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Dose Alterations at the Distal Surface by Tissue Inhomogeneity in High Energy Photon Beam (조직 불균질성에 의한 고에너지 광자선의 선량변화)

  • Kim, Young-Ai;Choi, Tae-Jin;Kim, Ok-Bae
    • Radiation Oncology Journal
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    • v.13 no.3
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    • pp.277-283
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    • 1995
  • Purpose : This study was performed to measure dose alteration at the air-tissue interface resulting from rebuild-up to the loss of charged particle equilibrium in the tissues around the air-tissue interfaces. Materials and Methods : The 6 and 10-MV photon beam in dual energy linear accelerator were used to measure the surface dose at the air-tissue interface The polystyrene phantom sized $25{\times}25{\times}5\;cm^3$ and a water phantom sized $29{\times}29{\times}48\;cm^3$ which incorporates a parallel-plate ionization chamber in the distal side of air gap were used in this study. The treatment field sizes were $5{\times}5\;cm^2,\;10{\times}10\;cm^2\;and\;20{\times}20\;cm^2$. Air cavity thickness was variable from 10 mm to 50 mm. The observed-expected ratio (OER) was defined as the ratio of dose measured at the distal junction that is air-tissue interface to the dose measured at the same point in a homogeneous phantom. Results : In this experiment, the result of OER was close or slightly over than 1.0 for the large field size but much less (about 0.565) than 1.0 for the small field size in both photon energy. The factors to affect the dose distribution at the air-tissue interface were the field size, the thickness of air cavity. and the photon energy. Conclusion : Thus, the radiation oncologist should take into account dose reduction at the air-tissue interface when planning the head and neck cancer especially pharynx and laryngeal lesions, because the dose can be less nearly $29{\%}$ than predicted value.

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Analysis of Anatomical Conformity of Straight Antegrade Humeral Intramedullary Nail in Korean (한국인에서의 직선형 전향적 상완골 골수 내 금속정의 해부학적 적합성 분석)

  • Choi, Sung;Jee, Seungmin;Hwang, Seongmun;Shin, Dongju
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.6
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    • pp.498-503
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    • 2021
  • Purpose: The aim of this study were to find ideal entry point of straight antegrade humeral intramedullary nail (SAHN) for the treatment of proximal humerus fracture in Korean and to analyze anatomical conformity using computed tomography. Materials and Methods: From May 2014 to October 2016, the study was conducted retrospectively on 74 Korean patients who had taken computed tomography on both normal and affected shoulder joint as result of shoulder injury. The mean age of the patients was 64.5 years (range, 22-95 years). Radiologic evaluation was done using multiplanar reconstruction technique of the computer tomography on normal proximal humerus. We located ideal entry point of SAHN as the point where humerus intramedullary center axis and humeral head meet. Distance between the entry point and local anatomical landmark was measured. We defined the critical distance as the distance between entry point and the most medial point of the supraspinatus attachment site. For adequate fixation and avoidance of injury to rotator cuff, critical distance should be over 8 mm according to Euler, and we defined the critical type when it is less than 8 mm. Critical distance, sex, age, height, body weight, body mass index was evaluated for the statistical significance. Results: The ideal entry point was as follows: the mean anteroposterior distance, the sagittal distance to the lateral margin of bicipital groove, was 11.5 mm and the mean mediolateral distance, the coronal distance to the lateral margin of grater tuberosity, was 20.5 mm. The mean critical distance, distance from the entry point to the just medial to insertion of the supraspinatus tendon, was 8.0 mm. Critical type with critical distance less than 8 mm was found in 41 in 74 patients (55.4%). Conclusion: The ideal entry point of SAHN in Korean was located on 11.5 mm posteriorly from the lateral margin of bicipital groove and 20.5 mm medially from lateral margin of greater tuberosity. More than half of the cases were critical type. Since critical type can possibly cause rotate cuff injury during nail insertion on entry point, surgeon should consider anatomical variance before choosing surgical option.

