• Journal of the Korean Society of Radiology
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• v.14 no.3
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• pp.203-209
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• 2020

The purpose of this study is to assess the mechanical stability and alignment of the patient positioning system (PPS) of Leksell Gamma Knife Perfexion(LGK PFX). The alignment of the PPS of the LGK PFX was evaluated through measurements of the deviation of the coincidence of the Radiological Focus Point(RFP) and the PPS Calibration Center Point(CCP) applying different weights on the couch(0, 50, 60, 70, 80, and 90 kg). In measurements, a service diode test tool with three diode detectors being used biannually at the time of the routine preventive maintenance was used. The test conducted with varying weights on the PPS using the service diode test tool measured the radial deviations for all three collimators 4, 8, and 16 mm and also for three different positions of the PPS. In order to evaluate the alignment of the PPS, the radial deviations of the correspondence of the radiation focus and the LGK calibration center point of multiple beams were averaged using the calibrated service diode test tool at three university hospitals in Busan and Gyeongnam. Looking at the center diode for all collimators 4, 8, and 16 mm without weight on the PPS, and examining the short and long diodes for the 4 mm collimator, the means of the validation difference, i.e., the radial deviation for the setting of 4, 8, and 16 mm collimators for the center diode were respectively measured to 0.058 ± 0.023, 0.079 ± 0.023, and 0.097 ± 0.049 mm, and when the 4 mm collimator was applied to the center diode, the short diode, and the long diode, the average of the radial deviation was respectively 0.058 ± 0.023, 0.078 ± 0.01 and 0.070 ± 0.023 mm. The average of the radial deviations when irradiating 8 and 16 mm collimators on short and long diodes without weight are measured to 0.07 ± 0.003(8 mm sd), 0.153 ± 0.002 mm(16 mm sd) and 0.031 ± 0.014(8 mm ld), 0.175 ± 0.01 mm(16 mm ld) respectively. When various weights of 50 to 90 kg are placed on the PPS, the average of radial deviation when irradiated to the center diode for 4, 8, and 16 mm is 0.061 ± 0.041 to 0.075 ± 0.015, 0.023 ± 0.004 to 0.034 ± 0.003, and 0.158 ± 0.08 to 0.17 ± 0.043 mm, respectively. In addition, in the same situation, when the short diode for 4, 8, and 16 mm was irradiated, the averages of radial deviations were 0.063 ± 0.024 to 0.07 ± 0.017, 0.037 ± 0.006 to 0.059 ± 0.001, and 0.154 ± 0.03 to 0.165 ± 0.07 mm, respectively. In addition, when irradiated on long diode for 4, 8, and 16 mm, the averages of radial deviations were measured to be 0.102 ± 0.029 to 0.124 ± 0.036, 0.035 ± 0.004 to 0.054 ± 0.02, and 0.183 ± 0.092 to 0.202 ± 0.012 mm, respectively. It was confirmed that all the verification results performed were in accordance with the manufacturer's allowable deviation criteria. It was found that weight dependence was negligible as a result of measuring the alignment according to various weights placed on the PPS that mimics the actual treatment environment. In particular, no further adjustment or recalibration of the PPS was required during the verification. It has been confirmed that the verification test of the PPS according to various weights is suitable for normal Quality Assurance of LGK PFX.

• Sleep Medicine and Psychophysiology
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• v.3 no.2
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• pp.32-42
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• 1996

