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Development of Respiration Gating RT Technique using Moving Phantom and Ultrasound Sensor: a feasibility study (동 팬텀과 초음파 센서를 이용한 호흡운동 조절 방사선치료 기술 개발)

  • Lee Suk;Lee Sang Hoon;Shin Dongho;Yang Dae Sik;Choi Myung Sun;Kim Chul Yong
    • Radiation Oncology Journal
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    • v.22 no.4
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    • pp.316-324
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    • 2004
  • Purpose : In radiotherapy of tumors in liver, enough planning target volume (PTV) margins are necessary to compensate breathing-related movement of tumor volumes. To overcome the problems, this study aims to obtain patients' body movements by using a moving phantom and an ultrasonic sensor, and to develop respiration sating techniques that can adjust patients' beds by using reversed values of the data obtained. Materials and Methods : The phantom made to measure patients' body movements is composed of a microprocessor (BS II, 20 MHz, 8K Byte), a sensor (Ultra-Sonic, range $3\~3$ m), host computer (RS232C) and stepping motor (torque 2.3 Kg) etc., and the program to control and operate it was developed. The program allows the phantom to move within the maximum range of 2 cm, its movements and corrections to take place In order, and x, y and z to move successively. After the moving phantom was adjusted by entering random movement data (three dimensional data form with distance of 2 cm), and the phantom movements were acquired using the ultra sonic sensor, the two data were compared and analyzed. And then, after the movements by respiration were acquired by using guinea pigs, the real-time respiration gating techniques were drawn by operating the phantom with the reversed values of the data. Results : The result of analyzing the acquisition-correction delay time the three types of data values and about each value separately shows that the data values coincided with one another within $1\%$ and that the acquisition-correction delay time was obtained real-time $(2.34{\times}10^{-4}sec)$. Conclusion : This study successfully confirms the clinic application possibility of respiration gating techniques by using a moving phantom and an ultrasonic sensor. With ongoing development of additional analysis system, which can be used in real-time set-up reproducibility analysis, it may be beneficially used in radiotherapy of moving tumors.

A Suggested New Clinical Classification for Pediatric Intussusception (소아 장중첩증의 새로운 임상적 분류의 제안)

  • Park, Moon Ho;Shon, Su Min;Choe, Byung Kyu;Kim, Yeo Hyang;Lee, Hee Jung;Choi, Won Joung;Kim, Ae Suk;Hwang, Jin-Bok
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.9 no.1
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    • pp.39-47
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    • 2006
  • Purpose: We proposed a new classification of pediatric intussusception based on clinical and radiologic findings. Methods: Data from 88 consecutive patients with intussusception were reviewed. We retrospectively analyzed six factors; patient age, sites of intussusception, symptoms, therapeutic methods, existence of enlarged mesenteric lymph nodes, and ultrasonographic (US) findings from clinical records. Results: 1) There was one neonatal case (1.1%), the others (98.9%) were infants and children. 2) These 87 infant and child cases consisted of 14 cases (16.1%) of small bowel intussusception (SBI) and 73 cases (83.9%) of ileo-colic intussusception (ICI). Of the 14 SBI cases, 12 cases were symptomatic and 2 cases were asymptomatic. The symptomatic group comprised 8 transient cases (66.7%), 3 operative cases (25.0%), and 1 enema-reduction case (8.3%). Two asymptomatic cases were incidentally captured by computed tomography. Of the 73 ICI cases, 19 cases (26.0%) required operation, and 54 (74.0%) enema-reduction. 3) When transient SBI cases were compared with operated SBI cases, enema-reduced and operated ICI cases, the age ($38.0{\pm}22.9$ months) of transient SBI cases were significantly higher than those of the others (p=0.003). Mean mass size ($20.8{\pm}2.7mm$) in transient SBI was significantly smaller than in the others (p=0.0001). 4) No correlation was found between the existence of enlarged mesenteric lymph nodes and therapeutic method or concomitant illness. 5) Most of the target types observed by US were in transient SBI cases, the remainder were in the enema-reduced ICI cases. In terms of the doughnuts type, all 8 cases (34.8%) with an external hypoechoic rim thickness of >8.9mm were treated surgically. Conclusion: Pediatric intussusception may be classified based on clinical and radiologic findings, which are likely to indicate appropriate therapies.