A Study on Estimation of Caring Demand for Extended Care Facilities by Activities of Daily Living (ADL(Activities of Daily Living)을 이용한 무료노인요양시설 수용노인의 돌봄필요도에 관한 연구)

  • Kim, Chul-Woung;Moon, Ok-Ryun;Lee, Sang-Yi;Yoo, Jae-Won;Yi, Sang-Gu
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.3 s.62
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    • pp.564-578
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    • 1998
  • Most extended care facilities have admitted both the healthy and unhealthy elderly, among which members' average caring demand vary. The Aged Welfare Law, however, currently provides no reasonable basis on the staffing policy for extended care facilities. It just reflects the admitted number of the elderly rather than differences in members' average caring demand among facilities. This study is designed to estimate the need for caring staff on the basis of the correlation between the individual health status measured by various tools including Activities of Daily Living and caring demand by actual service time for each one. The sample included all of the admitted elderly(187 persons) in 4 extended care facilities, two in Seoul and the other two in Kangwon-Do over the survey period October 5 through October 20, 1996. The survey process consisted of 3 stages. (1) The current staffing information was collected through self-completed written questionnaires left for head of official in each facility. (2) Six graduate students at School of Public Health interviewed all residents to collect information on their health status and sociodemographics. The response rate for the interview was relatively high(85%). (3) Information on direct and indirect caring time consumed for each residents came from self-completed written questionnaires given to nurses and helpers in each target facilities. Analysis of the data was made using Pearson's correlation and multiple regression technique through SAS program. Based on this procedure, the following was found. 1. No facility meet the staffing standard in the Aged Welfare Law completely. 2. It is actual service time that is most correlated with ADL(Activities of daily living). 3. When all of the elderly are divided by four groups based on the level of ADL, the mean values of needed caring time in each group are 15, 21, 36 and 88 minutes respectively. 4. There is no significant difference among facilities in distribution of elderly person by group. 5. No facility meets the estimated number of nurses and helpers which reflects health status of the admitted elderly. Therefore, it is required that severity of the admitted elderly be considered in establishing staffing standard for extended care facility.

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Usability Assessment of Plan Transfer between TOMO HAD and Radixact : Planning Study (TOMO HDA와 Radixact 치료 계획 간 Transfer에 대한 유용성 평가 : Planning Study)

  • An, Ye Chan;Kim, Jong Sik;Kwon, Dong Yeol;Kim, Jin Man;Choi, Byeong Ki
    • The Journal of Korean Society for Radiation Therapy
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    • v.30 no.1_2
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    • pp.117-128
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    • 2018
  • Purpose : To evaluate the usability of plan transfer between TOMO HD and Radixact, we compared the differences of dose in transferred plans by evaluating the dose of normal organ and target. TOMO HDA and Radixact. The completed plans were transferred each other and we compared the differences of dose by evaluating the DVH of each plans. Materials and Methods : We planned 4 different plans assuming the treatment of 2 cases in Head and Neck Cancer and 2 cases Prostate cancer. Each plan was designed so that 95 % of the prescription dose was irradiated over 99 % of the target volume, and the normal organ constraints dose was based on the SMC tolerance dose protocol. Each plan was transferred to each equipment and DVH(dose volume histogram) analysis of the transferred plans was compared and evaluated. Results : The Mean dose of CTV and GTV was increased and decreased in the transferred plans, but there was no significant differences. The target coverage of CTV and GTV was decreased in all cases of transferred plans from TOMO HAD to Radixact, and the change of CI and HI in CTV was within 0.1. Normal organ dose was increased in most cases when transferring from HAD to Radixact in both treatment plans. Conclusion : According to the results of this experiment, the target coverage was above the standard and the normal organ dose was almost same or decreased when transferring the plans from Radixact to HDA equipment. However the target coverage was reduced when transferring the plans from HDA to Radixact and there was an increase in dose in normal organs that could cause sever side effects such as Optic Chiasm ($D_{max}$1.38 Gy), Bladder ($D_{max}$3.07 Gy), Penile Bulb ($D_{max}$1.14 Gy). Therefore, it is necessary to pay attention to the dose change when transferring the plan and one-time transfer due to equipment inspection will be useful for efficient radiation therapy, but if the transferred treatment plans continue for several consecutive days, the treatment plan should be resumed.

