• 제목/요약/키워드: MAR index

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방사선치료 시 Metal artifact reduction Algorithm의 임상적용 유용성평가 (A Study on Usefulness of Clinical Application of Metal Artifact Reduction Algorithm in Radiotherapy)

  • 박자람;김민수;김정미;정현숙;이충환;백금문
    • 대한방사선치료학회지
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    • 제29권2호
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    • pp.9-17
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    • 2017
  • 목 적: 방사선치료에서 CT number에 의해 나타나는 조직의 묘사 및 전자밀도는 CT(Computed Tomography)기반의 전산화치료계획 정확성을 보장하는데 중요한 역할을 한다. 하지만 체내의 금속 이식물은 CT number의 정확성을 감소시킬 뿐 아니라 조직 묘사에 대한 불확실성을 나타내기 때문에 임상에서는 metal artifact를 감소시킬 수 있는 알고리즘이 개발되었다. 이에 본 연구에서는 본원에서 사용하고 있는 GE사의 SMART MAR의 CT number 정확도를 평가하고 방사선치료에서의 유용성에 대해 평가하고자 한다. 대상 및 방법: 영상평가를 위해 CIRS ED phantom을 이용하여 6개 조직의 rod를 삽입하여 동일한 체적의 ROI를 형성 후 original 영상을 획득하고 의료용 티타늄 rod를 삽입하여 non-SMART MAR 영상과 SMART MAR영상을 획득하여 CT number와 SD값을 비교하였다. Metal artifact로 인해 CT number 변화에 따른 선량변화 확인을 위해 전산화계획시스템 Epclipse를 사용하여 CIRS ED phantom CT 영상에 PTV를 형성하여 original 영상을 획득하고 편측 티타늄 삽입, 양측 티타늄 삽입 영상을 획득하여 non-SMART MAR와 SMART MAR영상에 동일한 치료계획을 수립하여 PTV가 받는 평균처방선량, HI(Homogeneity Index), CI(Conformity Index)를 비교, 분석하였다. 흡수선량 측정은 원통형 아크릴 팬텀과 0.125 cc ionchamber, electrometer를 이용하여 선량변환상수(cCy/nC)를 계산하고 CIRS phantom을 이용하여 편측, 양측 티타늄 rod를 삽입한 영상으로 non-SMART MAR와 SMART MAR 영상을 획득하여 동일한 지점에서의 흡수선량을 측정하여 전산화치료계획상의 point dose와 비교하였다. 결 과: 영상평가 결과 CT number는 non-SMART MAR영상보다 SMART MAR 영상이 original영상에 더 유사한 값이 나왔고 SD값은 SMART MAR영상에서 더 감소되었다. 선량평가 결과 평균처방선량과 HI 및 CI 값은 SMART MAR 영상보다 non-SMART MAR 영상이 original 영상에 더 근접한 결과가 나왔지만 통계적으로 유의하지 않았다. 흡수선량 측정결과 치료계획상의 point dose와 실제 흡수선량과의 차이가 non-SMART MAR의 영상에서는 각각 2.69, 3.63 %의 차이가 있었지만 SMART MAR영상에서는 0.56, 0.68 %로 감소하였다. 결 론: 금속 이식물을 삽입한 환자의 CT 영상에 SMART MAR를 적용했을 때 CT number 정확성 상승 및 SD 감소로 영상의 질이 향상되므로 종양과 정상조직의 윤곽도 생성 및 선량계산 시 유용할 것으로 사료된다.

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노인 영양증진전략연구 : 평균영양소 적정도에 따른 식행동 비교 분석 (Strategies to Improve Elderly Nutrition : Comparisons of Dietary Behavior according to the Mean Nutrient Adequacy Ratio)

