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Consideration of the Accuracy by Variation of Respiration in Real-time Position Management Respiratory Gating System (호흡동조 방사선치료에 사용되고 있는 RPM (Real-time Position Management) Respiratory Gating System의 호흡변화에 따른 정확성에 대한 고찰)

  • Na, Jun Young;Kang, Tae Young;Baek, Geum Mun;Kwon, Gyeong Tae
    • The Journal of Korean Society for Radiation Therapy
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    • v.25 no.1
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    • pp.49-55
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    • 2013
  • Purpose: Respiratory Gated Radiation Therapy (RGRT) has been carried out using RPM (Real-time Position Management) Respiratory Gating System (version 1.7.5, varian, USA) in Asan Medical Center. This study was to analyze and evaluate the accuracy of Respiratory Gated Radiation Therapy (RGRT) according to variation of respiration. Materials and Methods: Making variation of respiration using Motion Phantom:QUASAR Programmable Respiratory Motion Phantom (Moudus Medical Device Inc. CANADA) able to adjust respiration pattern randomly was varying period, amplitude and baseline by analyze 50 patient's respiration of lung and liver cancer. One of the variations of respiration is baseline shift gradually downward per 0.01 cm, 0.03 cm, 0.05 cm. The other variation of respiration is baseline shift accidently downward per 0.2 cm, 0.4 cm, 0.6 cm, 0.8 cm. Experiments were performed in the same way that is used RPM Respiratory Gating System (phase gating, usually 30~70% gating) in Asan Medical Center. Results: It was all exposed radiation under one of the conditions of baseline shift gradually downward per 0.01 cm, 0.03 cm, 0.05 cm. Under the other condition of baseline shift accidently downward per 0.2 cm, 0.4 cm, 0.6 cm, 0.8 cm equally radiation was exposed. Conclusion: The variations of baseline shifts didn't accurately reflect on phase gating in RPM Respiratory Gating System. This inexactitude makes serious uncertainty in Respiratory Gated Radiation Therapy. So, Must be stabilized breathing of patient before conducting Respiratory Gated Radiation Therapy. also must be monitored breathing of patient in the middle of treatment. If you observe considerable changes of breathing when conducting Respiratory Gated Radiation Therapy. Stopping treatment immediately and then must be need to recheck treatment site using fluoroscopy. If patient's respiration rechecked using fluoroscopy restabilize, it is possible to restart Respiratory Gated Radiation Therapy.

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Evaluation of Uncertainty of IMRT QA Using 2Dimensional Array Detector for Head & Neck Patients (두경부암에서 2차원 배열 검출기를 이용한 IMRT QA의 불확실성에 대한 연구)

  • Ban, Tae-Joon;Lee, Woo-Suk;Kim, Dae-Sup;Baek, Geum-Mun;Kwak, Jung-Won
    • The Journal of Korean Society for Radiation Therapy
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    • v.23 no.2
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    • pp.97-102
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    • 2011
  • Purpose: IMRT QA using 2Dimensional array detector is carried out with condition for discrete dose distribution clinically. And it can affect uncertainty of evaluation using gamma method. We analyze gamma index variation according to grid size and suggest validate range of grid size for IMRT QA in Hospital. Materials and Methods: We performed QA using OniPro I'mRT system software version 1.7b on 10 patients (head and neck) for IMRT. The reference dose plane (grid size, 0.1 cm; location, [0, 0, 0]) from RTP was compared with the dose plane that has different grid size (0.1 cm, 0.5 cm, 1.0 cm, 2.0 cm, 4.0 cm) and different location (along Y-axis 0 cm, 0.2 cm, 0.5 cm, 1.0 cm). The gamma index variation was evaluated by observing the level of changes in Gamma pass rate, Average signal, Standard deviation for each case. Results: The average signal for each grid size showed difference levels of 0%, -0.19%, -0.04%, -0.46%, -8.32% and the standard deviation for each grid size showed difference levels of 0%, -0.30%, 1.24%, -0.70%, -7.99%. The gamma pass rate for each grid size showed difference levels of 0%, 0.27%, -1.43%, 5.32%, 5.60%. The gamma evaluation results according to distance in grid size range of 0.1 cm to 1.0 cm showed good agreement with reference condition (grid size 0.1 cm) within 1.5% and over 5% in case of the grid size was greater than 2.0 cm. Conclusion: We recognize that the grid size of gamma evaluation can make errors of IMRT QA. So we have to consider uncertainty of gamma evaluation according to the grid size and apply smaller than 2 cm grid size to reduce error and increase accuracy clinically.

