• Title/Summary/Keyword: life planning

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Closed Interlocking Intrmedullary Nailing of Metastatic Diaphyseal Fractures of the Humerus (상완골 간부 악성 병적골절의 비관혈적 고합성 골수강내 금속정 고정술)

  • Bahk, Won-Jong;Rhee, Seung-Koo;Kang, Yong-Koo
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.1-11
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    • 2003
  • Purpose: To analysis of the result of the treatment of metastatic diaphyseal fracture of the humerus with closed interlocking intrameduallry nailing. Materials and Methods: Among surgically treated 29 patients with pathologic or impending fracture of diaphysis of the humeurs, 13 patients (16 cases) treated with closed intramedullary interlocking nail were selected for the study. The final result of pain relief and functional recovery was evaluated by modified rating system of Perez et al. Results: Primary cancer was diagnosed after fracture was developed in 2 patients and pathologic or impending fracture was occurred average period of 28.9 months after primary cancer was diagnosed. The main primary malignancies were multiple myeloma, lung cancer and breast cancer. Mean survival after humeral metastasis was 11.7 months. The final result was superior to fair in 13 of 16 cases, and poor in 3 cases with progression of tumor spread or distant dissemination to the ipsilateral fingers. Except the latter 3 patients and other 3 patients, who died before 3 months postoperatively, bony union was achieved in 10 cases. There were no complications related to surgery. Conclusion: Closed interlocking intrameduallry nailing is accomplished with brief operative time, small amount of bleeding and provides immediate stability with resultant early return of function to the arm. Additionally it allows early postoperative irradiation. However, some of our cases shows that intramedullary nailing can accelerate tumor spread and metastases elsewhere, so that serious consideration must be given in planning this treatment. In conclusion, the functional status before fracture, life expectancy, type of tumor and extent of involvement should be carefully considered to decide operative treatment of metastatic disease.

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Exploring the Theoretical Trends of an Integrated Environmental Design (통합적 환경설계 이론 기초 연구)

  • Ahn, Myung-June;Pae, Jeong-Hann
    • Journal of the Korean Institute of Landscape Architecture
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    • v.37 no.2
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    • pp.14-25
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    • 2009
  • We live in an age which is exponentially growing as the knowledge paradigm is changing. New sites are subject to contemporary landscape architecture function as "fields" in which this hybrid aspect is both actively practiced and becoming a catalyst for change in the area of landscape architecture. With this as its background, this study attempts to deal with how the aspect of integration in environmental design is manifested. For this purpose, the tendencies for the discussion of integration in various fields of practice were examined: planning theories, urban theories, architecture, public environment, engineering, and landscape architecture. As yet, the discussions of interdisciplinary integration, which occur in practice in these respective fields, mainly tend to be oriented toward the effective implementation of the merits of other related fields. Seen from these examples of practice, integrated design approaches can be found in the following three aspects: design objects, respective professional areas, and methodologies of approaches and design. In terms of design objects, the positions of individual design subjects present themselves as most obvious, and integration or combination of the physical targets that come to exist through design can be easily seen. Most examples of integration turn out to be this, in almost every case of which the theme and the target of expression are integrated via a small number of certain methods. In terms of professional areas, what can be mainly evidenced is how the individual subject acts when the subject designs. The strong points of professionals from each field seem to create synergy, achieving through integration optimum results. In terms of methodologies of approaches and design, there are attempts to create integrated approaches as ways of effective decision-making, in which case the integration of all of the interest parties is of primary concern. As yet, few instances have been found in which integrated design has had enough strength to be seen as a concrete design methodology based on practical examples. However, it is encouraging that theoretical approaches and the necessity for integrated design have been identified from multiple perspectives, and that a practical movement such as landscape urbanism has come into active being. The authors of this study find this point in time to be ripe for discussions on integrated practices in terms of environmental design, on the basis of the synthetic approaches mentioned above.

