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The Effects of Modafinil on Clinical Features and Sleep Structure of Narcolepsy Patients and Healthy Controls (모다피닐이 기면병 환자와 대조군의 임상 양상과 수면구조에 구조에 미치는 영향)

  • Shin, Hong-Beom;Jeong, Do-Un;Kim, Eui-Joong
    • Sleep Medicine and Psychophysiology
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    • v.13 no.2
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    • pp.67-74
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    • 2006
  • Introduction: Excessive daytime sleepiness and cataplexy are key features of narcolepsy. Modafinil is psychostimulant used in the treatment of narcolepsy. In this study, we evaluated effects of modafinil on nocturnal sleep structure and sleep latency in multiple sleep latency test and clinical features. Methods: Twelve narcoleptic patients (7 male, age: $22.9{\pm}2.6\;yrs$) were participated in the study. All of them had done nocturnal polysomnography (nPSG), multiple sleep latency test (MSLT), clinical symptoms scales and have repeated same procedure after taking 200 mg of modafinil. We have done linear mixed model analysis to describe effects of group, medication and nap time on these measures. Results: Modafinil did not affect clinical scales except PSQI which had been reduced after medication. In this study, Modafinil reduced total sleep time, sleep efficiency and increased wake after sleep onset and percent of arousal during sleep in nocturnal polysomnography and prolonged mean sleep latency in multiple sleep latency tests in both group. Discussion: Modafinil has stimulant effect of central nervous system but its effect on night sleep is less than other psychostimulants such as methylphenidate. We ascertained that modafinil affected total sleep time, sleep efficiency and percent of wake during sleep but did not effect on sleep structure. Modafinil was effective in the management of day time sleepiness. Modafinil can enhance alertness of control group without day time sleepiness.

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Optimizing Surfactant-Enhanced Solubilzation of LNAPL from Soil in Saturated Zone (포화지층내 저비중 비수용성 유기용매의 용해제거를 위한 계면활성제법의 최적 조작인자 도출)

  • 이재원;박규홍;박준범
    • Journal of the Korean Geotechnical Society
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    • v.15 no.2
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    • pp.153-164
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    • 1999
  • The solubilization of BTEX was evaluated in aqueous surfactant solutions with and without several additives. Anionic surfactant(Sodium Dodecyl Sulfate, SDS) and nonionic surfactants (NEODOL(equation omitted)25-3 and $SOFTANOL\circledR-90$ were used as test surfactants. The effects of surfactant HLB(Hydrophile-Lipophile Balance) Number and hydrocarbon molar volume and polarity of BTEX on the MSR(Molar Solubilization Ratio), micelle-water partition coefficient of BTEX, and CMC(C,itical Micelle Concentration) were investigated. Optimizing treatment conditions applicable to enhanced solubilization was also studied by manupulating salinity or electrolyte control with additives of ethyl alcohol, hydrotrope, and electrolyte solution. The most effective surfactant for solubilization was found $SOFTANOL\circledR-90$, since HLB number of 13.6 is similar to those values of BTEX ranging between 11.4 and 12.2, which was also proved experimentally. Ethyl alchohol of 3% was the most effective additives in reducing CMC and improving solubilization among the conditions using SDS, NEODOL(equation omitted)25-3, and $SOFTANOL\circledR-90$ with three additives. The partitioning of BTEX between surfactant micelles and aqueous solutions was characterized by a mole fraction micelle-phase/aqueous phase partion coefficient, $K_m$. Values of log $K_m$. for BTEX compounds in surfactant solutions of this study range from 2.95 to 3.76(100mM SDS) and 2.95 to 3.49(117mM $SOFTANOL\circledR-90$. Log $K_m$ appears to be a linear function of log $K_{ow}$ for SDS and $SOFTANOL\circledR-90$. A knowledge of partitioning of BTEX in aqueous surfactant system can be a prerequisite for the understanding of the behavior of hydrophobic organic compounds in soil-water systems in which surfactants play a role in remediation of contaminated soil and facilitated transport.

