDC subjective score. In KT-1000 arhtometric test, group I had better results than group III and group IV. Also in anterior drawer test and Lachman test, group 1 had better result than group III and group IV. In pivot shift test, there was no significant difference among four groups. Conclusion: Medial or both medial and lateral meniscectomy had greater laxity in anterior drawer test, Lachman test and KT-1000 arthrometric test and both medial and lateral meniscectomy had a lower subjective score than both meniscus intact group.

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Characteristics of Middle Aged Depressed Women with Hot Flushes (안면 홍조 증상을 수반한 중년 우울증 여성의 특성)

  • Song, Minjae;Joe, Sook-Haeng;Jung, Hyun-Gang
    • Korean Journal of Psychosomatic Medicine
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    • v.25 no.2
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    • pp.176-184
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    • 2017
  • Objectives : Middle aged women with depression often experience hot flush symptoms. It is still unclear about the association between depression and hot flush symptoms. Therefore, we investigated hormonal profile, functional somatic symptoms, coping styles and attitude for menopause between depressed women with hot flush and those without hot flush. Methods : This study included 33 depressed patients with hot flush symptoms and 33 depressed patients without hot flush symptoms. Hot flush was confirmed through prospective daily symptom ratings for a week. Subjects' coping styles were assessed by the stress coping checklist. Somatic symptoms were assessed by the Patient Health Questionnaire-15(PHQ-15). Sex hormonal levels were assayed by a radioimmunoassay. The Brief World Health Organization Quality of Life Assessment Instrument(WHOQOL-BREF) was used to evaluate quality of life. Results : In coping style, depressed women with hot flush symptoms used less 'problem-centered coping'($13.15{\pm}3.17$) and 'search for social support'($11.83{\pm}2.84$) than those without hot flush symptoms($15.17{\pm}3.1$, p=0.028 ; $14.25{\pm}3.22$, p=0.009 ; respectively). Depressed women with hot flush symptoms showed more negative attitude toward post-menopause, but its statistical significance was marginally insufficient(p=0.059). We did not find any group differences in sex hormonal levels and somatic complaints assessed by the PHQ-15. The score of social relationship domain of WHOQOL-BREF was significantly lower in subjects with hot flush symptoms($8.62{\pm}2.04$) than subjects without hot flush symptoms($9.71{\pm}1.65$ ; p=0.044). Conclusions : Among middle aged women with depression, the manifestation of hot flush symptoms was associated with coping styles and attitude for menopausal transition. Hot flush symptoms in depressed women negatively influence quality of life, so clinicians actively perform therapeutic approach in case of depressed patients with hot flush symptoms. In case of depressed patients who present hot flushes, cognitive behavior therapy or stress management might be an effective treatment option in company with antidepressants or hormonal treatment. Later, longitudinal study will be needed to evaluate risk factor, cause and effect associated with hot flush and depression.

Comparisons of Subjective and Actigraphic Measurements of Sleep between Shift-working and Daytime Psychiatric Nurses (정신과 교대근무와 주간근무 간호사에서 수면의 주관적 및 활동기록기 평가의 비교)

  • Kwak, Jun;Yoon, Bo-Hyun;Jeon, Bong-Hee;Sea, Young-Hwa;Song, Jye-heon;Park, Su-hee;Kim, Kyung-Min;Jung, Ha-ran;Jeong, Yu-Ran;Park, Jinhyeong
    • Korean Journal of Psychosomatic Medicine
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    • v.25 no.2
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    • pp.166-175
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    • 2017
  • Objectives: Shiftwork is known to be one of the common causes of sleep and health problems and finally causes the decreased quality of life. The purpose of this study was to investigate the sleep patterns of shift-working and daytime psychiatric nurses using actigraphy and compare it with subjective assessment for sleep. Methods : Twenty-three shift-working and 25 daytime nurses were enrolled. They rated their sleep quality using Pittsburgh Sleep Quality Index(PSQI) and other self-rating scales were measured for psychosocial aspects. Actigraphy was applied to the subjects for a total of 7 days to measure the sleep parameters. They also wrote sleep diaries during the period of wearing actigraphy. Sleep-related parameters of actigraphy, global score and components of PSQI, and the results of other self-rating scales were compared between shift-working and daytime nurses. Results : Although the global score of PSQI did not show significant difference, the PSQI components showed significant differences between two groups: the shift-working nurses showed lower sleep quality, more sleep disturbance and hypnotic medication use, and worsened daytime dysfunction than daytime nurses. The shift-working nurses showed significantly shorter total time in bed and total sleep time, lower sleep efficiency, and longer average awakening time than those of daytime nurses in actigraphy. Conclusions : The results showed that shift-working nurses experienced more sleep disturbances in both subjective and objective aspects of sleep than daytime nurses. This study also suggests that actigraphy may be useful to measure the objective aspects of sleep that are difficult to assess with subjective questionnaires alone.

