• Radiation Oncology Journal
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• v.33 no.4
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• pp.320-327
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• 2015

Purpose: To investigate the treatment outcome and the toxicity of helical tomotherapy (HT) in patients with metastatic colorectal cancer (mCRC). Materials and Methods: We retrospectively reviewed 18 patients with 31 lesions from mCRC treated with HT between 2009 and 2013. The liver (9 lesions) and lymph nodes (9 lesions) were the most frequent sites. The planning target volume (PTV) ranged from 12 to 1,110 mL (median, 114 mL). The total doses ranged from 30 to 70 Gy in 10-30 fractions. When the ${\alpha}/{\beta}$ value for the tumor was assumed to be 10 Gy for the biologically equivalent dose (BED), the total doses ranged from 39 to $119Gy_{10}$ (median, $55Gy_{10}$). Nineteen lesions were treated with concurrent chemotherapy (CCRT). Results: With a median follow-up time of 16 months, the median overall survival for 18 patients was 33 months. Eight lesions (26%) achieved complete response. The 1- and 3-year local progression free survival (LPFS) rates for 31 lesions were 45% and 34%, respectively. On univariate analysis, significant parameters influencing LPFS rates were chemotherapy response before HT, aim of HT, CCRT, PTV, BED, and adjuvant chemotherapy. On multivariate analysis, $PTV{\leq}113mL$ and $BED>48Gy_{10}$ were associated with a statistically significant improvement in LFPS. During HT, four patients experienced grade 3 hematologic toxicities, each of whom had also received CCRT. Conclusion: The current study demonstrates the efficacy and tolerability of HT for mCRC. To define optimal RT dose according to tumor size of mCRC, further study should be needed.

• Journal of Korean Academy of Nursing
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• v.3 no.1
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• pp.85-95
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• 1972

For the purpose to clarify the effects of nursing, intervention with comfort measures which promote rest, exercise and sleep on the patient′s rehabilitation, this study was carried out on 119 postoperative patients at St. Mary′s Hospital, the National Medical Center and Seoul Red Cross Hospital during the 9 months period from March 1971 to November 1971. In this study one experimental nursing approach was utilized; an emphasis on interpersonal techniques along with physical care-comfort measures. A daily evening care including support and instruction was given to facilitate interaction of nursing to the experimental group by the investigator. For the control group, routine hospital nursing care was performed. The nursing observation was followed for 4 days postoperatively and recorded in check list. The results of the findings were as follows. 1. 3.5% of control group and 32.3% of experimental group got out of bed within 24 hours postoperatively. 38.6% of control group got out of bed within 72 hours postoperatively where only 16.1% of the experimental group did (x$^2$= 19.865, p<0.005). Interaction in nursing is, in turn, significantly more effective than the usual routine care in improving rate of healing. 2. The irritations and tension that may interfere patient′s sleep and rest at night can be reduced to a minimum if nursing environment is better controlled with planned nursing care for individual patient. Various treatments which tend to give patient discomfort may preferably be performed before 6 p.m. if not absolutely indicated. 3. During 4 days of observation the patients without administration of sedatives and analgesics postoperatively were 25.9% in the experimental group where as 10.5% in the control group. The frequency of administration of sedatives and analgesics in average was 1.4 in the experimental group, and 2.0 in the control group. This indicates that not all postoperative discomforts expressed by the patients should be regarded as incision pain, and those discomforts could be relieved to a certain extent by nursing interventions effectively. 4. There were significant differences between the responses to nursing care given in the experimental group and 33% of the control group in average through 4 days of observation responded "good". 3.6% of the experimental group and 17. 1% of the control group responded "poor" in this study. It was recommended that the study be replicated in a more defined and controlled manner. Some alternative areas for investigation were suggested.