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Diagnosis of Enteropathogens in Children with Acute Gastroenteritis: One Year Prospective Study in a Single Hospital (소아의 급성 위장관염의 원인균 진단: 단일 병원에서 1년간의 전향적 연구)

  • Chang, Ju Young;Choi, Ji Eun;Shin, Sue;Yoon, Jong Hyun
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.9 no.1
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    • pp.1-13
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    • 2006
  • Purpose: Acute gastroenteritis in children is one of the frequently encountered diseases with relatively high admission rate. The aim of this study is to determine the isolation trends of common and emerging pathogens in acute gastroenteritis in children over a 12-month period in a community hospital. Methods: The study group included the children who were hospitalized to Seoul National University Boramae Hospital from April, 2003 to March, 2004 or visited outpatient clinic from April, 2003 to July, 2003 with presenting features of acute gastroenteritis. Stool specimens were obtained within 2 days after the visit and examined for the following pathogens: rotavirus, adenovirus, Salmonella, Shigella, Vibrio, pathogenic Escherichia coli (E.coli), Campylobacter and Yersinia species. Viral study was done with commercial kits for antigen detection. Identification of the bacterial pathogens was done by culture using selective media. For pathogenic E.coli, polymerase chain reaction (PCR) was done with the target genes related to the pathogenecity of enterotoxigenic E.coli (ETEC), enteropathogenic E.coli (EPEC) and enterohemorrhagic E.coli (EHEC). Results: The 130 hospitalized children and 28 outpatients were included in this study. The majority of children (>93%) were less than 6 years. Pathogens were isolated in 47% of inpatients and 43% of outpatients, respectively. Rotavirus was the most frequently identified pathogen, accounting for 42.3% of inpatients and 29.6% of outpatients. Nontyphoidal salmonella is the most commonly isolated bacterial pathogen (3.9%) in hospitalized children. Pathogenic E.coli (EPEC, ETEC) was detected in 2.1% (2/97) of inpatients and 25% (3/12) of outpatients. EHEC, adenovirus, Campylobacter, Yersinia and Shigella species were not detected in this study. Conclusion: Rotavirus is the most common enteropathogen in children with acute gastroenteritis. Nontyphoidal salmonella and pathogenic E.coli are important bacterial pathogens. Campylobacter species may not be commonly detected organism in hospitalized children with acute diarrhea.

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Antibiotics Susceptability of Streptococcus pneumoniae Isolated from Pharynx in Healthy Korean Children and Choice of Proper Empirical Oral Antibiotics Using Pharmacokinetics/Pharmacodynamics Model (국내의 소아에서 분리된 폐구균의 항생제 감수성 양상 및 약력동학 모델을 이용한 적절한 항생제의 선택)

  • Paik, Ji Yeun;Choi, Jae Hong;Cho, Eun Young;Oh, Chi Eun;Lee, Jina;Choi, Eun Hwa;Lee, Hoan Jong
    • Pediatric Infection and Vaccine
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    • v.18 no.2
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    • pp.109-116
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    • 2011
  • Purpose : Pneumococcus is one of the most important causes of invasive infection through the childhood period. In January 2008, the Clinical and Laboratory Standards Institute (CLSI) published revised penicillin breakpoints for Streptococcus pneumoniae and penicillin susceptibility rates of S. pneumoniae increased in Korea. This study was performed to determine the probability of oral amoxicillin for the empirical treatment achieving bactericidal exposure against pneumococcus using pharmacodynamics model. Methods : Twenty-three isolates of pneumococci were subjected to determine minimum inhibitory concentration (MIC) for ${\beta}$-lactams and macrolide. For the ${\beta}$-lactams, exposure of fT >MIC (time that free drug concentrations remain above the MIC) for 50% of the administration interval have determined the probability of target attainment (PTA), and regimens that had a PTA >90% were considered optimal. An analysis was performed by applying MIC of 23 isolates to a 5000-patient Monte Carlo simulation model. Results : Among 23 isolates from healthy children, 7 (30.4%) isolates were MIC ${\leq}$1.0 ${\mu}g$/mL and 19 (82.6%) were MIC ${\leq}$2 ${\mu}g$/mL for amoxicillin. Amoxicillin 40 mg/kg/day achieved PTA >90% at MIC ${\leq}$1.0 ${\mu}g$/mL but PTA decreased to 52% at MIC 2 ${\mu}g$/mL, whereas amoxicillin 90 mg/kg/day can predict 97% of PTA at MIC 2 ${\mu}g$/mL. Overall, oral amoxicillin 90 mg/ kg/day for the empirical treatment against pneumococcus can expect more successful response in Korean children. Conclusion : Considering the resistantce pattern of pneumococci in Korean children, we estimate that oral amoxicillin 90 mg/kg/day will provide a pharmacodynamic advantage for the empirical treatment against pneumococcus. And low dose amoxicillin or macrolide are expected to have higher chance of treatment failure than high dose oral amoxicillin.

