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Improved Breast Irradiation Techniques Using Multistatic Fields or Three Dimensional Universal Compensators (Multistatic Field또는 3차원 공용보상체를 사용한 유방의 방사선 조사법의 평가)

  • Han Youngyih;Cho Jae Ho;Park Hee Chul;Chu Sung Sil;Suh Chang-Ok
    • Radiation Oncology Journal
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    • v.20 no.1
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    • pp.24-33
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    • 2002
  • Purpose : In order to improve dose homogeneity and to reduce acute toxicity in tangential whole breast radiotherapy, we evaluated two treatment techniques using multiple static fields or universal compensators. Materials and Methods : 1) Multistatic field technique : Using a three dimensional radiation treatment planning system, Adac Pinnacle 4.0, we accomplished a conventional wedged tangential plan. Examining the isodose distributions, a third field which blocked overdose regions was designed and an opposing field was created by using an automatic function of RTPS. Weighting of the beams was tuned until an ideal dose distribution was obtained. Another pair of beams were added when the dose homogeneity was not satisfactory. 2) Universal compensator technique : The breast shapes and sizes were obtained from the CT images of 20 patients who received whole breast radiation therapy at our institution. The data obtained were averaged and a pair of universal physical compensators were designed for the averaged data. DII (Dose Inhomogeneity Index : percentage volume of PTV outside $95\~105\%$ of the prescribed dose) $D_{max}$ (the maximum point dose in the PTV) and isodose distributions for each technique were compared. Results : The multistatic field technique was found to be superior to the conventional technique, reducing the mean value of DII by $14.6\%$ (p value<0.000) and the $D_{max}$ by $4.7\%$ (p value<0.000). The universal compensator was not significantly superior to the conventional technique since it decreased $D_{max}$ by $0.3\%$ (p value=0.867) and reduced DII by $3.7\%$ (p value=0.260). However, it decreased the value of DII by maximum $18\%$ when patients' breast shapes fitted in with the compensator geometry. Conclusion : The multistatic field technique is effective for improving dose homogeneity for whole breast radiation therapy and is applicable to all patients, whereas the use of universal compensators is effective only in patients whose breast shapes fit inwith the universal compensator geometry, and thus has limited applicability.

Relationship between health behaviors and nutrient supplement intake (건강행태와 영양제 복용 유무의 관련성)

  • Lee, Jong-suk;Kim, In-tae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.11
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    • pp.498-508
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    • 2017
  • Purpose: The present study investigated nutrient supplement intake to examine the relationship between the health behaviors of nutrient supplement users and nonusers and nutrient supplement users and other drug users. The results provide baseline data to understand whether nutrient supplements actually perform as expected in view of the fact that healthy people that take nutritional supplements may become healthier, but may also develop nutritional supplement abuse problems. Among 7,006 household heads of 24,614 household members from the Korea Health Panel data in 2008, a total of 6,009 household heads were the respondents of the Korea Health Panel Survey (appendix) in 2009. Method: The subjects of the present study were targeted household heads. The respondents who reported that they had taken (planned to take) life/health promotion-related drugs (01. vitamins/nutritional supplements) for more than three months that were purchased at pharmacies during the past one year at the time of the survey were defined as nutritional supplement users. Those who took other drugs (05. hair-loss treatments, 06. obesity treatments, 10. others) were regarded as other drug users. A chi-squared test was performed to analyze the sociodemographic characteristics of the subjects and differences between groups. Multiple regression analyses were conducted to analyze health behaviors according to nutrient supplement intake. Result: Comparison of (A) nutritional supplement users and nonusers revealed that those who were women, 50 years or older, and spent more than average living expenses were more likely to take nutritional supplements, which was not significant in health behavior variables. Analysis of nutritional supplement users and other drug users (B) revealed that those who were high school graduates or above, had a spouse, were non-smokers, took drugs, ate regular meals, and were not stressed by economic or family conflicts were more likely to take nutritional supplements. Conclusion: The results of the present study indicated that people take nutritional supplements because of their psychological desire to be healthy, not because they are not healthy, have problems, or believe supplements will make them healthier.