• Journal of Korean Academy of Nursing
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• v.1 no.1
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• pp.111-132
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• 1970

An analysis of nursing activities in a in-patient ward and its management was observed in order to assess necessary number of nursing hands and find out reasonable work management with them. The study was performed with two wards of St. Mary′s Hospital, Catholic Medical Center, for the period from July to December 1970. The results and conclusions were as the following 1. The role of the nurses are determined by doctor′s order in 57.7% in kind, 80.0% in amount. and by nurses decision 20.0% in amount. 2. Works related to patient care are found to be 20.6% in the internal medicine ward and 20.4% in the surgical ward while works related to treatment are 4.7% in the former and 27.2% in the letter. Medication occupies 40.0% in the internal medical ward while 26.6% in the surgery ward, and observation occupies 34.7% in the former while 25.8% in the letter. These can be said to reflect characteristic differences bet ween the two wards. 3. When nursing functions were evaluated by importance "A" level in the amount of works to be done occupied 67.6% in the surgical ward and 62.8% in the internal medical ward. In the kind of the important works, "B"level is found to be most frequent with 50% while "A"level 43%. When evaluated by difficulty, "B"level was found to be most frequent in amount in both internal medicine and surgical wards (52.6%, 38.2%). 4. Works needing professional knowledge and skills occupied 92% in the both wards while unprofessional works 2.8% and 4.2% respectively. There are indications, however, that unprofessional works have an increasing tendency. 5. When evaluated by the amount of works, the surgical ward has 11 nurses less and the internal medicine ward 3 nurses less then the necessary number of nursing staffs. There are shortage of 12 and 6 nurses respectively when evaluated by the number of patients and 18 nurses in the both wards when evaluated by the medical regulations of the Government. 6. The ratio of the nursing staff to patient was found to be 1:11.5, 1:23.0 and 1:34.5 in the morning, evening and night turn in the surgical ward. In the medical word the ratio was 1:9.4, 1:22.0 and 1:33.0. 7. The deficiency of necessary equipment and tension accompanying management of those equipment were found to lower the effective functioning of the head nurse who is a junior manager of the ward. They also consume much of the time and energy of the nurses at work who are over burdened in most of the cases. 8. The high rate of the number of nurses who leave the job impairs the functioning of team work which is considered to be most important in the effective performance of nursing activities and thus contributes to lower the efficiency of nursing functions.

• The korean journal of orthodontics
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• v.40 no.2
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• pp.66-76
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• 2010

Objective: Obstructive sleep apnea (OSA) is a common disorder which is characterized by a recurrence of entire or partial collapse of the pharyngeal airway during sleep. A given tidal volume must traverse the soft tissue tube structure of the upper airway, so the tendency for airway obstruction is influenced by the geometries of the duct and characteristics of the airflow in respect to fluid dynamics. Methods: Individualized 3D FEA models were reconstructed from pretreatment computerized tomogram images of three patients with obstructive sleep apnea. 3D computational fluid dynamics analysis was used to observe the effect of airway geometry on the flow velocity, negative pressure and pressure drop in the upper airway at an inspiration flow rate of 170, 200, and 230 ml/s per nostril. Results: In all 3 models, large airflow velocity and negative pressure were observed around the section of minimum area (SMA), the region which narrows around the velopharynx and oropharynx. The bigger the Out-A (outlet area)/ SMA-A (SMA area) ratio, the greater was the change in airflow velocity and negative pressure. Conclusions: Pressure drop meaning the difference between highest pressure at nostril and lowest pressure at SMA, is a good indicator for upper airway resistance which increased more as the airflow volume was increased.

• Journal of KIISE:Information Networking
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• v.31 no.4
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• pp.414-428
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• 2004

Many portable devices are coming to be commercially successful and provide useful services to mobile users. Mobile devices may request a variety of data types, including text and multimedia data, thanks to the rich content of the Internet. Different types of data and/or different classes of users may need to be treated with different qualities of service. The implementation of service differentiation in wireless networks is very difficult because of device mobility and wireless channel contention when the backoff algorithm is used to resolve contention. Modification of the t)mary exponential backoff algorithm is one possibility to allow the design of several classes of data traffic flows. We present a study of modifications to the backoff algorithm to support three classes of flows: sold, silver, and bronze. For example, the gold c]ass flows are the highest priority and should satisfy their required target bandwidth, whereas the silver class flows should receive reasonably high bandwidth compared to the bronze class flows. The mixture of the two different transport protocols, UDP and TCP, in ad hoc networks raises significant challenges when defining backoff algorithm modifications. Due to the different characteristics of UDP and TCP, different backoff algorithm modifications are applied to each class of packets from the two transport protocols. Nevertheless, we show by means of simulation that our approach of backoff algorithm modification clearly differentiates service between different flows of classes regardless of the type of transport protocol.

