• The Korean Journal of Nuclear Medicine Technology
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• v.15 no.2
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• pp.76-82
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• 2011

Purpose: Lymphoscintigraphy is absolutely being used standard examination in lymphatic diagnosis, evaluation after treatment, and it is useful for lymphedema to plan therapy. In case of lymphoscintigraphy of lower-extremity lymphedema, it had an effect on results if patients had not pose same position on the examination of 1 min, 1 hour and 2 hours after injection. So we'll study the methods to improve confidence with minimized quantitative analysis errors by influence factors. Materials and Methods: Being used the Infinia of GE Co. we injected $^{99m}Tc$-phytate 37 MBq (1.0 mCi) 4 sylinges into 40 people's feet hypodermically from June to August 2010 in Samsung Medical Center. After we acquired images of fixed and unfixed condition, we confirmed the count values change by attenuation of soft tissue and bone according to different feet position. And we estimated 5 times increasing 2 cm of distance between $^{99m}Tc$ point source and detector each time to check counts difference according to distance change by different feet position. Finally, we compared 1 and 6 min lymphoscintigraphy images with same position to check the effect of quantitative analysis results owing to difference of amounts of movement of the $^{99m}Tc$-phytate in the lymphatic duct. Results: Percentage difference regarding error values showed minimum 2.7% and maximum 25.8% when comparing fixed and unfixed feet position of lymphoscintigraphy examination at 1 min after injection. And count values according to distance were 173,661 (2 cm), 172,095 (4 cm), 170,996 (6 cm), 167,677 (8 cm), 169,208 counts (10 cm) which distance was increased interval of 2 cm and basal value was mean 176,587 counts, and percentage difference values were not over 2.5% such as 1.27, 1.79, 2.04, 2.42, 2.35%. Also, Assessment results about amounts of movement in lymphatic duct within 6 min until scanning after injection showed minimum 0.15%, and maximum 2.3% which were amounts of movement. We can recognize that error values represent over 20% due to only attenuation of soft tissue and bone except for distance difference (2.42%) and amounts of movement in lymphatic duct (2.3%). Conclusion: It was show that if same patients posed different feet position on the examination of 1 min, 1 hour and 2 hours after injection in the lymphoscintigraphy which is evaluating lymphatic flow of patients with lymphedema and analyzing amount of intake by lymphatic system, maximum error value represented 25.8% due to attenuation of soft tissue and bone, and PASW (Predictive Analytics Software) showed that fixed and unfixed feet position was different each other. And difference of distance between detector and feet and change of count values by difference of examination beginning time after injection influence on quantitative analysis results partially. Therefore, we'll make an effort to fix feet position and make the most of fixing board in lymphoscintigraphy with quantitative analysis.

• Archives of Plastic Surgery
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• v.44 no.3
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• pp.202-209
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• 2017

Background No consensus exists on the optimal treatment protocol for orofacial clefts or the optimal timing of cleft palate closure. This study investigated factors influencing speech outcomes after two-stage palate repair in adults with a non-syndromal complete unilateral cleft lip and palate (UCLP). Methods This was a retrospective analysis of adult patients with a UCLP who underwent two-stage palate closure and were treated at our tertiary cleft centre. Patients ${\geq}17$ years of age were invited for a final speech assessment. Their medical history was obtained from their medical files, and speech outcomes were assessed by a speech pathologist during the follow-up consultation. Results Forty-eight patients were included in the analysis, with a mean age of 21 years (standard deviation, 3.4 years). Their mean age at the time of hard and soft palate closure was 3 years and 8.0 months, respectively. In 40% of the patients, a pharyngoplasty was performed. On a 5-point intelligibility scale, 84.4% received a score of 1 or 2; meaning that their speech was intelligible. We observed a significant correlation between intelligibility scores and the incidence of articulation errors (P<0.001). In total, 36% showed mild to moderate hypernasality during the speech assessment, and 11%-17% of the patients exhibited increased nasalance scores, assessed through nasometry. Conclusions The present study describes long-term speech outcomes after two-stage palatoplasty with hard palate closure at a mean age of 3 years old. We observed moderate long-term intelligibility scores, a relatively high incidence of persistent hypernasality, and a high pharyngoplasty incidence.