Predictors of breast-feeding discontinuation in some followed-up hospital-delivered mothers (추적조사된 대구시내 일부 병원분만 산모에서 모유수유중단 예측변수)

  • Lee, Choong-Won;Lee, Moo-Sik;Park, Jong-Won;Lee, Mi-Young;Kang, Mi-Joung;Shin, Dong-Hoon;Lee, Se-Youp
    • Journal of Preventive Medicine and Public Health
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    • v.28 no.4 s.51
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    • pp.845-862
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    • 1995
  • We followed prospectively some hospital-delivered mothers to identify characteristics of those not initiated breast-feeding and predictors of breast-feeding discontinuation in monthly telephone interviews. Recruits were composed of 482 mothers who delivered their babies at one university hospital and one OB/GYN clinic in September to November 1991. Breast-feeding discontinuation was defined as switch to 100% formula lasting more than one week regardless of solid foods. Average age of the study subjects was 27.3 years of age(standard deviation 3.2). Multiple logistic regression analysis indicated native place, occupation, method of delivery and method of feeding considered to be better for maternal health were statistically significant(p<0.1) between initiators and non-initiators of breast feeding. In starting cohort(N=242) of those initiated breast-feeding, that median of breast-feeding discontinuation were 5 months and 25th and 75th percentiles were 3 and 9 months respectively. In Cox's proportional hazard model, mothers with $10\sim13$ years of education were 2.63 times (95% confidence interval, CI $1.50\sim4.60$) more likely to discontinue than those with less than 9 years of education and those with more than 13 years of education were 3.55 time (95% CI $1.99\sim6.33$). Compared with house wife, mothers with part-time jobs were 1.99 times (95% CI $0.86\sim4.57$) more likely to discontinue and those with employed full-time were 1.55 times (95% CI $0.96\sim2.51$). These results suggest that the predictors of initiation and discontinuation of breast-feeding may be different and different target populations should be selected to promote initiation and to prevent discontinuation of breast-feeding according to the period after birth.

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A Survey on Status of Pregnancy and Delivery at a Rural Village, Nepal(Dolakha Bazar Area) (네팔 돌카지역의 임신분만 환경)

  • Ahn, Young-Woo;Kang, Yune-Sik;Kam, Sin;Lee, Jong-Young
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.4 s.55
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    • pp.721-732
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    • 1996
  • This study was conducted to investigate the status of pregnancy and delivery and relationship among knowledge, attitude and practice about pregnancy and delivery in poor country, Nepal. A questionnaire survey by interviewer was conducted to examine the general characteristics, knowledge about pregnancy and delivery, attitude about pregnancy and delivery, the rate of prenatal care and delivery condition of women who had an experience of delivery during last year$(1994.4.13\sim1995.4.12)$ at a rural area, nepal(Dolakha Bazar Area). The major findings are as follows ; Among respondents, 87.5 percentage never had health education and the degree of knowledge about pregnancy and delivery was low. Among respondents, 56.6 percentage had the attitude that they didn't want antenatal care, 42.8 % of respondents answered that they wouldn't visit hospital or health center when vaginal bleeding occurred and 82.9% thought that the delivery itself was dirty. The proportion of women who experienced antenatal care was 28.3%, the proportion of health facilities delivery was 5.3%, which was very low and 82.6% of home delivery case didn't sanitate the tool to cut the umbilical cord. The women who had positive attitude about antenatal care and health facility utilization experienced more antenatal care and health facilities delivery. On consideration of above findings, health education for pregnancy and delivery is required to improve mother-child health status in poor country. To make efficient health education, the target population group, such as the uneducated, inhabitants far from health center or medical facility, must be chosen. To help the poor countries in medical field, the study on health status and its related factors on these countries like this article would be required.