Impact of fetal diagnosis of congenital heart disease on parents (선천성 심질환의 산전 진단이 보호자의 임신 유지 결정에 미치는 영향)

  • Choi, Eun Young;Lee, Chang Hoon;Yoon, Myung Ja;Han, Eun Sook;Hong, Joon Suk;Jung, Yun Sook;Choi, Jung Yun
    • Clinical and Experimental Pediatrics
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    • v.49 no.10
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    • pp.1073-1078
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    • 2006
  • Purpose : This study was performed to assess how a fetal diagnosis of congenital heart disease affects parents, as regards pregnancy management and care of infants after birth. Methods : Database search to find out abnormal fetal echocardiography performed at Seoul National University Children's Hospital from July 1988 to June 2003 revealed 370 examinations. After excluding both arrhythmias without structural cardiac disease and multiple pregnancies, 299 pregnancies remained and this data formed the basis of this analysis. We retrospectively reviewed the medical records with special attention to pregnancy outcomes and also tried to find out factors influencing parental decisions on whether to continue or terminate pregnancy. Results : In this study, the mean gestation age at diagnosis was $28{\pm}6.0weeks$. The mean age of mothers was $30{\pm}3.9$ years old. Younger gestational ages at diagnosis(P=0.000), more severe grades of fetal heart disease(P=0.002) and younger mothers(P=0.014) correlated with terminations of pregnanies. But the grades of fetal status, the grades of associated anomaly, whether in-vitro-fertilization was carried out or not and numbers of previous children were not significant. Conclusion : This study found that the earlier gestational ages at diagnosis, younger maternal age and higher grades of fetal heart disease tended to lead parent to select abortions. Fetal echocardiographies were performed too late. Moreover Koreans have a biased view that malformation is a something incurable and a tragedy not only to oneself, but also to a family. So parents select terminations of pregnancy, even in curable cases. This is very unethical.

Geographic Conditions and Garden Designs of Byeol-seo Scenic Site of Gimcheon Bangcho-Pavilion and Mrs Choi's Pond (별서 명승 김천 방초정(芳草亭)과 최씨담(崔氏潭)의 입지 및 조영 특성)

  • Rho, Jae-Hyun;Lee, Hyun-Woo
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.34 no.1
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    • pp.71-82
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    • 2016
  • Through literature review and on-site survey of Gimcheon Bangcho pavilion(芳草亭), the features of garden design(庭園意匠) including geographic conditions, landscape modeling of Nujeong(樓亭) and Jidang(池塘, Pond), and scenic interpretations in Nujeong Jeiyoung poetry(樓亭題詠詩) have been carefully researched and the findings are presented below. Bangcho pavilion is located in a village called Wonteomaeul, which belongs to the feng shui state of golden hairpin and floating lotus. It has long been the cultural hub of communication and social interactions among the villagers. The Head House of Jeongyanggong(靖襄公宗宅), the main house(本第) of the Yeonan Yi Clan(延安李氏), is about 150m away from Bangcho pavilion, an artistic space whose landscape modeling is of the form called Nujeong. The name 'Bangcho' reflects the noble man(君子)'s determination: "I yearn for the place where honey parrots fly and the fragrant grass grow." From the two story structure of the pavilion where there is an additional floor installed to the central ondol room by a four-sided subdivision door, one can detect the aspiration of the men for pursuing an open view. One can also observe the efforts in designing the room to be used for multiple purposes from a private place to an office for periodic publication of a family lineage document called "Garyejunghae(家禮增解)". Bangcho pavilion's main sight of interest is Mrs Choi's Pond(崔氏潭), the one and only garden structure that comprises the twin round island of square pond(方池雙圓島) among the existing Jidangs in Korea. In this special Jidang, there are two coexisting islands that represent a well thought out garden facility for symbolizing conjugal affection and unyielding fidelity between master and servent(主從). In addition, the three inflows and one outflow facing the Ramcheon valley is regarded as an ideal garden design optimized for performing the function of a village bangjuk which is the site for undercurrent creation and ecological reprocessing. At present, Giant pussy willow is the only circular vegetation identified in the area of Bangcho pavilion, although this plant species is about to wither away judging from the signs of decrepitude that seems to persist for two out of three weeks. The old pine tree that appears in the 1872 Jeiyoung poetry of Byeongseon Song(宋秉璿) no longer exists. Anjae(安齋) Jang Yoo(張瑠)'s "Eight Scenary on Bangcho pavilion(芳草亭八詠)" and its expansive reproduction "Ten Scenary on Bangcho pavilion(芳草亭十景)" from Gwagang(守岡) Lee Manyoung(李晩永) depict vividly the pastoric scenery of an idyll(田園景) that stretches throughout the natural and cultural landscape of the province of Gimcheon and Guseong surrounding the Bangcho pavilion. The Bangcho pavilion sutra aims to establish Bangcho pavilion and the village of Wonteomaeul as the centre of microcosmos by dividing and allocating its scenic features according to the four seasons and times(四季四時), the eight courses(八方) and the meteorological phenomena, and it is the incarnation(顯現) of landscape perception upon the Byeol-seo Scenic site of Bangcho pavilion, the cultural hub of the region.

