• The Journal of Korean Society for Radiation Therapy
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• v.25 no.1
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• pp.1-8
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• 2013

Purpose: A selection of proper energy in treatment planning is very important because of having different dose distribution in body as photon energy. In generally, the low energy photon has been used in intensity-modulated radiation therapy (IMRT) for head and neck (H&N) cancer. The aim of this study was to evaluate the effect of partially used high energy photon at posterior oblique fields on IMRT plan for H&N cancer. Materials and Methods: The study was carried out on 10 patients (nasopharyngeal cancer 5, tonsilar cancer 5) treated with IMRT in Seoul National University Bundang Hospital. CT images were acquired 3 mm of thickness in the same condition and the treatment plan was performed by Eclipse (Ver.7.1, Varian, Palo Alto, USA). Two plans were generated under same planing objectives, dose volume constraints, and eight fields setting: (1) The low energy plan (LEP) created using 6 MV beam alone, (2) the partially used high energy plan (PHEP) created partially using 15 MV beam at two posterior oblique fields with deeper penetration depths, while 6 MV beam was used at the rest of fields. The plans for LEP and PHEP were compared in terms of coverage, conformity index (CI) and homogeneity index (HI) for planning target volume (PTV). For organs at risk (OARs), $D_{mean}$ and $D_{50%}$ were analyzed on both parotid glands and $D_{max}$, $D_{1%}$ for spinal cord were analyzed. Integral dose (ID) and total monitor unit (MU) were compared as addition parameters. For the comparing dose to normal tissue of posterior neck, the posterior-normal tissue volume (P-NTV) was set on the patients respectively. The $D_{mean}$, $V_{20Gy}$ and $V_{25Gy}$ for P-NTV were evaluated by using dose volume histogram (DVH). Results: The dose distributions were similar with regard to coverage, CI and HI for PTV between the LEP and PHEP. No evident difference was observed in the spinal cord. However, the $D_{mean}$, $D_{50%}$ for both parotid gland were slightly reduced by 0.6%, 0.7% in PHEP. The ID was reduced by 1.1% in PHEP, and total MU for PHEP was 1.8% lower than that for LEP. In the P-NTV, the $D_{mean}$, $V_{20Gy}$ and $V_{25Gy}$ of the PHEP were 1.6%, 1.8% and 2.9% lower than those of LEP. Conclusion: Dose to some OARs and a normal tissue, total monitor unit were reduced in IMRT plan with partially used high energy photon. Although these reduction are unclear how have a clinical benefit to patient, application of the partially used high energy photon could improve the overall plan quality of IMRT for head and neck cancer.

• KOREAN JOURNAL OF CROP SCIENCE
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• v.34 no.1
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• pp.60-73
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• 1989

Two field experiments were carried out to assess the applicability of a central composite design (CCD) in determining optimum culture condition of an early rice cultivar, Unbongbyeo in southern Korea. A central composite design with two replicates was applied to five levels of five factors such as the number of hills per 3.3m2, the number of seedlings per hill, the levels of nitrogen, the transplanting date and the seedling age (Experiment 1). The levels of planting density were ranged from 30 hills to 150 hills per 3.3m2 ; the number of seedlings per hill from 1 seedling to 9 seedlings per hill; the levels of nitrogen application from 1 kg/l0a to 21 kg/l0a; the transplanting date from June 15 to July 5; the seedling age from 25 days to 45 days. A fractional factorial design was applied to three levels of five factors tested in CCD (Experiment 2). Yield per hill and per unit area were examined and the results obtained from both experiments were compared. The benefits from the central composite design were discussed. Maximum yield of brown rice per unit area was obtained at the combination of the central levels of one of five factors when the other four factors were fixed at central point. Furthermore, brown rice yield per unit area affected by interaction of two factors was maximized at the central point when the remain three factors being fixed at the central level. The responses of five factors to brown rice yield per hill and unit area were found to be a saddle point in both designs. Actual values of the stationary points were 107 hills per 3.3 m2, 4 seedlings per hill, 10 kg nitrogen per l0a, transplanting date of rice on June 26 and 33 days of seedling age in the central composite design. Brown rice yield per unit area at the stationary points were estimated 439 kg/l0a in the central composite design and 442 kg/l0a in the fractional factorial design. Considering the number of experimental treatment combinations, the central composite design was rather convenient in reducing the number of treatment combinations for similar information. It was more convenient for an experimenter to present the results from the central composite design than those from the fractional factorial design. Considering the optimum yields of brown rice per unit area at the stationary points being verified as saddle points in both designs. inter-heterogeneity of each of the factors should be avoided in setting up factors in pursuit of inducing unidirectional response of the factors to yield. Even though both the lower and higher levels in the central composite design being beyond the region of an experimenter's interest. they were considered highly valued in interpretation of the results. Conclusively. the central composite design was found to be more beneficial to optimize culture condition of paddy rice even with several levels of various factors were involved.

