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Investigation of Study Items for the Patterns of Care Study in the Radiotherapy of Laryngeal Cancer: Preliminary Results (후두암의 방사선치료 Patterns of Care Study를 위한 프로그램 항목 개발: 예비 결과)

  • Chung Woong-Ki;Kim I1-Han;Ahn Sung-Ja;Nam Taek-Keun;Oh Yoon-Kyeong;Song Ju-Young;Nah Byung-Sik;Chung Gyung-Ai;Kwon Hyoung-Cheol;Kim Jung-Soo;Kim Soo-Kon;Kang Jeong-Ku
    • Radiation Oncology Journal
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    • v.21 no.4
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    • pp.299-305
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    • 2003
  • Purpose: In order to develop the national guide-lines for the standardization of radiotherapy we are planning to establish a web-based, on-line data-base system for laryngeal cancer. As a first step this study was performed to accumulate the basic clinical information of laryngeal cancer and to determine the items needed for the data-base system. Materials and Methods: We analyzed the clinical data on patients who were treated under the diagnosis of laryngeal cancer from January 1998 through December 1999 In the South-west area of Korea. Eligiblity criteria of the patients are as follows: 18 years or older, currently diagnosed with primary epithelial carcinoma of larynx, and no history of previous treatments for another cancers and the other laryngeal diseases. The items were developed and filled out by radiation oncologlst who are members of forean Southwest Radiation Oncology Group. SPSS vl0.0 software was used for statistical analysis. Results: Data of forty-five patients were collected. Age distribution of patients ranged from 28 to 88 years(median, 61). Laryngeal cancer occurred predominantly In males (10 : 1 sex ratio). Twenty-eight patients (62$\%$) had primary cancers in the glottis and 17 (38$\%$) in the supraglottis. Most of them were diagnosed pathologically as squamous cell carcinoma (44/45, 98$\%$). Twenty-four of 28 glottic cancer patients (86$\%$) had AJCC (American Joint Committee on Cancer) stage I/II, but 50$\%$ (8/16) had In supraglottic cancer patients (p=0.02). Most patients(89$\%$) had the symptom of hoarseness. indirect laryngoscopy was done in all patients and direct laryngoscopy was peformed in 43 (98$\%$) patients. Twenty-one of 28 (75$\%$) glottic cancer cases and 6 of 17 (35$\%$) supraglottic cancer cases were treated with radiation alone, respectively. The combined treatment of surgery and radiation was used in 5 (18$\%$) glottic and 8 (47$\%$) supraglottic patients. Chemotherapy and radiation was used in 2 (7$\%$) glottic and 3 (18$\%$) supraglottic patients. There was no statistically significant difference in the use of combined modality treatments between glottic and supraglottic cancers (p=0.20). In all patients, 6 MV X-ray was used with conventional fractionation. The iraction size was 2 Gy In 80$\%$ of glottic cancer patients compared with 1.8 Gy in 59$\%$ of the patients with supraglottic cancers. The mean total dose delivered to primary lesions were 65.98 ey and 70.15 Gy in glottic and supraglottic patients treated, respectively, with radiation alone. Based on the collected data, 12 modules with 90 items were developed or the study of the patterns of care In laryngeal cancer. Conclusion: The study Items for laryngeal cancer were developed. In the near future, a web system will be established based on the Items Investigated, and then a nation-wide analysis on laryngeal cancer will be processed for the standardization and optimization of radlotherapy.

The Structural Relationships between Control Types over Salespeople, Their Responses, and Job Satisfaction - Mediating Roles of Role Clarity and Self-Efficacy - (영업사원에 대한 통제유형, 반응, 그리고 직무만족 간의 구조적 관계 - 역할명확성과 자기효능감의 매개효과 -)

