• Radiation Oncology Journal
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• v.13 no.3
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• pp.277-283
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• 1995

Purpose : This study was performed to measure dose alteration at the air-tissue interface resulting from rebuild-up to the loss of charged particle equilibrium in the tissues around the air-tissue interfaces. Materials and Methods : The 6 and 10-MV photon beam in dual energy linear accelerator were used to measure the surface dose at the air-tissue interface The polystyrene phantom sized $25{\times}25{\times}5\;cm^3$ and a water phantom sized $29{\times}29{\times}48\;cm^3$ which incorporates a parallel-plate ionization chamber in the distal side of air gap were used in this study. The treatment field sizes were $5{\times}5\;cm^2,\;10{\times}10\;cm^2\;and\;20{\times}20\;cm^2$. Air cavity thickness was variable from 10 mm to 50 mm. The observed-expected ratio (OER) was defined as the ratio of dose measured at the distal junction that is air-tissue interface to the dose measured at the same point in a homogeneous phantom. Results : In this experiment, the result of OER was close or slightly over than 1.0 for the large field size but much less (about 0.565) than 1.0 for the small field size in both photon energy. The factors to affect the dose distribution at the air-tissue interface were the field size, the thickness of air cavity. and the photon energy. Conclusion : Thus, the radiation oncologist should take into account dose reduction at the air-tissue interface when planning the head and neck cancer especially pharynx and laryngeal lesions, because the dose can be less nearly $29{\%}$ than predicted value.

• Journal of Preventive Medicine and Public Health
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• v.22 no.3 s.27
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• pp.368-379
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• 1989

The relationship between mercury level of hair and mental retardation was investigated. The 297 subjects with mental retardation were drawn from two schools providing special educational services, one, consisted of children living in an orphan home, another, children with parents. The 117 centre] subjects were drawn from whom had got average or above average academic achivement in a regular elementary school. Hair sample were taken from the nape of the neck and the mercury analysis was carried out on an atomic absorption spectrophotometer(IL 551). There was no relationship between mercury contents and age, and there was a statistically significant difference in mercury contents between male and female in the mentally retarded children living with parents. Children in the retarded group had significantly higher mercury contents compared with control group except the female group with parents. Also, the mercury levels in the retarded group living in an orphan home were significantly higher than that of the retarded group with parents. The concomitant diseases were Down's syndrome, epilepsy, cerebral palsy and autism. There were statistically significant differences in hair mercury levels in the cases of accompanying Down's syndrome and cerebral palsy in male and Down's syndrome and autism in female compared with the control group of the same sex. The most accompanying handicap was speech disturbance(40.7%) and the others were crippled, emotional disturbance etc. The percentages of double handicap were 66.7% among 6 persons exceeding 6ppm of their hair mercury contents. 10.4% among $3{\sim}6$ ppm and 15.7% among the group of 3ppm or less. The findings of this study suggest that the more opportunities of exposure to mercury in mentally retarded children may have occurred, so it can not be excluded the possibility of mercury as a contributing factor to mental retardation. Therefore, the causal relationship between mercury levels and mental retardation should be established through the examinations about their living environments, dietary pattern, eating habit etc.

• Korean Journal of Clinical Laboratory Science
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• v.44 no.2
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• pp.52-58
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• 2012

