• Title/Summary/Keyword: Medical charge

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Improvement of Artificial Antibody Secretion Using Supercharged Protein (단백질의 과전하화를 이용한 인공 항체의 분비 개선)

  • Park, Jiyeon;Choi, Heeju;Lee, Hyejin;Ahn, Jung Hoon
    • Journal of Life Science
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    • v.30 no.5
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    • pp.420-427
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    • 2020
  • A repebody, an artificial non-immunoglobulin protein scaffold, is expected to be a solution in the search for faster, cheaper, and customizable antibodies. However, the production of medical repebodies remains difficult due to their low yield and the complex purification processes required. The Pseudomonas fluorescens ABC transporter system has been suggested as an efficient and cost-effective method for repebody production, but the total yield is low because of the secreted protein's positive charge; thus, a repebody with a high isoelectric point needs to be changed into a more negatively charged protein for better secretion. To achieve this, we first attached oligo-aspartic acids to the N- and C-terminals of the repebody, but secretion efficiency was not enhanced significantly. Subsequently, we devised an alternative method for improved secretion efficiency by engineering fifteen positively charged amino acids to aspartic acid in the non-antigen binding sites of the repebody to give a high net negative charge. As a result, secretion efficiency was greatly enhanced from 21.2% (wildtype) to 58.5% (negatively supercharged). The negatively supercharged repebody was succussfully produced extracellularly by ABC transporter secretion system in P. fluorescens.

Development of Signal Processing Modules for Double-sided Silicon Strip Detector of Gamma Vertex Imaging for Proton Beam Dose Verification (양성자 빔 선량 분포 검증을 위한 감마 꼭지점 영상 장치의 양면 실리콘 스트립 검출기 신호처리 모듈 개발)

  • Lee, Han Rim;Park, Jong Hoon;Kim, Jae Hyeon;Jung, Won Gyun;Kim, Chan Hyeong
    • Journal of Radiation Protection and Research
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    • v.39 no.2
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    • pp.81-88
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    • 2014
  • Recently, a new imaging method, gamma vertex imaging (GVI), was proposed for the verification of in-vivo proton dose distribution. In GVI, the vertices of prompt gammas generated by proton induced nuclear interaction were determined by tracking the Compton-recoiled electrons. The GVI system is composed of a beryllium electron converter for converting gamma to electron, two double-sided silicon strip detectors (DSSDs) for the electron tracking, and a scintillation detector for the energy determination of the electron. In the present study, the modules of a charge sensitive preamplifier (CSP) and a shaping amplifier for the analog signal processing of DSSD were developed and the performances were evaluated by comparing the energy resolutions with those of the commercial products. Based on the results, it was confirmed that the energy resolution of the developed CSP module was a little lower than that of the CR-113 (Cremat, Inc., MA), and the resolution of the shaping amplifier was similar to that of the CR-200 (Cremat, Inc., MA). The value of $V_{rms}$ representing the magnitude of noise of the developed system was estimated as 6.48 keV and it was confirmed that the trajectory of the electron can be measured by the developed system considering the minimum energy deposition ( > ~51 keV) of Compton-recoiled electron in 145-${\mu}m$-thick DSSD.

Changes in the Health Life of the Elderly Through the Handle Height of Walking Assistant Vehicle Article : Emphasizing on State Anxiety, Heart Rate and Fall Efficacy (보행보조차 손잡이 높이에 따른 노인들의 건강생활의 변화 : 상태불안과 심박수, 낙상효능감을 중심으로)