  • Yoo, Dong-Keun;Lim, Jong-Koo;Lim, Ji-Hoon
    • Journal of Global Scholars of Marketing Science
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    • v.17 no.4
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    • pp.23-49
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    • 2007
  • Salespeople act at the point of MOT with customers and deliver the enterprise's message to the customers. They build up relationships with customers as well as deliver the customer's message to the enterprise. The salespeople's activity at the point of MOT with the customers and the degree of satisfaction of the customers' needs will affect the customers' attitude toward the enterprise, brand loyalty, and retention intention. Ultimately, it will influence the enterprise's financial performance. The control of salespe1ople is one of the most interesting topics of marketing. This research investigates the relationships of the control types over salespeople(positive/negative outcome control, positive/negative behavior control) and job satisfaction and their mediating variables. The mediating variables in the relationships have been identified as outcome/behavior-related role clarity and self-efficacy. The purpose of this study is more specifically as follows: First, it investigate how the perception of salespeople control types affect role-clarity. Second, it examines how the perception of salespeople control types influence self-efficacy. Third, it investigate the mediating role of role-clarity between the perception of salespeople control types and self-efficacy. Fourth, it investigates how role-clarity affect self-efficacy and job satisfaction. Finally, it will investigates how self-efficacy influences job satisfaction. Data were collected from the pharmaceutical industry salespeople and analyzed by SPSS 12.0 and AMOS 6.0. The data were collected by 400 respondents and 377 valid questionnaires were analyzed. The results are summarized as follows: First, positive/negative outcome controls had a positive relationship with outcome-related role clarity. Also positive behavior control had a positive effect on behavior-related role clarity, but negative behavior control didn't influence behavior-related role clarity. Second, positive outcome control influenced self-efficacy positively, but positive behavior control didn't have a positive effect on self-efficacy. In addition negative outcome control and negative behavior control had a positive effect on self-efficacy due to the mediating role of outcome-related and behavior-related role clarity. Third, outcome-related role clarity and behavior-related role clarity influenced self-efficacy positively. Behavior-related role clarity had a positive effect on job satisfaction, but outcome-related role clarity didn't influence job satisfaction. Finally, self-efficacy didn't have any effect on job satisfaction. The contributions of this study are as follows: First, existing studies have investigated the direct causal relationship between salespeoples' control type and performance, but this study investigates the structural causality between salespeoples' control types, responses, and performances. Second, this study found the mediating role of outcome-related/behavior-related role-clarity between outcome/behavior control and self-efficacy. Finally, the findings of this study further insight to existing studies on the relationship between job satisfaction and self-efficacy. The confidence of salespeoples' task influenced job satisfaction positively in existing articles,field studies, but the relationship between these two variables was not significant in this study. This means that there can be a different relationship between confidence and job satisfaction according to salespeoples' business. That is, the business environment may not be satisfying, even if the salespeople say that they have ability and confidence about their business. This means that able salespeople who have ability and confidence about their business are not satisfied with their job advancement in the company. Therefore, enterprise need to provide training that can establish a business environment that can satisfy the salespeole's expectation level which will secure good salespeople. This study may have limitation when applied to future studies. First,in this study as with existing studies it investigates the control level that salespeople feel is being measured. Actuality, the control level that a manager enforces and the control level that salespeople perceive when one is late can be different. There is need to measure lateness from both the perspective of the manager and salespeople should be done to supplement this study in the future Second, this study used variables that were connected with action result but salespeople's job satisfaction is due to the result of control. But, focusing on result of control can provide a more important financial result than sales performance. This study is also limited in that it did not consider financial result by result of control. Further studies on this will need to be done in the future. Third, this study may have a further limitation,because the investigation was restricted to pharmaceutical salespeople selling to hospitals. It is necessary to execute investigations in various industries to increase the generalization of the study findings Fourth, in this study, role clarity and self-efficacy by response variable for control and considered job satisfaction by outcome variable of control was considered. But, can other variables be considered beside response variable and result variable for control? For example, can financial affairs and change of post by outcome variable along with business stress by response variable for control be considered? Therefore, future studies need to consider various control variables. Finally, there is limited supporting research in the field of marketing which restricts the generalization of the study finding along with collecting material through random sampling of a limited size. This research summarizes the research in this area, the difference from the previous research, and provides a discussion of its limitations and the need and direction for further future research.