• The Journal of Korean Society for Radiation Therapy
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• v.19 no.1
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• pp.43-49
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• 2007

Purpose: The aim of this study was the clinical implementation of IGRT using KV CBCT for setup correction in radiation therapy. Materials and Methods: We selected 9 patients (3 patient for each region; head, body, pelvis)and acquired 135 CBCT images with CLINAC iX (Varian medical system, USA). During the scan, the required time was measured. We analyzed the result in 3 direction; vertical, longitudinal, lateral. Results: The mean setup errors at the couch position of vertical, lateral, and longitudinal direction were 0.07, 0.12, and 0.1 cm in the head region, 0.3, 0.26, and 0.22 cm in the body region, 0.21, 0.18, and 0.15 cm in the pelvis region respectively. The mean time required for CBCT was $6{\sim}7$ minute. Conclusion: The CBCT on the LINAC provides the capacity for soft tissue imaging in the treatment position and real time monitoring during treatment delivery. With presented workflow, the setup correction within reasonable time for more accurate radiation therapy is possible. And it's image can be very useful for adaptive radiation therapy(ART) in the future with improved image quality.

• Geotechnical Engineering
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• v.14 no.5
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• pp.129-142
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• 1998

This research is focused on the inducement of the constitutive equation considering the creep strain component and on the development of a finite element method program. The purpose of this research was to contribute to the design of construction structures or to the construction management in soft clay ground through predicting the long-term strain of construction structures reasonably bused on the above program. Modified Cam Clay model was adopted to describe the elastic-plastic behavior of clayey soil. And in the calculation of the creep sprain, the secondary coefficient of consolidation C. was applied for considering the volumetric creep element and the constants m, $\alpha$, A were rosed by the empirical creep equation proposed by Singh 8E Mitchell for considering the deviatoric creep element. To examine the reliability of the program which is developed in this study, the estimated values by this program were compared with the theoretical solution and the experimental results. And the applicability of the developed program was found to be reliable from the sensitive analysis of each parameters used in this study. According to the results obtained from the application of the program on the field measurement data, the estimated values by the program were found with be consistent with the actual values. And from the analysis of the displacement of embankments, the case of considering the creep behavior induced much fower errors than the case of neglecting it. But the results obtained from considering the volumetric creep behavior only were slightly underestimated the results from considering the deviator creep behavior showed the slightly overestimated values. Therefore, it remains the task of further studios to develop the laboratory test devices to obtain the reliable creep parameters, and to select the appropriate soil parameters, etc.

• Archives of Plastic Surgery
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• v.36 no.5
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• pp.623-628
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• 2009

Purpose: In cases where nasal fractures involve frontal process of maxilla or perpendicular plate of ethmoid, 4 - 5 days of nasal packing may not provide sufficient support for avoiding displacement after packing removal. Therefore a single Kirschner - wire(K - wire) is used as an internal splint when nasal fractures involve the above two areas. Methods: Thirty five patients during the last 3 practical years were treated with a K -wire pinning according to the anatomic locations of nasal fractures. We performed a retrospective study using 13 nasal fractures out of total 35 patients. Among 13 cases, 10 patients involved frontal process of maxilla, and 3 patients were diagnosed as bilateral nasal side wall fractures accompanied with fractures of perpendicular plate of ethmoid. One patient of the last three cases had been augmented with dorsal silicone implant long before the trauma. We analyzed the anteroposterior displacement of key stone area and the width between both lateral walls by comparing immediate postoperative radiographs with 2 month follow - ups. To reduce the errors, the same measurements were taken by two different inspectors, and the mean of each inspector's measurements was compared. Patient satisfaction was analyzed using a questionnaire regarding the esthetic and functional outcomes. Results: Ten patients underwent a longitudinal K - wire fixation in submucoperiosteal plane underneath the frontal process of maxilla. And three patients underwent a transverse K - wire fixation from the one side of lateral wall to the perpendicular plate of ethmoid and to the other side of lateral wall. The mean postoperative anteroposterior displacement of the key stone area measured by two inspectors were 1.84% and 3.06%; mean narrowing of bony pyramid were 1.33% and 1.48%, respectively. Subjective satisfaction scores regarding the esthetic appearance and the maintenance of nasal shape compared with immediate post - operative state with the long term ones were not different (p>0.05). Conclusion: K - wire pinning after closed reduction is a reliable and useful method for the treatment of nasal fractures involving frontal process of maxilla or perpendicular plate of ethmoid. This is because it achieves longer intranasal support after reduction. This method also leaves conspicuous external scar, and minimal soft - tissue injury.