Patients with obstructive sleep apnea (OSA) often have more aggravated symptoms in the supine position. We tried to investigate the clinical characteristics and the predictive factors for positional OSA. Polysomnographic data were reviewed for OSA patients (apnea hypopnea index, $AHI{\geq}5$) from April, 2008 to April, 2011 at the Asan Medical Center. Clinical data, comorbid medical condition data and questionnaires (SF-36, MFI-20, ESS, BDI, STAI) were assessed. All patients were classified into two groups: positional patients (PP) group and non-positional patients (NPP) group. PP was defined as a patient who had the AHI in the supine position was at least twice as high as that in the lateral position. The body position of patients was confirmed by sleep position sensor and video monitor. All patients had at least 30 minutes of positional and 30 minutes of non-positional sleep. We compared clinical, medical, polysomnographic data, and questionnaire results between two (PP and NPP) groups and investigated predictive factors for the PP group using binary logistic regression analysis. In total, 371 patients were investigated. 265 (71.4%) was categorized as PP group and 106 (28.5%) as NPP group. The mean age ($mean{\pm}SD$) was higher in the PP group ($52.4{\pm}9.8$) than in the NPP group ($49.5{\pm}11.9$) (p<0.05). Comparison of sleep parameters between the PP and the NPP group showed that the PP group had significantly lower BMI (PP: $26.1{\pm}3.2kg/m^2$; NPP: $27.8{\pm}4.3kg/m^2$, p<0.001), neck circumference (PP: $39.7{\pm}2.8cm$; NPP: $41.5{\pm}3.7cm$, p<0.001) and hypertension rate (PP: n=89/265 (33.5%); NPP: n=48/106 (45.2%), p=0.0240). In the PP group, the percentage of deep sleep (PP: $8.7{\pm}8.1%$; NPP: $5.6{\pm}7.0%$, P=0.001) and rapid eye movement (REM) (PP: $17.5{\pm}6.1%$; NPP: $14.0{\pm}6.9%$, p<0.001) were significantly higher whereas the percentage of light sleep (stage N1) was significantly lower than the NPP group (PP: $30.4{\pm}12.3$; NPP: $44.5{\pm}20.8%$, p<0.001). During the sleep, the AHI in the supine position (PP: $48.6{\pm}19.5$; NPP: $60.5{\pm}22.6$, p<0.001) and in the non-supine position (PP: $9.4{\pm}8.9$; NPP: $48.4{\pm}24.8$, p=<0.001) were significantly lower and the minimal arterial oxygen saturation in non-REM sleep was significantly higher in the PP group (PP: $80.3{\pm}7.6$; NPP: $75.1{\pm}9.9$, p=<0.001). There were no significant differences in all questionnaires including quality of life. The results of the binary logistic regression analysis showed that age, the amount of REM sleep(%) and AHI were significant predictive factors for positional OSA. The significant predictive factors for positional OSA were older age, higher percentage of REM and lower AHI. The questionnaire results were not significantly different between the two groups.

• Korean Journal of Clinical Laboratory Science
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• v.46 no.3
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• pp.106-110
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• 2014

Obstructive sleep apnea-hypopnea (OSAH) is known to be related to nocturnal blood pressure (BP) and hypertension. The aim of this study was to evaluate the prevalence of hypertension according to the apnea-hypopnea grading. A total of 2,210 adults with snoring and obstructive sleep apnea were referred to our sleep center from July 2009 to May 2013. Clinical blood pressure (BP) was measured before sleeping (bedtime BP) and immediately after waking up in the next morning (morning BP). Subjects were classified into four groups based on the apnea-hypopnea index (AHI) from PSG as follows: control group (n=470) simple snoring and with AHI<5; mild group (n=577) with $AHI{\geq}5$ and <15; moderate group (n=508) $AHI{\geq}15$ and <30; and severe group (n=655) with $AHI{\geq}30$. The differences and correlations between BP and PSG parameters according to the AHI groups were analyzed. Patient's were classified as nomentensive (blood pressure <120/90 mmHg, n=700), prehypertensive (blood pressure < $140-120{\leq}mmHg$, n=1297) hypertensive (blood pressure ${\geq}140/90mmHg$, n=214) according to the office blood pressure measurements. The comparison of sleep parameters showed that OSA groups had a significantly higher stage N1 (control group vs. moderate OSA, severe OSA; $66.4{\pm}30.7$ vs. $85.5{\pm}36.6$, $128.4{\pm}57.3$, p<0.001) and total arousal number (control vs. moderate OSA, severe OSA; $110.7{\pm}47.7$ vs. $150.8{\pm}56.6$, $236.6{\pm}95.8$, p<0.001) compared to control group. The comparison of sleep parameters showed that OSA groups had a significantly lower stage N2 (control group vs. moderate OSA, severe OSA; $172.6{\pm}47.2$ vs. $150.7{\pm}50.5$, $120.3{\pm}57.4$, p<0.001), stage N3 (control group vs. moderate OSA, severe OSA; $38.4{\pm}33.4$ vs. $27.4{\pm}26.0$, $56.1{\pm}27.5$, p<0.001), REM (control group vs. moderate OSA, severe OSA; $64.3{\pm}25.5$ vs. $56.1{\pm}27.5$, $47.3{\pm}25.9$, p<0.001) and mean SaO2% (control group vs. moderate OSA, severe OSA; $90.0{\pm}3.5$ vs. $82.5{\pm}5.5$, $70.0{\pm}8.8$, p<0.001) compared to control group. The Apnea-hypopnea index was significantly higher in OSA groups, increased systolic and diastolic blood pressure than in the nomentensive group (bed time systolic pressure vs. AHI; <120 vs. 120-139, 140-159, >159; $17.5{\pm}18.6$ vs. $24.9{\pm}21.0$, $31.0{\pm}25.7$, $42.3{\pm}31.7$, p<0.001), (bed time diastolic pressure vs. AHI; 60-79 vs. 80-89, 90-99, >99; $19.3{\pm}19.7$ vs. $22.4{\pm}20.3$, $29.8{\pm}23.3$, $38.8{\pm}28.5$, p<0.001). AHI was positively correlated with morning systolic pressure, diastolic pressure, bed time systolic pressure and diastolic pressure (r=0.314, 0.279, 0.233 and 0.200, respectively, p<0.001). We conclude that BMI, Age, neck circumference and AHI increase with the blood pressure.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.11 no.11
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• pp.4346-4353
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• 2010