• Clinical and Experimental Pediatrics
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• v.51 no.1
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• pp.73-77
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• 2008

Purpose : p16 gene, mapped to the 9p21 chromosomal region, has emerged as a candidate tumor suppressor gene in human neoplasm. It is an inhibitor of cyclin-dependent kinase and inhibits Rb phosphorylation. In a variety of tumors including childhood acute lymphoblastic leukemia (ALL), deletion and/or mutation of the p16 gene has been found. Despite their high frequency, the prognostic importance of p16 alterations is still controversial in ALL and has been reported to be either unfavorable or similar to that of other patients. We studied the correlation between loss of p16 protein confirmed by immunohistochemical staining and clinical outcomes of patients diagnosed as ALL. Methods : We performed an immunohistochemical staining for p16 protein in 74 cases of bone marrow biopsy slide initially diagnosed as ALL between January 1998 and December 2006. We reviewed the clinical manifestations, laboratory findings, treatment outcomes retrospectively. Results : Of 74 slides, 12 were negative for p16 protein. Seven were males and 5 were females with a median age at diagnosis was 5.8 (1.3-18.8) years. Initial WBC were 17,225 $(500-403,300)/{\mu}L$. By immunologic surface marker analysis, 7 patients were early pre-B CALLA (+) and 5 patients were T-cell ALL. Two patients of intermediate risk group had relapsed and died. Three patients had family history of breast cancer. Four patients died and overall survival rates were $53.5{\pm}18.7%$. Conclusion : Loss of p16 protein is supposed to be an independent risk factor of childhood ALL associated with poor outcomes. In clinical setting, the clinician must take into account p16 status, not only at the genomic but also at the protein level. Further clinical experience on thoroughly investigated cases will help a better understanding between p16 status and clinical outcomes.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.11
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• pp.5254-5260
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• 2012

The purpose of this study is to find the relationship between lumber Herniated Nuclesus Pulposus of specific part and fat infiltration in paraspinal muscle. Also we intended to find the relationship between Body Mass Index(BMI) and fat infiltration ratio in the lumber paraspinal muscle based on the sexes of patients. We conducted this study of patients who visited our hospital from May, 2010 to May, 2012. The subjects are composed of 40 patients(20 females and 20 males), who are 30 to 50 years old suffering from severe lumber herniated nuclesus pulposus, who had or were going to have operation treatment. BMI is measured through anthropometry of each patient and fat infiltration inside the muscle is estimated by measuring the cross section area of lumbar paraspinal muscle from mid-cross section of disc(L2-S1) and fat infiltration ratio. The data of this study are analyzed by independent t-test to figure out the difference of fat infiltration between male and female, and by paired sample T-test after getting mean and standard deviation to find the changes of fat infiltration of lumbar on each level. Also correlation analysis is done by setting age as a control variable to find the correlation between BMI and fat infiltration of the whole lumbar. As a result, we could get only the meaningful difference between the sexes on upper lumber part(L2-L3) while we couldn't find any significant difference in the rest of lumbar(L3-S1). Besides, the changes of fat infiltration ratio on each lumbar level increased rapidly from lumbar 3,4 to lumbar 4,5. We also found that there is no correlation between fat infiltration ratio of lumbar paraspinal muscle(L2-S1) and BMI.