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Consideration of the Effect according to Variation of Material and Respiration in Cone-Beam CT (Cone-Beam CT에서 물질 및 호흡 변화가 영상에 미치는 영향에 대한 고찰)

  • Na, Jun-Young;Kim, Jung-Mi;Kim, Dae-Sup;Kang, Tae-Young;Baek, Geum-Mun;Kwon, Gyeong-Tae
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.1
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    • pp.15-21
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    • 2012
  • Purpose: Image Guided Radiation Therapy (IGRT) has been carried out using On-Board Imager system (OBI) in Asan Medical Center. For this reason, This study was to analyze and evaluate the impact on Cone-Beam CT according to variation of material and respiration. Materials and Methods: This study was to acquire and analyze Cone-Beam CT three times for two material: Cylider acryl (lung equvalent material, diameter 3 cm), Fiducial Marker (using clinic) under Motion Phantom able to adjust respiration pattern randomly was varying period, amplitude and baseline vis-a-vis reference respiration pattern. Results: First, According to a kind of material, when being showed 100% in the acryl and 120% in the Fiducial Marker under the condition of same movement of the motion phantom. Second, According to the respiratory alteration, when being showed 1.13 in the baseline shift 1.8 mm and 1.27 in the baseline shift 3.3 mm for acryl. when being showed 1.01 in 1 sec of period and 1.045 in 2.5 sec of period for acryl. When being showed 0.86 in 0.7 times the standard of amplitude and 1.43 in 1.7 times the standard of amplitude for acryl. when being showed 1.18 in the baseline shift 1.8 mm and 1.34 in the baseline shift 3.3 mm for Fiducial Marker. when being showed 1.0 in 1 sec of period and 1.0 in 2.5 sec of period for Fiducial Marker. When being showed 0.99 in 0.7 times the standard of amplitude and 1.66 in 1.7 times the standard of amplitude for Fiducial Marker. Conclusion: The effect of image size of CBCT was 20% in the case of Fiducial marker. The impact of changes in breathing pattern was minimum 13% - maximum 43% for Arcyl, min. 18% - max. 66% for Fiducial marker. This difference makes serious uncertainty. So, Must be stabilized breathing of patient before acquiring CBCT. also must be monitored breathing of patient in the middle of acquire. If you observe considerable change of breathing when acquiring CBCT. After Image Guided, must be need to check treatment site using fluoroscopy. If a change is too big, re-acquiring CBCT.

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A bibliographical research of the 『Dongyi Suse Bowon Sasang ChobonGuen』 (『동의수세보원사상초본권(東醫壽世保元四象草本卷)』의 서지학적(書誌學的) 연구(硏究))

  • Lee, Su-kyung;Song, Il-byung
    • Journal of Sasang Constitutional Medicine
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    • v.11 no.1
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    • pp.63-77
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    • 1999
  • This research was intended to make the writer and the written times of "Dongyi Suse Bowon Sasang ChobonGuen" clear. Considering the contents of "Dongyi Suse Bowon Sasang ChobonGuen", it was the manuscripts of "Dongyi Suse Bowon". So it was written by Lee Je-ma and it was written when he was in the late of 40s and the beginning of the 50s. The chapter of "The origin of human being" was the manuscript of the "Dongyi Suse Bowon" and it had many clues to understand the view points to recoginze the human being, and the chapter of "The herbology and The prescription" had many drafts of original prescription of the "Dongyi Suse Bowon". 'Bangang-tang' is the original prescription of 'GyejiBanhaSnggang-tang' of "Dongyi Suse Bowon" and 'GumiChyunMunDong-tang' is the original prescription of 'CheongsimYeonja-tang' of "Dongyi Suse Bowon". Compared with the 'The pharmacology' of "Dongyi Suse Bowon", it showed the order when the pharmacology of each constitution was completed. The pharmacology of Soyangin was completed the early ears of his c1inical experience, and secondly that of Taeumin was completed, and that of Soeumin was completed in the end.

