• The Journal of Korean Physical Therapy
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• v.27 no.4
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• pp.175-182
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• 2015

Purpose: The purposes of this study were to develop the Korean version of the trunk impairment scale (K-TIS) and to examine reliability and responsiveness of the K-TIS in patients with stroke. Methods Subjects of the study were 51 stroke patients (mean age: 57.78 years) recruited from two stroke clinics. For the interrater and test-retest reliability, two raters measured the K-TIS two times using video clips with an interval of 2 weeks. For the responsiveness, intensive physical therapy training was provided to all participants 2 times a day for one month or three months depending on the onset of the stroke and the admission rules of the two clinics. Inter-rater reliability and test-retest reliability of the K-TIS three subscales (static sitting balance, dynamic sitting balance, and coordination) scores and total scores were examined using intra-correlation coefficient ($ICC_{3,1}$) and Pearson's correlation coefficient (r). To examine responsiveness, the minimally important difference (MID) was calculated with effect size. Results: Inter-rater reliability of the K-TIS subscales and total scores were all high (ICC3,1=0.920-0.983 and r=0.924-0.984). For the test-retest reliability, $ICC_{3,1}$=0.805-0.901 and r=0.806-0.903, and the MID for acute and post-acute as well as chronic stroke patients remained in the mean change range. Conclusion: It is suggested that the K-TIS might be used for clinical and research purposes as a standardized tool for stroke patients. In addition, it can also be useful in establishment of treatment goal(s) and planning treatment program(s) for patients with stroke.

• The Journal of Korean Society for Radiation Therapy
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• v.24 no.1
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• pp.23-30
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• 2012

Purpose: There was a problem with using MU verification programs for the reasons that there were errors of MU when using MU verification programs based on Pencil Beam Convolution (PBC) Algorithm with radiation treatment plans around lung using Analytical Anisotropic Algorithm (AAA). On this study, we studied the methods that can verify the calculated treatment plans using AAA. Materials and Methods: Using Eclipse treatment planning system (Version 8.9, Varian, USA), for each 57 fields of 7 cases of Lung Stereotactic Body Radiation Therapy (SBRT), we have calculated using PBC and AAA with dose calculation algorithm. By developing MU of established plans, we compared and analyzed with MU of manual calculation programs. We have analyzed relationship between errors and 4 variables such as field size, lung path distance of radiation, Tumor path distance of radiation, effective depth that can affect on errors created from PBC algorithm and AAA using commonly used programs. Results: Errors of PBC algorithm have showned $0.2{\pm}1.0%$ and errors of AAA have showned $3.5{\pm}2.8%$. Moreover, as a result of analyzing 4 variables that can affect on errors, relationship in errors between lung path distance and MU, connection coefficient 0.648 (P=0.000) has been increased and we could calculate MU correction factor that is A.E=L.P 0.00903+0.02048 and as a result of replying for manual calculation program, errors of $3.5{\pm}2.8%$ before the application has been decreased within $0.4{\pm}2.0%$. Conclusion: On this study, we have learned that errors from manual calculation program have been increased as lung path distance of radiation increases and we could verified MU of AAA with a simple method that is called MU correction factor.

• Progress in Medical Physics
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• v.17 no.4
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• pp.192-200
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• 2006

We evaluated the positional accuracy of the delivered beams to the target in a phantom by simulating the whole process of the radiation treatments Including CT scanning, planning and beam exposures with MLCs. For this purpose, a phantom was made to calibrate the alignment between the CT and the attached laser system. A new, convenient method was also devised to align the setup lasers in the treatment room. Film was used for the Identification of the delivered beam and analyzed with a homemade computer program. The positional differences between the target and the beam centers varied with the couch rotations. The accelerator we used showed a maximum discrepancy of 2.0 mm at the table angle of $295^{\circ}$. The same measurements based on the new isocenter from the Winston-Lutz test resulted in the maximum of 1.35 mm for all rotation angles. The evaluation of the differences between the target and the beam centers is useful for the treatment planning.