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A Study on the Current Status of Prescribed Drugs in Oriental Health Insurance and their Improvement (한방건강보험 약제 투약 실태 및 활성화 방안 연구)

  • Kwon, Yong-Chan;Yoo, Wang-Keun;Seo, Bu-Il
    • The Korea Journal of Herbology
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    • v.27 no.2
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    • pp.1-16
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    • 2012
  • Objective : To investigate the current status of prescription drugs in Oriental medical institutes and to draw up a future plan for the revitalization of Oriental medical health insurance, this survey has been performed. Method : The survey has been made with 321 doctors working at Oriental medical institutes in Daegu and Kyungbuk areas for a period of 3 month from June 1, 2010 until September 1, 2010. Result : 1. When it comes to the current status of the use of herbal drugs in Oriental Health insurance, most of doctors surveyed prescribe insurance drugs, and they prescribe insurance drugs to patients, who are less than 20% of total patients visiting their clinics. 2. The awareness of Herbal Health Care Drugs is investigated. When it comes to the understanding of the difference between insurance drugs(powder type drugs) and granular type drugs, doctors admit that they differ only in one aspect, whether or not their being covered by health insurance. Based on the survey results on the understanding of insurance coverage of granular type drugs, doctors, even though they long for granular type drugs to be accepted as insurance drugs, are worrying whether the number of outpatients might dwindle due to increased insurance co-payments. They also point out that the biggest obstacles in the expansion of the granular type drugs as insurance drugs are the lack of understanding of the government and the objection of the Health Insurance Review and Assesment service (HIRA) for fear of increased insurance claims. 3. Upon investigation on Oriental medicine doctors' understandings of herbal pharmaceutical industry, it is found that doctors' responses on pharmaceutical industry are not all positive ones('new product development and neglect of R&D infrastructure' and 'smallness of industry'). When it is investigated what area needs the greatest improvement in herbal pharmaceutical industry, 'securing sufficient capital, good manufacturing, and strengthening quality control', is the highest. 4. When it is asked what are the most needed in order to improve herbal health insurance medicine, responses such as 'the increase in the accessibility to and the utilization of Oriental medical clinics through the diversification of the means of prescriptions', 'the improvement of insurance benefits(cap adjustments)', 'increase the proportion of high quality medicinal plants', 'the ceiling of co-payments(deductible) at 20,000 won or more', 'expansion of the choices of formulations', 'formulational expansions of tablets and pills', and finally 'admittance and expansion of granular type drug as insurance drug' are the highest. 5. Upon investigating the general characteristics of the current status of the usage of Oriental health care herbal drugs, the followings are observed. First, the frequency of use of health insurance drugs by the doctors who use health insurance with general characteristics shows similar differences in case of total monthly sales amount (p<0.001), average number of daily patients (p<0.05). Secondly, as to the willingness of the expanded usage of insurance drugs, similar differences are observed in case of total monthly sales amount (p<0.05). 6. Upon investigating the general characteristics of the perception of Herbal health care drugs, the followings are observed. First, inspecting general characteristics and insurance claims due to increased co-payments(deductible amount) reveals similar differences in case of working period (p<0.01) and in case of total monthly sales amount (p <0.01). Secondly, inspecting general characteristics and the obstacles that hinder granular type drugs from being accepted as health care insurance drugs shows similar differences in case of working period (p<0.05). 7. Upon investigating the general characteristics of the understanding of Oriental Herbal pharmaceutical companies, the followings are observed. First, opinions on the general characteristics of pharmaceutical companies, when examined with variance analysis, shows similar differences in case of total monthly sales amount (p<0.05). Secondly, when opinions are examined on general characteristics and the problems of herbal pharmaceutical companies, similar differences are found in case of working period (p<0.01) and in case of total monthly sales amount (p<0.001). Lastly, opinions on the general characteristics and reforms of pharmaceutical companies, similar differences are observed in case of working period (p<0.001). 8. Upon investigating the general characteristics of the improvement of insurance Herbal drugs, the followings are observed. First, regarding general characteristics and insurance benefits, similar differences are observed in case of working period (p<0.05), in case of total monthly sales amount (p<0.05), and in case of average number of daily patients (p<0.01). Secondly, opinions on the general characteristics and the needs for the improvement of Herbal insurance drugs are examined in 5 different aspects, which are the approval of granular type drugs as insurance drugs, the expanded practices of the number of prescription insurance drugs, the needs of a variety of formulations, the needs of TFT of which numbers of Oriental medical doctors are members for the revision of the existing system, and the needs of adjusting the current ceiling of the fixed amount and the fixed rate. When processed by the analysis of variance, the results show similar differences in case of average number of daily patients (p<0.01). Conclusion : From the results of this study the first measures to take are, to reform overall insurance benefit system, including insurance co-payment system(fixed rate cap adjustment), to expand the number of the herbal drugs to be prescribed matching with insurance benefit accordingly, and to revitalize herbal medicine insurance system through the change of various formulations. In addition, it is recommended to improve the effectiveness of herbal medicine by making plans to enhance the efficacy of herbal medicine and by enabling small pharmaceutical companies to outgrow themselves.

