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The efficacy of continuous positive airway pressure (CPAP) for patient with left breast cancer (좌측 유방암 방사선치료에서 CPAP(Continuous Positive Airway Pressure)의 유용성 평가)

  • Jung, Il Hun;Ha, Jin Sook;Chang, Won Suk;Jeon, Mi Jin;Kim, Sei Joon;Jung, Jin Wook;Park, Byul Nim;Shin, Dong Bong;Lee, Ik Jae
    • The Journal of Korean Society for Radiation Therapy
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    • v.31 no.2
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    • pp.43-49
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    • 2019
  • Purpose: This study examined changes in the position of the heat and lungs depending on the patient's breathing method during left breast cancer radiotherapy and used treatment plans to compare the resulting radiation dose. Materials and methods: The participants consisted of 10 patients with left breast cancer. A CT simulator(SIMENS SOMATOM AS, Germany) was used to obtain images when using three different breathing methods: free breathing(FB), deep inspiration breath hold(DIBH with Abches, DIBH), inspiration breath hold(IBH with CPAP, CPAP). A Ray Station(5.0.2.35, Sweden) was used for treatment planning, the treatment method was volumetric modulated arc therapy (VMAT) with one partial arc of the same angle, and the prescribed dose to the planning target volume (PTV) was a total dose of 50Gy(2Gy/day). In treatment plan analysis, the 95% dose (D95) to the PTV, the conformity index(CI), and the homogeneity index (HI) were compared. The lungs, heart, and left anterior descending artery (LAD) were selected as the organs at risk(OARs). Results: The mean volume of the ipsilateral lung for FB, DIBH, and CPAP was 1245.58±301.31㎤, 1790.09±362.43 ㎤, 1775.44±476.71 ㎤. The mean D95 for the PTV was 46.67±1.89Gy, 46.85±1.72Gy, 46.97±23.4Gy, and the mean CI and HI were 0.95±0.02, 0.96±0.02, 0.95±0.02 and 0.91±0.01, 0.90±0.01, 0.92±0.02. The V20 of Whole Lung was 10.74±4.50%, 8.29±3.14%, 9.12±3.29% and The V20 of the ipsilateral lung was 20.45±8.65%, 17.18±7.04%, 18.85±7.85%, the Dmean of the heart was 7.82±1.27Gy, 6.10±1.27Gy, 5.67±1.56Gy, and the Dmax of the LAD was 20.41±7.56Gy, 14.88±3.57Gy, 14.96±2.81Gy. The distance from the thoracic wall to the LAD was measured to be 11.33±4.70mm, 22.40±6.01mm, 20.14±6.23mm. Conclusion: During left breast cancer radiotherapy, the lung volume was 46.24% larger for DIBH than for FB, and 43.11% larger for CPAP than FB. The larger lung volume increases the distance between the thoracic wall and the heart. In this way, the LAD, which is one of the nearby OARs, can be more effectively protected while still satisfying the treatment plan. The lung volume was largest for DIBH, and the distance between the LAD and thoracic wall was also the greatest. However, when performing treatment with DIBH, the intra-fraction error cannot be ignored. Moreover, communication between the patient and the radiotherapist is also an important factor in DIBH treatment. When communication is problematic, or if the patient has difficulty holding their breath, we believe that CPAP could be used as an alternative to DIBH. In order to verify the clinical efficacy of CPAP, it will be necessary to perform long-term follow-up of a greater number of patients.

Translocation of Tolclofos-methyl from Ginseng Cultivated Soil to Ginseng (Panax ginseng C. A. Meyer) and Residue Analysis of Various Pesticides in Ginseng and Soil (토양 중 잔류된 Tolclofos-methyl의 인삼(Panax ginseng C. A. Meyer)에 대한 이행 및 잔류 특성)

  • Kim, Ji Yoon;Kim, Hea Na;Saravanan, Manoharan;Heo, Seong Jin;Jeong, Haet Nim;Kim, Jang Eok;Kim, Kwan Rae;Hur, Jang Hyun
    • The Korean Journal of Pesticide Science
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    • v.18 no.3
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    • pp.130-140
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    • 2014
  • Recently, some of the previous studies reported that tolclofos-methyl is still exist in ginseng cultivated soil, even though it is has been banned for ginseng. Therefore, the current study was aimed to examine the levels of absorption and translocation of tolclofos-methyl from ginseng cultivated soil to ginseng root and leaf stem for the period of 1 year. For this study, ginseng plants were transplanted in pots and treated with $5.0mg\;kg^{-1}$ of tolclofos-methyl (50% WP). At the end of each interval periods (every three months) the samples (soil, roots and leaf stems) were collected and analyzed the absorption and translocation levels of tolclofos-methyl using gas chromatography and mass spectrometry (GC-MS). The limit of quantitation of tolclofos-methyl was found to be $0.02mg\;kg^{-1}$ and 70.0~120.0% recovery was obtained with coefficient of variation of less than 10% regardless of sample types. In this study, a considerable amount of translocation of tolclofos-methyl residues were found in soil (4.28 to $0.06mg\;kg^{-1}$), root (7.09 to $1.54mg\;kg^{-1}$) and leaf stem (0.79 to $0.69mg\;kg^{-1}$). The results show that the tolclofos-methyl was absorbted and translocated from ginseng cultivated soil to ginseng root and ginseng leaf stem and found to be decreased time-coursely. Secondly, we were also analyzed soil, root and leaf stems samples from Hongcheon, Cheorwon, Punggi and Geumsan by GC-MS/MS (172 pesticides), LC-MS/MS (74 pesticides). In this study, 43 different pesticides were detected ($0.01{\sim}7.56mg\;kg^{-1}$) in soil, root and leaf stem. Further, tolclofos-methyl was detected 4 times separately in root sample alone which is less ($0.01{\sim}0.05mg\;kg^{-1}$) than their maximum residual limit (MRL) in ginseng. Consequently, the results from both studies indicate the residues of tolclofos-methyl found in ginseng cultivated soil and ginseng ensuring their safety level. Moreover, long-term evaluations are needed in order to protect the soil as well as ginseng free from tolclofos-methyl residues.