Vertical Ozone Distribution over Seoul: Ozonesonde Measurements During June 6~9, 2003 (서울지역 연직 오존 분포: 2003년 6월 6~9일 오존존데 관측)

  • Hwang, Mi-Kyoung;Kim, Yoo-Keun;Oh, In-Bo;Song, Sang-Keun;Lim, Yun-Kyu
    • Journal of Korean Society for Atmospheric Environment
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    • v.24 no.2
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    • pp.196-205
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    • 2008
  • Variability in vertical ozone and meteorological profiles was measured by 2Z electrochemical concentration cells (ECC) ozonesonde at Bangyi in Seoul ($37.52^{\circ}N$, $127.13^{\circ}E$) during June $6{\sim}9$, 2003 in odor to identify the vertical distribution of ozone and its relationship with the lower-atmospheric structure resulted in the high ozone concentrations near the surface. The eight profiles obtained in the early morning and the late afternoon during the study period clearly showed that the substantial change of ozone concentrations in lower atmosphere(${\sim}5\;km$), indicating that it is tightly coupled to the variation of the planetary boundary layer (PBL) structure as well as the background synoptic flow. All profiles observed early in the morning showed very low ozone concentrations near the surface with strong vertical gradients in the nocturnal stable boundary layer due to the photochemical ozone loss caused by surface NO titration under very weak vertical mixing. On the other hand, relatively uniform ozone profiles in the developed mixing layer and the ozone peaks in the upper PBL, were observed in the late afternoon. It was noted that a significant increase in ozone concentrations in the lower atmosphere occurred with the corresponding decrease of the mixing height in the late afternoon on June 8. Ozone in upper layer did not vertically vary much compared to that in PBL but changed significantly on June 6 that was closely associated with the variation of synoptic flows. Interestingly, heavily polluted ozone layers aloft (a maximum value of 115 ppb around 2 km) were formed early in the morning on 6 through 7 June under dominant westerly synoptic flows. This indicates the effects of the transport of pollutants on regional scale and consequently can give a rise to increase the surface ozone concentration by downward mixing processes enhanced in the afternoon.

Kinetics of the Reaction of Carbon Dioxide with AMP and Piperazine (AMP에 Piperazine을 첨가한 CO2 흡수 동역학)

  • Jang, Sang-Yong;Song, Ju-Seouk;Cho, Sang-Won;Oh, Kwang-Joong
    • Journal of Korean Society of Environmental Engineers
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    • v.22 no.3
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    • pp.485-494
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    • 2000
  • According to the worldwide interest in controlling $CO_2$ which contributes to green house effect. new techniques of reducing $CO_2$ are under development. We have developed new technique for reducing $CO_2$. In low $CO_2$ concentration. the chemical absorption method is useful. In this study. the kinetics of the reaction between $CO_2$ and the sterically hindered amine solution with piperazine. have been investigated from measurements of the rate of absorption of $CO_2$ in the stirred vessel that has a horizontal liquid-gas interface, in the temperature range $30{\sim}70^{\circ}C$. The experiments were carried out in the range 10.130~20.260 kPa of partial pressure of $CO_2$, and in aqueous $2.0kmol/m^3$ AMP solution with $0{\sim}0.4kmol/m^3$ piperazine The experimental results are as follows: 1) The absorption rate of $CO_2$ into aqueous AMP + piperazine solution is gett ng faster than that of aqueous AMP absorbents with temperature. Because the activation energy of piperazine 57.147 kJ/mol is higher than that of AMP 41.7kJ/mol. therefore the effect of piperazine on absorption rate increases with temperature. 2) Compared with aqueous AMP solution. the absorption rate of $CO_2$ into AMP + piperazine solution increases from 6.33% at $30^{\circ}C$ to 12% at $70^{\circ}C$, so AMP + piperazine solution is thought to be a better than AMP solution, 3) The reaction rate constants of piprazine in aqueous AMP solution with $CO_2$ have been determined as 217.21, 420.46, 707.00 and $3162.167m^3/kmol{\cdot}s$ respectively at 30, 40, 50 and $70^{\circ}C$ but these results are higher than those of Xu which were 186.7. 367.32. 693.01. $2207.65m^3/kmol{\cdot}s$ at 30, 40, 55, $70^{\circ}C$in aqueous MDEA solution. So the regression analysis of the data has led to the following equation In $k_p$ =28.324-6934.7/T.