Relationship of Compliance and Oxygen Transport in Experimental Acute Respiratory Failure during Positive End-Expiratory Pressure Ventilation (실험적 급성호흡부전에서 호기말양압에 의한 폐유순도와 산소운반의 변화 및 상관관계 - 호흡부전의 기전에 따른 차이 -)

  • Lee, Sang-Do;Yoon, Se-Jin;Lee, Bok-Hee;Han, Sung-Koo;Shim, Young-Soo;Kim, Keun-Youl;Han, Yong-Chol
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.1
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    • pp.6-15
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    • 1993
  • Background: Positive end, expiratory pressure (PEEP) has become one of the standard therapies for adult respiratory distress syndrome (ARDS). Total static compliance has been proposed as a guide to determine the size of PEEP ('best PEEP') which is of unproven clinical benefit and remains controversial. Besides increasing functional residual capacity and thus improving oxygenation, PEEP stimulate prostacyclin secretion and was proposed for the treatment of acute pulmonary embolism. But little is known about the effect of PEEP on hemodynamic and gas exchange disturbances in acute pulmonary embolism. Methods: To study the validity of total static compliance as a predictor of 'best PEEP' in ARDS and acute pulmonary embolism, experimental ARDS was induced in mongrel dog with oleic acid and acute pulmonary embolism with autologous blood clot. Then hemodynamic and gas exchange parameters were measured with serial increment of PEEP. Results:In ARDS group, total static compliance and oxygen transport were maximal at 5 cm$H_2O$, and decreased thereafter (p<0.05). With increment of PEEP, arterial oxygen tension ($PaO_2$) and arterial carbon dioxide tension ($PaCO_2$) increased and cardiac output and physiological shunt decreased. In pulmonary embolism group, total static compliance, oxygen transport, physiological shunt and cardiac output decreased and $PaO_2$ and $PaCO_2$ increased with increment of PEEP (p<0.05). Comparing the change induced by increment of PEEP by 1 cm$H_2O$ in ARDS group with that in pulmonary embolism group, there was no significant difference between two groups except cardiac output which decreased more in pulmonary embolism group (p<0.05). In ARDS group, oxygen transport and total static compliance increased after PEEP application, and total static compliance was maximal at the PEEP level where oxygen transport was maximal. However in pulmonary embolism group, oxygen transport and total static compliance decreased after application of PEEP. There was significant correlation between change of total static compliance and change of oxygen transport in both groups. Conclusion: In both ARDS and acute pulmonary embolism, it can be concluded that total static compliance is useful as a predictor of 'best PEEP'.

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Hypoxemia In Liver Cirrhosis And Intrapulmonary Shunt Determination Using Tc-99m-MAA Whole Body Scan (간경화 환자에서의 저산소혈증과 Tc-99m-MAA 주사를 이용한 폐내단락 측정)

