• Title/Summary/Keyword: System Coverage

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Location Error of the Dens in a Two-Dimensional Set-up Verification During Head and Neck Radiotherapy (뇌.두경부 방사선치료 시 전자조사문영상장치를 이용한 세트업 오차 확인에서 제2경추 치상돌기 위치의 임상적 의의)

  • Kim, Dong-Hyun;Kim, Won-Taek;Ki, Yong-Gan;Nam, Ji-Ho;Lee, Mi-Ran;Jeon, Ho-Sang;Park, Dal;Kim, Dong-Won
    • Radiation Oncology Journal
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    • v.29 no.2
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    • pp.107-114
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    • 2011
  • Purpose: To assess the degree and clinical impact of location error of the dens on the X-axis during radiotherapy to brain and head and neck tumors. Materials and Methods: Twenty-one patients with brain tumors or head and neck tumors who received three-dimensional conformal radiation therapy or intensity-modulated radiation therapy from January 2009 to June 2010 were included in this study. In comparison two-dimensional verification portal images with initial simulation images, location error of the nasal septum and the dens on the X-axis was measured. The effect of set-up errors of the dens was simulated in the planning system and analyzed with physical dose parameters. Results: A total of 402 portal images were reviewed. The mean location error at the nasal septum was 0.16 mm and at the dens was 0.33 mm (absolute value). Location errors of more than 3 mm were recorded in 43 cases (10.7%) at the nasal septum, compared to 133 cases (33.1%) at the dens. There was no case with a location error more than 5 mm at the nasal septum, compared to 11 cases (2.7%) at the dens. In a dosimetric simulation, a location error more than 5 mm at the dens could induce a reduction in the clinical target volume 1 coverage (V95: 100%${\rightarrow}$87.2%) and overdosing to a critical normal organ (Spinal cord V45: <0.1%${\rightarrow}$12.6%). Conclusion: In both brain and head and neck radiotherapy, a relatively larger set-up error was detected at the dens than the nasal septum when using an electronic portal imaging device. Consideration of the location error of the dens is necessary at the time of the precise radiation beam delivery in two-dimensional verification systems.

Reconstruction after Wide Excision of Malignant Soft Tissue Tumor in Ankle and Foot (족관절 및 족부에 발생한 연부 조직 악성 종양의 광범위 절제술 후 재건술)

  • Kwon, Young-Ho;Cho, Yool;Kim, Jae-Do;Chung, So-Hak
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.1
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    • pp.33-43
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    • 2008
  • Purpose: To evaluate the clinical usability of reconstructive methods, and how to select flap after wide excision of malignant soft tissue tumor in ankle and foot. Materials and Methods: The 15 cases shown in the 14 patients (In case of a male patient, reconstruction was performed two times due to local recurrence.) with malignant soft tissue tumor in ankle and foot, who underwent reconstruction after wide excision from March 2000 until March 2007. Oncologic, surgical and functional results were evaluated. Results: The method of reconstruction used were anterolateral thigh perforator flap (5cases), Reversed superficial sural artery flap (4 cases), dorsalis pedis flap (3 cases), local flap (3cases). The defect, mean size was $5.5{\times}5.7\;cm$, was reconstructed with rotation flap or free flap, mean size was $5.9{\times}6.0\;cm$, skin graft for remnant. The mean operation time was 310 minutes (120~540 minutes); it took 256 minutes to reconstruct by rotation flap, and 420 minutes by free flap. As oncologic results, 7 patients were no evidence of disease, 6 patients were alive with disease and 1 patient was expired by pulmonary metastasis at the time of the last follow-up. 4 patients had local recurrence and 4 pateints had distant metastases. As functional results, 14 patients were evaluated with average score of 68.8% using the system of the Musculoskeletal Tumor Society. Conclusion: The dorsalis pedis and reverse superficial sural artery rotation flap which is easy procedure, has less complication and takes short operation time, can be primarily considered to reconstruct a small defect. And the anterolateral thigh perforator flap is suitable for coverage of a large defects after wide excision of malignant soft tissue tumor in ankle and foot.