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The Effects of Corneal Eccentricity and Shape on Toric Soft Lens Rotation by Change of Postures (이심률 및 각막형상이 자세변화에 의한 토릭소프트렌즈의 회전에 미치는 영향)

  • Kim, So Ra;Hahn, Shin Woong;Song, Ji Soo;Park, Mijung
    • Journal of Korean Ophthalmic Optics Society
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    • v.18 no.4
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    • pp.449-456
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    • 2013
  • Purpose: The present study aimed to investigate the effects of corneal eccentricity and shape on the rotational pattern of toric soft lens by the postural change of lens wearers. Methods: The corneal eccentricity of 41 eyes (aged 20s) having -1.0 D with-the-rule corneal astigmatism (WRCA) was measured, and then toric soft lenses were fitted with the amount of total astigmatism. In lying and straight postures, the rotation of toric soft lenses was recorded by a camera attached to slitlamp and analyzed. Results: Most toric soft lens designed with accelerated stabilization rotated to the temporal direction, which was the lying position direction, regardless of corneal eccentricity, and some lenses rotated to the nasal direction for high corneal eccentricity and corneal type of asymmetric bowtie. There was no correlation between the amount of rotation and corneal eccentricity right after of contact lens wearing in straight and lying posture, however, the amount of rotation was the greater for the cornea with the higher eccentricity after the subjects laying down for some period. The speed of lens rotation started to decrease after the subjects laying down, but the speed was not different according to corneal eccentricity difference. The amount of lens rotation for symmetric and asymmetric bowtie-typed corneas increased more than it for oval-typed cornea, and it was same even with time elapsing. The speed of lens rotation in lying posture was the slowest in asymmetric bowtie-typed cornea compared with other corneal types. Conclusions: From the present study, it was revealed that the rotational pattern of toric soft lens was affected by corneal eccentricity and corneal shape when the wearer's posture changed. Thus, it should be considered for the development of the fitting guideline and the design of toric soft lens.

Characterization of Bruton's Tyrosine Kinase Genetic Mutations in One Korean X-linked Agammaglobulinemia Family (반성 열성 범저감마글로불린혈증 1가계 3환자의 Bruton's Tyrosine Kinase 유전자 변이 및 임상 양상)

  • Jo, Eun-Kyeong;Song, Chang-Hwa;Park, Jeong-Kyu;Baek, Young-Jong;Rhu, Hye-Young;Lee, Jae-Ho;Hwang, Tai-Ju;Kook, Hoon
    • Clinical and Experimental Pediatrics
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    • v.45 no.2
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    • pp.183-191
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    • 2002
  • Purpose : X-linked agammaglobulinemia(XLA) is an immunodeficiency caused by abnormalities in Bruton's tyrosine kinase(Btk), and is characterized by a deficiency of peripheral blood B cells. We studied the cytoplasmic expression of Btk protein and analyzed the Btk gene in peripheral blood mononuclear cells from two siblings and one cousin with XLA, as well as additional family members. Methods : Btk protein expression was analyzed by flow cytometry. Isolation of the coding sequence of the Btk gene was performed by amplification using the reverse transcription-polymerase chain reaction(RT-PCR) technique. Sequence alterations were screened by the single-stranded conformation polymorphism(SSCP) method and characterized by standard sequencing protocols. Results : Cytoplasmic expression of Btk protein in monocytes was not detected in three patients with XLA. In addition, Btk protein analysis clearly showed cellular mosaicism in monocytes from four obligate carriers, findings further supported by SSCP. A single base pair mutation(T to C) in Btk-exon three, which encodes the PH domain, was identified in four XLA patients. A diagnostic sequencing analysis was established to detect heterozygotic pattern in 4 carrier females. Furthermore, we found significant clinical heterogeneity in individuals with the same gene mutation. Conclusion : The implicating genetic alteration provided valuable clues to the pathogenesis of XLA in Korea and the flow cytometric analysis was suggested as a useful tool for rapid detection of XLA patients and carriers. The present study has identified a genetic mutation in the Btk coding region and demonstrated heterogeneity in clinical manifestations among patients with the same mutation. A flow cytometric analysis was found to be informative in establishing a deficiency of Btk protein in both patients and carriers and is recommended as a frontline procedure in the molecular diagnosis and work-up of XLA.