• Journal of Korean Academy of Nursing
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• v.30 no.6
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• pp.1488-1502
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• 2000

This study, based on current home nursing services, aims at promoting measures for establishing a community-based home nursing system derived from the pilot home nursing demonstration project conducted by the Seoul Nurses Association. The study was based on an analysis of home nursing records from march 1993 to December 1999. The following is a summary analysis, based on individual characteristics of the patients, the organization, which recommended the service for their patients and personnel services. 1. The service has been used by many elderly people 60years of age or older(66.4%). and married people(60.9%). The average number of visits by service personnel for patients of city government was 23.5. This is 2.5 times as many visits by general patients. General patients(20.2%) had only one visit from service personnel, while 65.5% of patients of city government had 10 or more visits. Particularly, for government recommended patients, 72.7% of the patients were recommended by nurses, while only 21.9% where referred to the services by doctors. The main focus of a home nursing service was to maintain present health status (53.4%), and hospice(11.6%). Also to increase hospital-based home nursing services focused on recovery(55.9%) and maintain present health conditions (19.0%). 2. For general patients, 42.0% of patients were suffering from problems related to CVA, 11.3% from high blood pressure, and for patients referred from city, 21.2% from skeletal muscular disease. Results of home nursing services 29.4% of patients were able to recover or maintain their health status, but 48.9% of the patients died. Another main point of community-based home nursing services is medication(6.7%), other basic nursing services(6.1%), special treatment, instructions on how to use medical devices(5.9%), change of physical posture(4.6%), and training on changing physical positions(4.7%). As mentioned above there were some differences between the characteristics of patients who used the pilot home nursing service conducted by the Seoul Nurses Association and those hospital-based service users. The results are believed to be useful to support a community-based home nursing service model. Particularly, patients under medical supervision and patients recommended by government-run health clinics show a higher frequency and longer use of home nursing services compared to general patients or hospital-based home nursing service users. According to the study, nurses accounted for a large number of recommendations for home nursing services. Many patients with CVA, high blood pressure, skeletal muscular disease and bedsores used community-based home nursing services, while others used the service for minor treatments or maintaining their current health status. Based on the study, the researchers make several suggestions to establish a community- based home nursing service system. First, different ways of setting up a community-based home nursing system have to be mapped out based on the evaluation of the pilot home nursing service conducted by the Seoul Nurses Association. Secondly, a new, community-based, home health care nursing service model, and reimbursement payment system have to be developed. This is based on the outcome of the analysis, and implemented policy. Accordingly, efforts are needed to develop a community- based home nursing system with an intermediary role to promote the visiting nursing services of government-run health centers.

• Radiation Oncology Journal
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• v.9 no.1
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• pp.123-130
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• 1991

A docking intraoperative electron beam applicator system, which is easily docking in the collimator for a linear accelerator after setting a sterilized transparent cone on the tumor bearing area in the operation room, has been designed to optimize dose distribution and to improve the efficiency of radiation treatment method with linear accelerator. This applicator system consisted of collimator holder with shielded metals and docking cone with transparent acrylic cylinder, A number of technical innovations have been used in the design of this system, this dooking cone gives a improving latral dose coverage at therapeutic volume. The position of $90\%$ isodose curve under suface of 8 cm diameter cone was extended $4\sim7$ mm at 12 MeV electron and the isodose measurements beneath the cone wall showed hot spots as great as $106\%$ for acrylic cone. The leakage radiation dose to tissues outside the cone wall was reduced as $3\sim5\%$ of output dose. A comprehensive set of dosimetric characteristics of the intraoperative radiation therapy applicator system is presented.

• Journal of Korean Academy of Nursing
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• v.3 no.3
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• pp.97-110
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• 1973

