• 제목/요약/키워드: Previous Risk Evaluation

검색결과 146건 처리시간 0.032초

Dosimetric and Radiobiological Evaluation of Dose Volume Optimizer (DVO) and Progressive Resolution Optimizer (PRO) Algorithm against Photon Optimizer on IMRT and VMAT Plan for Prostate Cancer

  • Kim, Yon-Lae;Chung, Jin-Beom;Kang, Seong-Hee;Eom, Keun-Yong;Song, Changhoon;Kim, In-Ah;Kim, Jae-Sung;Lee, Jeong-Woo
    • 한국의학물리학회지:의학물리
    • /
    • 제29권4호
    • /
    • pp.106-114
    • /
    • 2018
  • This study aimed to compare the performance of previous optimization algorithms against new a photon optimizer (PO) algorithm for intensity-modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) plans for prostate cancer. Eighteen patients with prostate cancer were retrospectively selected and planned to receive 78 Gy in 39 fractions of the planning target volume (PTV). All plans for each patient optimized with the dose volume optimizer (DVO) and progressive resolution optimizer (PRO) algorithms for IMRT and VMAT were compared against plans optimized with the PO within Eclipse version 13.7. No interactive action was performed during optimization. Dosimetric and radiobiological indices for the PTV and organs at risk were analyzed. The monitor units (MU) per plan were recorded. Based on the plan quality for the target coverage, prostate IMRT and VMAT plans using the PO showed an improvement over DVO and PRO. In addition, the PO generally showed improvement in the tumor control probability for the PTV and normal tissue control probability for the rectum. From a technical perspective, the PO generated IMRT treatment plans with fewer MUs than DVO, whereas it produced slightly more MUs in the VMAT plan, compared with PRO. The PO showed over potentiality of DVO and PRO whenever available, although it led to more MUs in VMAT than PRO. Therefore, the PO has become the preferred choice for planning prostate IMRT and VMAT at our institution.

해양환경의 변동성을 고려한 해상풍력터빈 지지구조물의 기대수명 평가 (Expected Life Evaluation of Offshore Wind Turbine Support Structure under Variable Ocean Environment)

  • 이기남;김동현;김영진
    • 한국해양공학회지
    • /
    • 제33권5호
    • /
    • pp.435-446
    • /
    • 2019
  • Because offshore structures are affected by various environmental loads, the risk of damage is high. As a result of ever-changing ocean environmental loads, damage to offshore structures is expected to differ from year to year. However, in previous studies, it was assumed that a relatively short period of load acts repeatedly during the design life of a structure. In this study, the residual life of an offshore wind turbine support structure was evaluated in consideration of the timing uncertainty of the ocean environmental load. Sampling points for the wind velocity, wave height, and wave period were generated using a central composites design, and a transfer function was constructed from the numerical analysis results. A simulation was performed using the joint probability model of ocean environmental loads. The stress time history was calculated by entering the load samples generated by the simulation into the transfer function. The damage to the structure was calculated using the rain-flow counting method, Goodman equation, Miner's rule, and S-N curve. The results confirmed that the wind speed generated at a specific time could not represent the wind speed that could occur during the design life of the structure.

UM-CMAQ-Pollen 모델의 참나무 꽃가루 배출량 산정식 개선과 예측성능 평가 (Improvement and Evaluation of Emission Formulas in UM-CMAQ-Pollen Model)

  • 김태희;서윤암;김규랑;조창범;한매자
    • 대기
    • /
    • 제29권1호
    • /
    • pp.1-12
    • /
    • 2019
  • For the allergy patient who needs to know the situation about the extent of pollen risk, the National Institute of Meteorological Sciences developed a pollen forecasting system based on the Community Multiscale Air Quality Modeling (CMAQ). In the old system, pollen emission from the oak was estimated just based on the airborne concentration and meteorology factors, resulted in high uncertainty. For improving the quality of current pollen forecasting system, therefore the estimation of pollen emission is now corrected based on the observation of pollen emission at the oak forest to better reflect the real emission pattern. In this study, the performance of the previous (NIMS2014) and current (NIMS2016) model system was compared using observed oak pollen concentration. Daily pollen concentrations and emissions were simulated in pollen season 2016 and accuracy of onset and end of pollen season were evaluated. In the NIMS2014 model, pollen season was longer than actual pollen season; The simulated pollen season started 6 days earlier and finished 13.25 days later than the actual pollen season. The NIMS2016 model, however, the simulated pollen season started only 1.83 days later, and finished 0.25 days later than the actual pollen season, showing the improvement to predict the temporal range of pollen events. Also, the NIMS2016 model shows better performance for the prediction of pollen concentration, while there is a still large uncertainty to capture the maximum pollen concentration at the target site. Continuous efforts to correct these problems will be required in the future.