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A Study of Community Residents' Consciousness of Taking Herb Medicine (지역사회 주민의 한약복용에 대한 의식 조사 연구)

  • Kim Sung-Jin;Nam Chul-Hyun;Kang Young-Woo;Suh Ho-Suk;Jeon Bong-Cheon;Chang Young-Jin
    • Journal of Society of Preventive Korean Medicine
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    • v.6 no.1
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    • pp.15-35
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    • 2002
  • This study was conducted to provide basic data for policy of Oriental medicine by analyzing community resident's consciousness of taking herb medicine and its related factors. Data were collected from 1478 residents from March 2, 2001 to May 31, 2001. The results of this study are summarized as follows. 1) The rate of experience of taking herb medicine was 85.2%(88.2% of 'male'; 82.5% of 'female'). It appeared to be significantly higher in the groups of 'the married', 'housewife', and 'Buddhist'. As the age increased, so the rate of experience of taking herb medicine was significantly high. 2) In case of purpose of taking herb medicine, taking herb medicine as a restorative(66.8%) was much higher than taking it as a curative medicine. 3) 52.1% of the respondents satisfied with the effect of herb medicine. The groups of 'male', 'older age', 'residents in a big city', 'insurant in company', and 'the employed' showed significantly high rate in satisfying with herb medicine than the other groups. 4) According to the reason for preferring herb medicine, 36.7% of the respondents preferred herb medicine because the herb medicine was effective, while 27.8% preferred it because its side effect was low. 16.7% preferred it because persons around them recommended it. 5) 42.6% of the respondents did not want to take the herb medicine because the price of the herb medicine was high. Also 20.6% of the respondents did not want to take herb medicine because it is uneasy to take herb medicine. 15.8% did not want to take it because certain food should not be taken during the period of taking it. 9.4% did not want to take it because it tasted bitter. 6) In case of opinions on side effects of herb medicine, 40.8% of the respondents thinks that herb medicine is free from side effects, while 37.5% thinks that it causes side effects. There were significant difference in the opinions on side effects by sex, age, marital status, resident area, education level, occupation, and type of health insurance. 7) 60.7% of the respondents thinks the price of herb medicine is not resonable, while only 10.9% thinks it is resonable. 8) 45.2% of the respondents uses packs of decocted herbs although they think the packs of decocted herb are a little low effective because decocting herbs in home is bothersome. 45.2% uses packs of decocted herbs because they are convenient, being not related to the effect. 7.6% takes medicinal herbs after decocting them in a clay pot because they think the packs of decocted herbs have low effect. 51.9% does not know whether taking herb medicine in summer is effective or not because the effect is different according to their physical constitutions. 35.5% thinks that taking herb medicine is summer is effective because their physical stamina is weakened after sweated a lot, while 12.6% thinks that it is not effective because the effect of herb medicine disappears with sweat. 9) According to the level of satisfaction with Oriental medical care, the respondents marked $3.47{\pm}0.64$ points on the base of 5 points. It was significantly higher in the groups of 'male', 'the married, resident in a big city', 'highschool graduate', 'the unemployed', 'office clerk', 'growing up in a big city', 'insurant in region', and 'the middle class'. 10) According to the result of a regression analysis of factors influencing preference for herb medicine, the factors displayed significant difference by sex, age, education level, health status, and times of receiving Oriental medical care. As shown in the above results, the community residents satisfy with the effect of herb medicine. Therefore, the method of taking herb medicine without difficulty must be devised. The medicinal herbs in packages need to be included in health insurance coverage and resonable price of herb medicine must be set. Also, education program for community residents must be developed in order to provide right information in herb medicine. Therefore, related public authority, associations, and professionals must make efforts, forming organic cooperative system.