The purpose of this study was to estimate the cervical range of motion and the effects of massage and static stretching in their 20s of normal adult. One hundred participants(massage=50, stretching=50) with no musculoskeletal and nervous system problems volunteered for this study. Massage and static stretching were applied to sternocleidomstoid, scalenes, trapezius, semispinalis, splenius, suboccipital, multifidi and rotatores. Both groups received intervention for 3 times in a week. The time the intervention was applied was for 10minutes. Effleurage, petrissage and stripping technique was applied to massage group and static stretching technique was applied to stretching group. The cervical range of motion (CROM) instrument was used to measure eight cervical motions (suboccipital flexion, suboccipital extension, neck flexion and extension, and left and right lateral flexion, left and right rotation). As a result of making a statistical analysis of the data, the following findings were given: First, normal cervical range of motion revealed; suboccipital flexion($2.39^{\circ}$) and extension($38.36^{\circ}$), flexion($54.11^{\circ}$) and extension($69.39^{\circ}$), lateral flexion on left($43.50^{\circ}$) and right($41.28^{\circ}$), rotation on left($66.39^{\circ}$) and right($65.94^{\circ}$) in male and suboccipital flexion($5.14^{\circ}$) and extension($36.47^{\circ}$), flexion($55.92^{\circ}$) and extension($71.22^{\circ}$), lateral flexion on left($43.34^{\circ}$) and right($41.06^{\circ}$), rotation on left($69.38^{\circ}$) and right($68.63^{\circ}$) in female. Second, women had greater range of motions than men in suboccipital flexion, left and right rotation(p<0.05). Third, it showed significantly increasing cervical range of motion in all directions within groups following treatments but not between groups(p<0.05). Our results suggest that massage and static stretching are an appropriate intervention to increase cervical range of motion by muscle relaxation and stretching and may be provided a basis for future studies investigating the cervical range of motion.

• The Korean Nurse
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• v.36 no.5
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• pp.45-62
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• 1998

