• 한국의학물리학회지:의학물리
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• 제30권3호
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• pp.65-73
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• 2019

Purpose: We evaluated the motion-induced dosimetric effects on the field-in-field (FIF) technique for whole-breast irradiation (WBI) using actual patient organ motion data obtained from cine electronic portal imaging device (cine EPID) images during treatment. Materials and Methods: Ten breast cancer patients who received WBI after breast-conserving surgery were selected. The static FIF (SFIF) plan involved the application of two parallel opposing tangential and boost FIFs. To obtain the amplitude of the internal organ motion during treatment, cine EPID images were acquired five times for each patient. The outside contour of the breast (OCB) and chest wall (CW) contour were tracked using in-house motion analysis software. Intrafractional organ motion was analyzed. The dynamic FIF (DFIF) reflecting intrafractional organ motion incorporated into the SFIF plan was calculated and compared with the SFIF in terms of the dose homogeneity index (DHI_90/10) for the target and V₂₀ for the ipsilateral lung. Results: The average motion amplitudes along the X and Y directions were 1.84±1.09 mm and 0.69±0.50 mm for OCB and 1.88±1.07 mm and 1.66±1.49 mm for CW, respectively. The maximum motion amplitudes along the X and Y directions were 5.53 and 2.08 mm for OCB and 5.22 and 6.79 mm for CW, respectively. Significant differences in DHI_90/10 values were observed between SFIF and DFIF (0.94 vs 0.95, P<0.05) in statistical analysis. The average V₂₀ for the lung in the DFIF was slightly higher than that of the SFIF in statistical analysis (19.21 vs 19.00, P<0.05). Conclusion: Our findings indicate that the FIF technique can form a safe and effective treatment method for WBI. Regular monitoring using cine EPID images can be effective in reducing motion-induced dosimetric errors.

• 대한간호학회지
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• 제45권2호
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• pp.280-292
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• 2015

Purpose: In this study a system dynamics methodology was used to identify correlation and nonlinear feedback structure among factors affecting unplanned extubation (UE) of ICU patients and to construct and verify a simulation model. Methods: Factors affecting UE were identified through a theoretical background established by reviewing literature and preceding studies and referencing various statistical data. Related variables were decided through verification of content validity by an expert group. A causal loop diagram (CLD) was made based on the variables. Stock & Flow modeling using Vensim PLE Plus Version 6.0b was performed to establish a model for UE. Results: Based on the literature review and expert verification, 18 variables associated with UE were identified and CLD was prepared. From the prepared CLD, a model was developed by converting to the Stock & Flow Diagram. Results of the simulation showed that patient stress, patient in an agitated state, restraint application, patient movability, and individual intensive nursing were variables giving the greatest effect to UE probability. To verify agreement of the UE model with real situations, simulation with 5 cases was performed. Equation check and sensitivity analysis on TIME STEP were executed to validate model integrity. Conclusion: Results show that identification of a proper model enables prediction of UE probability. This prediction allows for adjustment of related factors, and provides basic data do develop nursing interventions to decrease UE.

• 대한치과교정학회지
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• 제50권6호
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• pp.383-390
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• 2020

Objective: To investigate the distribution, side involvement, phenotype, and associated anomalies of Korean patients with craniofacial clefts (CFC). Methods: The samples consisted of 38 CFC patients, who were treated at Seoul National University Dental Hospital during 1998-2018. The Tessier cleft type, sex, side involvement, phenotype, and associated anomalies were investigated using non-parametric statistical analysis. Results: The three most common types were #7 cleft, followed by #0 cleft and #14 cleft. There was no difference between the frequency of male and female. Patients with #0 cleft exhibited nasal deformity, bony defect, and missing teeth in the premaxilla, midline cleft lip, and eye problems. A patient with #3 cleft (unilateral type) exhibited bilateral cleft lip and alveolus. All patients with #4 cleft were the bilateral type, including a combination of #3 and #4 clefts, and had multiple missing teeth. A patient with #5 cleft (unilateral type) had a posterior openbite. In patients with #7 cleft, the unilateral type was more prevalent than the bilateral type (87.0% vs. 13.0%, p < 0.001). Sixteen patients showed hemifacial microsomia (HFM), Goldenhar syndrome, and unilateral cleft lip and palate (UCLP). There was a significant match in the side involvement of #7 cleft and HFM (87.5%, p < 0.01). Patients with #14 cleft had plagiocephaly, UCLP, or hyperterorbitism. A patient with #30 cleft exhibited tongue tie and missing tooth. Conclusions: Due to the diverse associated craniofacial anomalies in patients with CFC, a multidisciplinary approach involving a well-experienced cooperative team is mandatory for these patients.