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Studies on the soil - erosion- control effect of underground growth of several grasses used to rodside vegetation (도로비탈면 녹화에 사용되는 주요 초목식물의 지하부 생육이 토양안정에 미치는 효과에 관한 연구)

  • 김남춘
    • Journal of the Korean Institute of Landscape Architecture
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    • v.18 no.2
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    • pp.45-55
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    • 1990
  • This study describes on the erosion control effects of the several grasses and its mixtures for the man-made slopes. The grasses used for this experiment include cool-season grasses such as Festuca rubra L. (Creeping redfescue), Poa pratensis L. (Kentucky bluegrass), Lolium perenne L. (Perenial ryegrass), Lolium multiflorum LAM. (Italian ryegrass), Festuca arundinacea Schrel. (Tall fescue), and warm-season grasses such as Eragrostis curvula Schrad. (Weeping lovegrass), Zoysia japonica Steud. (Zoysiass) and native plants (Artemisia princeps var. orientalis Hara, Lespedeza cuneata G. Don, Arundinella hirta var. ciliata K.) This study was conducted at Dan-kook University from April, 1988 to Octover, 1989. The results are summurized as follows; 1.Cool-season grasses covered the ground quickly in early stage, and weekened slowly during sumer season. Warm-season grasses and native-plants covered the ground slowly in early stage, but during summer season they grew vigorously, so outweighed cool season grasses. 2. The amount of aboveground growth of weeping locearass and underground growth of Artemisia prinoepts are quite differant from others. Since Arumdinella hirta has deep root system, it is thought to very useful protection of unstable for hrdro-seeding. Because cool-season grasses are useful for quick coverage, and native plants or warm-season grow well during summer season with the better compatability to weeds. 3.Mixture III(cool-season and warm-season grasses), mixtureIV(native spp. and Italian ruegrass), and mixtureV(native spp.) resulted in better control of erosion control on man-made slopes. Native spp. has equivallent capacity of erosion control compared to several foreign grasses.

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An Adjustment of Cloud Factors for Continuity and Consistency of Insolation Estimations between GOES-9 and MTSAT-1R (GOES-9과 MTSAT-1R 위성 간의 일사량 산출의 연속성과 일관성 확보를 위한 구름 감쇠 계수의 조정)

  • Kim, In-Hwan;Han, Kyung-Soo;Yeom, Jong-Min
    • Korean Journal of Remote Sensing
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    • v.28 no.1
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    • pp.69-77
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    • 2012
  • Surface insolation is one of the major indicators for climate research over the Earth system. For the climate research, long-term data and wide range of spatial coverage from the data observed by two or more of satellites of the same orbit are needed. It is important to improve the continuity and consistency of the derived products, such as surface insolation, from different satellites. In this study, surface insolations based on Geostationary Operational Environmental Satellite (GOES-9) and Multi-functional Transport Satellites (MTSAT-1R) were compared during overlap period using physical model of insolation to find ways to improve the consistency and continuity between two satellites through comparison of each channel data and ground observation data. The thermal infrared brightness temperature of two satellites show a relatively good agreement between two satellites : rootmean square error (RMSE)=5.595 Kelvin; Bias=2.065 Kelvin. Whereas, visible channels shown a quite different values, but it distributed similar tendency. And the surface insolations from two satellites are different from the ground observation data. To improve the quality of retrieved insolations, we have reproduced surface insolation of each satellite through adjustment of the Cloud Factor, and the Cloud Factor for GOES-9 satellite is modified based on the analysis result of difference channel data. As a result, the insolations estimated from GOES-9 for cloudy conditions show good agreement with MTSAT-1R and ground observation : RMSE=$83.439W\;m^{-2}$ Bias=$27.296W\;m^{-2}$. The result improved accuracy confirms that the modification of Cloud Factor for GOES-9 can improve the continuity and consistency of the insolations derived from two or more satellites.