  • 임경숙
    • 대한지역사회영양학회지
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    • 제4권1호
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    • pp.46-56
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    • 1999
  • A deep understanding of the dietary patterns and nutrient intake is important for assessment of possilbe nutritional risk and for establishing nutrition improvement strategies. This study was conducted toexamine the dietary characteristics of a nutritionally poor elderly group compared to the middle-and highly-nourished group. Elderly participant was recruited from local elderly centers in Suwon city in 1998. Trained dietitians interviewed 119 elderly(35 males, 84 females) aged 60 years and over for collecting dietary data(24-hour recall) and related variables. Male and female subjects were grouped into high, middle, and low according to the mean nutrient adequancy ratio(MAR) tertiles. An analysisof the percentage of RDA(Recommended Daily Allowances of Korea) for each of the 10 nutrients showed that the male low-MAR group consumed below the RDA in all kinds of nutrients, and the female low-MAR group consumed nutrients below the RDA except vitamin C. An evaluation of nutrient density by Index of Nutritonal Quality(INQ) also showed a similar tendency. Thus, the INQ level of the male low-MAR group was significantly lower than the middle-or high-MAR group, especially in protein, vitamin A, thiamin, riboflavin, and phosphorus(p<0.05). Moreover, INQ level of female low-MAR group was significantly lower than that of the high group(p<0.05) in all nutrients. The female low-MAR group's daily food intake were also lower than those of the high-MARgroup in gains, fish, fruits, oil and beverages. The energy distribution from carbohydrates, fats and proteins showed that the male low-MAR group had significantly higher carbohydrate and lower fat proportions compared to each gender high-MAR group, respectively. The male and female low-MAR group had low scores about eating all side dishes. These findings indicate that a moderate increase of the meat/egg/fishes intake was needed by the male low-MAR group for improving nutrition adequacy, and an overall increase of the food quantity and quality was desired for the female low-MAR group. These data could be used for planning a community elderly nutrition program and establishing strategies for tailored guidelines for the individuals.

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양식 굴(Crassostrea gigas)에서 분리된 장염비브리오균의 독소 유전자 보유 및 항균제 감수성 (Virulence Factors and Antimicrobial Susceptibility of Vibrio parahaemolyticus Isolated from the Oyster Crassostrea gigas)

  • 김수경;안세라;박보미;오은경;송기철;김정완;유홍식
    • 한국수산과학회지
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    • 제49권2호
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    • pp.116-123
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    • 2016
  • This study investigated the prevalence of Vibrio parahaemolyticus in the oyster Crassostrea gigas, which is commonly consumed raw. The presence of virulence factors and the antimicrobial susceptibility of isolates were also investigated. The overall prevalence rate of V. parahaemolyticus in oysters was 37.5% (36/96) and the range of concentrations was 30-11,000 MPN/100 g. PCR-based assays indicated that 9.6% (11/115) of the isolates were positive for the thermostable direct hemolysin-related hemolysin gene (trh), while none of the isolates were positive for the thermostable direct hemolysin gene (tdh). The Multiple Antibiotics Resistance (MAR) index was measured for 16 common antimicrobial agents and 46.1% (53/115) of the isolates had a MAR index > 0.2. The MAR index ranged from 0.07 to 0.73. The highest MAR index was observed with strain s150608, isolated in June 2015, which exhibited resistance to 11 antimicrobial agents. Our results demonstrate that oysters are high-risk sources of V. parahaemolyticus, although no antimicrobial agent was being used to promote growth or to treat bacterial infections in the sampled oyster-growing areas.

서울지역 여대생의 비만도 및 식습관에 따른 혈중 adiponectin 농도의 차이 (Comparison of Serum Adiponectin Levels According to Body Mass Index and Dietary Behaviors of Female University Students in Seoul)