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Effect of GB 34-GB 39 Electro-acupuncture on Regional Cerebral Blood Flow in Stroke Patients and Normal Volunteers Evaluated by $^{99m}Tc-ECD$ SPECT (양릉천-현종 전침치료가 뇌경색환자 및 정상인의 뇌혈류에 미치는 영향 - SPECT와 SPM을 이용한 연구 -)

  • Han, Jin-An;Jeong, Dong-Won;Bae, Hyung-Sup;Park, Sung-Uk;Jung, Woo-Sang;Park, Jung-Mee;Ko, Chang-Nam;Cho, Ki-Ho;Kim, Young-Suk;Kim, Deok-Yoon;Moon, Sang-Kwan
    • The Journal of Korean Medicine
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    • v.27 no.3 s.67
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    • pp.187-200
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    • 2006
  • Objectives: Acupuncture has been applied in Asia for thousands of years, especially to rehabilitation after stroke. It has been reported that acupuncture increased cerebral blood supply and stimulated the functional activity of brain nerve cells shown by using brain imaging techniques. This study was to evaluate the effect of GB 34-GB 39 electro-acupuncture (EA) on regional cerebral blood flow (rCBF) in stroke patients and normal volunteers using single photon emission computed tomography (SPECT). Methods: The study procedure was divided into two parts: patients and volunteers studies. For the patients study, ten ischemic stroke patients (3 males, 7 females, mean age $68.5{\pm}8.9$ years old) were selected. Baseline brain SPECT was done with triple head gamma camera (MultiSPECT3, Siemens, USA) after intravenous administration of 1,110 MBq of $^{99m}Tc-ECD$. Fifteen-minute EA at GB 34 and GB 39 were applied on the affected limb. The same dose of $^{99m}Tc-ECD$ was injected during the EA, and the second set of SPECT images wasobtained. Using the computer software (ICON 7.1, Siemens, USA), 3 SPECT slices (upper, middle, lower) surrounding the brain lesion were selected and each slice was divided into 10-16 brain regions. Asymmetry indexes (AI) were analyzed in each brain region. We regarded over 10% changes of AI between before and after EA as significance. For the volunteers study, 10 healthy human volunteers (5 males, 5 females, mean age $28.1{\pm}6$ years old) were selected. In the resting state, $^{99m}Tc-ECD$ brain SPECT scans were performed. On the 7th day after the resting examination, 15 minute EA was applied at GB 34 and GB 39 on the right side of the subjects. Immediately after EA, the second SPECT images were obtained inthe same manner as the resting state. Significant increases and decreases of rCBF after EA were estimated by comparing their SPECT images with those of the resting state using paired t statistics at every voxel, which were analyzed by statistical parametric mapping with a threshold of p = 0.01, uncorrected (extent threshold: k=100 voxels). Results: In stroke patients, six of the eight (75%) had significantly increased perfusion in post-acupuncture scans compared to their baseline state. In normal volunteers, GB 34-GB GB EA increased rCBF in both hemispheres including right ventral posterior cingulate (Brodmann area (BA) 23), left superior temporal, anterior transverse temporal (BA 22, 41), left parastriate, peristriate (BA 18, 19), right occipitotemporal, angular (BA 37, 39), left rostral postcentral, caudal postcentral and preparietal (BA 2, 3, 5). However GB 34-GB 39 EA decreased rCBF in the right hemisphere including triangular and middle frontal lobes. Conclusions: The results demonstrated that OB 34-GB 39 EA increased cerebral perfusion in ischemic stroke patients and increased rCBF grossly in temporal lobes of normal volunteers. It is also suggested that there may be a correlation between the GB meridian and the territory of the middle cerebral artery.