• Journal of Preventive Medicine and Public Health
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• v.16 no.1
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• pp.163-192
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• 1983

In order to facilitate the Korean government's efforts in integrating family planning and maternal & child health at the primary health care level (or township level), the Soon Chun Hyang College of Medicine, with the financial and technical assistance of WHO, has under-taken a service research project. The project has employed a quasi-experimental study design introducing interventions tat provide crucial factors lacking in the ongoing government programs such as midwives and qualified referral physicians. The study is being conducted in three locations, one control area and two study areas. Before introducing trained Nurse/Midewives into the study areas, a baseline prevalence survey was undertaken from 15 July 1981 to 10 August 1981 in selelcted townships of Seosan County. In this sample survey of bath the study and control areas, 2,484 eligible women (97% reponse rate) were interviewed to obtain benchmark data on basic evaluation indicators related to family planning and maternal and child health. The salients results were summarized as follows.: 1. CONTACT RATES WITH HEALTH WORKERS; During the year preceding the survey, 12% of women were visited by government health workers. The primary reason for such visits by health workers was family planning (45% of the visits). About 34% of the women visited the health centers during the year. The primary reason for visiting health centers was immunizations for their children (45% of the visits). 3. FAMILY PLANNING USE RATE; The baseline data showed little difference between women in the study area and the control area on contraceptive use. Approximately 59% were currently using some methods. However, among those current users, almost half were practicing less effective methods of birth control such as rhythm or withdrawal. Among other methods, the tubectomy was the most popular (16%), while use of the IUD, oral pill and condom together reached only 14%. 3. PRENATAL CARE RATE; About 75% of the women reported no prenatal care for their last births (the youngest child of each women), Additionally, among women received prenatal care, over half had only one visit. 4. ATTENDANCE AT DELIVERY; Most of the women surveyed (over 80%) were attended by a non-medical person during their last delivery. These figures are somewhat comparable to the national figure of 84% for remote areas. 5. POSTNATAL CARE; The proportion of women reporting postnatal care was only 4.5%, and postnatal care was not received by the majority of women surveyed. 6. CHILD HEALTH CARE: In contrast to the low rate of maternity care for women themselves, most women reported obtaining immunization care for their children. About 75% of the women obtained Polio and/or DPT, 58% BCG, and 44% Measles vaccine for their children. However, in terms of illness care, while 35% of the women stated that their youngest child had been sick during the month preceding the survey, only 28% of these women took their child to the clinic for treatment. 7. COMPLICATIONS OF PREGNANCY AND DELIVERY AND ABNORMALITIES IN THE NEWBORN; Among all last deliveries, 18% of the women had pregnancy complications and 9% of the women had complications during delivery About 5% of the women reported abnormality in their most recent newborn. 8. REPRODUCTION EFFICIENCY; PERINATAL MORTALITY AND INFANT MORTALITY Based on data from the pregnancy history in this survey, reproduction efficiency was estimated. Out of the 11,154 pregnancies reported by all women surveyed, foetal loss was 21% (almost 16% were induced abortions) and infant deaths before reaching one year old were 3.1%. The reproduction efficiency was, therefore, reduced to 76%. In terms of perinatal and infant mortality rates, the former was 40.2 per 1,000 total births and the latter was 39.3 per 1,000 live births. Both rates described J shaped relationships with age of mothers and parity, and they were also correlated with birth interval and mother's education. In summary, this baseline survey data indicated a need for (1) improving contraceptive practices with more effective methods to prevent unwanted pregnancies and (2) providing better services for maternal and child care to protect wanted pregancies. In the Korean rural setting. the author believes that the latter is more important as the value of each child has increased as a result of the family planning campaign for the past two decades. This calls for more effective integration of Family Planning and MCH programmes to meet the needs of the family in each stage of the child bearing and rearing period with deploying more qualified personnel than the current government program personnel.