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Development of Quality Assurance Software for $PRESAGE^{REU}$ Gel Dosimetry ($PRESAGE^{REU}$ 겔 선량계의 분석 및 정도 관리 도구 개발)

  • Cho, Woong;Lee, Jaegi;Kim, Hyun Suk;Wu, Hong-Gyun
    • Progress in Medical Physics
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    • v.25 no.4
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    • pp.233-241
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    • 2014
  • The aim of this study is to develop a new software tool for 3D dose verification using $PRESAGE^{REU}$ Gel dosimeter. The tool included following functions: importing 3D doses from treatment planning systems (TPS), importing 3D optical density (OD), converting ODs to doses, 3D registration between two volumetric data by translational and rotational transformations, and evaluation with 3D gamma index. To acquire correlation between ODs and doses, CT images of a $PRESAGE^{REU}$ Gel with cylindrical shape was acquired, and a volumetric modulated arc therapy (VMAT) plan was designed to give radiation doses from 1 Gy to 6 Gy to six disk-shaped virtual targets along z-axis. After the VMAT plan was delivered to the targets, 3D OD data were reconstructed from 512 projection data from $Vista^{TM}$ optical CT scanner (Modus Medical Devices Inc, Canada) per every 2 hours after irradiation. A curve for converting ODs to doses was derived by comparing TPS dose profile to OD profile along z-axis, and the 3D OD data were converted to the absorbed doses using the curve. Supra-linearity was observed between doses and ODs, and the ODs were decayed about 60% per 24 hours depending on their magnitudes. Measured doses from the $PRESAGE^{REU}$ Gel were well agreed with the TPS doses at central region, but large under-doses were observed at peripheral region at the cylindrical geometry. Gamma passing rate for 3D doses was 70.36% under the gamma criteria of 3% of dose difference and 3 mm of distance to agreement. The low passing rate was resulted from the mismatching of the refractive index between the PRESAGE gel and oil bath in the optical CT scanner. In conclusion, the developed software was useful for 3D dose verification from PRESAGE gel dosimetry, but further improvement of the Gel dosimetry system were required.

A Three-year Study on the Leaf and Soil Nitrogen Contents Influenced by Irrigation Frequency, Clipping Return or Removal and Nitrogen Rate in a Creeping Bentgrass Fairway (크리핑 벤트그라스 훼어웨이에서 관수회수.예지물과 질소시비수준이 엽조직 및 토양 질소함유량에 미치는 효과)