  • Lee, Kye-Young;Kim, Young-Whan;Han, Sung-Koo;Shim, Young-Soo;Kim, Keun-Youl;Han, Yong-Chol
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.5
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    • pp.504-512
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    • 1994
  • Background: It is well known that severe hypoxemia is often associated with liver cirrhosis without preexisting cardiac or pulmonary diseases. Pulmonary vascular impairments, more specifically, intrapulmonary shunting have been considered as a major mechanism. Intrapulmonary shunting arises from pulmonary vascular dilatation at the precapillary level or direct arteriovenous communication and has relationship with the characteristic skin findings of spider angioma. However, these results are mainly from Western countries where alcoholic and primary biliary cirrhosis are dominant cuases of cirrhosis. It is uncertain that the same is true in viral hepatitiss associated liver cirrhosis, which is dominant causes of liver cirrhosis in Korea. We investigated the incidences of hypoxemia and orthodeoxia in Korean cirrhotic patients dominantly composed of postnecrotic cirrhosis and the significance of intrapulmonary shunting as the suggested mechanism of hypoxemia, Method: We performed the arterial blood gas analysis separately both at the supine and errect position in 48 stable cirrhotic patients without the evidences of severe complications such as ascites, variceal bleeding, and hepatic coma. According to the results of arterial blood gas analysis, all patients were divided into hypoxemic and normoxemic group. In each group, pulmonary function test and Tc-99m-MAA whole body scan were performed. The shunting fraction was calculated based on the fact that the sum of cerebral and bilateral renal blood flow is 32% of the systemic blood flow. Results: The hypoxemia of $PaO_2$ less than 80 mmHg was observed in 9 patients(18.8%) and Orthodeoxia more than 10 mmHg was observed in 8 patients(16.7%). But there was no patient with significant hypoxemia of $PaO_2$ less than 60 mmHg. $PaO_2$ was significantly decreased in the patients with spider angioma than the pathients without spider angioma and showed no correlation with the serologic type and severities of liver function test findings. Any parameters of pulmonary function test did not demonstrate the difference between normoxemic and hypoxemic group. But hypoxemic group showed significantly increased shunt fraction of $11.4{\pm}4.1%$ than normoxemic group of $4.1{\pm}2.0%$ (p<0.05). Conclusions: Hypoxemia is not infrequently observed complication in liver cirrhosis and intrapulmonary shunting is suggested to p1ay a major ro1e in the development of hypxemia. But there was no great likelihood of clinically significant hypoxemia in our domestic cirrhotic patients predominantly composed of postnecrotic type.

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The Effects of Urokinase Instillation Therapy via Percutaneous Transthoracic Catheter Drainage in Loculated Tuberculous Pleural Effusion: A Randomized Prospective Study (소방이 형성된 결핵성 흉막염 환자에서 경피적 도관을 이용한 유로카나제 치료의 효과 ; 전향적 무작위연구)

  • Lee, Yong-Whan;Kwak, Seung-Min;Kwon, Mee-Young;Bae, In-Young;Park, Chan-Sup;Moon, Tae-Hun;Cho, Jae-Hwa;Ryu, Jeong-Seon;Lee, Hyong-Lyeol;Roh, Hyung-Keun;Cho, Chul-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.5
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    • pp.601-608
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    • 1999
  • Background: Tuberculous pleural effusion responds well to the anti-tuberculosis agents in general, so no further aggressive therapeutic managements to drain the tuberculous effusion is necessary except in case of diagnostic thoracentesis. But in clinical practice, we often see some patients who later decortication need due to dyspnea caused by pleural thickening despite the completion of anti-tuberculosis therapy in the patients with tuberculous effusion. Especially, the patients with loculated tuberculous effusion might have increased chance of pleural thickening after treatment. The purpose of this study was that intrapleural urokinase instillation could reduce the pleural thickening in the treatment of loculated tuberculous pleural effusion. Methods: Thirty-seven patients initially diagnosed as having loculated tuberculous pleural effusion were randomly assigned to receive either the combined treatment of urokinase instillation and anti-tuberculosis agents(UK group) and anti-tuberculosis agents(Non-UK group) alone. The 16 patients in UK group received a single radiographically guided pig-tail catheter ranging in size from 10 to 12 French. 100,000 units of urokinase was dissolved in 150 ml of normal saline and instilled into the pleural cavity via pig-tail catheter every day, also this group was treated with anti-tuberculosis agents. While the 21 patients in Non-UK group were treated with anti-tuberculosis agents only except diagnostic thoracentesis. Then we evaluated the residual pleural thickening after treatment for their loculated tuberculous pleural effusion between the two groups. Also the duration of symptoms and the pleural fluid biochemistry like WBC counts, pH, lactic dehydrogenase(LDH), glucose, proteins, and adenosine deaminase(ADA) were compared. Results: 1) The residual pleural thickening(RPT)($5.08{\pm}6.77$ mm) of UK group was significantly lower than that($20.3222{\pm}26.37$ mm) of Non-UK group(P<0.05). 2) The duration of symptoms before anti-tuberculosis drug therapy of patients with RPT$\geq$10 mm($5.23{\pm}3.89$ wks) was significantly longer than the patients with RPT<10 mm($2.63{\pm}1.99$ wks)(P<0.05). 3) There were no significant differences in the pleural fluid findings like WBC count, glucose, LDH, proteins, pH, ADA between the patients with RPT$\geq$10 mm and the patients with RPT<10 mm. Conclusion : The treatment of loculated tuberculous pleural effusion with the urokinase instillation via percutaneous transthoraic catheter was effective to reduce the pleural thickening.