A Study on Constituents of the New Apprenticeship Concept for the Promotion of Industrial Growth Potential (산업 성장잠재력 제고를 위한 신도제제도의 개념 요소에 대한 연구)

  • Yin, Zi Long;Rho, Tae Chun;Choi, Won Sik
    • 대한공업교육학회지
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    • v.38 no.1
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    • pp.1-27
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    • 2013
  • The purpose of this study was to find out the areas and their constitute elements of new apprenticeship through the expert of vocational education to improve the growth potential in the field of industry. Through the three times Delphi research process final composing areas and elements(total 6 areas and 41 sub-elements) of new apprenticeship were extracted. Followings are specific study results of 41 sub-elements for the 6 areas. In area A(Technology Skill aspect) total nine sub-elements were deducted as follows. Technology skill's field appling ability, new technology skill's acquisition, quality assurance ability, research development ability, material management using ability, problem solving ability, core technology skill understanding ability, idea's imagery expressing ability, creative design ability. In area B(Institutional aspect) total five sub-elements were deducted as follows. Flexible human material support, precise division of works, objective result assessment, institutionalization of responsibilities and liabilities between teacher and student, institutionalization of duty invention reward. In area C(Affective aspect) total eight sub-elements were deducted as follows. Manners and cooperation between teacher & student and peer, values for job, basic attitude for technology, job ethic sense, respect of other organization, active action to organization change, attitude of technology successor, service mind. In area D(Self-improvement aspect) total nine sub-elements were deducted as follows. Self evaluation and reflection, cultivate of organization understanding, career planning and developing ability, sound philosophy of life, communication ability, decision making ability, prepare of individual competence enhance system, self-control ability improvement, reaction of unexpected situation. In area E(Knowledge aspect) total four sub-elements were deducted as follows. Basic knowledge of relevant area, knowledge of new technology & preceding technology, fusion and relocation of knowledge, practical knowledge. In area F(Environmental aspect) total six sub-elements were deducted as follows. Awareness of business environment, understanding of education and practice environment, understanding of apprenticeship's business demand, connectivity of region community, adapt ability of labor market's change, awareness of society environment change.

Case Report of Radiotherapy to a Breast Cancer Patient with a Pacemaker (인공심장박동기가 이식된 유방암환자의 방사선 치료에 대한 사례 보고)

  • Chae, Seung-Hoon;Park, Jang-Pil;Lee, Yang-Hoon;Yoo, Suk-Hyun;Seong, Won-Mo;Kim, Kyu-Bo
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.2
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    • pp.197-203
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    • 2012
  • Purpose: In this study, we considerate our radiation therapy process for the breast cancer patient implanted a pacemaker applying the machine movement surgery, shielding, beam selection. Materials and Methods: We perform radiation therapy to a 54 years old, breast cancer patient implanted a pacemaker. The patient underwent a surgery to move the position of a pacemaker to right side breast after consultation with cardiology department. Prescribed dose was 5,040 cGy and daily dose 180 cGy for 28 fractions. The 10 MV photon energy, field size 0/$9.5{\times}20$ cm, half beam and opposing portal irradiation are used. To find out appropriate thickness of shielding board, we carried out an experiment using a solid water phantom ($30{\times}30{\times}7$ cm), a Farmer-type chamber (TN30013, PTW, Germany) and a shielding board (Pb $28{\times}27{\times}0.1$ cm). We calculated expected absorbed dose to te pacemaker with absorb ratio and shielding ratio. In the PTP system (Eclipse, Varian, USA), we figured out how much radiation would be absorbed to the machine with and without shielding. First day of the radiation therapy, we measured head scatter to the pacemaker with MOSFET Dose Verification System (TN-RD-70-W, Medical Canada Ltd., Canada). Results: In the phantom measurement, we found out appropriate thickness was 2 mm of shielding board. In the RTP, when using 2 mm shielding the pacemaker will be absorbed 11.5~38.2 cGy and DVH is 77.3 cGy. In the first day of the therapy, 4.3 cGy was measured so 120.4 cGy was calculated during total therapy. The patient was free from any side effects, and the machine also normally functioned. Conclusion: As the report of association which have public confidence became superannuated, there is lack of data about new machine. We believe that radiation therapy to thiese kind of patients could be done successfully with co-operation, patient-suitable planning, accurate QA, frequent in-vivo dosimetry and monitoring.