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Relationship of Maternal Perception of the Infant Temperament and Confidence and Satisfaction of Maternal Role (어머니가 지각한 영아기질과 어머니 역할수행에 대한 자신감 및 만족도의 관계)

  • Lee Young-Eun;Kang Yang-Hee;Park Hae-Sun;Hwang Eun-Ju;Mun Mi-Young
    • Child Health Nursing Research
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    • v.9 no.2
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    • pp.206-220
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    • 2003
  • Purpose: this study was intended to search the relationship between perception of the infant temperament in mother of infant at the age of 1~12 months and maternal confidence and satisfaction in performing maternal role, and to submit a basic data to establish a nursing intervention program which is helpful for determination of infant development and performing maternal role promotion by identify variables associated with infant temperament. Method: The subjects of this study were 300 mothers of infant at the age of 1~12 months who visited well baby clinic in 4 hospitals in Busan city and Kyoung-Nam province. Final analysis was performed in 293 cases. Seven cases was excluded in this study because of its inappropriate data collection. The data was collected from 1st July to 15th August 2002. The questionaries which were fill-up by mother were collected. Infant temperament was measured by using the tool of 'what my baby is like'(WBL) which was developed by Priham et. al.(1994) and translated by Bang(1999). The scale of postpartum self evaluation which was developed by Lederman et al(1981) and translated by Lee(1992) was used for the confidence and satisfaction of maternal role. All statistical analyses were performed using SPSS-PC for window, version 10.0: frequency, percentage, minimum, maximum, mean, SD, t-test, ANOVA, Post-hoc test(Scheffe's test), Pearson Correlation Coefficients. Result: The mean score of maternal perception of the infant temperament was 6.17±1.04, and mother recognized her infant as positive. The mean score of confidence of maternal role was 2.89± .41 and this revealed in an average level. The mean score of satisfaction of maternal role was 3.29± .51 and this revealed in a higher level. There was a weak significant positive correlation between the score of maternal perception of infant temperament and confidence of maternal role(r=0.176, P= .003), but there was no significant correlation between satisfaction of maternal role(P> .05). It revealed the more maternal perception of the infant temperament as positive, the higher confidence of maternal role. There was a moderate significant positive correlation between confidence of maternal role and satisfaction of maternal role(r=0.410, P= .000). It revealed the more confidence of maternal role, the higher satisfaction of maternal role. The variables related with the score of maternal perception of infant temperament were the type of delivery (t=-2.600, P= .010), experience of learning baby care(t=2.382, P= .018), maternal perception on baby's health status(F=3.467, P= .033), maternal perception on her health status(F=3.467, P= .027), baby's age(F=3.080, P= .028). Conclusion: Our result showed the confidence of maternal role was increased as the maternal perception of infant temperament was positive, and conformed that the confidence of maternal role was also related with satisfaction of maternal role. Prenatal education, type of delivery, baby's age were also related with the maternal perception of infant temperament. So, nursing intervention program of developmental stage maybe necessary in order to help maternal perception of infant temperament as positive, and it will be increased the confidence of maternal role and satisfaction of performing maternal role which was considered as real indicate of achievement of maternal role.