The study was conducted from November 1995 to May 1996 at the one general hospital in Seoul. The total subjects of this study were 412 patients who have the experience of fall accident, among them 31 was who have fallen during hospitalization and 381 was who visited emergency room and out patient clinic. The purposes of this study were to determine the characteristics, risk factors and results of fall accident and to suggest the nursing strategies for prevention of fall. Data were collected by reviewing the medical records and interviewing with the fallers and their family members. For data analysis, spss/pc+ program was utilized for descriptive statistics, adjusted standardized $X^2$-test. The results of this study were as follows: 1) Total subjects were 412 fallers, of which 245(59.5%) were men and 167(40.5%) were women. Age were 0-14 years 79(19.2%), 15-44 years 125(30.4%), 45-64 years 104(25.2%), over 65 years 104(25.2%). 2) There was significant association between age and the sexes ($X^2$=39.17, P=0.00). 3) There was significant association between age and history of falls ($X^2$=44.41. P= .00). And history of falls in the elderly was significantly associated with falls. 4) There was significant association with age and medical diagnosis ($X^2$=140.66, P= .00), chief medical diagnosis were hypertension(34), diabetis mellitus(22), arthritis(11), stroke(8), fracture(7), pulmonary tuberculosis(6), dementia(5) and cataract(5), 5) There was significant association between age and intrinsic factors: cognitive impairment, mobility impairment, insomnia, emotional problems, urinary difficulty, visual impairments, hearing impairments, use of drugs (sedatives , antihypertensive drugs, diuretics, antidepressants) (P < 0.05). But there was no significant association between age and dizziness ($X^2$=2.87, P=.41). 6) 15.3% of total fallers were drunken state when they were fallen. 7) Environmental factors of fall accident were unusual posture (50.9%), slips(35.2%), trips (9.5%) and collision(4.4%). 8) Most of falls occurred during the day time, peak frequencies of falls occurred from 1pm to 6pm and 7am to 12am. 9) The places of fall accident were roads(22.6%), house-stairs 06.7%), rooms, floors, kitchen (11.2%), the roof-top, veranda, windows(10.9%), hospital(7.5%), ice or snowy ways(5.8%), bathroom(4.9%), playground, park(4.9%), subway-stairs(4.4%) and public-bathrooms (2.2%). 10) Activities at the time of fall accident were walking(37.6%), turning around or reaching for something(20.9%), going up or down stairs09.2%), exereise, working07.4%), up or down from a bed(2.7%), using wheelchair or walking aids, standing up or down from a chair(2.2%) and standing still(2.2%). 11) Anatomical locations of injuries by falls were head, face, neck(31.3%), lower extremities (29.9%). upper extremities(20.6%), spine, thorax, abdomen or pelvic contents(l1.4%) and unspecified(2.9%). 12) Types of injures were fracture(47.6%), bruises03.8%), laceration (13.3%), sprains(9.0%), headache(6.6%), abrasions(2.9%), intracranial hemorrage(2.4%) and burns(0.5%). 13) 41.5% of the fallers were hospitalized and average of hospitalization was 22.3 days. 14) The six fallers(1.46%) died from fall injuries. The two fallers died from intracranial hemorrage and the four fallers died of secondary infection; pneumonia(2), sepsis(1) and cell lulitis(1). It is suggested that 1) Further study is needed with larger sample size to identify the fall risk factors. 2) After the fall accident, comprehensive nursing care and regular physical exercise should be emphasized for the elderly person. 3) Safety education and safety facilities of the public place and home is necessary for fall prevention.

• Journal of the Institute of Convergence Signal Processing
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• v.16 no.4
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• pp.149-155
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• 2015

Tooth implant is located in oral cavity and affects neck, skull base, and facail image. These magnetic inhomogeneities are usually frequency encoding direction which cause artifacts due to change of signal strength and geometric distortion. First, to evaluate signal to noise ratio (SNR) of magnetic resonance image caused by tooth implant this study uses meat phantom which is similar to human body and is consisted with fat, muscle, and water to measure signal to noise ratio. Second, signal to noise ratio by using custom-made fixed phantom is measured, and then signal to noise ratio size of different tooth implant types is compared and analyzed. The measured signal to noise ratio values of Brushite, HSA, Metal, and RBM for meat phantom were 2.76, 2.22, 1.88, and 1.57 on T1 SE, 1.88, 1.78, 1.65, and 1.79 on T2 FLAIR, 2.28, 2.25, 2.88, and 2.05 on T2 FSE, and 2.74, 1.94, 1.67, and 1.48 on T2 GRE. The measured signal to noise ratio values of Brushite, HSA, Metal, and RBM for fixed water phantom were 1.2, 1.06, 1.12, and 1.22 on DWI, 1.93, 1.87, 1.93, and 2.06 T1 SE, 1.83, 1.76, 1.82, and 1.92 on T2 FLAIR, 1.85, 1.79, 7.86, and 1.97 on T2 FSE, and 1.97, 1.93, 1.99, and 2.06 on T2 GRE. By considering through the results, patients and dentists need to consider some impacts from testing many aspects although their main purpose of having tooth implants is a dental restoration. Moreover, depending on the tooth implant characteristics of individual patients this study results can be used as baseline data when choosing test protocol.