• Proceedings of the KSPS conference
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• 1997.07a
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• pp.228-229
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• 1997

1 Intonation is important. It cannot be ignored. To convince students of the importance of intonation, we can use sentences with two very different interpretations according to intonation. Example: "I thought it would rain" with a fallon "rain" means it did not rain, but with a fall on "thought" and a rise on "rain" it means that it did rain. 2 Although complex, intonation is structured. For both teacher and student, the big job of tackling intonation is made simpler by remembering that intonation can be analysed into systems and units. There are three main systems in English intonation: Tonality (division into phrases) Tonicity (selection of accented syllables) Tone (the choice of pitch movements) Examples: Tonality: My brother who lives in London is a doctor. Tonicity: Hello. How ARE you. Hello. How are YOU. Tone: Ways to say "Thank you" 3 In deciding what to teach, we must distinguish what is universal from what is specifically English. This is where contrastive studies of intonation are very valuable. Usually, for instance, division into phrases (tonality) works in broadly similar ways across languages. Some uses of pitch are also similar across languages - for example, very high pitch may signal excitement or urgency. 4 Although most people think that intonation is mainly about pitch (the tone system), actually accent placement (tonicity) is probably the single most important aspect of English intonation. This is because it is connected with information focus, and the effects on interpretation are very clear-cut. Example: They asked for coffee, so I made them coffee. (The second occurrence of "coffee" must not be accented). 5 Ear-training is the beginning of intonation training in the VeL approach. First, students learn to identify fall vs rise vs fall-rise. To begin with, single words are used, then phrases and sentences. When learning tones, the fIrst words used should have unstressed syllables after the stressed syllable (Saturday) to make the pitch movement clearer. 6 In production drills, the fIrst thing is to establish simple neutral patterns. There should be no drama or really special meanings. Simple drills can be used to teach important patterns: Example: A: Peter likes football B: Yes JOHN likes football TOO A: Mary rides a bike B: Yes JENny rides a bike TOO 7 The teacher must be systematic and let learners KNOW what they are learning. It is no good using new patterns and hoping that students will "pick them up" without noticing. 8 Visual feedback of fundamental frequency with a computer display can help students learn correct patterns. The teacher can use the display to demonstrate patterns, or students can practise by themselves, imitating recorded models.

• Radiation Oncology Journal
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• v.3 no.2
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• pp.137-144
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• 1985

Radiation therapy was the treatment of choice for CML in the past, in the form of SI or radioactive phosphorus. Its use has been replaced to a large extent by various chemotherapeutic agents. Recently SI in CML has been used, both to relieve painful splenomegaly and to take advantage of an indirect effect of SI on unirradiated bone marrow. We have treated 15 CML cases who had a huge spleen during chemotherapy or even after chemotherapy by 6 MV linear accelerator during the past two years at the Division of Radiation Therapy, Kang Nam St. Mary's Hospital, Catholic College. Response to SI has been rated according to the scoring system of Roger W. Byhardt, et al. which evaluated the splenic and hematologic response as well as the response of disease-related systems. According to this scoring system, most patients demonstrated a significant relief of splenomegaly along with improvement of hemogram. And we observed the change of Karnofsky Performance Status after SI, and survival after a confirmative diagnosis and SI.

• IMMUNE NETWORK
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• v.13 no.4
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• pp.116-122
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• 2013

This study was conducted to determine whether CD4 T cell responses to citrullinated fibrinogen occur in patients with rheumatoid arthritis (RA), especially in HLA-DR4-positive subjects. Whole peripheral blood mononuclear cells (PBMCs) of RA patients and control subjects were stimulated with citrullinated fibrinogen peptides, and T-cell production of proliferation and proinflammatory cytokines, such as interferon-${\gamma}$(IFN-${\gamma}$) and interleukin-17A (IL-17A), were measured. In addition, CD4 T cells from RA patients were stimulated with the citrullinated fibrinogen peptide, $Fib-{\alpha}$ R84Cit, identified as a DRB1*0401-restricted T cell epitope in HLA-DR4 transgenic mice, and the degree of T cell activation was examined similarly. No proliferative responses to the citrullinated fibrinogen peptides were observed in whole PBMCs or CD4 T cells from RA patients. Furthermore, no increased production of IFN-${\gamma}$ or IL-17A was found in whole PBMCs or CD4 T cells stimulated with the citrullinated fibrinogen peptides, although these cells responded to recall antigen, a mixture of tetanus toxoid, purified protein derivative (PPD) from Mycobacterium tuberculosis, and Candida albicans. The results of this study indicate that anti-citrulline immunity in RA patients may be mediated by fibrinogen because there is no evidence of CD4 T cell-mediated immune responses to citrullinated fibrinogen peptides.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.38
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• pp.16.1-16.9
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• 2016