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A study on the shear bond strengths of veneering ceramics to the colored zirconia core (착색지르코니아 코어와 전장 도재 사이의 전단결합강도에 관한 연구)

  • Kang, Sun-Nyo;Cho, Wook;Jeon, Young-Chan;Jeong, Chang-Mo;Yun, Mi-Jung
    • The Journal of Korean Academy of Prosthodontics
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    • v.47 no.3
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    • pp.312-319
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    • 2009
  • Statement of problem: Delamination of veneering porcelain from underlying ceramic substructures has been reported for zirconia-ceramic restorations. Colored zirconia cores for esthetics have been reported that their bond strength with veneered porcelain is weaker compared to white zirconia cores. Purpose: This study aimed to investigate the shear bond strength by manufacturing the veneering porcelain on the colored zirconia core, using the layering technique and heat-pressing technique, and to evaluate the clinical stability by comparing the result of this with that of conventional metal ceramic system. Material and methods: A Metal ceramic (MC) system was tested as a control group. The tested systems were Katana zirconia with CZR (ZB) and Katana Zirconia with NobelRondo Press (ZP). Thirty specimens, 10 for each system and control, were fabricated. Specimen disks, 3 mm high and 12 mm diameter, were fabricated with the lost-wax technique (MC) and the CAD-CAM (ZB and ZP). MC and ZB specimens were prepared using opaque and dentin veneering ceramics, veneered, 3 mm high and 2.8 mm in diameter, over the cores. ZP specimens were prepared using heat pressing ingots, 3 mm high and 2.8mm in diameter. The shear bond strength test was performed in a Shear bond test machine. Load was applied at a cross-head speed of 0.50 mm/min until failure. Mean shear bond strengths (MPa) were analyzed with the One-way ANOVA. After the shear bond test, fracture surfaces were examined by SEM. Results: The mean shear bond strengths (SD) in MPa were MC control 29.14 (2.26); ZB 29.48 (2.30); and ZP 29.51 (2.32). The shear bond strengths of the tested systems were not significantly different (P > .05). All groups presented cohesive and adhesive failures, and showed predominance of cohesive failures in ceramic veneers. Conclusion: 1. The shear bond strengths of the tested groups were not significantly different from the control group (P >.05). 2. There was no significant different between the layering technique and the heat pressing technique in the veneering methods on the colored zirconia core. 3. All groups presented cohesive and adhesive failures, and showed predominance of cohesive failures in ceramic veneers.

A Study on the Characteristic and Improvement Method of Private Consignment of Social Welfare Facility(Organization) (사회복지시설(기관)의 민간위탁제도 특성 및 개선방안에 관한 연구)

  • Kong, Chang-Suk
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.6 no.3
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    • pp.109-129
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    • 2011
  • Since the introduction of local autonomy system, various specific theories and practical approaches for private commission system have been common concerns and interests of the fields practicing social welfare. In the discussion about private consignment system of social welfare facility and organization, both of private section and government have shown different opinions from various aspects such as related regulation, consignment procedure, proper period and consignment condition. According to the discussion about the consignment system of social welfare facility, the purpose of this study is as follows. The first purpose is to suggest the current status of private consignment of social welfare facility and the characteristic and issue of consignment procedure by considering domestic & overseas literatures about the characteristic of private consignment system. The second purpose is to find out the general characteristics and current statuses of consignment process and system of social welfare facilities (organizations) located in Gyeonggi-do area. The third purpose is to draw the current status and general problem of field consignment system and suggest the practical alternative plan and improvement method of private consignment system of social welfare facility in the future. The result of researching private consignment process by head and manager of social welfare facility (organization), private consignment agreement and its conclusion process and current consignment system improvement method revealed that the number of reconsigned (over 1~3 times) facilities was more than that of initially consigned facilities and senior welfare facility and general social welfare center were most frequent in private consignment organization. In addition, as an improvement method of current private consignment process, the consideration on each organization and standard was required for new consignment and reconsignment and the problem of fairness and objectiveness was indicated when deliberation committee was organized in private consignment process. Besides them, it was found that consignment period shall be adjusted on the basis of facility type and business characteristic and the problems such as worker's succession, worker's transfer and service disconnection were suggested when consignment organization was changed. For conclusion and suggestion, the study suggested the establishment of common standard about private consignment, alternative plan of private consignment process issue and improvement method of consignment period issue.