  • 김경남;로버트쉬어만
    • Asian Journal of Turfgrass Science
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    • v.11 no.2
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    • pp.105-115
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    • 1997
  • Responses of 'Penncross' creeping bentgrass turf to various fairway cultural practices are not well-established or supported by research results. This study was initiated to evaluate the effects of irrigation frequency, clipping return or removal, and nitrogen rate on leaf and soil nitrogen con-tent in the 'Penncross' creeping bentgrass (Agrostis palustris Huds.) turf. A 'Penncross' creeping bentgrass turf was established in 1988 on a Sharpsburg silty-clay loam (Typic Argiudoll). The experiment was conducted from 1989 to 1991 under nontraffic conditions. A split-split-plot experimental design was used. Daily or biweekly irrigation, clipping return or removal, and 5, 15, or 25 g N $m-^2$ $yr-^1$ were the main-, sub-, and sub-sub-plot treatments, respectively. Treatments were replicated 3 times in a randomized complete block design. The turf was mowed 4 times weekly at a l3 mm height of cut. Leaf tissue nitrogen content was analyzed twice in 1989 and three times in both 1990 and 1991. Leaf samples were collected from turfgrass plants in the treatment plots, dried immediately at 70˚C for 48 hours, and evaluated for total-N content, using the Kjeldahl method. Concurrently, six soil cores (18mm diam. by 200 mm depth) were collected, air dried, and analyzed for total-N content. Nitrogen analysis on the soil and leaf samples were made in the Soil and Plant Analyical Laboratory, at the University of Nebraska, Lincoln, USA. Data were analyzed as a split-split-plot with analysis of variance (ANOVA), using the General Linear Model procedures of the Statistical Analysis System. The nitrogen content of the leaf tissue is variable in creeping bentgrass fairway turf with clip-ping recycles, nitrogen application rate and time after establishment. Leaf tissue nitrogen content increased with clipping return and nitrogen rate. Plots treated with clipping return had 8% and 5% more nitrogen content in the leaf tissue in 1989 and 1990, respectively, as compared to plots treated with clipping removal. Plots applied with high-N level (25g N $m-^2$ $yr-^1$)had 10%, 17%, and 13% more nitrogen content in leaf tissue in 1989, 1990, and 1991, respectively, when compared with plots applied with low-N level (5g N $m-^2$ $yr-^1$). Overall observations during the study indicated that leaf tissue nitrogen content increased at any nitrogen rate with time after establishment. At the low-N level treatment (5g N $m-^2$ $yr-^1$ ), plots sampled in 1991 had 15% more leaf nitrogen content, as compared to plots sampled in 1989. Similar responses were also found from the high-N level treatment (25g N $m-^2$ $yr-^1$ ).Plots analyzed in 1991 were 18% higher than that of plots analyzed in 1989. No significant treatment effects were observed for soil nitrogen content over the first 3 years after establishment. Strategic management application is necessary for the golf course turf, depending on whether clippings return or not. Different approaches should be addressed to turf fertilization program from a standpoint of clipping recycles. It is recommended that regular analysis of the soil and leaf tissue of golf course turf must be made and fertilization program should be developed through the interpretation of its analytic data result. In golf courses where clippings are recycled, the fertilization program need to be adjusted, being 20% to 30% less nitrogen input over the clipping-removed areas. Key words: Agrostis palustris Huds., 'Penncross' creeping bentgrass fairway, Irrigation frequency, Clipping return, Nitrogen rate, Leaf nitrogen content, Soil nitrogen content.

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Game Theoretic Optimization of Investment Portfolio Considering the Performance of Information Security Countermeasure (정보보호 대책의 성능을 고려한 투자 포트폴리오의 게임 이론적 최적화)

  • Lee, Sang-Hoon;Kim, Tae-Sung
    • Journal of Intelligence and Information Systems
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    • v.26 no.3
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    • pp.37-50
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    • 2020
  • Information security has become an important issue in the world. Various information and communication technologies, such as the Internet of Things, big data, cloud, and artificial intelligence, are developing, and the need for information security is increasing. Although the necessity of information security is expanding according to the development of information and communication technology, interest in information security investment is insufficient. In general, measuring the effect of information security investment is difficult, so appropriate investment is not being practice, and organizations are decreasing their information security investment. In addition, since the types and specification of information security measures are diverse, it is difficult to compare and evaluate the information security countermeasures objectively, and there is a lack of decision-making methods about information security investment. To develop the organization, policies and decisions related to information security are essential, and measuring the effect of information security investment is necessary. Therefore, this study proposes a method of constructing an investment portfolio for information security measures using game theory and derives an optimal defence probability. Using the two-person game model, the information security manager and the attacker are assumed to be the game players, and the information security countermeasures and information security threats are assumed as the strategy of the players, respectively. A zero-sum game that the sum of the players' payoffs is zero is assumed, and we derive a solution of a mixed strategy game in which a strategy is selected according to probability distribution among strategies. In the real world, there are various types of information security threats exist, so multiple information security measures should be considered to maintain the appropriate information security level of information systems. We assume that the defence ratio of the information security countermeasures is known, and we derive the optimal solution of the mixed strategy game using linear programming. The contributions of this study are as follows. First, we conduct analysis using real performance data of information security measures. Information security managers of organizations can use the methodology suggested in this study to make practical decisions when establishing investment portfolio for information security countermeasures. Second, the investment weight of information security countermeasures is derived. Since we derive the weight of each information security measure, not just whether or not information security measures have been invested, it is easy to construct an information security investment portfolio in a situation where investment decisions need to be made in consideration of a number of information security countermeasures. Finally, it is possible to find the optimal defence probability after constructing an investment portfolio of information security countermeasures. The information security managers of organizations can measure the specific investment effect by drawing out information security countermeasures that fit the organization's information security investment budget. Also, numerical examples are presented and computational results are analyzed. Based on the performance of various information security countermeasures: Firewall, IPS, and Antivirus, data related to information security measures are collected to construct a portfolio of information security countermeasures. The defence ratio of the information security countermeasures is created using a uniform distribution, and a coverage of performance is derived based on the report of each information security countermeasure. According to numerical examples that considered Firewall, IPS, and Antivirus as information security countermeasures, the investment weights of Firewall, IPS, and Antivirus are optimized to 60.74%, 39.26%, and 0%, respectively. The result shows that the defence probability of the organization is maximized to 83.87%. When the methodology and examples of this study are used in practice, information security managers can consider various types of information security measures, and the appropriate investment level of each measure can be reflected in the organization's budget.