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Efficacy and Accuracy of Patient Specific Customize Bolus Using a 3-Dimensional Printer for Electron Beam Therapy (전자선 빔 치료 시 삼차원프린터를 이용하여 제작한 환자맞춤형 볼루스의 유용성 및 선량 정확도 평가)

  • Choi, Woo Keun;Chun, Jun Chul;Ju, Sang Gyu;Min, Byung Jun;Park, Su Yeon;Nam, Hee Rim;Hong, Chae-Seon;Kim, MinKyu;Koo, Bum Yong;Lim, Do Hoon
    • Progress in Medical Physics
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    • v.27 no.2
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    • pp.64-71
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    • 2016
  • We develop a manufacture procedure for the production of a patient specific customized bolus (PSCB) using a 3D printer (3DP). The dosimetric accuracy of the 3D-PSCB is evaluated for electron beam therapy. In order to cover the required planning target volume (PTV), we select the proper electron beam energy and the field size through initial dose calculation using a treatment planning system. The PSCB is delineated based on the initial dose distribution. The dose calculation is repeated after applying the PSCB. We iteratively fine-tune the PSCB shape until the plan quality is sufficient to meet the required clinical criteria. Then the contour data of the PSCB is transferred to an in-house conversion software through the DICOMRT protocol. This contour data is converted into the 3DP data format, STereoLithography data format and then printed using a 3DP. Two virtual patients, having concave and convex shapes, were generated with a virtual PTV and an organ at risk (OAR). Then, two corresponding electron treatment plans with and without a PSCB were generated to evaluate the dosimetric effect of the PSCB. The dosimetric characteristics and dose volume histograms for the PTV and OAR are compared in both plans. Film dosimetry is performed to verify the dosimetric accuracy of the 3D-PSCB. The calculated planar dose distribution is compared to that measured using film dosimetry taken from the beam central axis. We compare the percent depth dose curve and gamma analysis (the dose difference is 3%, and the distance to agreement is 3 mm) results. No significant difference in the PTV dose is observed in the plan with the PSCB compared to that without the PSCB. The maximum, minimum, and mean doses of the OAR in the plan with the PSCB were significantly reduced by 9.7%, 36.6%, and 28.3%, respectively, compared to those in the plan without the PSCB. By applying the PSCB, the OAR volumes receiving 90% and 80% of the prescribed dose were reduced from $14.40cm^3$ to $0.1cm^3$ and from $42.6cm^3$ to $3.7cm^3$, respectively, in comparison to that without using the PSCB. The gamma pass rates of the concave and convex plans were 95% and 98%, respectively. A new procedure of the fabrication of a PSCB is developed using a 3DP. We confirm the usefulness and dosimetric accuracy of the 3D-PSCB for the clinical use. Thus, rapidly advancing 3DP technology is able to ease and expand clinical implementation of the PSCB.