  • Son, Sung-Min;Kwag, Sung-Won
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.7
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    • pp.519-528
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    • 2020
  • Purpose of this study is to analyze the changes in state anxiety, heart rate, and fall efficacy of the elderly through the handle height of walking assistant vehicle (WAV). The subjects were 32 elderlies. WAV was in the form of strollers, and it's handle height was set as 48% of a subject's total height. Also, it's height was divided into 48, 43, 38%. To measure the state anxiety, Korean State-Trait Anxiety Inventory was used and to measure the heart rate, Fitbit Charge 2 wrist heart rate monitor was used. To measure the fall efficacy, Fall Efficacy Scale-Korea was used. As the results of state anxiety and heart rate, the statistically significant increase showed continuously through the decrease of the handle height of WAV. As the results of fall efficacy, the statistically significant decrease showed continuously through the decrease of the handle height of WAV. In all of the post hoc test, the results of the state anxiety and fall efficacy showed significant difference among the each handle height of WAV and the results of the heart rate showed significant difference between the 48, 43% and 38% handle height of WAV. Thus, to decrease the state anxiety and heart rate and increase the fall efficacy of the elderly, the handle height of WAV should be properly positioned and considered to adjust to 48% of the user's total height.

Innovative approaches to the health problems of rural Korea (한국농촌보건(韓國農村保健)의 문제점(問題點)과 개선방안(改善方案))

  • Loh, In-Kyu
    • Journal of agricultural medicine and community health
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    • v.1 no.1
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    • pp.5-9
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    • 1976
  • The categories of national health problems may be mainly divided into health promotion, problems of diseases, and population-economic problems which are indirectly related to health. Of them, the problems of diseases will be exclusively dealt with this speech. Rurality and Disease Problems There are many differences between rural and urban areas. In general, indicators of rurality are small size of towns, dispersion of the population, remoteness from urban centers, inadequacy of public transportation, poor communication, inadequate sanitation, poor housing, poverty, little education lack of health personnels and facilities, and in-accessibility to health services. The influence of such conditions creates, directly or indirectly, many problems of diseases in the rural areas. Those art the occurrence of preventable diseases, deterioration and prolongation of illness due to loss of chance to get early treatment, decreased or prolonged labour force loss, unnecessary death, doubling of medical cost, and economic loss. Some Considerations of Innovative Approach The followings art some considerations of innovative approaches to the problems of diseases in the rural Korea. 1. It would be essential goal of the innovative approaches that the damage and economic loss due to diseases will be maintained to minimum level by minimizing the absolute amount of the diseases, and by moderating the fee for medical cares. The goal of the minimization of the disease amount may be achieved by preventive services and early treatment, and the goal of moderating the medical fee may be achieved by lowering the prime cost and by adjusting the medical fees to reasonable level. 2. Community health service or community medicine will be adopted as a innovative means to disease problems. In this case, a community is defined as an unit area where supply and utilization of primary service activities can be accomplished within a day. The essential nature o the community health service should be such activities as health promotion, preventive measures, medical care, and rehabilitation performing efficiently through the organized efforts of the residents in a community. Each service activity should cover all members of the residents in a community in its plan and performance. The cooperation of the community peoples in one of the essential elements for success of the service program, The motivations of their cooperative mood may be activated through several ways: when the participation of the residents in service program of especially the direct participation of organized cooperation of the area leaders art achieved through a means of health education: when the residents get actual experience of having received the benefit of good quality services; and when the health personnels being armed with an idealism that they art working in the areas to help health problems of the residents, maintain good human relationships with them. For the success of a community health service program, a personnel who is in charge of leadership and has an able, a sincere and a steady characters seems to be required in a community. The government should lead and support the community health service programs of the nation under the basis of results appeared in the demonstrative programs so as to be carried out the programs efficiently. Moss of the health problems may be treated properly in the community levels through suitable community health service programs but there might be some problems which art beyond their abilities to be dealt with. To solve such problems each community health service program should be under the referral systems which are connected with health centers, hospitals, and so forth. 3. An approach should be intensively groped to have a physician in each community. The shortage of physicians in rural areas is world-wide problem and so is the Korean situation. In the past the government has initiated a system of area-limited physician, coercion, and a small scale of scholarship program with unsatisfactory results. But there might be ways of achieving the goal by intervice, broadened, and continuous approaches. There will be several ways of approach to motivate the physicians to be settled in a rural community. They are, for examples, to expos the students to the community health service programs during training, to be run community health service programs by every health or medical schools and other main medical facilities, communication activities and advertisement, desire of community peoples to invite a physician, scholarship program, payment of satisfactory level, fulfilment of military obligation in case of a future draft, economic growth and development of rural communities, sufficiency of health and medical facilities, provision of proper medical care system, coercion, and so forth. And, hopefully, more useful reference data on the motivations may be available when a survey be conducted to the physicians who are presently engaging in the rural community levels. 4. In communities where the availability of a physician is difficult, a trial to use physician extenders, under certain conditions, may be considered. The reason is that it would be beneficial for the health of the residents to give them the remedies of primary medical care through the extenders rather than to leave their medical problems out of management. The followings are the conditions to be considered when the physician extenders are used: their positions will be prescribed as a temporary one instead of permanent one so as to allow easy replacement of the position with a physician applicant; the extender will be under periodic direction and supervision of a physician, and also referral channel will be provided: legal constraints will be placed upon the extenders primary care practice, and the physician extenders will used only under the public medical care system. 5. For the balanced health care delivery, a greater investment to the rural areas is needed to compensate weak points of a rurality. The characteristics of a rurality has been already mentioned. The objective of balanced service for rural communities to level up that of urban areas will be hard to achieve without greater efforts and supports. For example, rural communities need mobile powers more than urban areas, communication network is extremely necessary at health delivery facilities in rural areas as well as the need of urban areas, health and medical facilities in rural areas should be provided more substantially than those of urban areas to minimize, in a sense, the amount of patient consultation and request of laboratory specimens through referral system of which procedures are more troublesome in rural areas, and more intensive control measures against communicable diseases are needed in rural areas where greater numbers of cases are occurred under the poor sanitary conditions.