Verify Image-Guided Shifts for 6DoF Couch using Yonsei Cancer Center QA Set (Yonsei Cancer Center QA Set을 이용한 6DoF Couch의 이동 정확성 검증)

  • Jung, Dongmin;Park, Hyokuk;Yoon, Jongwon;Lee, Sangkyu;Kim, Jooho;Cho, Jeonghee
    • The Journal of Korean Society for Radiation Therapy
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    • v.29 no.1
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    • pp.7-18
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    • 2017
  • Purpose: A QA Set was established to verify the movement accuracy of image-guided 6DoF Couch and to evaluate its usefulness. Materials and Methods: Two sets of linear accelerators equipped with 6DoF Couch and CBCT were used. Using the established QA Set, each CBCT image was obtained over 15 times through the Penta-Guide Phantom installed with off-set shift values along six translational (Translation; TX, TY, TZ) and rotational (Rotation, Pitch; RX, Roll; RY, Yaw; RZ) directions. Using this method, we compared the reference image and the registration image, and we analyzed the error calculated by measuring the positional accuracy of the modified 6DoF Couch. Results: The Air Cavity corresponding to the Pixel of the reference image and the registration image were all contained between 30 and 66, and the revealing high registration accuracy. Error between the modified off-set value of 6DoF Couch and the measured value along translational directions were $0.25{\pm}0.18mm$ in the TX direction, $0.25{\pm}0.25mm$ in the TY direction, and $0.36{\pm}0.2mm$ in the TZ direction. Misalignments along the rotational axis were $0.18{\pm}0.08^{\circ}$ in the RX direction, $0.26{\pm}0.09^{\circ}$ in the RY direction, and $0.11{\pm}0.08^{\circ}$ in the RZ direction, it was corrected precisely for any value. Conclusion: Using the YCC QA Set, we were able to verify the error of 6DoF Couch along both the translational and rotational directions in a very simple method. This system would be useful in performing Daily IGRT QA of 6DoF Couch.

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Dose Distribution According to the Tissue Composition Using Wedge Filter by Radiochromic Film (쐐기필터 사용 시 레디오크로믹 필름을 이용한 조직에 따른 선량분포 연구)

  • Kim, Yon-Lae;Lee, Jeong-Woo;Park, Byung-Moon;Jung, Jae-Yong;Park, Ji-Yeon;Suh, Tae-Suk
    • Journal of radiological science and technology
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    • v.35 no.2
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    • pp.157-164
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    • 2012
  • The purpose of this study is to analyze the dose distribution when wedge filter is used in the various tissue electron density materials. The dose distribution was assessed that the enhanced dynamic wedge filter and physical wedge filter were used in the solid water phantom, cork phantom, and air cavity. The film dosimetry was suitable simple to measure 2D dose distribution. Therefore, the radiochromic films (Gafchromic EBT2, ISP, NJ, USA) were selected to measure and to analyze the dose distributions. A linear accelerator using 6 MV photon were irradiated to field size of $10{\times}10cm^2$ with 400 MUs. The dose distributions of EBT2 films were analyzed the in-field area and penumbra regions by using dose analysis program. In the dose distributions of wedge field, the dose from a physical wedge was higher than that from a dynamic wedge at the same electron density materials. A dose distributions of wedge type in the solid water phantom and the cork phantom were in agreements with 2%. However, the dose distribution in air cavity showed the large difference with those in the solid water phantom or cork phantom dose distributions. Dose distribution of wedge field in air cavity was not shown the wedge effect. The penumbra width, out of the field of thick and thin, was observed larger from 1 cm to 2 cm at the thick end. The penumbra of physical wedge filter was much larger average 6% than the dynamic wedge filter. If the physical wedge filter is used, the dose was increased to effect the scatter that interacted with photon and physical wedge. In the case of difference in electron like the soft tissue, lung, and air, the transmission, absorption, and scattering were changed in the medium at high energy photon. Therefore, the treatment at the difference electron density should be inhomogeneity correction in treatment planning system.