• Tuberculosis and Respiratory Diseases
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• v.84 no.1
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• pp.46-54
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• 2021

Background: The aim of this study was to investigate inhaler device handling in elderly patients. Inhaler devices with respect to misuse and error correction were also compared. Methods: Inhaler use technique was assessed using standardized checklists at the first visit and 3-month follow-up visit after retraining. The primary outcome was difference in the acceptable use ratio among inhaler devices. Secondary outcomes included differences in error correction, the most common step of misuse, and factors affecting the accuracy of inhaler use. Results: A total of 251 patients (mean age, 76.4 years) were included. The handling of 320 devices was assessed in the study. All patients had been trained before. However, only 24.7% of them used inhalers correctly. Proportions of acceptable use for Evohaler, Respimat, Turbuhaler, Ellipta, and Breezhaler/Handihaler were 38.7%, 50.0%, 61.4%, 60.8%, and 43.2%, respectively (p=0.026). At the second visit, the acceptable use ratio had increased. There were no significant differences among inhaler types (Evohaler, 63.9%; Respimat, 86.1%; Turbuhaler, 74.3%; Ellipta, 64.6%; and Breezhaler/Handihaler, 65.3% [p=0.129]). In multivariate analysis, body mass index, Turbuhaler, and Ellipta showed positive correlations with acceptable use of inhalers, whereas Chronic Obstructive Pulmonary Disease Assessment Test score showed a negative correlation. Conclusion: Although new inhalers have been developed, the accuracy of inhaler use remains low. Elderly patients showed more errors when using pressurized metered-dose inhalers than using dry powder inhalers and soft-mist inhalers. However, there were no significant differences in misuse among inhaler devices after individual training. Results of this study suggests that repeat training is more important than inhaler type.

• The Journal of Korean Society for Radiation Therapy
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• v.20 no.2
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• pp.83-89
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• 2008

Purpose: The checking method of target and normal structure are used by MVCBCT, KVCBCT, CT On-rail System, Ultrasound in H&N cancer patient. In case of MVCT, the utilization of bone structure is valuable to check around tissue. But the utilization of soft tissue is not enough. The point of this paper is dose variation in movable parotid and changeable volume of H&N cancer patient of CT On-rail System. Materials and Methods: The object of H&N cancer patient is 5 in this hospital. The selected patient are scanned ARTISTE CT Vision (CT On-ral System) a triweekly. After CT scanning, tranfered coordinates are obtained by movable of parotid gland comparison with planning image. Checking for the changeable volume of parotid gland. A Obtained CT image are tranfered to the RTP System. So dose variation are checked by following changed volume. Results: The changes of target coordinate by the parotid gland movement are X: -0.4~0.4 cm, Y: -0.4~0.3 cm, Z: -0.3~0.3 cm. the volume of GTV is decreased to about 7.11%/week and then both parotid gland volume are shrinked about 4.81%/week (Lt), 2.91%/week (Rt). At the same time, each parotid gland are diminished in radiation dose as 3.66%/week (Lt), 2.01%/week. Conclusion: Images from CT on the rail System which are able to aquire the better quality images of soft tissue in Target area than MVCBCT. After replanning and dose redistribution by required images, It could gain not only the correction of the patient set-tup errors but exact dose distribution. Accordingly, the delivery of compensated dose, It makes that we could do Adaptive Targeting Radiotherapy and need Real Time Adaptive Targeting Radiotherapy by reduce beam delivary time.