The goal of modern nursing is to provide comprehensive nursing care to patients. If comprehensive nursing care to children (within the hospital setting) is to be provided, consideration of the stage of growth and development of the child is especially important. From clinical observation, it appeared that nurses often disregarded individual requirements of children in giving nursing care. Therefore, the purpose of this study is to show that comprehensive nursing care which is based on an understanding of the growth and development of the child contributes to both the child and the mother's adaptability to the child's hospitalization. Method: Sixty children, three to three year of age, hospitalized at the Yonsei University Pediatric Ward ware studied. From April 1, 1973 to May 5, 1973, children admitted to the hospital were assigned to either an experimental or a compare groups. There were 30 children in each group. The sex and age of the children in each group was similar. In both groups were more male than female children. In the experimental group, each mother stayed with hot child continuously during his hospitalization. In the compare groups, the mother or some other member of the family stayed with the child. Each day on the child's admission the investigator visited the ward from 1-2 P.M. to 9-10 P.M., in order to provide comprehensive care for the experimental -group. The assistance given the nurses by the investigator was in the form of conferences regarding care and in giving direct care to the child and his mother. The compare group of children received nursing care as usually provided by the hospital. The instruments used to obtain the data for analysis were as follows: 1. The fear and anxiety reaction of the child was recorded by observation of the investigator for four areas: 1) separation from parent and relatives 2) reaction to Doctor and Nurse with white gowns 3) reaction to nursing care 4) reaction to injection and tests, etc. 2. Regression in area of eating, sleeping, and elimination were recorded by the investigator by questioning the mother and by observation. 3. Adaptability to the hospitalization was recorded by direct questioning of the children for areas of emotional and social adjustment. For children older than 3 years of age or children not seriously ill, using the simple I. Q. test this was possible for only 35 of the total 60 children. Result: 1. 55 percents of the total 60 children had been prepared by their parents for hospitalization. The children who had received prior preparation accepted hospitalization more readily than those who had received no preparation. (χ²=4.6 Ρ<0.05) 2. On admission 31.7 percent of the children expressed verbal fear of their discase or treatment. 25 percent felt that the disease was due to their mistake. 3. There was a significant difference in the reaction of the child to separation from the parent or relatives between the two groups. The experimental groups showed less anxiety due to separation than the compare group. (χ²=4.34 Ρ<0.05) In both groups there was less anxiety due to separation among school age (6-12 years) children than among preschool age (3-5 years) children. (χ²=9.22 Ρ<0.05) 4. More than half of the children in both groups reacted with fear and avoidance to doctor and/or nurses wearing white gowns. (χ²=0.06 Ρ<0.05) 5. The experimental group reacted more favorably to nursing in general than the compare group. (χ²=4.8 Ρ<0.05) 6. There was no difference in the fear and refused reaction to special tests and/or such as X-rays and injections, etc. between the groups. (χ²=3.77 Ρ<0.05) 7. More children in the compare group showed regressive tendencies in eating, sleeping, and elimination habits than in experimental groups. (χ²=2.3 Ρ<0.05 χ²=3.88 Ρ<0.05 χ²=4.9 Ρ<0.05) 8. There was a significant difference in the adaptability to hospitalization between the two groups. The experimental groups adapted more readily. (χ²=2.02 Ρ<0.05) 9. For children who had higher I.Q. s the adaptability to hospitalization was better regardless of the group. (χ²=5.03 Ρ<0.05) However, because of the small number of cases (60), this finding cannot be extrapolated without further verification. The date demonstrates that there was a greater adaptability to hospitalization by the child when comprehensive nursing care was given. By planning care and applying knowledge of growth and development to meet, nurses are in a position to prevent some of the psychological trauma associated with hospitalization.

• Korean Journal of Environmental Agriculture
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• v.16 no.2
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• pp.130-135
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• 1997

Tomatoes are flooded differently 0, 5, 10 and 15cm, according to the developing stages such as flowering stage under the condition of greenhouse. Along with this, they are treated according to the time condition such as 6, 12, 24, 48 and 120 hours. The results obtained are summarized as follows. Plant height decreased in the depth of $0{\sim}10cm$ for over 48 hours, in the depth of 15cm for over 24 hours. Number of leaves was the same as in control, and it decreased over. Number of flowers and fruit setting of individuals decreased conspicuously according as the depth and the hours got greater and longer. Adventitious root occurred remarkably in the depth of $0{\sim}10cm$, for over 24 hours and in the depth of 15cm, 12 hours. Epinastic curvature increased greatly as the depth and the hours got greater and longer. Diffusion resistance of stomata cell increased as the depth and the hours got greater and longer. Diseases occurred conspicuously as the hours of flooding got longer rather than as the depth greater. The preventing of diseases caused by insecticide was observed, but it was not greater than in the seedling and transplanting stage. Fertilization was effective in the case of increasing the weight of shoot. Number of fruits per plant did not decrease in the depth of 0cm up to 24 hours, but decreased on the deeper level of flooding and increased as the hours got longer. Moreover with the exception of 120 hours per respective depth of the treatment, average weight of a fruit got greater as the depth and the hours got greater and longer. In the case of epinastic curvature and diffusion resistance, there was negative correlation between all the other investigated characters and positive correlation between weight of a fruits and average weight of a fruit.