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Efficient Application of Westgard Multi-Rules and Quality Control Implementation Improvement (Westgard Multi-Rules의 효율적 적용과 조치사항의 개선)

  • Jung, Heung Soo;Oh, Youn Jung;Bae, Jin Soo;Baek, Jin Young;Hwang, Bo ra;Shin, Yong Hwan
    • The Korean Journal of Nuclear Medicine Technology
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    • v.21 no.1
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    • pp.60-64
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    • 2017
  • Purpose Westgard multi-rules application based on test quality improvement and commercialized international standard has been widely used in quality control. However, it is difficult to applicate the Westgard multi-rules in nuclear medicine in vitro tests due to the larger sample sizes and the simultaneous measurement of quality control material and patient sample. This study investigated the usefulness of Westgard multi-rules application in nuclear medicine in vitro tests. Materials and Methods A total of 282 systematic error multi-rules (22s, 101s) recorded in the samsung medical center computer system from January 2013 to June 2016 along with 117 cases of corrective measure record was analyzed. The Quality control implementation is recorded in Hospital information system were divided into 4 high-level areas including quality control material error, experimental procedural error, Kit lot number management error, and others. To prevent quality control material error, the existing method that each staff used their own method was changed. The staff who in charge of managing the quality control material was designated and daily consumption amount of every test was strictly controlled by one person. To prevent other errors, every test step was standardized so that the entire test procedures are identically implemented. Results The total quality control implementation was 117 cases; As a result, 62 quality control material errors were 62 cases, experimental process errors were 24 cases, Kit lot number control errors were 18 cases, and other errors were 13 cases. The quality control material error was corrected and could be used fresh materials within 2 days after thawing. The cases of systemic error were decreased to causes as quality control material error. The quality control materials were reduced above 10 vials to a monthly average. In addition, these errors of experimental processing and Kit lot number were improved by test standardization. Consequently, the cases of 101s and 22s in systematic error rules decreased at least 2 cases to a monthly average. Conclusion To confirm of systematic error through multi-rules application quickly, it is necessary to base on management of the QC material, target values and standard deviation. Moreover, in the event of a systematic error, it was found important to record measures based on test cause analysis. The experiment results are expected to contribute to internal quality control improvement and prompt and accurate result reporting through error recording and causal analysis based on Westgard multi-rules analysis.