• The Journal of Korean Society for Radiation Therapy
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• v.30 no.1_2
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• pp.117-128
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• 2018

Purpose : To evaluate the usability of plan transfer between TOMO HD and Radixact, we compared the differences of dose in transferred plans by evaluating the dose of normal organ and target. TOMO HDA and Radixact. The completed plans were transferred each other and we compared the differences of dose by evaluating the DVH of each plans. Materials and Methods : We planned 4 different plans assuming the treatment of 2 cases in Head and Neck Cancer and 2 cases Prostate cancer. Each plan was designed so that 95 % of the prescription dose was irradiated over 99 % of the target volume, and the normal organ constraints dose was based on the SMC tolerance dose protocol. Each plan was transferred to each equipment and DVH(dose volume histogram) analysis of the transferred plans was compared and evaluated. Results : The Mean dose of CTV and GTV was increased and decreased in the transferred plans, but there was no significant differences. The target coverage of CTV and GTV was decreased in all cases of transferred plans from TOMO HAD to Radixact, and the change of CI and HI in CTV was within 0.1. Normal organ dose was increased in most cases when transferring from HAD to Radixact in both treatment plans. Conclusion : According to the results of this experiment, the target coverage was above the standard and the normal organ dose was almost same or decreased when transferring the plans from Radixact to HDA equipment. However the target coverage was reduced when transferring the plans from HDA to Radixact and there was an increase in dose in normal organs that could cause sever side effects such as Optic Chiasm ($D_{max}$1.38 Gy), Bladder ($D_{max}$3.07 Gy), Penile Bulb ($D_{max}$1.14 Gy). Therefore, it is necessary to pay attention to the dose change when transferring the plan and one-time transfer due to equipment inspection will be useful for efficient radiation therapy, but if the transferred treatment plans continue for several consecutive days, the treatment plan should be resumed.

• The Journal of Korean Society for Radiation Therapy
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• v.30 no.1_2
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• pp.97-105
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• 2018

Purpose : Proton Therapy using Bragg-peak, because it has distinct characteristics in providing maximum dosage for tumor and minimal dosage for normal tissue, a medical imaging system that can quantify changes in patient position or treatment area is of paramount importance to the treatment of protons. The purpose of this research is to evaluate the usefulness of the algorithm by comparing the image matching through the set-up and in-house code through the existing dips program by producing a Matlab-based in-house registration code to determine the error value between dips and DRR to evaluate the accuracy of the existing treatment. Materials and Methods : Thirteen patients with brain tumors and head and neck cancer who received proton therapy were included in this study and used the DIPS Program System (Version 2.4.3, IBA, Belgium) for image comparison and the Eclipse Proton Planning System (Version 13.7, Varian, USA) for patient treatment planning. For Validation of the Registration method, a test image was artificially rotated and moved to match the existing image, and the initial set up image of DIPS program of existing set up process was image-matched with plan DRR, and the error value was obtained, and the usefulness of the algorithm was evaluated. Results : When the test image was moved 0.5, 1, and 10 cm in the left and right directions, the average error was 0.018 cm. When the test image was rotated counterclockwise by 1 and $10^{\circ}$, the error was $0.0011^{\circ}$. When the initial images of four patients were imaged, the mean error was 0.056, 0.044, and 0.053 cm in the order of x, y, and z, and 0.190 and $0.206^{\circ}$ in the order of rotation and pitch. When the final images of 13 patients were imaged, the mean differences were 0.062, 0.085, and 0.074 cm in the order of x, y, and z, and 0.120 cm as the vector value. Rotation and pitch were 0.171 and $0.174^{\circ}$, respectively. Conclusion : The Matlab-based In-house Registration code produced through this study showed accurate Image matching based on Intensity as well as the simple image as well as anatomical structure. Also, the Set-up error through the DIPS program of the existing treatment method showed a very slight difference, confirming the accuracy of the proton therapy. Future development of additional programs and future Intensity-based Matlab In-house code research will be necessary for future clinical applications.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.25 no.2
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• pp.1-19
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• 2012