Matching Points Filtering Applied Panorama Image Processing Using SURF and RANSAC Algorithm (SURF와 RANSAC 알고리즘을 이용한 대응점 필터링 적용 파노라마 이미지 처리)

  • Kim, Jeongho;Kim, Daewon
    • Journal of the Institute of Electronics and Information Engineers
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    • v.51 no.4
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    • pp.144-159
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    • 2014
  • Techniques for making a single panoramic image using multiple pictures are widely studied in many areas such as computer vision, computer graphics, etc. The panorama image can be applied to various fields like virtual reality, robot vision areas which require wide-angled shots as an useful way to overcome the limitations such as picture-angle, resolutions, and internal informations of an image taken from a single camera. It is so much meaningful in a point that a panoramic image usually provides better immersion feeling than a plain image. Although there are many ways to build a panoramic image, most of them are using the way of extracting feature points and matching points of each images for making a single panoramic image. In addition, those methods use the RANSAC(RANdom SAmple Consensus) algorithm with matching points and the Homography matrix to transform the image. The SURF(Speeded Up Robust Features) algorithm which is used in this paper to extract featuring points uses an image's black and white informations and local spatial informations. The SURF is widely being used since it is very much robust at detecting image's size, view-point changes, and additionally, faster than the SIFT(Scale Invariant Features Transform) algorithm. The SURF has a shortcoming of making an error which results in decreasing the RANSAC algorithm's performance speed when extracting image's feature points. As a result, this may increase the CPU usage occupation rate. The error of detecting matching points may role as a critical reason for disqualifying panoramic image's accuracy and lucidity. In this paper, in order to minimize errors of extracting matching points, we used $3{\times}3$ region's RGB pixel values around the matching points' coordinates to perform intermediate filtering process for removing wrong matching points. We have also presented analysis and evaluation results relating to enhanced working speed for producing a panorama image, CPU usage rate, extracted matching points' decreasing rate and accuracy.

Tumor Prosthetic Replacement for the Metastatic Bone Tumors Involving the Proximal Femur (대퇴골 근위부 전이성 종양 환자의 종양 대치물 삽입술)

  • Sung, Ki-Sun;Chang, Moon-Jong
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.1
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    • pp.48-54
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    • 2007
  • Purpose: To evaluate clinical results of the tumor prosthetic replacement for pathologic fracture of the proximal femur with extensive bony destruction due to metastatic bone tumors. Materials and Methods: From 2005 October to 2006 October, resection of proximal femur and tumor prosthesis replacement was performed for metastatic bone tumors extensively involving trochanteric area in 6 patients. The mean age of overall patients was 61(range, 48~77). Mean clinical follow up was 10.5 months (range, 6~16). Primary tumor consisted with multiple myeloma in 2 patients, lung cancer in 1, breast cancer in 1, transitional cell carcinoma of the renal pelvis in 1, unknown origin in 1 patient. $MUTARS^{(R)}$ proximal femur (Implantcast, Munster, Germany) were used in all cases. The functional evaluation in the lower extremities was performed with Musculoskeletal Tumor Society 1993 scores. The degree of pain relief after surgical treatment was assessed with Visual Analogue Scale (VAS). Results: At the final follow up, all of the patients survived. The mean lower extremities functional score of Musculoskeletal Tumor Society 1993 was 17.8(59.3%)(range, 12~25). VAS was improved to 2.5 from 8.5 after the surgical treatment. Ambulation was encouraged as soon as possible and mean duration after surgery for ambulation was 7.3(range, 3~16) days. Post-operatively, there was no surgical infection, periprosthetic fracture or loosening. Dislocation occurred in one out of six cases. Conclusion: Resection of proximal femur and tumor prosthesis replacement for metastatic bone tumors around proximal femur extensively involving trochanteric area seems to be safe procedure in view of post-operative complication, and effective for functional restoration as well as pain relief. Thus, it is accordant to the treatment principle of the metastatic bone tumors.