The Role of Radiotherapy in the Treatment of Extrahepatic Bile Duct Carcinoma (간외담도종양에서 방사선치료의 역할)

  • Shin Hyun Soo;Kim Gwi Eon;Lee Hyung Sik;Suh Chang Ok;Loh John JK;Lee Jong Tae
    • Radiation Oncology Journal
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    • v.9 no.2
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    • pp.253-263
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    • 1991
  • Twenty-seven patients with unresectable extrahepatic bile duct carcinoma (n=21) or with microscopic evidence of tumor rest after aggressive surgery for extrahepatic bile duct carcinoma (n=6) between 1985 and 1990 were given radiotherapy consisting intentionally external radiotherapy and/or intraluminal therapy using Gamma-Med 12i (192-Ir) high dose rate (HDR) remote control afterloading system following bile drainage procedures and Gianturco stent insertion. The objectives of this study has been to assess the feasibility and effects on survival of a combination of external radiotherapy and brachytherapy with which we hope to achieve optimal loco-regional control for patients with unresectable extrahepatic bile duct tumors. Sixteen patients were men and eleven were women, and the mean age was 58 years (34-70). 10MV X-ray was used for radiation therapy, with the total dose ranging from 45 Gy to 55 Gy, and intraluminal brachytherapy performed after external radiotherapy, with the dose of total 15 Gy. The minimum follow up was 12 months. Failure were predominantly local-regional, without distant failure. Median survival was 10 months; 2-year actuarial survival rates was $21\%$. Median survival for common hepatic duct (CHD) cancer was 9 months; for common bile duct (CBD) cancer, was 16 months. And median survival for incomplete surgery/external radiotherapy group and external/intraluminal radiotherapy group was 10 months; for external radiotherapy alone group, was 6 months. Use of chemotherapy and/or hyperthermia were not affected in survival. Therefore, our result is that the survival rates in the group of external/intraluminal radiotherapy were comparable with ones in the group of incomplete resection/external radiotherapy, and so we believe that the aggressive local and regional radiotherapy can improve the quality of life and the survival length.

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Results of Radiotherapy in Nasopharyngeal Cancer (비인두암의 방사선치료 결과)