Objectives : Upper airway resistance syndrome(UARS) is a sleep-related breathing disorder characterized by abnormal negative intrathoracic pressure during sleep. Abnormally increased negative intrathoracic pressure results in microarousal and sleep fragmentation which underlay UARS-associated complaints of daytime fatigue and sleepiness. Although daytime dysfunction in patients with UARS is comparable to that of sleep apnea syndrome, UARS has been relatively unnoticed in clinical setting. That is why UARS is apt to be excluded in diagnosing of sleep-related breathing disorders since its respiratory disturbance index and arterial oxygen saturation are within normal limits. The current study presents a summary of clinical and polysomnographic characteristics found in patients with UARS. The present study aims (1) to explore characteristics of patients diagnosed with UARS, (2) to characterize the polysomnographic findings of UARS patients, and (3) to enhance the understanding of UARS through those clinical and laboratory characteristics. Methods : This was a retrospective study of 20 UARS patients (male 15, female 5) and 30 obstructive sleep apnea (OSA) patients (male 21, female 9) at the Stanford Sleep Disorders Clinic. We diagnosed patients as having UARS when they met critenia, RDI < 5 characteristic findings of an elevated esophageal pressure($<-10\;cmH_2O$), frequent arousals secondary to an elevated esophageal pressure, and symptoms of daytime fatigue and sleepiness. We used polysomnographic value, which is standardized by Williams et al(1974), as normal control. Statiotical test were done with student t-tests. Results : (1) Mean age of UARS was $41.0\;{\pm}\;14.8$ years and OSA was $50.9\;{\pm}\;12.0$ years. UARS subject was significantly younger than OSA subject (p<0.05). (2) The total score of Epworth Sleepiness Scale (ESS) was UARS $9.7\;{\pm}\;6.3$ and OSAS $11.2\;{\pm}\;6.3$. There was no significant difference between two groups. (3) The mean body mass index was UARS $28.1\;{\pm}\;5.7\;kg/m^2$ and OSAS $32.9\;{\pm}\;7.0\;kg/m^2$. UARS had significantly lower meen body man index than OSAS subjects (p<0.05). (4) The polysomnographic parameters of UARS were not significantly different from those of OSA except RDI(p<0.001), $SaO_2$ (p<0.001) and slow wave sleep latency (p<0.05). (5) Compared with normal control, Total sleep time in UARS subjects was significantly shorter (p<0.001), sleep efficiency index was significantly lower (p<0.001), total awakening percentage was significantly higher (p<0.001), and sleep stage 1 (p<0.001) were significantly higher. (6) OSA patients showed poor sleep quality and distinct abnormal sleep architectures compared with normal control. Conclusions : Conclusions from the above results are as follows : (1) UARS patients were younger and had lower body mass index when umpared with OSA patients. (2) The quality of sleep and sleep architectures of the UARS and OSA patients are significantly different from those of normal control. (3) ESS scores and awakening frequencies of UARS are similar with those of OSA, suggesting that daytime dysfunction of UARS patients may be comparable to those of OSA patients. (4) The RDI and the $SaO_2$ which are important indicators in diagnosing sleep-related breathing disorders, of UARS subjects are close to normal value. (5) According to the the above results, we unclude that despite the absence of $SaO_2$ drops and the absence of an elevated number of apnea and hypopnea, subjects developed clinical complaints which were associated with laborious breathing, elevated Pes nadir, and frequently snoring. (6) Accordingly, we suggest including LIARS in the differential diagnosis list when sleep related breathing disorder is suspected clinically and overnight polysomnographic findings except snoring and frequent microarousal are within normal limits.

• Magazine of the Korean Society of Agricultural Engineers
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• v.15 no.3
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• pp.3059-3088
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• 1973