  • 김미정;전현영;라혜복
    • 대한지역사회영양학회지
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    • 제18권4호
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    • pp.354-364
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    • 2013
  • This study was conducted to determine whether dietary factors could be related with serum adiponectin concentrations in 243, year-three female university students living in Seoul. The mean of body mass index (BMI) and adiponectin levels of all subjects were $20.17kg/m^2$ and $11.07{\mu}g/ml$, respectively. When the subjects were divided into 3 groups based on BMI (underweight: < 18.5, normal: $18.5{\leq}&lt;23$, overweight and obesity: ${\geq}23$), serum adiponectin levels in underweight group was significantly higher than that in 'normal' or 'overweight and 'obesity' groups. Also when the subjects were divided into two groups by mean adequacy ratio (MAR), serum adiponectin concentration of the high MAR group (MAR > 75) was slightly higher than that the low MAR group ($MAR{\leq}75$). Serum adiponectin levels showed a negative correlation with body weight (p < 0.01) or BMI (p < 0.001) and a positive correlation with intakes of of animal or total protein (please clarify) or vegetable protein.Among the dietary behaviors, serum adiponectin levels of females who answered 'yes' to the question about 'eating breakfast' was significantly higher than that of those who answered 'sometimes' or 'No' (p < 0.05) and serum adiponectin levels were higher among those who reported higher fruit intakes. Overall, our results suggested that healthy lifestyle including acceptable BMI, eating breakfast and higher fruit consumption might play an important role in the prevention of obesity and enhancement of blood adiponectin levels.

Sedimentary Excess Barium from a Core of the Northwest Pacific Ocean: Geochemical Proxy

  • Suk, Bong-Chool;Park, Chan-Hong;Taira, Asahiko;Hyun, Sang-Min
    • Journal of the korean society of oceanography
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    • 제35권2호
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    • pp.98-108
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    • 2000
  • A geochemical study on a hemipelagic core sediment taken from the northwest Pacific Ocean (eastern edge of the Shikoku Basin) was conducted to use of excess barium (Ba(ex)) for evaluate the paleoceano-graphic changes. Also, the excursion of sedimentary Ba(ex) was compared with those of biogenic opal, carbonate and organic carbon content in the sediment during the last glacial and interglacial periods. The calculated Ba(ex) derived from the major and minor element shows a distinctive glacial-interglacial variations, and the mass accumulation rate (MAR) of Ba(ex) shows coincident variations with the MARs of biogenic fractions. Especially, strong positive correlation (r$^2$=0.85) between the MAR of Ba(ex) and the MAR of biogenic carbonate is recognized. Based on the strong positive correlation(r$^2$=0.85) between the MAR of Ba(ex) and the MAR of carbonate content, we estimated the degree of carbonate dissolution rate during the glacial and interglacial periods. Assuming the proportional variation and the refractory nature of barium exist between two factors, the variation of index Ca/Ba ratio in sediment indicates the degree of carbonate dissolution. Sedimentary Ca/Ba ratios index clearly show a striking fluctuation between the glacial and interglacial periods with higher positive correlation during glacial and lower correlation during interglacial. This fact indicates enhanced carbonate dissolution during interglacial period. Thus, the sedimentary Ca/Ba ratio in sedimentary records can be used as one of the useful tools for estimation of the relative degree of carbonate dissolution. The excursion of Ba(ex) and the sedimentary Ca/Ba ratio follows the typical pacific carbonate dissolution type(enhanced dissolution during interglacial and reduced dissolution during glacial time) as suggested by previous work (e.g., Wu et al., 1990). Variation in sedimentary Ca/Ba ratio thus strongly supports that glacial-interglacial fluctuation in carbonate dissolution has been prevailed in the northwest Pacific Ocean.

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토모테라피에서 반복적 금속 인공물 감소 알고리즘의 유용성 평가: 팬톰 실험 (Effect of Iterative-metal Artifact Reduction (iMAR) at Tomotherapy: a Phantom Study)

  • 김대건;정재홍;김성철
    • 한국방사선학회논문지
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    • 제16권6호
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    • pp.709-718
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    • 2022
  • 본 연구의 목적은 토모테라피 방사선치료에서 고밀도 알루미늄, 티타늄, 강철 금속 삽입물에 대한 단층촬영(CT)을 평가하고 자 하였다. 다양한 밀도의 원통형 막대를 포함한 금속 삽입물과 함께 원통형 토모팬텀을 이용하여 영상을 얻었다. 총 세 가지의 CT 영상에 대해 평균 CT 값(number)와 표준 편차를 구하고, 치료계획 선량평가도 수행하였다. 고밀도 금속 삽입물이 CT값과 변화가 가장 컸다. 타겟에 대한 선량평가(적합성 지수, CI)에서 반복적 금속 인공물 감소 알고리즘(iMAR)이 적용된 영상이 그렇지 않은 영상에 비해 약 20% 좋았으나 유의한 차이는 없었다. iMAR은 표적 및 장기의 묘사에 도움을 주고 토모테라피를 이용한 3차원 입체조형 방사선치료기술(3D-CRT)에서 불확실성을 줄이는 데 도움이 될 것으로 사료된다.