  • Shin Byung Chul;Ma Sun Young;Moon Chang Woo;Yum Ha Yong;Jeung Tae Sig;Yoo Myung Jin
    • Radiation Oncology Journal
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    • v.13 no.3
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    • pp.215-223
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    • 1995
  • Purpose : The aim of this study was to assess the effectiveness, survival rate and complication of radiation in nasopharyngeal cancer. Materials and Methods : From January 1980 to May 1989. Fifty patients who had nasopharyngeal carcinoma treated with curative radiation therapy at Kosin Medical Center were retrospectively studied. Thirty seven patients($74{\%}$) were treated with radiation therapy alone(Group I) and 13 patients ($26{\%}$) treated with combination of chemotherapy and radiation (Group II). Age distribution was 16-75 years(median : 45.8 years). In histologic type, squamous cell carcinoma was in 30 patients($60{\%}$), undifferentiated carcinoma in 17 patients($34{\%}$), and lymphoepithelioma in 3 patients($6{\%}$). According t AJCC staging system. 4 patients($8{\%}$) were in $T_1$, 13 patients($26{\%}$) in $T_2$. 20 patients($40{\%}$) in $T_3$, 13 patients($26{\%}$) in $T_4$ and 7 patients($14{\%}$) in $N_0$, 6 patients($12{\%}$) $N_1$, 23 patients($46{\%}$) in $N_2$, 14 patients($28{\%}$) in $N_3$. Total radiation dose ranges were 5250-9200cGy(median : 7355 cGy) in Group I and 5360-8400cGy(median : 6758cGy) in Group II Radiotherapy on 4-6MV linear accelerator and/or 6-12MeV electron in boost radiation was given with conventional technique to 26 patients($52{\%}$), with hyperfractionation(115-120cGy/fr., 2times/day) to 16 patients($32{\%}$), with accelerated fractionation(160cGy/fr., 2 times/day) to 8 patients($16{\%}$). In chemotherapy, 5 FU 1000mg daily for 5 consecutive days, pepleomycin 10mg on days 1 and 3, and cisplatin 100mg on day 1 were administered with 3weeks interval, total 1 to 3 cycles(average 1.8cycles) prior to radiation therapy. Follow up duration was 6-140 months(mean : 58 months). Statistics was calculated with Chi-square and Fisher's exact test. Results : Complete local control rates in Group I and II were $75.7{\%},\;69.2{\%} Overall 5 year survival rates in Group I and II were $56.8{\%},\;30.8{\%}$. Five year survival rates by histologic type in Group I and II were $52.2{\%},\;14.3{\%}$ is squamous cell carcinoma and $54.5{\%},\;50{\%}$ in undifferentiated carcinoma. Survival rates in Group I were superior to those of Group II though there were not statistically significant. In both group, survival rates seem to be increased according to increasing total dose of radiation up to 7500cGy, but not increased beyond it. There were not statistically significant differences in survival rates by age, stage, and radiation techniques in both group. Twenty four patients($48{\%}$) experienced treatment failures. Complications were found in 12 patients($24{\%}$). The most common one was osteomyelitis(4 patients, $33.3{\%}$) involving mandible (3 patients) and maxilla(1 patient). Conclusion : Chemotherapy in combination with radiotherapy was found to be not effective to nasopharyngeal cancer and the survival rate was also inferior to that of radiation alone group though it was statistically not significant due to small population in chemotherapy combined group.

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Analysis of Respiratory Motion Artifacts in PET Imaging Using Respiratory Gated PET Combined with 4D-CT (4D-CT와 결합한 호흡게이트 PET을 이용한 PET영상의 호흡 인공산물 분석)

  • Cho, Byung-Chul;Park, Sung-Ho;Park, Hee-Chul;Bae, Hoon-Sik;Hwang, Hee-Sung;Shin, Hee-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.3
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    • pp.174-181
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    • 2005
  • Purpose: Reduction of respiratory motion artifacts in PET images was studied using respiratory-gated PET (RGPET) with moving phantom. Especially a method of generating simulated helical CT images from 4D-CT datasets was developed and applied to a respiratory specific RGPET images for more accurate attenuation correction. Materials and Methods: Using a motion phantom with periodicity of 6 seconds and linear motion amplitude of 26 mm, PET/CT (Discovery ST: GEMS) scans with and without respiratory gating were obtained for one syringe and two vials with each volume of 3, 10, and 30 ml respectively. RPM (Real-Time Position Management, Varian) was used for tracking motion during PET/CT scanning. Ten datasets of RGPET and 4D-CT corresponding to every 10% phase intervals were acquired. from the positions, sizes, and uptake values of each subject on the resultant phase specific PET and CT datasets, the correlations between motion artifacts in PET and CT images and the size of motion relative to the size of subject were analyzed. Results: The center positions of three vials in RGPET and 4D-CT agree well with the actual position within the estimated error. However, volumes of subjects in non-gated PET images increase proportional to relative motion size and were overestimated as much as 250% when the motion amplitude was increased two times larger than the size of the subject. On the contrary, the corresponding maximal uptake value was reduced to about 50%. Conclusion: RGPET is demonstrated to remove respiratory motion artifacts in PET imaging, and moreover, more precise image fusion and more accurate attenuation correction is possible by combining with 4D-CT.