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Evaluation of Scattered Dose to the Contralateral Breast by Separating Effect of Medial Tangential Field and Lateral Tangential Field: A Comparison of Common Primary Breast Irradiation Techniques (유방암 접선조사 치료 방법에 대한 반대쪽 유방에서의 산란선량 평가)

  • Ban, Tae-Joon;Jeon, Soo-Dong;Kwak, Jung-Won;Baek, Geum-Mun
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.2
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    • pp.183-188
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    • 2012
  • Purpose: The concern of improving the quality of life and reducing side effects related to cancer treatment has been a subject of interest in recent years with advances in cancer treatment techniques and increasing survival time. This study is an analysis of differing scattered dose to the contralateral breast using common different treatment techniques. Materials and Methods: Eclipse 10.0 (Varian, USA) based $30^{\circ}$ EDW (Enhanced dynamic wedge) plan, $15^{\circ}$ wedge plan, $30^{\circ}$ wedge plan, Open beam plan, FiF (field in field) plan were established using CT image of breast phantom which in our hospital. Each treatment plan were designed to exposure 400 cGy using CL-6EX (VARIAN, USA) and we measured scattered dose at 1 cm, 3 cm, 5 cm, 9 cm away from medial side of the phantom at 1 cm depth using ionization chamber (FC 65G, IBA). We carried out measurement by separating effect of medial tangential field and lateral tangential field and analyze. Results: The evaluation of scattered dose to contralateral breast, $30^{\circ}$ EDW plan, $15^{\circ}$ wedge plan, $30^{\circ}$ wedge plan, Open beam plan, FIF plan showed 6.55%, 4.72%, 2.79%, 2.33%, 1.87% about prescription dose of each treatment plan. The result of scattered dose measurement by separating effect of medial tangential field and lateral tangential field results were 4.94%, 3.33%, 1.55%, 1.17%, 0.77% about prescription dose at medial tangential field and 1.61%, 1.40%, 1.24%, 1.16%, 1.10% at lateral tangential field along with measured distance. Conclusion: In our experiment, FiF treatment technique generates minimum of scattered dose to contralateral breast which come from mainly phantom scatter factor. Whereas $30^{\circ}$ wedge plan generates maximum of scattered doses to contralateral breast and 3.3% of them was scattered from gantry head. The description of treatment planning system showed a loss of precision for a relatively low scatter dose region. Scattered dose out of Treatment radiation field is relatively lower than prescription dose but, in decision of radiation therapy, it cannot be ignored that doses to contralateral breast are related with probability of secondary cancer.

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Scalp Dose Evaluation According Radiation Therapy Technique of Whole Brain Radiation Therapy (전뇌 방사선치료 시 치료방법에 따른 두피선량평가)

  • Jang, Joon-Yung;Park, Soo-Yun;Kim, Jong-Sik;Choi, Byeong-Gi;Song, Gi-Won
    • The Journal of Korean Society for Radiation Therapy
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    • v.23 no.2
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    • pp.103-108
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    • 2011
  • Purpose: Opposing portal irradiation with helmet field shape that has been given to a patient with brain metastasis can cause excess dose in patient's scalp, resulting in hair loss. For this reason, this study is to quantitatively analyze scalp dose for effective prevention of hair loss by comparing opposing portal irradiation with scalp-shielding shape and tomotherapy designed to protect patient's scalp with conventional radiation therapy. Materials and Methods: Scalp dose was measured by using three therapies (HELMET, MLC, TOMO) after five thermo-luminescence dosimeters were positioned along center line of frontal lobe by using RANDO Phantom. Scalp dose and change in dose distribution were compared and analyzed with DVH after radiation therapy plan was made by using Radiation Treatment Planning System (Pinnacle3, Philips Medical System, USA) and 6 MV X-ray (Clinac 6EX, VARIAN, USA). Results: When surface dose of scalp by using thermo-luminescence dosimeters was measured, it was revealed that scalp dose decreased by average 87.44% at each point in MLC technique and that scalp dose decreased by average 88.03% at each point in TOMO compared with HELMET field therapy. In addition, when percentage of volume (V95%, V100%, V105% of prescribed dose) was calculated by using Dose Volume Histogram (DVH) in order to evaluate the existence or nonexistence of hotspot in scalp as to three therapies (HELMET, MLC, TOMO), it was revealed that MLC technique and TOMO plan had good dose coverage and did not have hot spot. Conclusion: Reducing hair loss of a patient who receives whole brain radiotherapy treatment can make a contribution to improve life quality of the patient. It is expected that making good use of opposing portal irradiation with scalp-shielding shape and tomotherapy to protect scalp of a patient based on this study will reduce hair loss of a patient.