The Determinants of Health Promoting Behavior in Students on Dept of Dental Hygiene (치위생과 학생의 건강증진행위 결정요인에 관한 연구)

  • Kim, Eun-Mi;Lee, Hyang-Nim
    • Journal of dental hygiene science
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    • v.4 no.3
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    • pp.141-148
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    • 2004
  • This study was examed in order to determine influential factors of health promoting behavior on Dental Hygiene students the health promoting behavior. So examed students' health promoting behavior, self-efficacy, perceived benefit, perceived barrier, a health locus of control, self-esteem. A the result of this study were as follows: (1) Performance mean score in health promoting behavior was 2.60, self achievement score was 2.89, health responsibility score was 2.12, exercise score was 1.89, nutrition score was 2.45, interpersonal support score was 2.97, stress management score was 2.63. Performance mean score in self-efficacy was 2.56, perceived benefit was 3.45, perceived barrier was 2.32, a health locus of control score was 3.04, self-esteem score was 2.81. (2) Performance in health promoting behavior was significant differences in year, religion, economical level, experience of disease on family, perceived health status(p<0.05), perceived oral health status(p<0.001). Performance in self achievement was significant differences in year, economical level, perceived health status(p<0.05), religion, perceived oral health status(p<0.01). Performance in health responsibility was significant differences in year, religion, economical level, BMI(p<0.05) and experience of disease on myself, perceived oral health status(p<0.001). Performance in excercise was significant differences in mother's educational level, experience of disease on family, perceived oral health status(p<0.05) and nutrient was economical level, perceived oral health status(p<0.01), perceived health status(p<0.05). Performance in interpersonal relations was only significant differences perceived oral health status(p<0.05) and in stress management was year, perceived oral health status(p<0.05). (3) Performance in self-efficacy was significant differences in economical level, health status(P<0.05) and perceived health status, perceived oral health status(p<0.01). Performance in perceived benefit was significant differences in religion(p<0.05). Performance in perceived barrier was significant differences economical level, perceived oral health status(p<0.05), experience of disease on myself(p<0.01). Performance in a health locus of control was significant differences year(p<0.05), performance in a perceived oral health status(p<0.01). (4) Performance in health promoting behavior was significantly correlated with self-efficacy(r=0.376), perceived benefit(r=0.188), perceived barrier(r=-0.155), a health locus of control (r=0.064), self-esteem(r=0.318). (5) Self-efficacy was the highest factor predicting health promoting behavior.

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Information Privacy Concern in Context-Aware Personalized Services: Results of a Delphi Study