학교급식 영양사의 식생활 태도에 따른 영양소 섭취상태 (Nutrient Intake According to Dietary Attitudes of School Foodservice Dietitians)

  • 윤현숙
    • 대한지역사회영양학회지
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    • 제6권3호
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    • pp.306-316
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    • 2001
  • This study investigated the correlations between nutrient intake and dietary attitudes in Korean school dietitians. A total of 493 school dietitians working in the Kangwon and Kyungnam areas participated in this study. The subjects were classified as the good group(33.5%), fair group(36.9%) and bad group(29.6%) based on dietary attitude score. The results were as follows. The average intake of energy, calcium, and iron were lower than the Korean RDA and average CPF ratio of energy intake was 64 : 17 : 19. The percent RDAs of nutrient intake of energy, calcium, iron and vitamin B$_1$were lower in the bad group than those in the fair group and good groups(p < 0.001). The mean adequacy ratio(MAR), an index of overall dietary quality, were different among the three groups(p < 0.001), the highest was 0.96 in the good group, the lowest was 0.88 in the bad group. The index of nutritional quality(INQ) was significantly higher in the good group than the other groups. The nutrient intakes were positively correlated with dietary attitudes(p < 0.01). The nutrient intakes, INQ, NAR and MAR were significantly increased as the dietary attitude score increased.

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24시간 회상법으로 조사된 영양섭취 상태와 신체계측결과 비교분석: '98 국민 건강,영양 조사 (Relationship between Nutrients intake and Anthropometric indices using '98 Korean National Health and Nutrition Examination Survey)

  • 심재은;문현경
    • 대한영양사협회학술지
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    • 제10권2호
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    • pp.174-183
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    • 2004
  • This analysis was performed to investigate the relationship between nutrition and anthropometric indices using the data from a cross-sectional survey of a large national sample, '98 Korean national health and nutrition examination survey. Subjects were selected by stratified multistage probability sampling design and completed dietary questionnares including food intakes for one day by 24-hour recall method. For this analysis, 6566 subjects were selected by age(over 20 years old). For anthropometry, height, weight, and waist- and hip- circumference were measured. They were classified by body mass index(BMI, weight(Kg)/$height^2 $($m^2 $)) and waist-hip ratio(WHR, waist circumference(Cm)/hip circumference(Cm)). The nutrients intake of subjects were compared with the recommended daily allowances(RDA). Mean adequacy ratio(MAR) was calculated. Mean heights, weights, BMIs were higher in the groups with nutrient intake over 125% of RDA than the lower intake groups for most nutrients. However, Mean WHR was the highest in the groups with nutrient intake under 75% of RDA for most nutrients excluding iron intake of women aged 20-64 years. Among women aged 20-64 years, means of MAR were 0.71 for obese individuals(BMI>30), 0.72 for subjects with underweight(BMI<18.5), and 0.76 for subjects with normal weight(18.5$\leq$BMI<25). Normal subjects has statistically significantly higher MAR than those of other groups. However, among elderly people aged over 65 years, obese group had the highest MAR, 0.68. Women with abdominal obesity(WHR>0.9) had lower MAR, 0.71 than those with normal weight(MAR=0.76). From these results, obesity and abdominal obesity seems to be the results of malnutrition including both undernutrition and overnutrition rather than simple problem of excess energy intake. Obesity in elderly people needs to be handled differently from adults.