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A Study on Differences of Opinions on Home Health Care Program among Physicians, Nurses, Non-medical personnel, and Patients. (가정간호 사업에 대한 의사, 간호사, 진료관련부서 직원 및 환자의 인식 비교)

  • Kim, Y.S.;Lim, Y.S.;Chun, C.Y.;Lee, J.J.;Park, J.W.
    • The Korean Nurse
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    • v.29 no.2
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    • pp.48-65
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    • 1990
  • The government has adopted a policy to introduce Home Health Care Program, and has established a three stage plan to implement it. The three stage plan is : First, to amend Article 54 (Nurses for Different Types of Services) of the Regulations for Implementing the Law of Medical Services; Second, to tryout the new system through pilot projects established in public hospitals and clinics; and third, to implement at all hospitals and equivalent medical institutions. In accordance with the plan, the Regulation has been amend and it was promulgated on January 9,1990, thus establishing a legal ground for implementing the policy. Subsequently, however, the Medical Association raised its objection to the policy, causing a delay in moving into the second stage of the plan. Under these circumstances, a study was conducted by collecting and evaluating the opinions of physicians, nurses, non-medical personnel and patients on the need and expected result from the home health care for the purpose of help facilitating the implementation of the new system. As a result of this study, it was revealed that: 1. Except the physicians, absolute majority of all other three groups - nurses, non-medical personnel and patients -gave positive answers to all 11 items related to the need for establishing a program for Home Health Care. Among the physicians, the opinions on the need for the new services were different depending on their field of specialty, and those who have been treating long term patients were more positive in supporting the new system. 2. The respondents in all four groups held very positive view for the effectiveness and the expected result of the program. The composite total of scores for all of 17 items, however, re-veals that the physicians were least positive for the- effectiveness of the new system. The people in all four groups held high expectation on the system on the ground that: it will help continued medical care after the discharge from hospitals; that it will alleviate physical and economic burden of patient's family; that it will offer nursing services at home for the patients who are suffering from chronic disease, for those early discharge from hospital, or those who are without family members to look after the patients at home. 3. Opinions were different between patients( who will receive services) and nurses (who will provide services) on the types of services home visiting nurses should offer. The patients wanted "education on how to take care patients at home", "making arrangement to be admitted into hospital when need arises", "IV injection", "checking blood pressure", and "administering medications." On the other hand, nurses believed that they can offer all 16 types of services except "Controlling pain of patients", 4. For the question of "what types of patients are suitable for Home Health Care Program; " the physicians, the nurses and non-medical personnel all gave high score on the cases of "patients of chronic disease", "patients of old age", "terminal cases", and the "patients who require long-term stay in hospital". 5. On the question of who should control Home Health Care Program, only physicians proposed that it should be done through hospitals, while remaining three groups recommended that it should be done through public institutions such as public health center. 6. On the question of home health care fee, the respondents in all four groups believed that the most desireable way is to charge a fixed amount of visiting fee plus treatment service fee and cost of material. 7. In the case when the Home Health Care Program is to be operated through hospitals, it is recommended that a new section be created in the out-patient department for an exclusive handling of the services, instead of assigning it to an existing section. 8. For the qualification of the nurses for-home visiting, the majority of respondents recommended that they should be "registered nurses who have had clinical experiences and who have attended training courses for home health care". 9. On the question of if the program should be implemented; 74.0% of physicians, 87.5% of non-medical personnel, and 93.0% of nurses surveyed expressed positive support. 10. Among the respondents, 74.5% of -physicians, 81.3% of non-medical personnel and 90.9% of nurses said that they would refer patients' to home health care. 11. To the question addressed to patients if they would take advantage of home health care; 82.7% said they would if the fee is applicable to the Health Insurance, and 86.9% said they would follow advises of physicians in case they were decided for early discharge from hospitals. 12. While 93.5% of nurses surveyed had heard about the Home Health Care Program, only 38.6% of physicians surveyed, 50.9% of non-medical personnel, and 35.7% of patients surveyed had heard about the program. In view of above findings, the following measures are deemed prerequisite for an effective implementation of Home Health Care Program. 1. The fee for home health care to be included in the public health insurance. 2. Clearly define the types and scope of services to be offered in the Home Health Care Program. 3. Develop special programs for training nurses who will be assigned to the Home Health Care Program. 4. Train those nurses by consigning them at hospitals and educational institutions. 5. Government conducts publicity campaign toward the public and the hospitals so that the hospitals support the program and patients take advantage of them. 6. Systematic and effective publicity and educational programs for home heath care must be developed and exercises for the people of medical professions in hospitals as well as patients and their families. 7. Establish and operate pilot projects for home health care, to evaluate and refine their programs.