• 대한디지털의료영상학회논문지
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• 제11권1호
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• pp.15-20
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• 2009

Far reducing medical radiation exposure and managing patient doses, Entrance surface doses(ESDs) were measured at Diagnostic Radiology Department in ASAN medical center, also we determined and compared with the Diagnostic Reference Level(DRL) of some other countries. ESDs were measured far the most common types of X-ray procedures, such as chest PA, lumbar spine AP, lumbar spine lateral, Pelvis AP, Skull PA. ESDs were measured by Glass dosimeter and Unfors Xi meter. Those were applied collimation center of phantom's entrance skin surface. The results of ESDs were compared Glass dosimeter with Unfors Xi meter. Those were measured within 5% statistical difference. It seemed well agreement at two devices. In most cases ESDs measured far the different types of X ray procedures were found to be lower than the DRL of IAEA, but ESDs on chest PA, lumbar spine AP, lumbar spine lateral, Pelvis AP, Skull PA were proximity ar excesses at DRL of advanced country. Through this study, we need an investigation and improvement at present diagnostic radiology exam system. Also, radiologists make an effort to reduce patient dose and having a technical skill.

• 대한간호학회지
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• 제7권2호
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• pp.83-94
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• 1977

Diabetes Mellitus is a worldwide disease affecting millions of persons and appears to be on the increase in Korea. At the present time it can not be cured but can be controlled. To achieve control the patient must know about the disease. Education of the patient is an essential part of the management of the diabetic and is the responsibility of the nurse. The educational program must be adapted according to patient's knowledge and attitude about their diseases. Therefore, the opportunity to assess the knowledge and attitude of diabetics must provided. The objectives of this study were : 1. To describe the general characteristics of the study population. 2. To find out the characteries of experience of treatment. 3. To exams the knowledge and attitude of diabetics about the self-control. 4. To learn the influencing factors affecting the knowledge and attitude of diabetics about self - control. The study population defined and selected was 65 diabetics registered at the Diabetic Clinic of 5. hospital who visited the Diabetic Clinic from April 16, 1976 to May 14, 1976. The direct interview method was used. Statistical analysis of the data was X²- test. The following results were obtained : A. General characteristics of the study population : The respondent's average age was 50. 8 years old, sex ratio(male to female) revealed as 1 : 1.1, economic background was upper middle class, the most respondents had better than- average education, 75.4 Percents of the respondents lived in Seoul, 47. 2 percents were unemployed, the average size of family was 5.3 and 47.7 percents of respondents had religions. B. The characteristics of clinical experience : The average duration was 7.0 years, 46.1 percents of respondents had experience of hospitalization, 56.9 percents was taking oral drugs, 67.7 percents examined urine- sugar at home, 60.0 Percents had treat compilations and 20.0 percents had experience of coma. C. There was significant difference in the relationship : Between complications and durations of diabetes, hospitalization and therapeutic methods.

• 디지털융복합연구
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• 제12권12호
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• pp.449-456
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• 2014

본 연구에서는 관할구역 인구분포와 대비하여 출동건수를 파악하였으며, 출동하여 실제 병원으로 이송한 비율을 파악함으로서, 실제 인구현황과 출동건수와 병원 이송환자의 비율 관계를 분석하였다. 본 연구를 위해, 우리는 2010년 1월부터 2012년 12월까지 3년 동안 대상 지역인 D광역시 소재 5개 소방서별 출동건수를 파악하였으며, 출동현황을 병원 이송과 미 이송으로 데이터를 분석했다. J 소방서에서 출동건수가 가장 높게 나타났으며, 병원 이송건수와 미 이송 건수에서도 가장 높게 나타나는 경향을 볼 수 있었다. 반대로, B 소방서에서 가장 낮게 나타났다. 관할구역 인구수에서는 S소방서 관할구역 인구수가 가장 많았으며, D소방서 관할구역 인구수가 가장 적게 나타났다. 결론적으로 총 출동건수에 의해 병원 이송 건수와 병원 미 이송건수가 유의하게 증감하는 것을 확인하였으며, 인구수에 의한 상관관계는 없는 것으로 나타났다.