Estimation of Internal Motion for Quantitative Improvement of Lung Tumor in Small Animal (소동물 폐종양의 정량적 개선을 위한 내부 움직임 평가)

  • Yu, Jung-Woo;Woo, Sang-Keun;Lee, Yong-Jin;Kim, Kyeong-Min;Kim, Jin-Su;Lee, Kyo-Chul;Park, Sang-Jun;Yu, Ran-Ji;Kang, Joo-Hyun;Ji, Young-Hoon;Chung, Yong-Hyun;Kim, Byung-Il;Lim, Sang-Moo
    • Progress in Medical Physics
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    • v.22 no.3
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    • pp.140-147
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    • 2011
  • The purpose of this study was to estimate internal motion using molecular sieve for quantitative improvement of lung tumor and to localize lung tumor in the small animal PET image by evaluated data. Internal motion has been demonstrated in small animal lung region by molecular sieve contained radioactive substance. Molecular sieve for internal lung motion target was contained approximately 37 kBq Cu-64. The small animal PET images were obtained from Siemens Inveon scanner using external trigger system (BioVet). SD-Rat PET images were obtained at 60 min post injection of FDG 37 MBq/0.2 mL via tail vein for 20 min. Each line of response in the list-mode data was converted to sinogram gated frames (2~16 bin) by trigger signal obtained from BioVet. The sinogram data was reconstructed using OSEM 2D with 4 iterations. PET images were evaluated with count, SNR, FWHM from ROI drawn in the target region for quantitative tumor analysis. The size of molecular sieve motion target was $1.59{\times}2.50mm$. The reference motion target FWHM of vertical and horizontal was 2.91 mm and 1.43 mm, respectively. The vertical FWHM of static, 4 bin and 8 bin was 3.90 mm, 3.74 mm, and 3.16 mm, respectively. The horizontal FWHM of static, 4 bin and 8 bin was 2.21 mm, 2.06 mm, and 1.60 mm, respectively. Count of static, 4 bin, 8 bin, 12 bin and 16 bin was 4.10, 4.83, 5.59, 5.38, and 5.31, respectively. The SNR of static, 4 bin, 8 bin, 12 bin and 16 bin was 4.18, 4.05, 4.22, 3.89, and 3.58, respectively. The FWHM were improved in accordance with gate number increase. The count and SNR were not proportionately improve with gate number, but shown the highest value in specific bin number. We measured the optimal gate number what minimize the SNR loss and gain improved count when imaging lung tumor in small animal. The internal motion estimation provide localized tumor image and will be a useful method for organ motion prediction modeling without external motion monitoring system.

GET Imaging Evaluation of Patients with Esophageal Cancer (식도암 환자의 GET 영상 평가)

  • Moon, Jong Wun;Lee, Chung Wun;Seo, Young Deok;Yun, Sang Hyeok;Kim, Yong Keun;Won, Woo Jae
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.2
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    • pp.31-36
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    • 2013
  • Purpose: Measure gastric emptying time (GET: Gastric Emptying Time) is a non-invasive and quantitative evaluation methods, mainly by endoscopic or radiological examination confirmed no mechanical obstruction in patients with symptoms of congestion is checked. Such tests are not common gastric emptying time measured esophageal cancer patients (who underwent esophagectomy) patients after surgery for gastric emptying time was measured test. And the period of time for more than one year after the gastric emptying time measurement was performed. By comparing the two kinds of tests in the chest cavity after surgery as the evaluation of gastrointestinal function tests evaluate the usefulness of GET, and will evaluate the characteristics of the image. Materials and Methods: 93 patients who underwent esophagectomy with gastric emptying time measurement of subject tests immediately after surgery and after 1 year or longer were twice. Preparation of the patient before the test is more than 12 hours of overnight fasting is important, in addition to the medicine or to stop smoking, and diabetes insulin injections should be early in the morning is ideal to test. Generally labeled with $^{99m}Tc-DTPA$ resin which is used to make steamed egg, seaweed and fermented milk with a high viscosity after eating, three hours in the standing position was measured. Evaluation of gastric emptying curves on the way intragastric radioactivity level by 50% the time (half-time [T1/2]) was calculated, based on the half-life was divided into three steps: over 180 minutes was defined as delayed gastric emptying, within 180minutes was defined as intermediate gastric emptying and when all the radioisotopes were dumped into the jejunum as soon as swallowed, was defined as rapid gastric emptying. Results: Gastric emptying time of a typical images stomach of antrum and fundus additional images appear stronger over time move on to the small intestine. but esophageal cancer who underwent esophagectomy side of the thoracic cavity showed a strong image. Immediately after surgery, the half-time (T1/2) of rapid gastric emptying appeared to 12.9%, intermediate gastric emptying appeared to 52.7%, delay gastric emptying appeared to 34.4%. After more than a year the results of the half-life after surgery, 67% of rapid gastric emptying to intermediate gastric emptying was changed, 69% of delay gastric emptying to intermediate gastric emptying changed. Intermediate gastric emptying worse in patients rapid gastric emptying and the delay gastric emptying is 24% in the case. Conclusion: Esophagectomy for esophageal cancer who underwent half-time measurement test (T1/2) rapid gastric emptying and delay gastric emptying are the result of the comparison over time, changes were observed intermediate gastric emptying. Mainly seeing of gastric emptying time measurement in the esophagus instead of thoracic cavity to check the evaluation of gastrointestinal function can be useful even means. And segmentation criteria and narrow time interval of checking if more accurate information and analysis of the clinical diagnosis and evaluation seems to be done.