An Analysis of Referrals, Nursing Diagnosis, and Nursing Interventions in Home Care - Wonju Christian Hospital Community Health Nursing Service - (가정간호 기록지 분석 - 원주기독병원 가정간호 보건활동을 중심으로 -)

  • Suh, Mi-Hae;Huh, Hae-Kyung
    • Journal of Home Health Care Nursing
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    • v.3
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    • pp.53-66
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    • 1996
  • Home Health Care is one part of the total health care system. It includes health care services that link the hospital to the community. While it is important for early discharge patients, home care is also important for people with chronic illnesses or handicapping conditions. In 1989 the Korean government passed a law that opened the way for formal development of home health care services beginning with education programs to certify nurses for home care, and then demonstration home care services. Part of the mandate of the demonstration projects was evaluation of home care services. This study was done in order to provide basic data that would contribute to the development of records that could be used for evaluation through a retrospective audit and to examine the care that had been given in Home Care at Wonju Christian Hospital over a twenty year period from 1974 to 1994. The purposes of the study were : to identify to characteristics of the clients who had received home care, to identify the reasons for client referrals, to identify the nursing problems of these clients, to identify the nursing care provided to these clients, and to identify differences in these areas over the twenty year period. The study was a descriptive study involving a retrospective audit of the client records. Demographic data on all clients were included : 4,171 clients from 2,564 families. Data on referrals, nursing diagnosis and nursing interventions were from even numbered records which had a patient problem list included in the record, 2,801 clients, Frequencies and ANOVA were used in the analysis. The results of the study showed that the majority of the clients were from Wonju city /county. There were more women than men related to the high number of postpartum clients(1,300). The high number of postparttum clients and newborns was also evident in the age distribution. An the number of maternal-child clients decreased over the 20 years, the mean age of the clients increased significantly. Other factors also contributed to this change ; as increasing number of clients with brain injuries or with cancer, and fewer children with burns, osteomyelitis and tuberculosis. There was a decrease in the mean number of visits and mean length of coverage, reflecting a movement towards a short term acute care model. The number of new clents dropped sharply after 1985. The reasons for this are : the development of other treatment alternatives for clients, the establishment of an active wellbaby clinic, many more options plus a decreasing number of new cases of Hansen's Disase, and insurance that allows people with burns to be kept in hospital until skin grafts are healed. Socioeconomic changes have resulted in an increase in the number of cases of cancer, stroke, head injuries following car accidents, and of diabetes. Of the 2,801 client records, 2,541(60.9%) contained a written referral but for 1,802 it contained only the medical diagnosis. The number of records with a referral requesting specific nursing care was 739(29.1%). Many family members who were identified as in need of nursing care had no written referral. Analysis of the patient problem list showed that 41.9% of the enteries were nursing diagnoses. Others incuded medical diagnosis, symptoms, and plans. The most frequently used diagnoses were alteration in nutrition, less than body requirements(115 entries), alteration in skin integrity(114), knowledge deficit(111), pain(78), self-care deficit(66), and alteration in pattern of urinary elimination(50). These are reflected in the NANDA categories for which the highest number of diagnosis was in the Exchanging pattern(446), followed by Moving(178), Feeling(136) and Knowing (115). Analysis of the frequency of interventions showed that exercise and teaching about exercise was the most frequent intervention, followed by teaching concering the need for follow-up care, checking vital signs, managing nutritional problems, managing catheters, giving emotional support, changing dressings, teaching about medication, teaching (subject not specified), teaching about diet, IM and IV medications or fluid, and skin care, in that order. Recommendations included: development of a record that would allow for efficient recording of frequently used nursing diagnoses and nursing interventions: expansion of the catchment area for Home Care at Wonju Christian Hospital ; expansion of the service to provide complication prevention, rehabilitation services, and support to increase the health maintenance /health promotion of the people being served as well as providing client dentered care ; and development of a clinical record that will allow efficient data collection from records, even though the recording is done by a variety of health care providers.