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섭취식품 가짓수와 영양소 섭취상태의 상관관계 분석 (Relationship between the Number of Different Food Consumed and Nutrient Intakes)

  • 이정원;현화진;곽충실;김초일;이행신
    • 대한지역사회영양학회지
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    • 제5권2호
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    • pp.297-306
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    • 2000
  • In order to examine the relationship between the number of different foods consumed and nutrient intake, one-day food consumption were surveyed by 24-hour recall from a sample of 287 individuals(20-49 years) living in Daejon City. The number of consumed food items did not include seasonings except red pepper power, sugar, oil, and soybean paste when used in large amounts(DVS). The number, including all seasonings except salt and vinegar(DVSS), was also counted. Of the total subjects, 43.6%(DVS) or 39.0%(DVSS) consumed 18-23 daily different foods with an average of 20.2 or 22.9, respectively. As the DVS increased, daily intakes of total foods and most food groups were elevated. Cereals however were not changed and eggs were decreased with increasing DVS. Energy and nutrient intakes and their mean adequacy ratio(MAR) and index of nutritional quality(INQ) also show positive correlations with DVS. MAR equal to or greater than($\geq$) 0.75 was taken as a cut-off point for nutritional adequacy. In that case, the mean INQ was shown to be $\geq$1. MRI(10) for energy and 9 nutrients and MAR(3) for Ca, vitamin A, and riboflavin were estimated. Form a regression analysis, when MAR(10) was 0.75, the DVS and DVSS were assumed to be 19.6 and 22.2, respectively. And when MAR(3) was 0.75, the DVS and DVSS were assumed to be 31.6 and 34.6, respectively. However the subjects whose MAR(3) was 0.75(0.7-0.8) 23.8(DVS) or 26.6(DVSS) different foods in average, and their mean intakes of energy and all nutrients, except vitamin A, were ranged at 85-100% of the RDA. Of the 74 subjects who consumed DVS$\geq$24, 24 to 42 numbers took 〈75% RDA of Fe, Ca, riboflavin, and vitamin A. And five of 7 who consumed DVS$\geq$32 took $\geq$125%RDA of protein, which showed concerns of overnutrition in case of DVS$\geq$32. Form the above results it could be suggested that a daily intake of 24-32(or 28) of DVS or 27-35(or 31) of DVSS was recommendable for an optimal nutritional of all nutrients if the variety of food groups and sufficient intake of vitamin A and calcium were emphasized together.

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고관절 인공치환술 환자에서 금속 인공물 감소 방법의 비교: 가상 단일에너지영상 대 금속 인공물 감소기법 (Comparison of Metal Artifact Reduction Algorithms in Patients with Hip Prostheses: Virtual Monoenergetic Images vs. Orthopedic Metal Artifact Reduction)

  • 류혜진;홍성환;최자영;채희동
    • 대한영상의학회지
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    • 제83권6호
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    • pp.1286-1297
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    • 2022
  • 목적 고관절 인공치환물을 가진 환자에서 여러 가지 금속인공물 감소 효과를 비교하였다. 대상과 방법 이 연구는 고관절 인공치환술과 이중에너지 전산화단층촬영을 시행한 47명 환자에서 시행하였다. 금속에서 발생한 인공물 감소효과는 서로 다른 3개의 영상(고식적 영상, 금속인공물 감소영상, 가상 단일에너지 영상)에서 비교하였다. 이를 위해 인공관절 주변 7곳에서 금속인공물에 대한 정량적 분석과 정성적 분석을 시행하였다. 결과 금속인공물 감소영상에서 가장 낮은 영상잡음과 인공물 지수를 보였고, 다음으로는 가상 단일에너지 영상이었다. 금속인공물 감소영상은 저음영 인공물이 매우 심한 영역에서만 높은 대조도를 보인 반면, 가상 단일에너지 영상은 인공물 주변 골조직과 그 외 영역에서 높은 대조도를 보였다. 연부조직 분석에서도 금속인공물 감소영상이 더 우수함을 보여 주었다. 정성적 분석에서도 금속인공물 감소영상이 가상 단일에너지 영상보다 인공물 감소 효과가 뛰어남을 밝혔지만, 이차적인 인공물 발생도 가장 흔히 발생하였다. 결론 금속인공물 감소영상이 심한 금속인공물감소에 가장 뛰어난 효과를 보였지만 새로운 이차적 인공물을 발생시켰다. 가상 단일에너지 영상은 인공물 주변 골조직 평가에서 우수함을 보였다.