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Comparison of Dietary Patterns, Health, and Blood Parameters of Elderly Women and College Women in the Seoul Area (노화 과정에 따른 노인과 여대생의 식생활, 건강 상태 및 혈액 성상 비교 연구)

  • Shin, Kyung-Ok;Chung, Keun-Hee;Choi, Kyung-Soon
    • Journal of the East Asian Society of Dietary Life
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    • v.19 no.5
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    • pp.703-712
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    • 2009
  • The principal objective of this study was to supply basic material determine basic information regarding effective health promotion regimens for elderly women via a comparative survey of health status by aging age between elderly women (=70 y) and college women. The subject groups of elderly women (=70 y) and college women were selected and surveyed from March to October, 2008, in the Seoul area. The average age of the elderly women assessed in this study was $78.64{\pm}7.30$, the average height was $147.07{\pm}5.72$ cm, and the average weight was $50.47{\pm}7.44$ kg. As compared with college women, a higher percentage of elderly women ate breakfast regularly, but the elderly women also experienced difficulties in chewing due to dentures, and therefore ate their meals with large quantities of liquids, and usually ate their meals within 10 minutes. The majority of elderly women suffered from at least one disease, and the most common symptom reported was hypertension (25%). 52.2% of elderly women and 47.8% of college women reported that they exercised 1~2 times per week. They reported that their favorite exercise was light exercise, such as jogging and athletics (73.1%). As compared with college women, the smoking rate was lower among elderly women, but some of the elderly women were long-time smokers or alcoholics. The differences in red blood cells counts, Hb, hematocrit, and MCV of the between elderly women and college women were significant. In addition, but the MCH and MCHC were higher in elderly women compared with college women and the total cholesterol of elderly woman ($175.62{\pm}38.89$ mg/dL) was significantly lower compared with college woman ($186.13{\pm}28.19$ mg/dL). TG ($127.89{\pm}51.25$ mg/dL) and LDL-cholesterol ($120.51{\pm}32.88$ mg/dL) of elderly woman were significantly higher than TG ($79.71{\pm}40.9$ 6mg/dL) and LDL-cholesterol($103.78{\pm}22.94$ mg/dL) of college woman (p<0.05). The levels of HDL-cholesterol ($58.78{\pm}12.90$ mg/dL) in the college women was significantly higher than the HDLcholesterol levels ($48.17{\pm}13.79$ mg/dL) of the elderly women (p<0.05). Serum vitamin C levels in elderly women were significantly higher than those of college women (p<0.05), whereas no significant difference was detected between the two groups. Consequently, it can be concluded that the appropriate education programs for dietary habits and health promotion are necessary for a healthier life. Additionally, it is necessary for individuals to precisely determine precisely their own health status, and develop appropriate dietary programs for themselves.

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