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A Review of Service Innovation Research: A Comparison of Domestic and International Research Papers (서비스혁신 연구 동향: 국내 및 해외 주요 학술지를 중심으로)

  • Ryu, Hyun-Sun
    • Asia pacific journal of information systems
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    • v.24 no.4
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    • pp.577-610
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    • 2014
  • Although service innovation is not a new concept, innovation research in general tends to focus on technological innovation by manufacturing firms. With this view, innovation studies focus on product(e.g., goods) and process(e.g., product systems) innovation, ignoring service innovation and its inherent opportunities. Since major economy has been transformed to service economy, service innovation is considered a new effective way to sustain and gain a competitive advantage. Service innovation is no longer regarded merely as a side activity to product innovation; it has become a main research topic in its own right, accompanied by an increasing focus on services. While the number of service innovation studies has increased dramatically in the past 30 years in international research, few studies have been performed in domestic studies because domestic service innovation research began from the middle of 2000. In addition, there are no comprehensive literature reviews describing the evolution of service innovation research in both international and domestic studies because of the heterogeneities of service industry and multidiscipline characteristics of service innovation studies. To bridge this research gap, the purpose of this paper is to perform an extensive literature review and synthesis to enable a critical review of extant research on service innovation and trace its evolution, which will establish a foundation for further studies. By reviewing 169 articles (136 international papers; 33 domestic papers) published between 2000 and 2014 (in past 15 years), primarily in leading service, innovation and management information systems journals, this study analyzes the progression of service innovation research according to the four aspects such as number of studies, topics, methodologies and target industries. Overall, the view of service innovation has evolved, from a complement of traditional product innovation to a multidimensional, all-encompassing concept that entails several functions, both within and outside the firms. The results showed that domestic research still stays at the formation phase of service innovation studies although international research is in the maturity or multidimensional phase. We found increasing recent activities pertaining to service innovation, resulting from the increasing interest in services innovation across various industries and the links of new topics to the service innovation concept in both international and domestic studies. However, the main focus of service innovation research showed a different propensity between international and domestic studies: the former mainly focuses on a much more diversified pattern, emphasizing the linkages between service innovation and business strategy while the latter mainly focuses on the service innovation process(system) and service design. In addition, there are many case studies in domestic studies while many empirical studies in international studies. Domestic studies should increases the understanding of the interplay between service innovation and product innovation within manufacturing firms. Furthermore, rather than focusing on intrinsic distinctions between service innovation and product innovation, researchers should strive to develop and conceptualize service innovation in domestics studies. The present research also provides useful implications for practitioners. First, this study contributes to expand the current understanding of service innovation research by performing an extensive literature review. Second, tracing and comparing the progression and trends of service innovation research between international and domestic studies, this study showed the similarities and differences between them, which provide practical guidance on future research directions and research agenda. Third, this study performed literature review establishing the analysis system in the initial stage and using them to analyze articles, which is leading to explain the research review of service innovation more systematically and objectively. Finally, this study suggests the domestic researchers their future interests and topics of service innovation research.

Efficient Application of Westgard Multi-Rules and Quality Control Implementation Improvement (Westgard Multi-Rules의 효율적 적용과 조치사항의 개선)

  • Jung, Heung Soo;Oh, Youn Jung;Bae, Jin Soo;Baek, Jin Young;Hwang, Bo ra;Shin, Yong Hwan
    • The Korean Journal of Nuclear Medicine Technology
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    • v.21 no.1
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    • pp.60-64
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    • 2017
  • Purpose Westgard multi-rules application based on test quality improvement and commercialized international standard has been widely used in quality control. However, it is difficult to applicate the Westgard multi-rules in nuclear medicine in vitro tests due to the larger sample sizes and the simultaneous measurement of quality control material and patient sample. This study investigated the usefulness of Westgard multi-rules application in nuclear medicine in vitro tests. Materials and Methods A total of 282 systematic error multi-rules (22s, 101s) recorded in the samsung medical center computer system from January 2013 to June 2016 along with 117 cases of corrective measure record was analyzed. The Quality control implementation is recorded in Hospital information system were divided into 4 high-level areas including quality control material error, experimental procedural error, Kit lot number management error, and others. To prevent quality control material error, the existing method that each staff used their own method was changed. The staff who in charge of managing the quality control material was designated and daily consumption amount of every test was strictly controlled by one person. To prevent other errors, every test step was standardized so that the entire test procedures are identically implemented. Results The total quality control implementation was 117 cases; As a result, 62 quality control material errors were 62 cases, experimental process errors were 24 cases, Kit lot number control errors were 18 cases, and other errors were 13 cases. The quality control material error was corrected and could be used fresh materials within 2 days after thawing. The cases of systemic error were decreased to causes as quality control material error. The quality control materials were reduced above 10 vials to a monthly average. In addition, these errors of experimental processing and Kit lot number were improved by test standardization. Consequently, the cases of 101s and 22s in systematic error rules decreased at least 2 cases to a monthly average. Conclusion To confirm of systematic error through multi-rules application quickly, it is necessary to base on management of the QC material, target values and standard deviation. Moreover, in the event of a systematic error, it was found important to record measures based on test cause analysis. The experiment results are expected to contribute to internal quality control improvement and prompt and accurate result reporting through error recording and causal analysis based on Westgard multi-rules analysis.