The Object of research was laid on the dry paddy field which had a low level of underground water, rather than on a paddy field with a high level of underground water. In the treatment of the clay paddy field before transplanting we employed 3 kinds of methods; deep plowing, development of cracks by drying the surface of the field under which pipe drain was built. This study was to find which one, among these three methods, is the most effective to let roots extend to deep zone and increase the yield of rice and at the same time, for trafficability of large scale machinery which will be introduced to the harvest, in the light of the earth bearing capacity in relation with underground drainage. In the treatments of plots, 1) the kyong plot was plowed 39 days before transplanting and dried, 2) the kyun plot was plowed again 2days before transplanting after plowing 39 days before transplanting, leveling field surface in the saturation with water and developing the cracks by drying, 3) the kyunam plot was plowed again 2 days before transplanting after setting the drainage pipe and at the same time plowing 39 days before transplanting, leveling field surface in the saturation with water and developing the cracks by drying. Also each plot above had three different levels of soil depth, respectively; that is 15cm, 25cm, 35cm. The kyong plot with 15cm-depth was he control. The results obtained were as follows; 1. The kyunam plot showed a remarkably lager amount of water consumption by better underground drainage than the kyong and the kyun plot, and the kyong plot indicated a greater amount of water consumption than the kyun plot. Therefore the amount of available rainfall was decreased in the order of kyunam>kyong>kyun. The net duty of water decreased in the order of kyunam>kyong>kyun and its showed about 105cm in depth at the kyunam plot, about 70cm in depth at the kyong plot and about 45cm in depth at kyun plot, regardless of soil depth. 2. According to the tendency that the weight of the total root was effected by the maximum depth of the crack, it seemed that the root development was more affected by the depth of the crack than by only the crack itself. The weight of the total roots tended to increase as the depth of the crack got deeper and deeper, and the weight of the total roots was increased in the order of kyun<kyunam<kyong. 3. In the growing of the plant height, the difference did not appear at the beginning of growing(peak period of tillering) of any plot, But for the mid period of growing(ending period of tillering) to the period of young panicle formation, the deeper the depth of plot is, the more the growing goes down. On the contrary at the late period of growing, growth was more vigorous in the plot with deep depth than in the plot with shallow depth. Since the midperiod of growing, in the light of experimental treatment, the kyun plot was not better in growing than the other two plots and no remarkable defference was shown between the kyunam and the kyong plot, but the kyunam plot had the tendency of superiority in growing plant height. 4. As the depth of plot went deeper, the decreasing tendency was shown in the number of tillers through a whole period of growingi. When the above results were observed concering each plot of experimental treatment, the kyun plot was always smaller in the number of tiilers than the kyunam and the kvong plot, and the kyong plot was slightly larger than the kyunam plot in the number of tillers. 5. When each plot of the different experimental treatments was compared with the control plot(15-kyong), yield(weight of grains) was increased by 17% for the 35-kyong plot, by 10% for the 35-kyunam and yields for the other plots were less or nomore than the control plot. On the whole, as the depth of plot went deeper, yields for plots was increased in the order of kyong>kyunam>kyun. 1% of significance between the levels of depths and 5% of significance between the treatments were shown. 6. The depth of consumptive water which was more effective on the weight of grains is that of the last half period. When the depth of consumptive water was increased at the range of less than 2.7cm/day in the 15cm plot, 3.0cm/day in the 25cm plot and 3.3cm/day in the 35cm plot, the weight of grains was increased, and at the same time the weight of grains was increased as the depth of plot went deeper. The deeper plots was of advantage to the productivity at the same depth of consumptive water. 7. The increase in the weight of grains in propertion to the weighte of root showed a tendency to increase depending on the depth of plot at each plot of the same weight of roots. The weight of roots and grains together increasezd in the order of kyun>kyunam>kyong, considering each treatment of experimental plot. The weight of grains was in relation to the minimum water content ratio during the midperiod of surface drainage and the average earth temperature was mainly affected by the minimum water content ratio because it was relatively increased in proportion to the water content ratio(at less than 40%) 8. The weight ratio of straw to grain showed an increasing tendency at the plot of shallow depth and had a relation of an inversely exponental function to the weight of roots. At the same depth of plot except the 15cm plot, the weight ratio of straw to grain was increased in proportion to the depth of consumptive water. The weight of grains was increased as the depth of consumptive water was increased to some extent, but at the same time the weight of ratio of straw to grain was increased. 9. At a certain texture of soils the increase in the amount of the cracks depends on meteorological conditions, especially increase in amounts of pan evaporation. So if it rains during the progressing of field drying the cracks largely decrease. The amount of cracks of clay soil had relation of inversely exponental function to the water content ratio(at more than 25%). The maximum depth of crack kept generally a constant value at less than 30% of water content ratio. 10. The cone index showed the tendency that it was propertional to the amount of cracks within a certain limit but more or less inversely proportional over a certain limit. The water content ratio at the limit may be about 25%. 11. The increase in the cone index with the progressing of time after final surface drainage showed the tendency that it was proportional to the depth of consumptive water at the last half of growing period. Based on the same depth of if the cone index in the kyunam plot was much larger than in the other two plots and that in the kyong plot was much smaller than in the kyun plott, as long as the depth of plot was deeper, especially in the 35-kyong plot. 12. In the light of a situation where water content ratio of soil decreased and the cone index increased after final surface drainage the porogress of the field dryness was much more rapid in the kyunam plot than in the kyong plot and the kyun plot, especially slowest in the kyong plot. In the plot with deeper zone the progress was much slower. The progress requiring the value of the cone index, $2.5kg/cm^2$, that working machinary can move easily on the field changed with the time of final surface drainage and the amount of rainfall, but without nay rain it required, in the kyunam plot, about 44mm in total amount of pan evaporation and more than 50mm in the other two plots. Therefore the drying in the kyunam plot was generally more rapid in the kyunam plot was generally more rapid over 2days than in the kyun plot, and especially may be more rapid over 5days than in the 35-kyong plot.