뇌졸중 환자의 실어증에 대한 전침 치료 : 체계적 문헌 고찰 (Electro-Acupuncture on Aphasia after Stroke: A Systemic Review of Randomized Controlled Trials)

  • 하정빈;이수정;양지수;유재환
    • 대한한방내과학회지
    • /
    • 제42권3호
    • /
    • pp.323-339
    • /
    • 2021
  • Objectives: This study investigates the effect of electro-acupuncture on aphasia after stroke. Methods: A search of OASIS, NDSL, PubMed, Cochrane, and CNKI was executed between 4 January 2021 and 4 February 2021, with no limitation on publication year. Extraction and selection from the studies were made by 3 authors. The quality of the studies was evaluated using Cochrane's risk of bias (RoB) tool. Results: 10 studies met the selection criteria. As the treatment site for electro-acupuncture, GV20 (Baihui) was used the most. In all studies, the region located on the head was used for treatment without distinguishing between acupoints and areas of scalp acupuncture, and the stimulation was organized into 3 conditions: speed, intensity, and time. The outcome indicators used before and after treatment focused on the evaluation of language function and the degree of aphasia. The results showed that using electro-acupuncture with speech rehabilitation therapy for aphasia after stroke was more effective than using speech rehabilitation therapy alone. Conclusions: In this review, electro-acupuncture for aphasia after stroke was found to have a significant effect compared to the previous treatment alone. However, because of limitations, information was not reliable enough. Additional research is needed to produce more objective evidence.

요인 및 군집분석을 이용한 유해화학물질 사고 잠재적 피해에 대한 도시 유형 분류 및 특성 분석 (The Analysis and Classification of Urban Types for Potential Damage from Hazardous Chemical Accidents Using Factor and Cluster Analysis)

  • 이승훈;유영은;김규리;백종인;김호현;반영운
    • 한국환경보건학회지
    • /
    • 제46권6호
    • /
    • pp.726-734
    • /
    • 2020
  • Objectives: The aim of this study was to analyze and classify the characteristics of potential damage from hazardous chemical accidents in 229 administrative units in South Korea by reflecting the social and environmental characteristics of areas where chemical accidents can occur. Methods: A number of indicators were selected through preceding studies. Factor analysis was performed on selected indicators to derive factors, and cluster analysis was performed based on the factor scores. Results: As a result of the cluster analysis, 229 administrative units were divided into three clusters, and it was confirmed that each cluster had its own characteristics. Conclusions: The first cluster, "areas at risk of accident occurrence and spread of damage" was a type with a high potential for accident damage and a high density of hazardous facilities. The second cluster, "Urban infrastructure damage hazard areas" appeared to be a cluster with high urban development characteristics. Finally, the third cluster 'Urban and environmental damage hazard areas' appeared to be a cluster with an excellent natural environment. This study went further from the qualitative discussion related to existing chemical accidents to identify and respond to accident damage by reflecting the social and environmental characteristics of the region. Distinct from the previous studies related to the causes of accidents and the response system, it is meaningful to conduct empirical research focusing on the affected areas by analyzing the possibility of accident damage in reflection of the social and environmental characteristics of the community.

Seroprevalence of Plasmodium vivax Circumsporozoite Protein Antibody in High-Risk Malaria Areas in Korea

  • Lee, Jinyoung;Jin, Kyoung;Ahn, Seong Kyu;Lee, Sung-Keun;Kwon, Hyung Wook;Na, Byoung-Kuk;Kim, Tong-Soo
    • Parasites, Hosts and Diseases
    • /
    • 제59권4호
    • /
    • pp.415-419
    • /
    • 2021
  • The circumsporozoite protein (CSP) of Plasmodium spp. is a diagnostic antigen and useful biomarker for monitoring short-term/seasonal changes to malaria transmission. Using P. vivax CSP antibody ELISA, epidemiological characteristics were analyzed in the residents of Ganghwa, Cheorwon, Paju, and Goseong from 2017 to 2018. In Ganghwa and Cheorwon, 1.6% and 1.2% of residents, respectively, were PvCSP-antibody-positive in 2018, which indicates a decrease of 0.4% in the positive rate compared to 2017. The annual parasite incidence (API) in Ganghwa and Cheorwon was 24.9 and 10.5 in 2017 and 20.3 and 10.7 in 2018, respectively. Although the changes were not significant, the API in Ganghwa decreased slightly by 4.5 in 2018 compared to the previous year. In Paju and Goseong, 3.9% and 2.0% of residents were positive for the PvCSP antibody. The API in Paju was 13.1 in 2017 and 16.0 in 2018, although no malaria patients were reported for the 2 years. Therefore, the results suggest that PvCSP is a useful antigen for confirming initial malaria infection. Additionally, considering that the antibody is relatively transient, it can be employed for sero-epidemiological studies to determine the extent of malaria transmission in the current year.