• The Journal of Korean Society for Radiation Therapy
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• v.12 no.1
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• pp.91-104
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• 2000

Recently linear accelerator in radiation therapy in asymmetric field has been easily used since the improvement and capability of asymmetrical field adjustment attached to the machine. It has been thought there have been some significant errors in dose calculation when asymmetrical radiation fields have been utilized in practice of radiation treatments if the fundamental data for dose calculation have been measured in symmetrical standard fields. This study investigated how much the measured data of dose distributions and their isodose curves are different between in asymmetrical and symmetrical standard fields, and how much there difference affect the error in dose calculation in conventional method measured in symmetrical standard field. The distributions of radiation dose were measured by photon diode detector in the water phantom (RFA-300P, Scanditronix, Sweden) as tissue equivalent material on utilization of 6 MV linear accelerator with source surface distance (SSD) 1000 mm. The photon diode detector has the velocity of 1 mm per second from water surface to 250 mm depth in the field size of $40mm{\times}40mm\;to\;250mm{\times}250mm\;symmetric\;field\;and\;40mm{\times}20mm\;to\;250mm{\times}125mm$ asymmetrical fields. The measurements of percent depth dose (PDD) and subsequent plotting of their isodose curves were performed from water surface to 250mm dmm from Y-center axis in $100mm{\times}50mm$ field in order to absence the variability of depth dose according to increasing field sizes and their affects to plotted isodose curves. The difference of PDD between symmetric and asymmetric field was maximum $4.1\%\;decrease\;in\;40mm{\times}20mm\;field,\;maximum\;6.6\%\;decrease\;in\;100mm{\times}50mm\;and\;maximum\;10.2\%\;decrease\;200mm{\times}100mm$, the larger decrease difference of PDD as the greater field size and as greater the depth, The difference of PDD between asymmetrical field and equivalent square field showed maximum $2.4\%\;decrease\;in\;60mm{\times}30mm\;field,\;maximum\;4.8\%\;decrease\;in\;150mm{\times}75mm\;and\;maximum\;6.1\%\;decrease\;in\;250mm{\times}125mm$, and the larger decreased differenced PDD as the greater field size and as greater the depth, these differences of PDD were out of $5\%$ of dose calculation as defined by international Commission on radiation unit and Measurements(ICRU). In the dose distribution of asymmetrical field (half beam) the plotted isodose curves were observed to have deviations by decreased PDD as greater as the blocking of the beam moved closer to the central axis, and as the asymmetrical field increased by moving the block 10 mm keeping away from the central axis, the PDD increased and plotted isodose curves were gradually more flattened, due to reduced amount of the primary beam and the fraction of low energy soft radiations by passing thougepth in asymmetrical field by moving independent jaw each 10 h beam flattening filter. As asymmetrical radiation field as half beam radiation technique is used, the radiation dosimetry calculated in utilizing the fundamental data which measured in standard symmetrical field should be converted on bases of nearly measured data in asymmetrical field, measured beam data flies of various asymmetrical field in various energy and be necessary in each institution.

• The Journal of Dong Guk Oriental Medicine
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• v.8 no.2
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• pp.1-24
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• 2000

The comparison of climate's character of Yunqi(運氣) with the data of meterological observation were made in the research of climate. 1. The comparison of the average velocity of wind, temperature, rainfall, humidity of Seoul, by late 1954 to 1983, with Yunqi(運氣) was made. Fire-Chi(火氣) and moisture-qi(濕氣) were matched with the attribute of Taiyun(大運). Cold-qi(寒氣) was had some relationship. Dry-qi(燥 氣) and Wind-qi(風氣) were not matched. About the relationship of Spirit-of-official-sky(司天之氣) with climate, when the Moisture-soil(濕土) was added, they were matched and when the King-fire(君火) was added, they have some relationship. But Wind-tree(風木), Dry-metal(燥金), Buble-fire(相火), Cold-water(寒水) was added they were not matched. 2. According to the observation data of rainfall by late 180 years of Seoul; about Taiyun(大運), when the Water-Yun(水運) was greatly exceeded and Fire-Yun(火運) was shorted, in the case of Official-sky(司天), when Wind-Tree(風木) was added, the frequency was highly. So when the Soil-Yun(土運) was greatly exceeded and when Official-sky(司天)was added to the Moisture-soil(濕土), the rainfall was not matched. 3. The relationship of the frequency of the abnormal climate occurrences between Yunqi-promotion-weak(運氣盛衰)and Yunqi-Harmony(運氣同化) and Yunqi-soft-attacking(運氣順逆) in the weather of Korean Peninsula was compared by 1564 to 1863. They were not matched except the case of Yunqi-Harmony(運氣同化). 4. There were some cases which were not matched exactly between the climate predicted by the theory and real climate in 1984, the year of Kap-ga(甲子年). But many correspondence between the observation by the office of meteorology and the prediction by the analysis from Yun-qi-sang-hab(運氣相合) theory. 5. Because meterological phenomena of real world and analysis from the hypothesis of Yunqi(運氣) have no relationship with each other, some of Doctor denied Yunqi(運氣) in the way of matching mechanically. But the thought of Doctor who denied Fortune-spirit(運氣) made promotion for the theory of divination by bringing deeper insight. And it was not only the negative side. 6. In the point of geographical difference, the climate of China, the origination Yunqi theory, is different from the Korea's. Thus some observation errors should be considered. From the basis of this thesis, I hope that the deeper advance would be made into the Korean Yunqi theory.