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Development and Evaluation of Sustainable Housing Teaching-Learning Process Plan for Achieving the Global SDGs by Home Economics in Middle School (중학교 가정교과의 SDGs 교육을 위한 지속가능한 주생활 교수·학습 과정안 개발 및 평가)

  • Kim, Eunkyung;Cho, Jaesoon
    • Journal of Korean Home Economics Education Association
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    • v.32 no.2
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    • pp.77-97
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    • 2020
  • The purpose of this study was to develop and evaluate the sustainable housing teaching-learning process plan aimed to achieve the global SDGs through home economics class in middle school that is based on the ADDIE model. The overall objective of the plan was to contribute to cultivating students' sustainable housing values and to creating sustainable lifestyle through everyday practice. The plan consisting of 4 lessons contained various activity and visual resources(4 individual and 4 team activity sheets, 4 reading texts, 1 homework sheet and 1 evaluation sheet, and 7 videos) for students and (4 sets of ppt and 4 reading texts) for teachers. The theme and team activities of each lesson were related to 2~7 targets of 2~3 SDGs, in total 11 targets of 5 SDGs. The plan was implemented to 4 classes of 127 senior students at Y middle school in Cheongju city during the period from the 29th of August to the 18th of September, 2019. The results showed that students were very positive and highly satisfied with not only practical contents but also adequacy of resources and activities of the whole 4-lessons, so that they actively participated in the lessons more than usual and looked forward to learning more about it. They thoroughly enjoyed various team activities such as brain writing, mandal art, visual thinking, making UCC, and planning the sustainable village as well as writing a short reflective journal at the end of each lesson. Students also reported that they highly accomplished the goal of each lesson and the overall objective. It could be concluded that the teaching-learning process plan of 4-lessons could contribute to cultivating students' sustainable housing values and to creating sustainable lifestyle through practicing everyday life. It indicates that home economics is one of the major subjects to contribute to the attainment of global issue of SDGs for OECD education 2030 and to educate the practically acting global citizen.

Clinical Significance of Low-colony Count Scotochromogen Nontuberculous Mycobacteria (균집락수가 적은 암색소성 비결핵항산균 배양의 임상적 의미)

  • Lee, Jung Yeon;Kim, Mi-Na;Chung, Hee-Jung;Jun, Kyung Ran;Choi, Hee Jin;Lee, Hyeyoung;Joung, Eun Young;Oh, Yeon-Mok;Lee, Sang Do;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Shim, Tae Sun
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.1
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    • pp.39-46
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    • 2005
  • Background : Even though it has been suggested that low-colony, scotochromogen nontuberculous mycobacteria (NTM) are usually contaminants and not true pathogens, evidence for this hypothesis has not been provided. This study investigated the colony characteristics, organism identification, and clinical significance of low-colony scotochromogen. Methods : The laboratory cultured 6,898 respiratory clinical specimens for an examination of mycobacteria over a three-month period. A low-colony count was arbitrarily defined as ${\leq}20$ colonies. This study analyzed the recovery rate of the mycobacteria, the number of colonies and their gross characteristics, and their clinical significance. PCR-restriction fragment length polymorphism analysis was carried out to identify the NTM species. NTM pulmonary disease was defined according to the American Thoracic Society. Results : A total of 6,898 respiratory specimens for mycobacterium were cultured. Of these, 263 (3.8%) grew NTM, and 382 (5.5%) grew M. tuberculosis. Of the 263 cultured NTM specimens, 124 (47.1%) were scotochromogens. The smear-positive rate was significantly lower in these scotochromogens (4.8%) than in the non-scotochromogens (23.7%) (p<0.05). The most common isolates were M. gordonae (83/102, 81.4%) in the scotochromogens, and MAC (52/121, 43.0%) in the non-scotochromogens. Even though three out of 113 patients with a low-colony scotochromogen has been diagnosed with NTM pulmonary disease, the isolated scotochromogen was not considered to be the cause of the NTM disease but was just a contaminant. Conclusion : In this study, the most common isolate of a low-colony count scotochromogen was M. gordonae, which appeared to be contaminants and not true pathogens. Greater efforts in the quality control of a mycobacterium laboratory are needed in cases where there is a high recovery rate of low-colony count scotochromogen.