• Journal of the Korean Society of Radiology
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• v.11 no.6
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• pp.509-515
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• 2017

The purpose of this study is to measure the 3 dimensional dose distribution of Gamma knife $Perfection^{TM}$, make a comparative analysis of the result and establish the measurement method for the procedures using EBT3 film. The dose distributions of the Gamma knife $Perfection^{TM}$ installed in two hospitals were evaluated in accuracy and precision. For accuracy, the difference between the mechanical center axis and the dose center axis was assessed on a 4 mm collimator. The allowed difference in accuracy is within 0.3 mm and it was measured as 0.098 mm, 0.195 mm for A hospital and 0.229 mm, and 0.223 mm for B hospital. For precision the difference between the FWHM(Full Width at Half Maximum) of Gamma Plan and measurement in the 4, 8, and 16 mm collimators was calculated. The allowed difference in precision is less than ${\pm}1mm$. The value of the hospital A was -0.283 ~ 0.583 mm, and the hospital B was -0.857 ~ 0.810 mm. When analyzing the dose distributions using the image-j program, it is necessary to establish a clearer reference point of the measurement point, and it is considered that the comparison of the dose distribution should be performed in actual treatment irradiation dose with a high dose usable film.

• The Journal of Korean Society for Radiation Therapy
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• v.18 no.2
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• pp.113-117
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• 2006

Purpose: Post-mastectomy radiotherapy (PMR) is known to decrease loco-regional recurrence. Adequate skin and dermal dose are achieved by adding bolus. The more difficult clinical issue is determining the necessary number of bolus treatment, given the limits of normal skin tolerance. The aim of this study is to evaluate the necessary number of bolus treatment after PMR in patients with breast cancer. Materials and Methods: Four female breast cancer patients were included in the study. The median age was 53 years(range, $38{\sim}74$), tumor were left sided in 2 patients and right sided in 2patients. All patients were treated with postoperative radiotherapy after MRM. Radiotherapy was delivered to the chest wall (C.W) and supraclavicular lymph nodes (SCL) using 4 MV X-ray. The total dose was 50 Gy, in 2 Gy fractions (with 5 times a week). CT was peformed for treatment planning, treatment planning was peformed using $ADAC-Pinnacles^3$ (Phillips, USA) for all patients without and with bolus. Bolus treatment plans were generated using image tool (0.5 cm of thickness and 6 cm of width). Dose distribution was analyzed and the increased skin dose rate in the build-up region was computed and the skin dose using TLD-100 chips (Harshaw, USA) was measured. Results: No significant difference was found in dose distribution without and with bolus; C.W coverage was $95{\sim}100%$ of the prescribed dose in both. But, there was remarkable difference in the skin dose to the scar. The skin dose to the scar without and with bolus were $100{\sim}105%\;and\;50{\sim}75%$. The increased skin dose rates in the build-up region for Pt. 1, Pt. 2. Pt. 3 and Pt. 4 were 23.3%, 35.6%, 34.9%, and 41.7%. The results of measured skin dose using TLD-100 chips in the cases without and with bolus were 209.3 cGy and 161.1 cGy, 200 cGy and 150.2 cGy, 211.4 cGy and 160.5 cGy, 198.6 cGy and 155.5 cGy for Pt. 1, Pt. 2, Pt. 3, and Pt. 4. Conclusion: It was concludes through this analysis that the adequate number of bolus treatments is 50-60% of the treatment program. Further, clinical trial is needed to evaluate the benefit and toxicity associated with the use of bolus in PMR.

• Journal of the Korean Society of Radiology
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• v.11 no.1
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• pp.9-17
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• 2017