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Comparison of Respiratory Mechanics and Gas Exchange Between Pressure-controlled and Volume-controlled Ventilation (압력조절환기법과 용적조절환기법의 호흡역학 몇 가스교환의 비교)

  • Jeong, Seong-Han;Choi, Won-Jun;Lee, Jung-A;Kim, Jin-A;Lee, Mun-Woo;Shin, Hyoung-Shik;Kim, Mi-Kyeong;Choe, Kang-Hyeon
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.5
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    • pp.662-673
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    • 1999
  • Background : Pressure-controlled ventilation (PCV) is frequently used recently as the initial mode of mechanical ventilation in the patients with respiratory failure. Theoretically, because of its high initial inspiratory flow, pressure-controlled ventilation has lower peak inspiratory pressure and improved gas exchange than volume-controlled ventilation (VCV). But the data from previous studies showed controversial results about the gas exchange. Moreover, the comparison study between PCV and VCV with various inspiration : expiration time ratios (I : E ratios) is rare. So this study was performed to compare the respiratory mechanics and gas exchange between PCV and VCV with various I : E raitos. Methods : Nine patients receiving mechanical ventilation for respiratory failure were enrolled. They were ventilated by both PCV and VCV with various I : E ratios (1 : 2, 1 : 1.3 and 1.7 : 1). $FiO_2$, tidal volume, respiratory rate and external positive end-expiratory pressure (PEEP) were kept constant throughout the study. After 20 minutes of each ventilation mode, arterial blood gas, airway pressures, expired $CO_2$ were measured. Results : In both PCV and VCV, as the I : E ratio increased, the mean airway pressure was increased, and $PaCO_2$ and physiologic dead space fraction were decreased. But P(A-a)$O_2$ was not changed. In all three different I : E ratios, peak inspiratory pressure was lower during PCV, and mean airway pressure was higher during PCV. But $PaCO_2$ level, physiologic dead space fraction and P(A-a)$O_2$ were not different between PCV and VCV with three different I : E ratios. Conclusion : There was no difference in gas exchange between PCV and VCV under the same tidal volume, frequency and I : E ratio.

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Reduction of Bacterial Wilt Diseases with Eggplant Rootstock EG203-Grafted Tomatoes in the Field Trials (가지대목 EG203을 이용한 토마토 풋마름병 경감효과)

  • Lee, Mun Haeng;Kim, Ji Kwang;Lee, Hee Kyoung;Kim, Keyng Jae;Yu, Seung Hun;Kim, Young Shik;Lee, Youn Su
    • Research in Plant Disease
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    • v.19 no.2
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    • pp.108-113
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    • 2013
  • Wilt damage on tomato plants caused by Ralstonia solanacearum has been increased as the areas of tomato cultivation increased during the warm seasons. Also, the tomato rootstocks used to prevent the disease occurrence are not effective in the highly prevailing regions. Therefore, bacterial wilt resistant eggplant rootstock EG203, collected from AVRDC, was tested for its effect to deter the Ralstonia solanacearum wilt disease in the greenhouses at Buyeo Tomato Experiment Station from 2003 to 2005, and at Gumi, Kyungpook province from 2009-2011. Planting of eggplant rootstock EG203 should be done three weeks before the planting of tomato scions so that they can have similar stem diameter (2.5-3.0 mm) and can be easily grafted. Both insertion and inarching grafting showed 93-96% success rates. In the greenhouse tests at Buyeo Tomato Experiment Station from 2003 to 2005, eggplant rootstock EG203-grafted tomatoes showed the disease occurrence of 4.3%. On the other hand, non-grafted or other commercial rootstock-grafted tomatoes showed disease occurrence of 58.0% and 25.0-36.7%, respectively. In the greenhouse tests at Gumi, Kyungpook province in 2009, the disease occurrence on the EG203-grafted and non-grafted tomatoes was 2-5% and 20-80%, respectively. In 2010, at Gumi, Kyungpook province, when the wilt disease occurred slightly, the tomatoes grafted with tomato rootstocks B-blocking and Chung-gang, and eggplant rootstock EG203 showed similar disease severities, but EG203-grafted tomatoes formed lately cluster, resulting in the reduction of yield compared to tomato-grafted tomatoes. In 2011, at Gumi, Kyungpook province, when the wilt disease occurred severely, the tomato rootstocks 'B-blocking' and Chung-gang and eggplant rootstock EG203-grafted tomatoes showed disease occurrences of 60-85% and 0-1%, respectively. Therefore, it was concluded that tomato rootstocks 'B-blocking' and 'Chung-gang' are more useful in the areas contaminated with low levels of pathogen and eggplant rootstock EG203 is more useful in the areas contaminated with high levels of pathogen.