Objective : The purpose of this study is to investigate about comparison of Eastern-Western medicine on the acne. Methods : We searched Eastern and Western medicine books for acne. We analyzed these books and examined category, definition, etiology, classification, internal and external methods of treatment of acne. Results : The results were as follows. 1. In Eastern medicine, Acne belongs to the category of the Bunja(粉刺), Jwachang(痤瘡), Pyepungbunja(肺風粉刺). In Western medicine, the other name of Acne is acne vulgaris. 2. In Eastern medicine, the definition of Acne includes manual extraction of comedones and skin appearance. In Western medicine, Acne is a common skin disease during adolescence and a chronic inflammatory disease of pilosebaceous unit of self localization. It is characterized by noninflammatory, open or closed comedones and by inflammatory papules, pustules, and nodules and it affects the areas of skin with the densest population of sebaceous follicles, these areas include the face, neck, back, and the upper part of the chest. 3. In Eastern medicine, the cause and mechanism of Acne arose from the state of internal dampness-heat and spleen-stomach internal qi deficiency due to dietary irregularities and then invaded external pathogen such as wind-dampness-heat-cold-fire in lung meridian lead to qi and blood heat depression stagnation. So it appears in skin. In Western medicine, the etiology and pathogenesis of Acne is clearly not identified, but there are most significant pathogenic factors of blood heat depression stagnation. So it appears in skin. In Western medicine, the etiology and pathogenesis of Acne is clearly not identified, but there are most significant pathogenic factors of Acne; Androgen-stimulated production of sebum, hyperkeratinization and obstruction of sebaceous follicles, proliferation of Propionibacterium acnes and inflammation, abnormaility of skin barrier function, genetic aspects, environmental factors etc. 4. In Eastern medicine, differentiation of syndromes classifies clinical aspects, and cause and mechanism of disease; the former is papular, pustular, cystic, nodular, atrophic, comprehensive type; the latter is lung blood heat, intestine-stomach dampness-heat, phlegm-stasis depression, thoroughfare-conception disharmony, heat toxin type. In Western medicine, it divides into an etiology and invasion period, and clinical aspects; Acne neonatorum, Acne infantum, Acne in puberty and adulthood, Acne venenata; Acne vulgaris, Acne conglobata, Acne fulminans, Acne keloidalis. 5. In Eastern medicine, Internal methods of treatment of Acne are divided into five treatments; general treatments, the treatments of single-medicine and experiential description, the treatments depending on the cause and mechanism of disease, and clinical differentiation of syndromes, dietary treatments. In Western medicine, it is a basic principles that regulation on production of sebum, correction on hyperkeratinization of sebaceous follicles, decrease of Propionibacterium acnes colony and control of inflammation reaction. Internal methods of treatment of Acne are antibiotics, retinoids, hormone preparations etc. 6. In Eastern medicine, external methods of treatment of Acne are wet compress method, paste preparation method, powder preparation method, pill preparation method, acupuncture and moxibustion therapy, ear acupuncture therapy, prevention and notice, and so on. In Western medicine, external method of treatments of Acne are divided into topical therapy and other surgical therapies. Topical therapy is used such as antibiotics, sebum regulators, topical vitamin A medicines etc and other surgical therapies are used such as surgical treatments, intralesional injection of corticosteroids, skin dermabrasion, phototherapy, photodynamic therapy, and so on. Conclusions : Until now, there is no perfect, effective single treatment. We think that Eastern medicine approach and treatment can be helpful to overcome the limitations of acne cure.