A high degree of precision and accuracy in Gamma Knife Radiosurgery(GKRS) is a fundamental requirement for therapeutical success. Elaborate radiation delivery and dose gradients with the steep fall-off of radiation are clinically applied thus necessitating a dedicated Quality Assurance(QA) program in order to guarantee dosimetric and geometric accuracy and reduce all the risk factors that can occur in GKRS. In this study, as a part of QA we verified the accuracy of single-shot dose profiles used in the algorithm of Gamma Knife Perfexion(PFX) treatment planning system employing Variable Ellipsoid Modeling Technique(VEMT). We evaluated the dose distributions of single-shots in a spherical ABC phantom with diameter 160 mm on Gamma Knife PFX. The single-shots were directed to the center of ABC phantom. Collimating configurations of 4, 8, and 16 mm sizes along x, y, and z axes were studied. Gamma Knife PFX treatment planning system being used in GKRS is called Leksell GammaPlan(LGP) ver 10.1.1. From the verification like this, the accuracy of GKRS will be doubled. Then the clinical application must be finally performed based on precision and accuracy of GKRS. Specifically the width at the 50% isodose level, that is, Full-Width-of-Half-Maximum(FWHM) was verified under such conditions that a patient's head is simulated as a sphere with diameter 160mm. All the data about dose profiles along x, y, and z axes predicted through VEMT were excellently consistent with dose profiles from LGP within specifications(${\leq}1mm$ at 50% isodose level) except for a little difference of FWHM and PENUMBRA(isodose level: 20%~80%) along z axis for 4 mm and 8mm collimating configurations. The maximum discrepancy of FWHM was less than 2.3% at all collimating configurations. The maximum discrepancy of PENUMBRA was given for the 8 mm collimator along z axis. The difference of FWHM and PENUMBRA in the dose distributions obtained with VEMT and LGP is too small to give the clinical significance in GKRS. The results of this study are considered as a reference for medical physicists involved in GKRS in the whole world. Therefore we can work to confirm the validity of dose distributions for all collimating configurations determined through the regular preventative maintenance program using the independent verification method VEMT for the results of LGP and clinically assure the perfect treatment for patients of GKRS. Thus the use of VEMT is expected that it will be a part of QA that can verify and operate the system safely.

• Journal of Korea Water Resources Association
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• v.57 no.3
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• pp.151-164
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• 2024

In water treatment plants supplying potable water, the management of chlorine concentration in water treatment processes involving pre-chlorination or intermediate chlorination requires process control. To address this, research has been conducted on water quality prediction techniques utilizing AI technology. This study developed an AI-based predictive model for automating the process control of chlorine disinfection, targeting the prediction of residual chlorine concentration downstream of sedimentation basins in water treatment processes. The AI-based model, which learns from past water quality observation data to predict future water quality, offers a simpler and more efficient approach compared to complex physicochemical and biological water quality models. The model was tested by predicting the residual chlorine concentration downstream of the sedimentation basins at Plant, using multiple regression models and AI-based models like Random Forest and LSTM, and the results were compared. For optimal prediction of residual chlorine concentration, the input-output structure of the AI model included the residual chlorine concentration upstream of the sedimentation basin, turbidity, pH, water temperature, electrical conductivity, inflow of raw water, alkalinity, NH₃, etc. as independent variables, and the desired residual chlorine concentration of the effluent from the sedimentation basin as the dependent variable. The independent variables were selected from observable data at the water treatment plant, which are influential on the residual chlorine concentration downstream of the sedimentation basin. The analysis showed that, for Plant, the model based on Random Forest had the lowest error compared to multiple regression models, neural network models, model trees, and other Random Forest models. The optimal predicted residual chlorine concentration downstream of the sedimentation basin presented in this study is expected to enable real-time control of chlorine dosing in previous treatment stages, thereby enhancing water treatment efficiency and reducing chemical costs.

• Korean Journal of Health Education and Promotion
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• v.17 no.1
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• pp.95-113
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• 2000