현수교의 시공절차와 인위적 불확실성을 고려한 구조신뢰성 평가 (Structural Reliability Evaluation Considering Construction Stage and Epistemic Uncertainty of Suspension Bridges)

  • 한성호;신재철
    • 대한토목학회논문집
    • /
    • 제29권3A호
    • /
    • pp.181-188
    • /
    • 2009
  • 본 연구에서는 현수교의 합리적인 시공방안 결정 및 구조안전성 평가에 대한 기초자료를 제시하였다. 기 연구된 현수교의 해석모델 및 신뢰성이론을 바탕으로 초기형상해석, 자유진동해석, 시공변수를 고려한 시공단계해석 및 신뢰성해석 등을 수행 할 수 있는 수치해석프로그램을 개발하였다. 현수교의 시공방안은 보강형의 시공순서, 시공방향 및 주경간과 측경간의 동시 시공성 등의 다양한 시공변수를 고려하여 설정하였다. 시공방안에 따른 동적시공단계해석은 작성된 해석프로그램에 의해 수행하였으며 주요부재의 응답특성을 검토하여 각각의 시공방안에 대한 장 단점을 제시하였다. 시공단계별 구조신뢰성해석은 자연적 불확실성을 고려하여 신뢰성지수 및 파괴확률을 산정함으로써, 설정된 시공방안에 따른 현수교의 안전성을 정량적으로 평가하였다. 아울러, 인위적 불확실성을 고려하여 산정된 해석결과에 대해 재평가하였으며, 시공단계 위험성의 주요 퍼센트 분포를 빈도수 히스토그램을 이용하여 제시하였다.

우울증 환자에서 불안장애의 동반이환 : 우울증 임상연구센터 코호트연구 (The Comorbidity of Anxiety Disorder in Depressed Patients : A CRESCEND(Clinical Research Center for Depression in Korea) Cohort Study)

  • 사공정규;이도윤;서호석;성형모;김정범;정영은;이민수;김재민;조선진
    • 우울조울병
    • /
    • 제9권1호
    • /
    • pp.30-36
    • /
    • 2011
  • Purpose : Anxiety disorder and depressive disorder are often comorbid with each other, and the comorbidity is associated with poorer psychiatric outcome, resistance to treatment, increased risk for suicide, greater chance for recurrence. We aimed to investigate the comorbidity of anxiety disorder in Korea. Method : Subjects were total of 867 depressed patients recruited CRESCEND-K multicenter trial. We used SCID (Structured Clinical Interview for DSM - IV) to find comorbidity of anxiety disorders in depressed patient. Results : Of 867 patients, total 8.2% had anxiety disorder. Proportion of anxiety disorder Not Otherwise Specified was 3.5%, panic disorder was 1.7%, generalized anxiety disorder was 1.1%, post traumatic stress disorder was 0.9%, obsessive compulsive disorder was 0.6%, social phobia was 0.4%. Conclusion : In this study, anxiety disorder in depression were measured at a low comorbidity rate in compare to previous studies. Selection bias, use of antidepressants at registration, severity of depression symptoms, and point of SICD administration seems to have affected these results. It is probable that comorbidity evaluation would be more precise if shorter, structured interviews such as M. I.N.I.-Plus were used during first clinical interview for depression diagnosis.

대장암 항암 화학요법의 처방 오류 평가 및 개선안 제시 (Guideline of Improvement and Evaluation of Prescribing Errors in Colorectal Chemotherapy)