Characteristic Evaluation of Optically Stimulated Luminescent Dosimeter (OSLD) for Dosimetry (광유도발광선량계(Optically Stimulated Luminescent Dosimeter)의 선량 특성에 관한 고찰)

  • Kim, Jeong-Mi;Jeon, Su-Dong;Back, Geum-Mun;Jo, Young-Pil;Yun, Hwa-Ryong;Kwon, Kyung-Tae
    • The Journal of Korean Society for Radiation Therapy
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    • v.22 no.2
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    • pp.123-129
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    • 2010
  • Purpose: The purpose of this study was to evaluate dosimetric characteristics of Optically stimulated luminescent dosimeters (OSLD) for dosimetry Materials and Methods: InLight/OSL $NanoDot^{TM}$ dosimeters was used including $Inlight^{TM}MicroStar$ Reader, Solid Water Phantom, and Linear accelerator ($TRYLOGY^{(R)}$) OSLDs were placed at a Dmax in a solid water phantom and were irradiated with 100 cGy of 6 MV X-rays. Most irradiations were carried out using an SSD set up 100 cm, $10{\times}10\;cm^2$ field and 300 MU/min. The time dependence were measured at 10 minute intervals. The dose dependence were measured from 50 cGy to 600 cGy. The energy dependence was measured for nominal photon beam energies of 6, 15 MV and electron beam energies of 4-20 MeV. The dose rate dependence were also measured for dose rates of 100-1,000 MU/min. Finally, the PDD was measured by OSLDs and Ion-chamber. Results: The reproducibility of OSLD according to the Time flow was evaluated within ${\pm}2.5%$. The result of Linearity of OSLD, the dose was increased linearly up to about the 300 cGy and increased supralinearly above the 300 cGy. Energy and dose rate dependence of the response of OSL detectors were evaluated within ${\pm}2%$ and ${\pm}3%$. $PDD_{10}$ and PDD20 which were measured by OSLD was 66.7%, 38.4% and $PDD_{10}$ and $PDD_{20}$ which were measured by Ion-chamber was 66.6%, 38.3% Conclusion: As a result of analyzing characteration of OSLD, OSLD was evaluated within ${\pm}3%$ according to the change of the time, enregy and dose rate. The $PDD_{10}$ and $PDD_{20}$ are measured by OSLD and ion-chamber were evaluated within 0.3%. The OSL response is linear with a dose in the range 50~300 cGy. It was possible to repeat measurement many times and progress of the measurement of reading is easy. So the stability of the system and linear dose response relationship make it a good for dosimetry.

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Should Voiding Cystourethrography be Performed for Infants with Urinary Tract Infection? (요로감염 영아에서 배뇨성방광요도조영술이 필요한가?)