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The Study about Role and Importance of Site Activity Stage in Safety Activity for the International Conference among Several Countries (다자간 국제회의 안전활동에 있어서 현장활동단계의 역할 및 중요성에 관한 연구 : 부산 APEC 행사를 중심으로)

  • Lee, Sun-Ki
    • Korean Security Journal
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    • no.19
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    • pp.105-138
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    • 2009
  • This study's purpose is to present the improvement of effectiveness of security activity for international conference among Several Countries which can be held hereafter. On the basis of security activity problems originating in APEC that had been held in Busan in 2005. I made up questions three times to on the members of the police, military, fire figher and national intelligence service who had experienced in Busan APEC and recognition of possible problem and possibility of improvement on each item of questions was analyzed by Delphi Method. Also interviews with 4 security experts selected from each security agency were conducted to present improvement in each part of problem. The results obtained from the face to face interview with four experts of security-enforcement agency about the role and importance of site activity stage for international conference among several countries are as followings ; First, the system that experienced security-enforcement agents can be selected for the next national security event is needed, by data-basing the security-enforcement agents who were experienced in security event as man power management. Second, the middle-term plan for the introduction of high-tech equipment and joint inspection with relevant security agents are needed for the efficient explosive technical detection. Third, high-tech security equipment could be introduced through the international high-tech security equipment exhibition. Fourth, an anti-terrorism plan should be measured by sharing information through the cooperation with domestic and international intelligence agency. Fifth, public relations should be measured systematically by organization rather than agents' individual public relations. Sixth, political consideration to secure integrative coordination with other agency is needed for security activity, through normal cooperation with fire fighting related agency such as an electric, gas, elevator company. Seventh, a definite press guideline is needed for a convenient news coverage and safety during security event.

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Shade comparative analysis of natural tooth measured by visual and spectrophotometric methods (육안과 분광 측정기를 이용한 자연 치아의 색조비교분석)

  • Kim, Bum-Suk;Shin, Soo-Yeon;Lee, Jong-Hyuk
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.5
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    • pp.443-454
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    • 2008
  • Statement of problem: A clinically successful color match is one of the important factor to get an esthetic dental restoration. Dental shade guides are commonly used to evaluate tooth color in restorative procedure. But numerous reports have indicated that common shade guides do not provide sufficient spectral coverage of the natural tooth colors. To address issues associated with the shade guide, distinct avenues have been pursued objective spectrophotometric / colorimetric assessment. Purpose: This study compared the accuracy of tooth color selection of spectrophotometer with that of human visual determination. Three main factors were investigated, namely, the effect of light, the individual variation and the experience of the observer. Material and methods: At the first experiment, on ten patients, one operator independently selected the best matching shade to the unrestored maxillary central incisor, using a Vita Classical Shade Guide in the morning, at noon and in the afternoon. The same teeth were measured by means of a reflectance spectrophotometer. At the second experiment, on ten patients, ten operators (5 experts, 5 novices) selected and measured by the same method above at noon. At the third experiment, the results of the second experiment were divided into two groups, expert and novice, and analyzed. Results: 1. There was significant difference between visual and spectrophotometric assessment (mean ${\Delta}E$ values) in experiment 1, 2, 3 (P < .05). 2. There was no significant difference between experts and novices group, when comparing with each visual and spectrophotometric assessment (mean ${\Delta}E$ values). Conclusion: Spectrophotometer could be used to analyze the shade of natural tooth objectively. Thereby, this method offers the potential tominimize considerably the need for corrections or even remakesafter intraoral try-in of restoration. Furthermore, to achieve its advantage, both the shade-matching environment and communication between dentist and technician should be optimized with use of visual and instrumental shade-matching systems.

Ecological Characteristics and Management Program for Buffer Greens at Sinhyeon-Eup, Geoje-Si (거제시 신현읍 완충녹지의 생태적 특성 및 관리방안)