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Concentrations and Distribution Patterns of PCDDs, PCDFs, DL-PCBs, PBDEs in Sediments from Ulsan Bay (울산만 퇴적물 내 PCDDs, PCDFs, DL-PCBs, PBDEs의 잔류수준과 분포패턴)

  • Baek, Seung-Hong;Lee, In-Seok;Choi, Minkyu;Lee, Boo-Han;Hwang, Dong-Woon;Kim, Sook-Yang;Choi, Hee-Gu
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.18 no.4
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    • pp.186-194
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    • 2013
  • We investigated the concentrations and distribution patterns of 17 polychlorinated dibenzo-p-dioxins/dibenzofurans(PCDD/Fs), 12 dioxin-like polychlorinated biphenyls(DL-PCBs) and 24 polybrominated diphenyl ethers(PBDEs) in sediments from Ulsan Bay in Korea. The concentrations of PCDD/Fs, DL-PCBs, and PBDEs in 33 sediment samples ranged from 0.11 to 4.86($1.81{\pm}1.04$) pg $WHO_{2005}$-TEQ $g^{-1}$ dry weight(dw), 0.06 to 44.2($4.02{\pm}7.99$) pg $WHO_{2005}$-TEQ $g^{-1}$ dw, and 2.81 to 63.8($19.4{\pm}13.9$) ng $g^{-1}$ dw, respectively. DL-PCBs had dominant contributions(mean, 88%) of total TEQ concentrations in sediment. The concentrations of target compounds in inner locations were higher than those in outer locations in Ulsan Bay (p<0.05). The dominant contribution of highly chlorinated DD/Fs in sediment was associated with combustion process from industrial complexes. Distribution pattern of DL-PCBs was similar with those of commercial PCB products. BDE209 was a dominant congener in sediment, suggesting high use amount of commercial deca-BDE product in surrounding areas.

Development of EvaGreen Based Real-time PCR Assay for Detection and Quantification Toxic Dinoflagellate Pfiesteria Piscicida and Field Applications (유독 와편모조류 Pfiesteria Piscicida 탐지 및 정량 분석을 위한 EvaGreen 기반 Real-time PCR기법 개발과 현장 적용)

  • PARK, BUM SOO;JOO, JAE-HYOUNG;KIM, MYO-KYUNG;KIM, JOO-HWAN;KIM, JIN HO;BAEK, SEUNG HO;HAN, MYUNG-SOO
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.22 no.1
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    • pp.31-44
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    • 2017
  • Pfiesteria piscicida is one of heterotrophic dinoflagellate having toxic metaboliges, and it is difficult to detect and quantify this dinoflagellate via light microscope due to small size and morphological similarity with Pfiesteria-like dinoflagellate (PLD) species. Alternatively, we developed quantitative real-time PCR assay based on EvaGreen and determined field accessibility throughout the investigation of distribution in the entire Korean coastal waters and population dynamics in Shihwa Lake. The P. piscicida-specific primers based on internal transcribed spacer 1 (ITS 1) were designed and the specificity of primers was confirmed by PCR with other genomic DNAs which have genetic similarity with target species. Through real-time PCR assay, a standard curve which had a significant linear correlation between log cell number and $C_T$ value ($r^2{\geq}0.999$) and one informative melting peak ($88^{\circ}C$) were obtained. These results implies that developed real-time PCR can accurately detect and quantify P. piscicida. Throughout the field applications of real-time PCR assay, P. piscicida was distributed in western (Mokpo and Kimje) and easthern (Gangneng) Korean coastal water even though light microscopy failed to identify P. piscicida. In the investigation of population dynamics in Shihwa Lake, the density of P. piscicida was peaked in June, July and August 2007 at St. 1 where salinity (${\leq}15psu$) was lower than the other 2 sites. In this study, we successed to develop EvaGreen bassed real-time PCR for detection and quantification of P. piscicida in fields, so this developed assay will be useful for various ecological studies in the future.