  • Woo, Mi-Kyeong;Kim, Mun-Sub;Koo, Ja-Wook
    • Childhood Kidney Diseases
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    • v.12 no.1
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    • pp.54-61
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    • 2008
  • Purpose: This study was performed to assess necessity of voiding cystourethrography (VCUG) for infants with urinary tract infection (UTI) who had both normal renal sonography and normal DMSA renal scans. Methods: We reviewed 117 infants hospitalized for UTI between February 2002 and July 2007 at Sanggye Paik Hospital. The diagnosis of UTI was made by culture from a urine specimen obtained by suprapubic puncture(n=57), catheterization(n=58), or collection bag method (n=2, twice positive culture of the same organism). All patients had undergone renal sonography, DMSA renal scan and VCUG. Children with both normal renal sonography and normal DMSA renal scans were evaluated for the presence or severity of vesicoureteral reflux (VUR). Results: Of the 117 patients, 96 were boys and 21 were girls. 28 patients(23.9%) had VUR. 59(50.4%) showed both normal renal sonography and normal DMSA renal scans. Among these 59 patients, 7(11.9%) showed VUR. Three of them had grade I-II reflux, two grade III reflux, and the other two grade IV reflux. One of them showed bilateral VUR, grade IV reflux on the right and grade III on the left. Conclusion: Although the negative predictive value of both normal renal sonography and normal DMSA renal scan for VUR was 88.1%, 7 patients had VUR and two of them had high grade reflux(grade IV). So, we suggest that VCUG should be performed in infants with UTI despite both normal renal sonography and normal DMSA renal scans.

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Properties of Indigenous Korean Paper(Hanji) - Classification of Oebal(single frame)Papermaking Methods - (토착한지의 특성 - 외발 초지법 분류를 중심으로 -)

  • Cheon, Cheol;Kim, Seong-Ju;Jin, Young-Mun
    • Journal of the Korean Wood Science and Technology
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    • v.27 no.1
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    • pp.88-104
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    • 1999
  • This study was carried out to classify the Hanjis into three groups that were indigenous Hanji, traditional Hanji, and improved Hanji handmade by paper making method according to the physical properties of each paper sheet such as tensile, bursting and tearing strength, folding endurance and fiber orientation in each layer. The results obtained were summarized as follows: 1. The multi-layered Hanjis made by "Oebal" Hanji making method in different direction of fiber orientation have good properties in tearing resistance. 2. The multi-layered Hanji in different direction of fiber orientation has good properties in the tearing resistance, but the burst index and the breaking length results were lower than the single layered Hanjis. 3. The different fiber orientation and multi-layered method didn't increase, the three indexes(burst index, tear index, breaking length). Only, the different direction of fiber orientation decreased the difference of width and length strength (tensile, tear) of the Hanji. 4. "Dochim"(Korean finishing touch process for indigenous Hanji by fulling round sticks) greatly increase folding endurance(double folds, not $log_{10}$) and good effect to tensile strength and burst strength. 5. The today's Oebal Hanji were the maximum of 2 layers and the indigenous Oebal Hanji were 16 layers the maximum. In addition, average of the indigenous Oebal Hanji was 4 layers(all 4-layer Hanji were the different fiber orientation of each layer). 6, The indigenous Hanji(multi-layered, and different fiber orientation) was good condition with "Dochim". Dochim increased tensile strength and burst strength of the indigenous Hanji. So the three-strength indexes were similar level("--"). 7. When the number of layer which were same fiber orientation increase, the increased Hanji became similar strength pattern("V", breaking length and burst index was higher than tear index) with "Ssangbal" Hanji. 8. The single layered papers that made by "Oebal" Hanji making method were similar strength pattern with Ssangbal Hanji. 9. There was no way to find the width and length direction of multi-layered Hanji by comparison between the difference of tensile strength and the difference of tearing resistance. 10. The compared pattern of tensile strength and tearing resistance of indigenous Oebal Hanji was different from today's Oebal Hanji. Especially, the tearing resistance of all indigenous Oebal Hanji(16 samples) was stronger on width of tearing resistance. And in the half of indigenous Oebal Hanji samples, the width of tensile strength and tearing resistance was stronger than length strength (Indigenous Oebal: '$\ulcorner\lrcorner$' 50%, '$\bigcup$' 50% $\leftrightarrow$ Today's Oebal: '$\ulcorner\lrcorner$' 12%, '$\bigcup$'6%, '$\llcorner\urcorner$'17%, '$\bigcap$'65%). In 65% today's Oebal, the length direction of tensile strength and tearing resistance was stronger than the width direction.

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