• Asian Pacific Journal of Cancer Prevention
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• 제17권6호
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• pp.2853-2856
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• 2016

Background: Many studies have pointed to strategies to cope with patient anxiety in colposcopy. Evidence shows that patients experienced considerable distress with the large loop excision of transformation zone (LLETZ) procedure and suitable interventions should be introduced to reduce anxiety. This study aimed to investigate the effects of music therapy in patients undergoing LLETZ. Materials and Methods: A randomized controlled trial was conducted with patients undergoing LLETZ performed under local anesthesia in an out patient setting at Ramathibodi Hospital, Bangkok, Thailand, from February 2015 to January 2016. After informed consent and demographic data were obtained, we assessed the anxiety level using State Anxiety Inventory pre and post procedures. Music group patients listened to classical songs through headphones, while the control group received the standard care. Pain score was evaluated with a visual analog scale (VAS). Statistical analysis was conducted using Pearson Chi-square, Fisher's Exact test and T-Test and p-values less than 0.05 were considered statistically significant. Results: A total of 73 patients were enrolled and randomized, resulting in 36 women in the music group and 37 women in the non-music control group. The preoperative mean anxiety score was higher in the music group (46.8 VS 45.8 points). The postoperative mean anxiety scores in the music and the non-music groups were 38.7 and 41.3 points, respectively. VAS was lower in music group (2.55 VS 3.33). The percent change of anxiety was greater in the music group, although there was no significant difference between two groups. Conclusions: Music therapy did not significantly reduce anxiety in patients undergoing the LLETZ procedure. However, different interventions should be developed to ease the patients' apprehension during this procedure.

• Journal of Oral Medicine and Pain
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• 제17권2호
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• pp.63-73
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• 1992

This study was performed for the purpose of investigating the relation between width of temporomandibular joint space and craniofacial morphology in patients with CMDs. The subjects utilized here were aged from 16 to 63 years old and 19 male and 46 female. For the study, each patient was taken radiographs by Transcranial and Lateral Cephalographic projection and the films were traced with routine method. The measured items were anterior, superior, posterior joint space and relative condylar position to the deepest part of glenoid fossa in Transcranial film and items related vertical and/or horizontal growth in Cephalogram. The data were processed with SPSS/PC+ package for statistical analysis. The obtained results were as follows : 1. Anterior joint space in affected side were wider than that of unaffected side, but for superior and posterior joint space, the value of unaffected side were more than those of affected side. 2. Superior or posterior joint space of affected side were significantly correlated with items related vertical growth, such as ramus height, Jarabak ratio, FMA. From this, the following cold be proposed, the wider the joint space of superior or posterior aspect of affected side was, the more the patient showed growth pattern of counter clockwise. 3. Superior or posterior joint space of affected side were significantly correlated with items related horizontal growth, such as SNPo, NAPo, APDI and ANB. From this the following could be proposed, the wider the joint space of superior or posterior aspect of affected side was, the more the patient showed anterior displacement of mandible. 4. It would be proposed that the diagnositic value of superior and posterior joint space of affected side in transcranial radiograph was excellent.

• 대한한방부인과학회지
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• 제21권1호
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• pp.179-198
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• 2008

Purpose: Obesity is already a major clinical problem in Korea, so obesity prevention and treatment practices are gradually interested in Korean Medicine doctors. Moreover subjective body shape image entered as a important medical topic recently. To make a graph system for clinical tool which based on the Korean national standard physical scale. Methods: Physical data of the girth of upper arm, abdomen, hip, buttock, flank, calf, and body weight were statistically analyzed, which collected through the fifth national standard physical scale research. And then reviewed those statistical validation. Results: Relationship of the each body scale data and those graphs were fit and right statistically. Conclusion: These new achieved graph system of Korean standard body scales could be adopt as a useful clinical tool for body image related patients such as obesity, PCOD and postpartum patient.

• 산업경영시스템학회지
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• 제32권1호
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• pp.20-25
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• 2009

Mahalanobis Taguchi System (MTS) is a pattern information technology, which has been used in different diagnostic applications to make quantitative decisions by constructing a multivariate measurement scale using data analytic methods without any assumption regarding statistical distribution. The MTS performs Taguchi's fractional factorial design based on the Mahahlanobis Distance (MS) as a performance metric. In this work, MTS is used for analyzing Wisconsin Breast Cancer data which has ten attributes. Ten different tests are conducted for the data to determine if the patient has cancer or not. Also, MTS is used for reducing the number of test to define the relationship between each attribute and diagnosis result. The accuracy of diagnosis is compare with two different previous research.