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A bibliographic study on medical science ancient period (上古時代) and the era of the old-Korea (古朝鮮時代) (상고시대(上古時代)와 고조선시대(古朝鮮時代)의 의학(醫學)에 관(關)한 문헌적(文獻的) 고찰(考察))

  • Kwon, Hak Cheol;Park, Chan-Guk
    • Journal of Korean Medical classics
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    • v.3
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    • pp.218-247
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    • 1989
  • As mentioned above, I got the next conclusion since I had considered the medical contents of the ancient period(上古時代) and the era of the old-Korea(古朝鮮時代) through several bibliographic records. 1. There were Pung-baeg(風伯), Uh-sa(雨師), Un-sa(雲師) that were the names of the governmental officials during the ancient period of Whan-ung(桓雄). Among them, Uh-sa specially managed the treatment for diseases. When we think of the significance of Pung(風)-which means the winds, Uh(雨)-which means the rain, Un(雲)-which means of clouds, we will find out that the human life will be affected by all kinds of phenomena of the nature. So I can infer that ancestries could prevent and treat diseases with adjusting them tn the changes in the weather. 2. There were five government officials(五事) in the ancient period of Whan-ung(桓雄上古時代). They are Uh-ga(牛加), Ma-ga(馬加), Ku-ga(狗加), Cheo-ga(猪加) and Yang-ga(羊加), and had charges of five important duties. Among them, Cheo-ga was set to a charge of treatment for diseases. So we can notice that there existed people who treated for diseases professionally. When we think of the meanings of Uh(牛)-which intends cows or bulls. Ma(馬)-which intends horses, Ku(狗)-which intends dogs, Cheo(猪)-which intends wild boars and Yang(羊)-which intends sheep, we can see that livestocks would be raised at that time, and they came to have more chances to digest meat. Since the digestion of meat became to be a burden on the stomach and the intestines, it might cause a lot of indigestive troubles. 3. When I compared Tan-gun Pal-ga(檀君八加) with the Oh-ga(五加) in the ancient period of Whan-ung(桓雄上古時代), I could tell that the community of Tan-gun's period is more advanced and specialized than one of Whan-ung's. When I think of the next sentence ; "The Prince Imperial, Bu-u(夫虞) become to be a Ro-ga(鷺加), who treat for diseases professionally.", I am sure that the treatment for diseases was more importment than any other things, because he was the third son of Tan-gun(檀君). 4. According to Tan-gun(檀君) mythology, Whan-ung(桓雄) came down from the heaven of the pure Yang(純陽) to the earth and then changed into a man who had had more Yang(陽) than Yin(陰). And a bear came up from the underground(or the cave) to the ground and then changed into a women who had had more Yin(陰) than Yang(陽). So both of them became to hold together. This story implicated that ancestors had taken a serious view of each of them, namely the ancestors didn't give the ascendance to the one side of them, and made much account of the mutual harmony. So I am sure that this fact coincided with the basic theories of oriental medical science. To refer to two proverbs of Tan-gun mythology that are "Ki-Sam-Chil-Il(忌三七日)" which means caring for twenty one days, and "Pul-Gyon-Il-Gwang-Baeg-Il(不見日光百日)" which means keeping indoors for one hundred days, I can tell you that "twenty-one-day" involves the principle of the birth of life, and "one-hundred-day" contains a preparatory period or the period of death to bear another life. 5. From the medical stuff, such as wormwood(艾), garlic(蒜), or wonder-working herbage(靈草), that had been written at the bibliographic papers of the ancient period(上古時代) and the era of the old-Korea(古朝鮮時代), I consider that many people might get a lot of women's diseases, indigestive troubles, and other diseases that were caused by the weakness, but with using various spices, such as the leaves of water pepper(蔘), they could prevent the occurrance of all kinds of diseases previously. So I regard this treatment as the medicine from food. 6. One of the sayings at Nae-gyong(內經) is that "The stone accupuncture(砭石) came from the orient." We can see both "wonder-wor-king wormwood(靈草)" and "dried wormwood(乾艾)" in the several bibliographic papers of the ancient history of the old-Korea(朝鮮上古史). From these records, I can be convinced that ancestors would utilize the acupuncture(針) and the moxa cautery(灸) to cure a patient of a disease. 7. Even though someone claimed that the book, "medical science and chemistry(醫學化學)" and "medical treatment(醫學大方)" had had been written during the ancient period of the old-Korea(上古朝鮮時代), such a fact can't have been ascertained historical evidence. But it has been handed down that there existed the original phonetic alphabet, such as the "Ka-Im-To alphabet(加臨土文字)" at that time. The terms about the diseases, which had been occurred at the community of the old-Korea(古朝鮮地域), were recorded fragmentarily at other records after that time. The origin of confucianism came from the race of the eastern barbarians, and Tae-Ho-Pok-Hi(太嗅伏義) and the king. Sun(舜) came from the eastern barbarians, too. The divination of tortoise shells at the country of Un(殷) is another from which was developed at the eastern barbarians' fortune-telling of animal bones. From these facts, I can infer that, by all means, they might record the medical knowledge which had been stored for thousands of years while contacting with china directly.