  • SaGong, Young-Bo;Lee, Soo-Dong
    • Korean Journal of Environment and Ecology
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    • v.21 no.3
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    • pp.243-256
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    • 2007
  • The purpose of this paper is aimed at identifying the planting condition of greenbelt axis covering forests located at Sinhyeon-eup, Geoje-si and also establishing improvement plans for the ecological organization. The study was executed with buffer green space designed to mitigate noise, which is located at a halfway point linking Mt. Yukkyo(altitude of 50m) and Mt. Jungmae(altitude of 131m). The number of the biotope patterns was classified into 17 in total: the two are urbanized districts such as a townified district and streets and another 15 are greenbelts and open space such as forest biotope, inland water biotope, and landscaping tree plantations biotope. According to the analysis of biotope types, it was estimated that the making use of already established buffer greens as a linking medium with a foothold of Mt. Yukkyo and Jungmae, whose natural eco-system is well suited for habitation of living organism, is the one and only way to the influx of living organism into the downtown area. The green coverage rate of the base green area, sub-base green area and linkage green area was 160.29%, 128.37% and 44.37% respectively; the green capacity coefficient(i.e. GVZ[$Gr{\ddot{u}}nvolumezahl$]) for base green area, sub-base green area and linkage green area was $4.04m^3/m^2,\;3.95m^3/m^2\;and\;0.65m^3/m^2$ respectively. The base green area has constituted multi-layered vegetation structure and thus played a role as habitats for living organism and supply centre of species, whereas the sub-base green area has destroyed lower layer vegetation, and the linkage green area was in bad shape due to the lack of planting volume and damage of the shrub layer. Accordingly, this research paper intended to suggest detailed implementation plans for the improvement in landscape for city dwellers' use and relaxation; in other words, this paper focused on ecological build-up for the Influx of wild birds into the downtown area for the promotion of bio-diversity of species through the linkage of base green areas and the fostering of nature observing trails for citizens as well as the connecting of green areas through the build-up of roadside greens to make these green areas to be efficiently used as corridors for the influx of wild birds and bio-organism habitation and for citizens' using space.

Evaluation of Setup Uncertainty on the CTV Dose and Setup Margin Using Monte Carlo Simulation (몬테칼로 전산모사를 이용한 셋업오차가 임상표적체적에 전달되는 선량과 셋업마진에 대하여 미치는 영향 평가)

  • Cho, Il-Sung;Kwark, Jung-Won;Cho, Byung-Chul;Kim, Jong-Hoon;Ahn, Seung-Do;Park, Sung-Ho
    • Progress in Medical Physics
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    • v.23 no.2
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    • pp.81-90
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    • 2012
  • The effect of setup uncertainties on CTV dose and the correlation between setup uncertainties and setup margin were evaluated by Monte Carlo based numerical simulation. Patient specific information of IMRT treatment plan for rectal cancer designed on the VARIAN Eclipse planning system was utilized for the Monte Carlo simulation program including the planned dose distribution and tumor volume information of a rectal cancer patient. The simulation program was developed for the purpose of the study on Linux environment using open source packages, GNU C++ and ROOT data analysis framework. All misalignments of patient setup were assumed to follow the central limit theorem. Thus systematic and random errors were generated according to the gaussian statistics with a given standard deviation as simulation input parameter. After the setup error simulations, the change of dose in CTV volume was analyzed with the simulation result. In order to verify the conventional margin recipe, the correlation between setup error and setup margin was compared with the margin formula developed on three dimensional conformal radiation therapy. The simulation was performed total 2,000 times for each simulation input of systematic and random errors independently. The size of standard deviation for generating patient setup errors was changed from 1 mm to 10 mm with 1 mm step. In case for the systematic error the minimum dose on CTV $D_{min}^{stat{\cdot}}$ was decreased from 100.4 to 72.50% and the mean dose $\bar{D}_{syst{\cdot}}$ was decreased from 100.45% to 97.88%. However the standard deviation of dose distribution in CTV volume was increased from 0.02% to 3.33%. The effect of random error gave the same result of a reduction of mean and minimum dose to CTV volume. It was found that the minimum dose on CTV volume $D_{min}^{rand{\cdot}}$ was reduced from 100.45% to 94.80% and the mean dose to CTV $\bar{D}_{rand{\cdot}}$ was decreased from 100.46% to 97.87%. Like systematic error, the standard deviation of CTV dose ${\Delta}D_{rand}$ was increased from 0.01% to 0.63%. After calculating a size of margin for each systematic and random error the "population ratio" was introduced and applied to verify margin recipe. It was found that the conventional margin formula satisfy margin object on IMRT treatment for rectal cancer. It is considered that the developed Monte-carlo based simulation program might be useful to study for patient setup error and dose coverage in CTV volume due to variations of margin size and setup error.