Background: The association of biomaterial combined with repair factor-like platelet-rich plasma (PRP) has prospective values. Bovine-derived xenograft has been identified as an osteoconductive and biocompatible grafting material that provides osseointegration ability. PRP has become a valuable adjunctive agent to promote healing in a lot of dental and oral surgery procedures. However, there are controversies with respect to the regenerative capacity of PRP and the real benefits of its use in bone grafts. The purpose of this study was to assess the influence of PRP combined with xenograft for the repair of peri-implant bone defects. Methods: Twelve rabbits were used in this study, and the experimental surgery with implant installation was performed simultaneously. Autologous PRP was prepared before the surgical procedure. An intrabony defect (7.0 mm in diameter and 3.0 mm deep) was created in the tibia of each rabbit; then, 24 titanium dental implants (3.0 mm in diameter and 8.5 mm long) were inserted into these osteotomy sites. Thus, a standardized gap (4.0 mm) was established between the surrounding bony walls and the implant surface. The gaps were treated with either xenograft alone (control group) or xenograft combined with PRP (experimental group). After healing for 1, 2, 3, 4, 5, and 6 weeks, the rabbits were sacrificed with an overdose of KCl solution. Two rabbits were killed at each time, and the samples including dental implants and surrounding bone were collected and processed for histological analysis. Results: More newly formed bone and a better bone healing process were observed in control group. The histomorphometric analysis revealed that the mean percentage of bone-to-implant contact in the control group was significantly higher than that of the experimental group (25.23 vs. 8.16 %; P < 0.05, independent-simple t test, analysis of variance [ANOVA]). Conclusions: The results indicate that in the addition of PRP to bovine-derived xenograft in the repair of bone defects around the implant, PRP may delay peri-implant bone healing.

• Journal of Korean Public Health Nursing
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• v.13 no.2
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• pp.101-114
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• 1999

This study was designed to investigate the effects of an aquatic exercise program on the shoulder joint function. physical symptom. quality of life and stress among the patients who received modified radical mastectomy between 6 to 12 months prior to their visits. The subjects were 31 women aged between 40 and 60 who visited the out-patient department at Kang Nam St. Mary's Hospital for follow-up care. and were not under the treatment of intravenous cancer chemotherapy or radiation therapy. and had no complications. Twelve of them were assigned to the control group. while nineteen subjects to the experimental group. The aquatic exercise program was developed by the author with the assistance of exercise specialists. The program includes warming uP. aerobic and cooling down exercises in water. The aquatic exercise program for the experimental group was carried out 3 times a week with 60 minutes in each time for 8 weeks from September 20th to November 15th. 1995 in a regular swimming pool in Seoul. Changes in the range of motion of the shoulder joint. muscle strength. physical symptom. quality of life. and stress were examined after the completion of treatment. The data were collected through isokinetic muscle strength evaluation and questionnaire survey before and after the treatment. Paired and unpaired t-test were adopted to analyze the data. The results were as follows ; 1. The increment in the range of motion of the shoulder joint in the experimental group after the exercise was significantly greater than those in the control group. 2. The peak torque of shoulder girdle muscles increased significantly after the exercise in the experimental group only. 3. The physical symptom score decreased significantly after the exercise in the experimental group only. 4. The experimental group revealed significantly higher level of quality of life and lower level of stress after the exercise compared with those before the exercise. whereas the control group showed no significant changes in those levels. These findings may indicate that the aquatic exercise program is effective in increasing the range of motion of the shoulder joint and muscle strength and quality of life. and also effective in decreasing physical symptoms. and the level of stress in postmastectomy patients. Accordingly. the acquatic exercise program' can be adopted as an effective nursing intervention for postmastectomy rehabilitation.