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A Study on Food Service Franchise Location Factors and Quality of Service Factors, The Impact on Customer Satisfaction (외식 프랜차이즈 입지요건과 서비스 품질 요인이 고객만족에 미치는 영향)

  • Kim, Jo In Seog;Cho, Kyu Youn;An, Sang
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.11 no.5
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    • pp.77-90
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    • 2016
  • This study is to examine the importance of site selection and service quality in franchise business as food service franchise became one of the fastest-growing service industries today. The chief finding of this study is as follows: First, a survey in locational and service quality factors affecting food service franchise shows that responders are more concerned with hygiene and visibility of the store than proximity and transportation advantages which reflects low statistical significance, thus the distance did not seem to be a big problem for the responders in the context that they mostly visit nearby food franchise. Second, the examination of the influence by the service quality factors and customer satisfaction shows significant positive relation with customer response, speed and accuracy, and accuracy factors which reveals that the responders prefer prompt response and swift judgment toward the customer's needs and expectations, professional knowledge services to the credibility factors in which little correlation with the customer satisfaction were found. Third, the examination of the influence by the service quality factors, locational factors, and re-visit reveals that customer response and specialty showed statistically significant correlation with intention of WOM (Word of Mouth) and revisit, which suggests that swift judgment and response toward the customer's needs and expectations, professional knowledge services is of great importance to both customer satisfaction and revisit. The study on the aspects of locational and service quality factors affecting franchise industry's customer satisfaction was conducted as above, an investigation in both factors' influence on the customer satisfaction was made, and based on the results of the analysis, this research seeks an optimal operation strategy of a franchise business. Food service franchise are relatively very competent to business adminstration and reaction capability to consumption changes due to the already established market, and there are stores springing up everywhere inspired by the founders who are too confident of their success in the franchise business. However, it is necessary for the franchise beginners to figure out a zone oriented, regular customer oriented business strategy than just complying with the head office manual. Owing to an increasing trend of opening medium to large sized stores and investments in the wake of converting to multiple business type Korean food franchise, there is growing need to set up new concept of store development and operational management strategy in order to overcome the excessive competition and limited sales volume of the old-fashioned small sized, small capital franchise stores. Furthermore, as most business category of food service franchise serve very similar menus, from a product differentiation point of view, it is required to map out flexible sales concept including the adoption of competitive and low-price strategy. In conclusion, as is shown in the analytical research, the customers' optimal choice fluctuate over their preferences like customer convenience and circumstances rather than insisting on specific brand, thus it will be necessary for the franchise stores to draw up aggressive strategy and planning in running food service franchise to maximize their profits.

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Genetic Alteration of Tumor Suppressor Gene and Microsatellite in Nonsmall Cell Lung Cancer (비소세포폐암에서 종양억제유전자와 극소위성 변이에 관한 연구)