The purpose of this study is to investigate the state of the dental health of adults, used self-reporting qestionnaire as objects of 923 residents living in nine districts at random among the sites of eleven town located in a County. The level of knowledge on dental health of adults in a County was 65.6 points out of 100 points, comparatively low. Accodingly, it is necessary for entire adults to have a dental health-related education and get high standard of knowledge. Especially, educational approach should be performed for groups of 40-49 years old, 50-59 years old, above 60 years old, male, no educational background, having only elementary and middle school education, not having any jobs, engaging in agriculture, doing business on their own and so on. When planning the contents of health education, one actually has to include the habit of amalgam, the factor in influencing on dental health as well as show an example such as how to brush teeth, checking point of proper brushing, how to grip toothbrush. The attitude score related to dental heath was 71.2 points out of 100 points, relatively low. Consequently, the change of attitude related the dental health among entire adults is necessary, particularily, the strategical approach is essential to change dental health connected to attitude positively for groups of male, having high school education background, office workers and the civil service. Besides, among dental health related symtoms, more that 30-40％ of objects showed negative attitude toward as the following cases; in case that plaque or food debris are attached to the teeth (40.8％), upper and lower teeth do not fit together(40.3％), you cannot sleep well because of toothache(31.0％), more than one tooth fall out(31.0％), you have loosing teeth(30.6％), the approach should be conducted to form attitude that dental care is necessry. The state of dental health through dental health related symtoms was 33.3 points out of 100 points, which was fairly satisfactory. However, dental treatment for the state of dental health should be executed in case of comparison of the dental health state according to general characteristics, the group who are above 60 years old, have elementary school education background, engage in aggriculture who are not good in dental health state as opposed to other groups. Furthermore, there should be dental care needs according to dental health related symtoms, particularly, more than 60-70％ of objects have experienced symtoms that plaque or food debris attached to the teeth, tartar is on the teeth so dental treatment should be peformed for a large number of adults. In addition, for the people who have indications that there was a cavity, more than one tooth loss, chilled teeth, toothache when chewing, loose teeth, upper and lower teeth do not fit together, you cannnt sleep well due to the toothach, etc, there should be care through dental treatment. The actual conditions of the hygine of the mouth was relatively good and the difference of the actual state of dental health care in terms of general characteristics showed in only gender; female was more careful in dental health. Comparing the state of oral health synthetically, when they have symtoms, only 34.8％ of objects go to a dentist, 60.7％ are using passive or negative care such as gargling, tolerating or ignoring. There was many symtoms to care through dental therapy such as plaque or food debris get in between the teeth, tartar on the teeth, teeth are very cold, more than one tooth fallout, loose teeth, there is wrong amalgam, and so on, among symtoms to care passively or negatively. Therefore the education for proper treatment program should be performed. As a result of dental health-related knowlege, attitude, health state, verification of correlation between the actual condition of care, the higher the dental heath-related knowldege becomes, the more positive the dental health-related attitude is, and the state of dental health, that is, the standard of the symtom of dental health diminishes. the care for dental health executed through more active method and the more positive dental health-related attitude is, the more active means they performed. Consequently, the high level of dental health-related knowledge should be necessary, the more positive the dental health-related attitude was, the more active method they adopted, therefore, the program is needed to form attitude related to the dental health positively. As the knowledge on dental health is increasing, the attitude is also positive, after all, the plan to increase the standard of knowledge on dental health should be contrived through education program related to dental health.

• Economic and Environmental Geology
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• v.50 no.3
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• pp.251-256
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• 2017

This study presents measures to enhance the efficiency of Successive Alkalinity Producing Systems(SAPS), a natural biological purification method that prevents environmental pollution arising from the release of Acid Mine Drainage(AMD) from abandoned mines into rivers and groundwater. The treatment of AMD using SAPS is based on biological processing technology that mostly involves sulfate reducing bacteria(SRB). It has been proven effective in real-world applications, and has been employed in various projects on the purification of AMD. However, seasonal decrease in temperature leads to a deterioration in the efficiency of the process because sulfate-reducing activity is almost non-existent during cold winters and early spring even if SRB is able to survive. Against this backdrop, this study presents measures to enhance the activity of the SRB of the organic layer by integrating light emitting diode(LED)s in SAPS and to maintain the active temperature using LEDs in cold winters. Given that mine drainage facilities are located in areas where power cannot be easily supplied, solar cell modules are proposed as the main power source for LEDs. By conducting further research based on the present study, it will be possible to enhance the efficiency of AMD treatment under extreme cold weather using solar energy and LEDs, which will serve as an environmentally-friendly solution in line with the era of green growth.