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A Study on Seok-kok Lee, Kyu-jun's Pu-yang-non (석곡 이규준의 부양론(扶陽論)에 관한 연구(硏究))

  • Hwang, In-Deok
    • Journal of Korean Medical classics
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    • v.12 no.2
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    • pp.16-53
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    • 1999
  • On the viewpoint of Nae-Kyung and Ju-Yeok, the Seok-Kok's Pu-Yang-Non and other oriental medical doctor's Po-Eum-Eok-Yang, Pu-Yang-Eok-Eum theory which are on the basis of the Kun-Shin-Sang-Wha theory of Nae-Kyung and Myung-Mun theory of Nan-Kyung were compared and studied. The results were as follows : 1. Ju-Yeok and Nae-Kyung said the South is Fire. And explained it as the chief object of life activity by likening to king or saint. And said the North is Water. but didn't mentioned that there exists Fire. The activity of Kun-Wha is regarded as the the chief object of life activity and the Shin-Su can be vatalized by receiving the Shim-Kun-Wha. Therefore, the Seok-Kok's opinion that Shang-Wha is the Fire received by Shin-Su matchs the theory of Nae-Kyung and Nan-Kyung. 2. The Kidney(Shin) in Nae-Kyung means Puk-Bang- Han-Su(The North Cold Water) which has two characters, charging and discharging, ascending and descending. The paragrap "Kam-Ga-Seub(坎加習)" in Ju-Yeok means Puk-Bang-Su(The North Water) which also has two characters, charging and discharging, ascending and descending. The beginning and the end. And One Eum and Two Yang of Ri Sign of divination(離卦) cannot be divided into Su-Jang and Wha-Jang, the same as that, One Yang and Two Eum of Kam Sign of divination(坎卦) is Puk-Bang-Han-Su which cannot be divided into Shin and Myung-Mun. The theory of Choa-Shin-Woo-Myung-Mun of Nan-Kyung is the result that the Shin which has two characters is regarded as two organs. Therefore, from the viewpoint of Nae-Kyung and Ju-Yeok, the Seok-Kok's opinion that the Shin is the Puk-Bang-Han-Su which charges from the right and discharges to the left is more proper. 3. For the first time, the right kidney(Woo-Shin) defined as Myung-Mun in the Nan-Kyung and it is trailblazing theory which dosen't exist in the Nae-Kyung. But from the viewpoint of Nae-Kyung, Myung-Mun-Shang-Wha which some oriental medical doctors thought importantly is considered as Shim-Po which is in charge of the order of Shim(心命). 4. The rush of heat to the upper part(上熱) is raised by blind acting of Shang-Wha which exists in the lower part. This theory is on the basis of the Myung-Mun-Shang-Wha theory of Nan-Kyung. The theory that Wha is in the Shin(Kidney) doesn't exist and only the theory exists that the fever happens by the Kun-Wha not going down but ascending in the Nae-Kyung. Therefore the Shang-Wha blind acting theory of the lower part is not coincided with the theory of Nae-Kyung. 5. When the Vital power(陽氣) is blocked by bad tendencies(邪氣) like uncontrolled joy and anger or too much cold and heat etc, the trapped heat(鬱熱) or Ascending Shang-Wha apper, so Vital power itself cannot have blind activity or excess. Therefore, the theory of oriental medical doctors that the remaining vital power is the fire(氣有餘便是火) cannot be materialized. 6. On the basis of the Woo-Shin-Myung-Mun theroy, oriental medical doctors attached importance to Shin-Eum and Shin-Yang. So they emphasized on Ja-Eum-Gang-Wha or On-Bo-Shin-Yang for curing the Fire. Contrarily, On the viewpoint of siding with the vital power which is the Good and repressing the bad tendency which is the Bad, and another viewpoint that when the vital power which is Shim-Kun-Wha moves through the body consistently and fills up the body, then the enery and blood can be made, the Seok-Kok's theory is coincided with the theory of Nae-Kyung.