  • Shin, Tae-Rim;Hong, Young-Sook;Kim, Jhin-Gook;Chang, Jung-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.4
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    • pp.453-465
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    • 2000
  • Background : Lung carcinogenesis is a multistage process involving alterations in multiple genes and diverse pathway. Mutational activation of oncogenes and inactivation of tumor suppressor genes, and subsequent increased genetic instability are the major genetic events. The p53 gene and FHIT gene as tumor suppressor genes contribute to the pathogenesis of lung cancer, evidenced by mutation, microsatellite instability(MI) and loss of heterozygosity(LOH). Methods : We analysed genetic mutations of p53 and FHIT gene in 29 surgical specimens of nonsmall cell lung cancer using PCR-single strand conformation polymorphism, DNA sequencing and RT-PCR. MI and LOH were analyzed in loci of D3S1285, D9S171, and TP53. Results : In 2 cases, point mutation of p53 gene was observed on exon 5. MI of 3 times and LOH of 14 times were observed in at least one locus. In terms of the location of microsatellite, D3S1285 as a marker of FH1T was observed in 5 cases out of 26 specimens; D9S171 as a marker of p16 in 5 out of 17; and TP53 as a marker of p53 in 7 out of 27. In view of histologic type, squamous cell carcinoma presented higher frequency of microsatellite alteration, compared to others. Mutation of FHIT gene was observed in 11 cases and 6 cases of those were point mutation as a silent substitution on exon 8. FHIT mRNA expression exhibited deletion on exon 6 to 9 in 4 cases among 15 specimens, presenting beta-actin normally. Conclusion : Our results show comparable frequency of genetic alteration in nonsmall cell lung cancer to previous studies of Western countries. Microsatellite analysis might have a role as a tumor marker especially in squamous cell carcinoma. Understanding molecular abnormalities involved in the pathogenesis could potentially lead to prevention, earlier diagnosis and the development of novel investigational approaches to the treatment of lung cancer.

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A Diagnostic Study on High School Students' Health and Quality of Life - Based on the PRECEDE model - (고등학생의 건강 및 삶의 질에 대한 진단적 연구 - PRECEDE 모형을 근간으로 -)

  • Yoo Jae-Soon;Hong Yeo-Shin
    • The Journal of Korean Academic Society of Nursing Education
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    • v.3
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    • pp.78-98
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    • 1997
  • Health education, as the most fundamental concept for national health promotion, alms for developing the self-care ability of the general public. High school days are regarded as the period when most important physical, mental and social developments occur, and most health-related behaviors are formed. School health education is one of the major learning resources influencing health potential in the home and community as well as for the individual student. High school health education in Korea has a fundamental systemic flaw in that health-related subjects are divided and taught under various subjects areas at school. In order to achieve the goal of school health education, it is essential to make a systematic assessment of the learner's concerns connected with his health and life, and the factors affecting them. So far, most of the research projects that had been carried out for improving high school health education were limited in their concerns to a particular aspect of health. Even though some had been done in view of comprehensive school health education, they failed to Include a health assessment of the learner. Therefore, in this study the high school students' concerns related to health and life were investigated in the first place on the basis of the PRECEDE model, developed by Green and others for the purpose of a comprehensive diagnostic research on high school health education. This study was done in two steps : one was the basic study for developing research instrument and the other was the main one. The former was conducted at five high schools in Seoul and Cheongju for 2 months-beginning in March, 1996. The students were asked to respond to questions related to their health and lives in unstructured open-ended question forms. On the basis of analysis of the basic study, the diagnostic instruments for the quality of life, health problems, health behavior and educational factors were constructed to be used for the collection of data for main study. An expert panel and the pilot study were used to improve content validity and reliability of the instruments. The reliability of the instruments was measured at between .7697 and .9611 by the Cronbach $\alpha$. The data for this study were collected from the sample consisted of the junior and senior classes of twenty general and vocational high schools in Seoul and Cheongju for two months period beginning in July, 1996. In analyzing the data, both t-test and $X^2$-test were done by using SAS-$PC^+$ Program to compare data between the sexes of the high school students and the types of high school. A canonical correlation analysis was carried out to determine the relationships among the diagnostic variables, and a multivariate multiple regression analysis was conducted by using LISREL 8.03 to ascertain the influences of variables on the high school students' health and quality of life. The results were as follows : 1) The findings of the hypothesis tests (1) The canonical correlation between the educational diagnosis variables and behavioral, epidemiological, social diagnosis variables was .7221, which was significant at the level of p<.001. (2) The canonical correlation between the educational diagnosis variables and the behavior variables was .6851, which also was significant (p<.001). (3) The canonical correlation between the behavioral diagnosis variables and the epidemiological variables was 4295, which was significant (p<.001). (4) The canonical correlation between the epidemiological diagnosis variables and the social variables was .6005, which was also significant (p<.001). Therefore, the relationship between each diagnosis variable suggested by the PRECEDE model had been experimentally proven to be valid, supporting the conceptual framework of the study as appropriate for assessing the multi-dimensional factors affecting high school students' health and quality of life. Health behavior self-efficacy, the level of parents' interest and knowledge of health, and the level of the perception of school health education, all of which are the educational diagnostic variables, are the most influential variables in students' health and quality of life. In particular, health behavior self-efficacy, a causative factor, was one of the main influential variables in their health and quality of life. Other diagnostic variables suggested in the steps of the PRECEDE model were found to have reciprocal relations rather than a unidirectional causative relationship. The significance of this research is that it has diagnosed the needs of high school health education by the learner-centered assessment of variety of factors related to the health and the life of the students. This research findings suggest an integrated system of school health education to be contrived to enhance the effectiveness of the education by strengthening the influential factors such as self-efficacy to improve the health and quality of the lives of high school students.