  • Lee, Yon-Nim;Kwon, Oh-Byung
    • Asia pacific journal of information systems
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    • v.20 no.2
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    • pp.63-86
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    • 2010
  • Personalized services directly and indirectly acquire personal data, in part, to provide customers with higher-value services that are specifically context-relevant (such as place and time). Information technologies continue to mature and develop, providing greatly improved performance. Sensory networks and intelligent software can now obtain context data, and that is the cornerstone for providing personalized, context-specific services. Yet, the danger of overflowing personal information is increasing because the data retrieved by the sensors usually contains privacy information. Various technical characteristics of context-aware applications have more troubling implications for information privacy. In parallel with increasing use of context for service personalization, information privacy concerns have also increased such as an unrestricted availability of context information. Those privacy concerns are consistently regarded as a critical issue facing context-aware personalized service success. The entire field of information privacy is growing as an important area of research, with many new definitions and terminologies, because of a need for a better understanding of information privacy concepts. Especially, it requires that the factors of information privacy should be revised according to the characteristics of new technologies. However, previous information privacy factors of context-aware applications have at least two shortcomings. First, there has been little overview of the technology characteristics of context-aware computing. Existing studies have only focused on a small subset of the technical characteristics of context-aware computing. Therefore, there has not been a mutually exclusive set of factors that uniquely and completely describe information privacy on context-aware applications. Second, user survey has been widely used to identify factors of information privacy in most studies despite the limitation of users' knowledge and experiences about context-aware computing technology. To date, since context-aware services have not been widely deployed on a commercial scale yet, only very few people have prior experiences with context-aware personalized services. It is difficult to build users' knowledge about context-aware technology even by increasing their understanding in various ways: scenarios, pictures, flash animation, etc. Nevertheless, conducting a survey, assuming that the participants have sufficient experience or understanding about the technologies shown in the survey, may not be absolutely valid. Moreover, some surveys are based solely on simplifying and hence unrealistic assumptions (e.g., they only consider location information as a context data). A better understanding of information privacy concern in context-aware personalized services is highly needed. Hence, the purpose of this paper is to identify a generic set of factors for elemental information privacy concern in context-aware personalized services and to develop a rank-order list of information privacy concern factors. We consider overall technology characteristics to establish a mutually exclusive set of factors. A Delphi survey, a rigorous data collection method, was deployed to obtain a reliable opinion from the experts and to produce a rank-order list. It, therefore, lends itself well to obtaining a set of universal factors of information privacy concern and its priority. An international panel of researchers and practitioners who have the expertise in privacy and context-aware system fields were involved in our research. Delphi rounds formatting will faithfully follow the procedure for the Delphi study proposed by Okoli and Pawlowski. This will involve three general rounds: (1) brainstorming for important factors; (2) narrowing down the original list to the most important ones; and (3) ranking the list of important factors. For this round only, experts were treated as individuals, not panels. Adapted from Okoli and Pawlowski, we outlined the process of administrating the study. We performed three rounds. In the first and second rounds of the Delphi questionnaire, we gathered a set of exclusive factors for information privacy concern in context-aware personalized services. The respondents were asked to provide at least five main factors for the most appropriate understanding of the information privacy concern in the first round. To do so, some of the main factors found in the literature were presented to the participants. The second round of the questionnaire discussed the main factor provided in the first round, fleshed out with relevant sub-factors. Respondents were then requested to evaluate each sub factor's suitability against the corresponding main factors to determine the final sub-factors from the candidate factors. The sub-factors were found from the literature survey. Final factors selected by over 50% of experts. In the third round, a list of factors with corresponding questions was provided, and the respondents were requested to assess the importance of each main factor and its corresponding sub factors. Finally, we calculated the mean rank of each item to make a final result. While analyzing the data, we focused on group consensus rather than individual insistence. To do so, a concordance analysis, which measures the consistency of the experts' responses over successive rounds of the Delphi, was adopted during the survey process. As a result, experts reported that context data collection and high identifiable level of identical data are the most important factor in the main factors and sub factors, respectively. Additional important sub-factors included diverse types of context data collected, tracking and recording functionalities, and embedded and disappeared sensor devices. The average score of each factor is very useful for future context-aware personalized service development in the view of the information privacy. The final factors have the following differences comparing to those proposed in other studies. First, the concern factors differ from existing studies, which are based on privacy issues that may occur during the lifecycle of acquired user information. However, our study helped to clarify these sometimes vague issues by determining which privacy concern issues are viable based on specific technical characteristics in context-aware personalized services. Since a context-aware service differs in its technical characteristics compared to other services, we selected specific characteristics that had a higher potential to increase user's privacy concerns. Secondly, this study considered privacy issues in terms of service delivery and display that were almost overlooked in existing studies by introducing IPOS as the factor division. Lastly, in each factor, it correlated the level of importance with professionals' opinions as to what extent users have privacy concerns. The reason that it did not select the traditional method questionnaire at that time is that context-aware personalized service considered the absolute lack in understanding and experience of users with new technology. For understanding users' privacy concerns, professionals in the Delphi questionnaire process selected context data collection, tracking and recording, and sensory network as the most important factors among technological characteristics of context-aware personalized services. In the creation of a context-aware personalized services, this study demonstrates the importance and relevance of determining an optimal methodology, and which technologies and in what sequence are needed, to acquire what types of users' context information. Most studies focus on which services and systems should be provided and developed by utilizing context information on the supposition, along with the development of context-aware technology. However, the results in this study show that, in terms of users' privacy, it is necessary to pay greater attention to the activities that acquire context information. To inspect the results in the evaluation of sub factor, additional studies would be necessary for approaches on reducing users' privacy concerns toward technological characteristics such as highly identifiable level of identical data, diverse types of context data collected, tracking and recording functionality, embedded and disappearing sensor devices. The factor ranked the next highest level of importance after input is a context-aware service delivery that is related to output. The results show that delivery and display showing services to users in a context-aware personalized services toward the anywhere-anytime-any device concept have been regarded as even more important than in previous computing environment. Considering the concern factors to develop context aware personalized services will help to increase service success rate and hopefully user acceptance for those services. Our future work will be to adopt these factors for qualifying context aware service development projects such as u-city development projects in terms of service quality and hence user acceptance.