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The Investigation Image-guided Radiation Therapy of Bladder Cancer Patients (방광암 환자의 영상유도 방사선치료에 관한 고찰)

  • Bae, Seong-Soo;Bae, Sun-Myoung;Kim, Jin-San;Kang, Tae-Young;Back, Geum-Mun;Kwon, Kyung-Tae
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.1
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    • pp.39-43
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    • 2012
  • Purpose: In hospital image-guided radiation therapy in patients with bladder cancer to enhance the reproducibility of the appropriate amount, depending on the patient's condition, and image-guided injection of saline system (On-Board Imager system, OBI, VARIAN, USA) three of the Cone-Beam CT dimensional matching (3D-3D matching) to be the treatment. In this study, the treatment of patients with bladder cancer at Cone-Beam CT image obtained through the analysis of the bones based matching and matching based on the bladder to learn about the differences, the bladder's volume change injected saline solution by looking at the bladder for the treatment of patients with a more appropriate image matching is to assess how the discussion. Materials and Methods: At our hospital from January 2009 to April 2010 admitted for radiation therapy patients, 7 patients with bladder cancer using a Folly catheter of residual urine in the bladder after removing the amount determined according to individual patient enough to inject saline CT-Sim was designed after the treatment plan. After that, using OBI before treatment to confirm position with Cone-Beam CT scan was physician in charge of matching was performed in all patients. CBCT images using a total of 45 bones, bladder, based on image matching and image matching based on the difference were analyzed. In addition, changes in bladder volume of Eclipse (version 8.0, VARIAN, USA) persuaded through. Results: Bones, one based image matching based on the bladder and re-matching the X axis is the difference between the average $3{\pm}2mm$, Y axis, $1.8{\pm}1.3mm$, Z-axis travel distance is $2.3{\pm}1.7mm$ and the overall $4.8{\pm}2.0mm$, respectively. The volume of the bladder compared to the baseline showed a difference of $4.03{\pm}3.97%$. Conclusion: Anatomical location and nature of the bladder due to internal movement of the bones, even after matching with the image of the bladder occurred in different locations. In addition, the volume of saline-filled bladder showed up the difference between the 4.03 percent, but matched in both images to be included in the planned volumes were able to confirm. Thus, after injection of saline into the bladder base by providing a more accurate image matching will be able to conduct therapy.