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STUDY ON THE GROWTH OF THE MANDIBLE USING WIDE OPEN LATERAL CEPHALOGRAM (Wide open lateral cephalogram을 이용한 하악골 성장에 관한 연구)

  • Moon, Sung-Uk;Park, Young-Guk;Chung, Kyu-Rhim
    • The korean journal of orthodontics
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    • v.31 no.1 s.84
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    • pp.39-50
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    • 2001
  • In proceeding with orthodontic treatment, the prediction for the shape, growth rate and growth direction of mandible plays a major role to set up the treatment plan and determine its period and prognosis. Various approaches being made so far have shown that the linear and angular measurement using lateral cephalograms are relatively accurate to estimate them. This study was purposed to find the shape of mandible more clearly by preventing the overlap of the Condyle head area which appears in lateral cephalogram, and to estimate its growth rate by comparing the growth quantity and ratio via lateral area measurement. This experimental was performed against 40 patients total, of which Class I of 14, Class II of 9 and Class III of 17 consist. Wide open lateral cephalograms of 40 patients were taken over average period of 4 Year 3 Months, then the linear and angular measurements were carried out with 11 itemized lists. Autocad Rl4 application program was utilized to draw their appearance, measure and compare their lateral area. As a result of study, conclusions were made as follows; 1. Mandibular body length (gonion-menton) tended to increase in order of CIII, CI and CII, and Mandibular body length of CIII group had a tendency to grow twice faster than that of CII group. 2. In lateral items such as Go-Me, A-Cd, B-Cp, E-F and G-H, CIII showed a significant increase on the year-average quantity and rate of the growth, and especially apparent difference was observed in CIII group rather than CII group. 3. For the 4 Year 3 Months period, the year-average growth quantity of lateral area of the mandible was $1.0cm^2$ for Class I, $0.8cm^2$ for Class II and $1.4cm^2$ for Class III, which corresponds to $11.9\%,\;11.8\%\;and\;20.3\%$ of growth ratio respectively. Thus, growth ratio almost 2 times more than other groups was observed in group CIII while growth ratio between group CI and CII has little difference. 4. Considering the results as above, it can be proposed that the difference in size of the mandible between groups is caused by the difference in the growth rate and growth quantity of the mandible, which generated in the middle of growth, rather than the difference in size of congenital Jaw-bone.

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A Study on Fall Accident (1개 종합병원 환자의 낙상에 관한 조사)

  • Lee, Hyeon-Suk;Kim, Mae-Ja
    • The Korean Nurse
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    • v.36 no.5
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    • pp.45-62
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    • 1998
  • The study was conducted from November 1995 to May 1996 at the one general hospital in Seoul. The total subjects of this study were 412 patients who have the experience of fall accident, among them 31 was who have fallen during hospitalization and 381 was who visited emergency room and out patient clinic. The purposes of this study were to determine the characteristics, risk factors and results of fall accident and to suggest the nursing strategies for prevention of fall. Data were collected by reviewing the medical records and interviewing with the fallers and their family members. For data analysis, spss/pc+ program was utilized for descriptive statistics, adjusted standardized $X^2$-test. The results of this study were as follows: 1) Total subjects were 412 fallers, of which 245(59.5%) were men and 167(40.5%) were women. Age were 0-14 years 79(19.2%), 15-44 years 125(30.4%), 45-64 years 104(25.2%), over 65 years 104(25.2%). 2) There was significant association between age and the sexes ($X^2$=39.17, P=0.00). 3) There was significant association between age and history of falls ($X^2$=44.41. P= .00). And history of falls in the elderly was significantly associated with falls. 4) There was significant association with age and medical diagnosis ($X^2$=140.66, P= .00), chief medical diagnosis were hypertension(34), diabetis mellitus(22), arthritis(11), stroke(8), fracture(7), pulmonary tuberculosis(6), dementia(5) and cataract(5), 5) There was significant association between age and intrinsic factors: cognitive impairment, mobility impairment, insomnia, emotional problems, urinary difficulty, visual impairments, hearing impairments, use of drugs (sedatives , antihypertensive drugs, diuretics, antidepressants) (P < 0.05). But there was no significant association between age and dizziness ($X^2$=2.87, P=.41). 6) 15.3% of total fallers were drunken state when they were fallen. 7) Environmental factors of fall accident were unusual posture (50.9%), slips(35.2%), trips (9.5%) and collision(4.4%). 8) Most of falls occurred during the day time, peak frequencies of falls occurred from 1pm to 6pm and 7am to 12am. 9) The places of fall accident were roads(22.6%), house-stairs 06.7%), rooms, floors, kitchen (11.2%), the roof-top, veranda, windows(10.9%), hospital(7.5%), ice or snowy ways(5.8%), bathroom(4.9%), playground, park(4.9%), subway-stairs(4.4%) and public-bathrooms (2.2%). 10) Activities at the time of fall accident were walking(37.6%), turning around or reaching for something(20.9%), going up or down stairs09.2%), exereise, working07.4%), up or down from a bed(2.7%), using wheelchair or walking aids, standing up or down from a chair(2.2%) and standing still(2.2%). 11) Anatomical locations of injuries by falls were head, face, neck(31.3%), lower extremities (29.9%). upper extremities(20.6%), spine, thorax, abdomen or pelvic contents(l1.4%) and unspecified(2.9%). 12) Types of injures were fracture(47.6%), bruises03.8%), laceration (13.3%), sprains(9.0%), headache(6.6%), abrasions(2.9%), intracranial hemorrage(2.4%) and burns(0.5%). 13) 41.5% of the fallers were hospitalized and average of hospitalization was 22.3 days. 14) The six fallers(1.46%) died from fall injuries. The two fallers died from intracranial hemorrage and the four fallers died of secondary infection; pneumonia(2), sepsis(1) and cell lulitis(1). It is suggested that 1) Further study is needed with larger sample size to identify the fall risk factors. 2) After the fall accident, comprehensive nursing care and regular physical exercise should be emphasized for the elderly person. 3) Safety education and safety facilities of the public place and home is necessary for fall prevention.