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A Study on the Effect of Cold Application Using a Sponge Bath in Healthy Adults (냉요법 적용방법에 따른 냉요법 효과에 관한 연구-건강한 성인 여성에서 스폰지 목욕방법을 중심으로)

  • Chung, Hyun-Sook;Kang, Kyu-Sook;Hwang, Ae-Ran
    • The Korean Nurse
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    • v.28 no.3
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    • pp.68-82
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    • 1989
  • This study was a quasi-experimental research study to test the characteristics of temperature regulation according to sponge bath methods of cold application. Thirteen volunteers were selected from among nursing college students according to an established criteria using a purposive sampling technique. Four different cold application methods were used: $\circled1$ tepid water sponge bath at $28^{\circ}C$, $\circled2$ 20% alcohol sponge bath at $28^{\circ}C$, $\circled3$ 40% alcohol sponge bath at $28^{\circ}C$ and $\circled4$ tepid water sponge bath at 28$^{\circ}$C plus an ice bag to the head. Changes in rectal temperature, mean skin temperature, mean body temperature, heat content change and thermal discomfort during the cold application were measured at 5 minute intervals over a 120 minute period. The data collection period was from Dec. 20, 1988 to Feb. 3, 1989. The data were analyzed using descriptive statistics, simple regression, ANOVA, Duncan's multiple range test and Pearson correlation coefficient using the SPSS-X Program. The results of the study are summarized as follows. Five general hypothesis were tested. Hypothesis 1 that "Change in heat content will be decreased for each cold application method according to the cold application time" was rejected. (tepid water sponge bath: after 10 minutes of cold application, 20% alcohol sponge bath: after 25 minutes of cold application: 40% alcohol sponge bath: after 45 minutes of cold application, tepid water sponge bath plus an ice bag to the head: after 80 minutes of cold application) Hypothesis 2 that "Thermal discomfort will be changed for each cold application method according to the cold application time" was rejected after 5minutes of cold application. Hypothesis 3 that "Change in heat content will differ among the cold application methods" was accepted except 0~5, 0~10, 0~65, 0~105 and 0~120 minute. This difference showed significance only between sponge bath methods and tepid water sponge bath plus an ice bag to the head. Hypothesis 4 that "Thermal discomfort will differ among the cold application methods" was accepted at 15, 20, 35, 45, 75, 80, 90, 95, 100, 105, 110, 115 and 120 minute of cold application time. This difference showed significance only between sponge bath methods and tepid water sponge bath plus an ice bag to the head. Hypothesis 5 that "The higher the change in heat content, the higher the thermal discomfort during the cold application time" was accepted for between 10~60 and 75 minute of cold application. In conclusion, this study showed that in sponge bath at $28^{\circ}C$, 10~80 minute was a effective cold application time in the view of heat loss through the skin. Concerning the effects of evaporation and thermal discomfort, it was found that there was no difference with regard to the solutions; tepid water sponge bath; 20% alcohol sponge bath or 40% alcohol sponge bath at a $28^{\circ}C$ controlled solution temperature. So it was thought that the type of solution itself did not have a big influence on the heat loss through skin. The combined effect of sponge bath with an ice bag to the head showed a significant difference and also showed a slight increase in thermal discomfort. On the basis of this research it can be concluded that cold application, for example, an ice bag to the head during a tepid water sponge bath is a good method as it increase heat loss through conduction, although fit can also cause a slight increase in thermal discomfort. The correlation between changes in heat content and thermal discomfort were not high. So factors other than change in heat content are considered to have an effect on the cognition of thermal discomfort.

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