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암환자 인식에 관한 연구 - 간호사ㆍ의사를 중심으로

  • Jo, In-Hyang
    • Korean Journal of Hospice Care
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    • v.2 no.1
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    • pp.58-74
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    • 2002
  • This paper constitutes a descriptive investigation and used a structured questionnaire to investigate nurses' and doctors' recognition of cancer patients. The subjects were extracted from the medical personnel working at the internal medicine, the surgery ward, the obstetrics and gynecology department, the pediatrics department, the cancer ward, and the emergency room of five general hospitals located in Seoul and Gyeonggi Province. The research lasted from August, 2001 to September 2001. Total 137 nurses and 65 doctors were included and made out the questionnaires directly distributed by the investigator. The study tool was also developed by the investigator and consisted of such items as the demographic and social characteristics, the medical personnel's recognition degree of cancer and cancer patients, their recognition of the management of cancer patients, and their participation in a hospice. The results were analyzed using the SPSS Window program in terms of technological statistics, ranks, t-test, and ANOVA. The reliability was represented in Cronbach' α=.75. The nurses' and doctors' recognition degree of cancer and cancer patients had an overall average of 3.86 at the 5 point-scale. The items that received an average of 4.0 or more included 'Medical personnel should explain about the cancer cure plans to the cancer patient and his or her family', 'A patient whose case has been diagnosed as a terminal cancer should be notified of it, 'If I were a cancer patient, I would want to get informed of it,' and 'Cancer shall be conquered whenever it is'. In the meantime, the items that received an average of 3.0 or less was 'My relationship with the cancer patient's family has gotten worse since I announced his or her impending death.' And according to the general characteristics and the difference test, the recognition degree of cancer and cancer patient was high among the subgroups of nurses, females, married persons, who were in their 30s, who had a family member that was a cancer patient, and who received a hospice education. The biggest number of the nurses and doctors saw 'a gradual approach over several days'(68.8%) as a method to tell a cancer patient about his or her cancer diagnosis or impending death. Those who usually tell tragic news were the physician in charge(62.8%), the family members or relatives(32.1%) and the clergymen(3.8%) in the order. The greatest number of them recommended a cancer patient's home as the place where he or she should face death because they thought 'it would stabilize his or her mentality'(91.9%) while a number of them recommended the hospital because they 'should give the psychological satisfaction to the patient'(40%) or 'should try their best until the last moment of the patient's death'(30%). A majority of the medical personnel regarded 'smoking or drinking' and 'diet' as the causes of cancer. The biggest symptom of a cancer patient was 'pain' and the pain management of a cancer patient was mostly impeded by the 'excessive fear of drug addiction, tolerance to drugs and side effects of drugs' by medical personnel, the patient, and his or her family. The most frequently adopted treatment plan of a terminal cancer patient was 'to do whatever the patient or his or her family wants' to resort to a hospice' and 'to continue active treatment efforts' in the order. The biggest reasons why a terminal cancer patient went to see a doctor were 'pain alleviation' 'control of symptoms other than pain(intravenous supply)' and 'incapability of the patient's family' in the order. Terminal cancer patients placed their major concern in 'spiritual(religious) matter' 'emotional matters' their family' 'existence' and 'physical matters' in the order. 113(58.5%) of the whole medical personnel answered they 'would recommend' an alternative treatment to a terminal cancer patient mostly because they assumed it would 'stabilize the patient's mentality.' Meanwhile, 80(41.5%) of them chose 'not to recommend it mostly due to the unverified effects and high cost of it(78.7%). A majority of them, I. e. 190(94.1%) subjects said they 'would recommend' a hospice to a terminal cancer patient mostly because they thought it would help the patient to 'mentally prepare'(66.6%) Only 17.3% of them, however, had received a hospice education, most of which was done through the hospital duty education(41.4%) and volunteer training(34.5%). The follows are results of this study: 1. The nurses and the doctors turned out to be still passive and experience confusion in dealing with a cancer patient despite their great sense of responsibility for him or her. 2.Nurses and Doctors realize the need of a hospice, but an extremely small number of them participate in a hospice education or performance. Thus, a whole recognition of a hospice should be changed, for which purpose a hospice education for nurses and doctors should be provided. 3.Terminal cancer patients preferred their home to a hospital as the place to face their impending death because they felt it would bring 'mental stability.' And most of nurses and doctors think it would be unnecessary for them to be hospitalized just for control of their symptoms. Accordingly a terminal cancer patient can be cared at home, and a home hospice care needs to be activated.

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