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Processing and Taste Compounds of the Fish Sauce from Skipjack Scrap (가다랑어잔사를 이용한 어간장 제조 및 대미성분)

  • LEE Eung-Ho;LEE Tae-Hun;KIM Jin-Soo;AHN Chang-Bum
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.22 no.1
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    • pp.25-35
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    • 1989
  • To prepare a new type of fish sauce from skipjack scrap, it was examined the effect of koji on the sauce flavor, conditions of low salt fish sauce processing and the changes of taste com-pounds during its fermentation. To prepare the skipjack scrap sauce, chopped skipjack head paste was mixed with $6.6\%$ skipjack viscera, $26.9\%$ koji, $71\%$ of $25\%$ brine, $13.3\%$ salt and $7.6\%$ glucose, and fermented at $25\pm4^{\circ}C$ for 90 days. The same process was also carried out to prepare the low salt skipjack scrap sauce adding $7.6\%$ sorbitol, $0.3\%$ lactic acid and $9.8\%$ ethyl alcohol instead of $13.3\%$ salt. The major free amino acids in the products were glutamic acid, Iysine, valine, phenylalanine, alanine, leucine and isoleucine at 90 days of fermentation. And the contents of total free amino acids in both products were 3,307mg/00m1, 3,637.1mg/100m1 at 90 days of fermentation. The predominating non-volatile organic acids showed in the products were lactic acid, succinic acid, pyroglutamic acid, which were $90\%$ over contents of the total non-volatile organic acids. Total non-volatile organic acid contents in both products were 1,002.1mg/100ml, 1,312.9mg/100m1 at 90 days of fermentation. During fermentation of sauce, ADP, AMP and IMP were decreased, while inosine and hypoxanthine were increased. The major taste compounds of the products were rove진ed free amino acids and non-volatile organic acids. The nucleotides and their related compounds, total creatinine, betaine, TAMO and sugar were seemed to be having an auxiliary role in taste of those products. Fishy odor in skipjack scrap sauce can be improved by adding koji. And the low salt skipjack scrap sauce ($9.12\%$ of salt contents) can be prepared by the replacement of a part of salt with sorbitol, lactic acid and ethyl alcohol. From the results of sensory evaluation and chemical experiments, the skipjack scrap sauce products supposed to be at least equal to the sold soy sauce on the market in quality.

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