• Journal of Intelligence and Information Systems
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• v.22 no.1
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• pp.107-118
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• 2016

The advent of 5G mobile communications, which is expected in 2020, will provide many services such as Internet of Things (IoT) and vehicle-to-infra/vehicle/nomadic (V2X) communication. There are many requirements to realizing these services: reduced latency, high data rate and reliability, and real-time service. In particular, a high level of reliability and delay sensitivity with an increased data rate are very important for M2M, IoT, and Factory 4.0. Around the world, 5G standardization organizations have considered these services and grouped them to finally derive the technical requirements and service scenarios. The first scenario is broadcast services that use a high data rate for multiple cases of sporting events or emergencies. The second scenario is as support for e-Health, car reliability, etc.; the third scenario is related to VR games with delay sensitivity and real-time techniques. Recently, these groups have been forming agreements on the requirements for such scenarios and the target level. Various techniques are being studied to satisfy such requirements and are being discussed in the context of software-defined networking (SDN) as the next-generation network architecture. SDN is being used to standardize ONF and basically refers to a structure that separates signals for the control plane from the packets for the data plane. One of the best examples for low latency and high reliability is an intelligent traffic system (ITS) using V2X. Because a car passes a small cell of the 5G network very rapidly, the messages to be delivered in the event of an emergency have to be transported in a very short time. This is a typical example requiring high delay sensitivity. 5G has to support a high reliability and delay sensitivity requirements for V2X in the field of traffic control. For these reasons, V2X is a major application of critical delay. V2X (vehicle-to-infra/vehicle/nomadic) represents all types of communication methods applicable to road and vehicles. It refers to a connected or networked vehicle. V2X can be divided into three kinds of communications. First is the communication between a vehicle and infrastructure (vehicle-to-infrastructure; V2I). Second is the communication between a vehicle and another vehicle (vehicle-to-vehicle; V2V). Third is the communication between a vehicle and mobile equipment (vehicle-to-nomadic devices; V2N). This will be added in the future in various fields. Because the SDN structure is under consideration as the next-generation network architecture, the SDN architecture is significant. However, the centralized architecture of SDN can be considered as an unfavorable structure for delay-sensitive services because a centralized architecture is needed to communicate with many nodes and provide processing power. Therefore, in the case of emergency V2X communications, delay-related control functions require a tree supporting structure. For such a scenario, the architecture of the network processing the vehicle information is a major variable affecting delay. Because it is difficult to meet the desired level of delay sensitivity with a typical fully centralized SDN structure, research on the optimal size of an SDN for processing information is needed. This study examined the SDN architecture considering the V2X emergency delay requirements of a 5G network in the worst-case scenario and performed a system-level simulation on the speed of the car, radius, and cell tier to derive a range of cells for information transfer in SDN network. In the simulation, because 5G provides a sufficiently high data rate, the information for neighboring vehicle support to the car was assumed to be without errors. Furthermore, the 5G small cell was assumed to have a cell radius of 50-100 m, and the maximum speed of the vehicle was considered to be 30-200 km/h in order to examine the network architecture to minimize the delay.