  • 임현수;임성실
    • 한국임상약학회지
    • /
    • 제23권2호
    • /
    • pp.158-166
    • /
    • 2013
  • Background: Colorectal cancer shows a significant increase in South Korea due to westernization of diet, lack of dietary fiber, drinking and smoking, irregular defecation. There are surgery, chemotherapy, radiation therapy in treatment of colorectal cancer. There may be a medication errors in the process of chemotherapy because of its high toxicity, narrow therapeutic index and the health status of cancer patients. Consequently medication errors can cause increasing the risk of death, prolonging hospital stay and increasing the cost. Among medication errors on medication use process, prescribing errors are of particular concern due to higher risk of serious consequences. It is important for pharmacist to prevent the prescribing errors before reaching patient. Therefore we analyzed the prescriptions of colorectal cancer, classified prescribing errors, suggested guideline to reduce prescribing errors and verified the importance of pharmacist's role in prevention of medication errors activity. Methods: We collected the numbers of prescriptions of colorectal cancer(n=2,373) through anti cancer management program and EMR and analyzed the errors of prescriptions by categories from Oct 1st 2011 to Sep 30th 2012 at Chungbuk National University Hospital. We reviewed the prescriptions as follows - patients' characteristics, the result of test, previous prescriptions, characteristics of antineoplastic agents and patients' allergy, drug sensitivity, adverse events. Prescriptions are classified into inpatient and outpatient and analyzed the errors of prescriptions by categories (dosage form, dose, input, diluents, regimen, product). Results: Total prescription number of inpatient and outpatient of colorectal cancer was 1,193 and 1,180 and that of errors was 107(9%) and 22(1.9%), respectively. In case of errors of categories, the number of errors of dosage form is 69 and 8, errors of dose is 15 and 5, errors of input is 9 and 9 in inpatient and outpatient prescriptions, respectively. Errors of diluents is 8, errors of regimen is 3, errors of product is 3 in only inpatient prescriptions. In case of errors of categories by inpatient department, the number of errors of dosage form is 34 and 35, errors of dose is 7 and 8, errors of input is 6 and 3, errors of diluents is 4 and 4, errors of regimen is 2 and 1, errors of product is 2 and 1 in SG and HO, respectively. In case of outpatient department, the number of errors of dosage form is 8 in HO, errors of dose is 5 in HO, errors of input is 5 and 4 in SG and HO, respectively. Conclusions: The rate of errors of inpatient is higher than that of outpatient. Junior doctors are engaged in prescriptions of inpatient and pharmacist need to pay attention to review all prescriptions. If prescribing errors are discovered, pharmacist should contact the prescriber and correct the errors without delay. The guideline to reduce prescribing errors might be upgrading software of anti cancer management program, education for physicians as well as pharmacists and calling prescriber's attention to preventing recurrence of errors.

허혈성 심질환의 치료에서 관동맥우회술의 임상적 고찰 (Clinical Analysis of Coronary Artery Bypass Surgery for Ischemic Heart Disease)

  • 정태은
    • Journal of Yeungnam Medical Science
    • /
    • 제13권2호
    • /
    • pp.225-233
    • /
    • 1996
  • 허혈성 심질환의 치료로서 시행되는 관동맥우회술은 최근 국내에서도 보편적으로 시행되고 있는데 1992년부터 1996까지 영남대학교 의과대학 흉부외과학교실에서 시행한 63례의 관동맥우회술을 대상으로 수술성적 및 술전 위험인자들이 술후 합병증에 미치는 영향을 조사하여 다음과 같은 결론을 얻었다. 환자의 성별 및 연령을 보면 총 63례의 환자 중 남자가 44례, 여자가 19례였으며 연령 분포는 36세에서 71세까지 평균 $58.3{\pm}8.6$세였으며 50대와 60대에서 대부분을 차지하였다. 원위문합수는 환자당 평균 3.5개의 원위부 문합을 하였으며 수술사망은 6례였으며 술후 합병증으로 부정맥이 7례, 창상감염이 5례, 술후 출혈이 4례, 술중 및 술후 심근경색이 4례, 뇌졸증이 4례, 그리고 위장관 및 신장 합병증이 5례에서 발생하였다. 술후 합병증 발생의 요소를 분석해 본 결과 술전 관동맥질환 발생의 위험인자 중 흡연환자에서 합병증의 발생빈도가 유의하게 증가하였으며(p<0.05) 술전 위험인자로 정맥으로 Nitroglycerin의 투여가 필요했던 경우와 대동맥 차단시간이 2시간 이상인 경우 합병증의 발생빈도가 유의하게 증가하였으며(p<0.05) 특히 65세 이상의 고령 환자의 경우 수술사망율이 유의하게 증가하였다(p<0.05). 이상의 결과로 흡연, 65세 이상의 고령, 술전 정맥으로 Nitroglycerin의 투여가 필요했던 경우 그리고 이식혈관의 수가 많아 대동맥 차단시간이 긴 경우 술중 및 술후 관리에 더욱 섬세한 주의가 필요함을 알 수 있었다.

  • PDF