A STUDY ON THE CLINICAL ANALYSIS AND PERFORMANCE IN COMPREHENSIVE NURSING CARE (전인간호의 임상학적 분석과 실행에 관한 연구)

  • 전산초
    • Journal of Korean Academy of Nursing
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    • v.4 no.1
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    • pp.1-21
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    • 1974
  • A considerable change of the Korean nursing system has been made during the last decade not only in its philosophy but also in its function and structure to meet political and scientific need of the modern society. The main purpose of this study is to develope the new concept of comprehensive nursing care, both its Philosophy and ethics, as the basic of modern clinical nursing theory and practice. Comprehensive nursing care is the concept of human centered nursing care, and it helps a man to meet the basic physical, psychological, environmental, socioeconomic and teaching needs. It also helps him to help himself to meet these needs. This concept starts from the individualized nursing care and its ultimate goal is to improve a man to have a better position in his own community so that he may able to have a meaningful life. To accomplish this goal, an individualized nursing care plan as a nursing diagnosis and problem solving method should be set up for different patients with similar diagnosis to meet their needs, because each patient has a different social background. from this viewpoint, nursing is a science as well as abstruse humanity. The performance of comprehensive nursing care is a goal and issue of modern clinical nursing care. If nursing is a science and a profession for man, it should have ethics which recognize the dignity of man and offers infinite service voluntarily, and should be able to show leadership in carrying out the nursing responsibility. This leadership finds a person's potential and encourages him to utilize it. Such concepts should develop into a nursing ideology and this ideology should become a priority in comprehensive nursing care. The following statements are the conclusion of this study. 1) Modern nursing has been developed from disease centered nursing care to comprehensive nursing care based on humanity. The primary principle of nursing was to assist in the treatment of disease, but it has been changed to the professional nursing system independently. 2) The concept of nursing is one of continuous or endless scope of dispersion. It proves that nursing is grasping the professional responsibility to be able to coordinate scientific principles Patient health problems are according to scientific principles rather than adhering to nursing technical discipline as a daily work. 3) In chapter I and Ⅱ, the philosophy and ideology of nursing have been discussed and the flow of concept of clinical nursing and the rate of progress which emerges from naturalizing performance of the concept of comprehensive nursing in clinical nursing studied. The discussion developed the theory that a nurse should be to embody nursing ideas and objectives by establishing definite conviction of professions and study. 4) In chapter lil, nursing planning based on nursing diagnosis as a method to attain ideal nursing care for humanity with a definite idea of establishing philosophy of nursing was presented. 5) From the result of survey on patient needs about treatment and nursing, it was observed that all patient had emotional stress from unknown factors. Therefore it was concluded that nurses should not only educate the patient but also give them the opportunity to communicate freely their needs and anxieties. Furthermore complaints and doubts of the patient should be carefully noted and must be considered to meet these needs. 6) Patient teaching is the most important part of comprehensive nursing care. In chapter, Ⅲ, the important of patient teaching was emphasized by demonstrating the effect of patient teaching for diabetic patient. 7) In Chapter Ⅳ, from the result of the study on nurses attitudes to comprehensive nursing care, it was pointed that the evolution of nursing education and the establishment of a complete concept and value of comprehensive nursing was necessary.

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A Study on the Design of Memorial in the Design Competition for Donghak Peasant Revolution Memorial Park (동학농민혁명 기념공원 설계공모에 나타난 메모리얼 설계 경향)

  • Lee, Jin-Wook;Sung, Jong-Sang;Son, Yong-Hoon
    • Journal of the Korean Institute of Landscape Architecture
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    • v.45 no.3
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    • pp.66-79
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    • 2017
  • In 2014, a Donghak Peasant Revolution Memorial Park design competition was held with various forms and techniques to convey mourning. This is a process of the reconsideration of memorial projects that are used to stimulate the collective memory and it is a meaningful resource for examining the consciousness of contemporary designers in regards to the memorial designs that are currently under planning in Korea. This study investigated the background of the Donghak commemorative projects that took place at the same site in a timely manner and analyzed the design competition through the existing literature research. Through this, it was seen that the memorial, which was formed by means of past political purposes, has changed into a way to collect various opinions and forms through open design competition. A framework of analysis prepared through multi-layer analysis is daily use, interaction and spontaneity, abstraction, temporality, locality, integration and harmony with surroundings. The results of this study are as follows. First, in order to convey memorial commemoration in everyday life, the projects organized scattered memorial spaces with special characteristics and linked them with daily activities program. Second, the projects used direct participation and emotional experiences to interact with monuments. Third, color, vertical elements, clustering, and park frame manipulation were used for abstract reproduction. Fourth, the projects introduce architecture and furniture that can be changed and plants for temporal change. Fifth, the previous terrain was restored and the setting of the scene was reproduced in order to make the site a space with place. Sixth, to improve the connection with existing monuments, the projects used techniques such as relaxation and the reinforcement of circulation lines and axes. Seventh, a path and a building conforming to the terrain were arranged for harmony with the surroundings.