• The Journal of Korean Society for Radiation Therapy
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• v.28 no.2
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• pp.87-99
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• 2016

Purpose : This study will evaluate the clinical utility by applying clinical schematic that uses monoenergy or dual energy as according to the location of tumors to the stereotactic radiotherapy to compare the change in actual dose given to the real tumor and the dose that locates adjacent to the tumor. Materials and Methods : CT images from a total of 10 patients were obtained and the clinical planning were planned based on the volumetric modulated arc therapy on monoenergy and dual energy. To analyze the change factor in the tumor, Comformity Index(CI) and Homogeneity Index(HI) and maximum dose quantity were each calculated and comparing the dose distribution on normal tissues, $V_{10}$ and $V_5$, first ~ fourth ribs closest to the tumor ($1^{st}{\sim}4^{th}$ Rib), Spinal Cord, Esophagus and Trachea were selected. Also, in order to confirm the accuracy on which the planned dose distribution is really measured, the 2-dimensional ion chamber array was used to measure the dose distribution. Results : As of the tumor factor, CI and HI showed a number close to 1 when the two energies were used. As of the maximum dose, the front chest wall showed 2% and the dorsal tumor showed equivalent value. As of normal tissue, the front chest wall tumors were reduced by 4%, 5% when both energies were used in the adjacent rib and as of trachea, reduced by 11%, 17%. As of the dose in the lung, as of $V_{10}$, it reduced by 1.5%, $V_5$ by 1%. As of the rear chest wall, when both energies were used, the ribs adjacent to the tumors showed 6%, 1%, 4%, 12% reduction, and in the lung dose distribution, $V_{10}$ reduced by 3%, and $V_5$ reduced by 3.1%. The dose measurement in all energies were in accordance to the results of Gamma Index 3mm/3%. Conclusion : It is considered that rather than using monoenergy, utilizing double energy in the clinical setting can be more effectively applied to the superficial tumors.

• Journal of Global Scholars of Marketing Science
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• v.20 no.2
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• pp.164-172
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• 2010

This study reviews the influence of culture in interpersonal servicescapes by examining the restaurant retail setting. Two cultures (Canada and France) are surveyed in order to better understand their retail expectations towards interpersonal servicescapes. Using Hofstede's (1991) cultural dimensions to explain some of the differences between Canadian and French restaurant patrons, this study demonstrates a potentially interesting research avenue in the field of cross-cultural interpersonal services marketing. It demonstrates that cultural dimensions do not operate independently but interdependently. Understanding this can help retailers better explain complex service interactions between countries that may appear similar in terms of various socio-demographic features. In this exploratory research, a measure via exploratory factor analysis was developed, one that encompasses both the physical and service aspects common to interpersonal servicescape by using personality traits. This measure was tested in order to better understand the service expectations between two cultures, Canada and France. Five dimensional structures were uncovered in both cultures but with different traits and groupings. The differences between the traits uncovered and the overall Canadian and French personality structures find some explanation using Hofstede's (1991) cultural dimensions. The results of this survey point to a possible explanation as to why when services are transferred between cultures, the perceptions of them can be different and sometimes even lead to service failure. There are clearly some cultural differences between the Canadian and French consumers and their overall expectations regarding their consumption experience. Reviewing the first factor of the French and Canadian personality structures shows that the individualist/collectivist differences are apparent between the Canadian and the French cultures. The second dimension also has quite a few traits in common, five, all of which have the personal treatment aspect of the restaurant experience that a service provider would be responsible for: polite, respectful, and dedicated. Notable is that the French dimension does not include the authenticity or the hospitable aspect of the experience but includes even more features that are inherent to the personal interaction, such as charming and courteous. The third dimension of the Canadian and French structures reflects completely different expectations. Whereas the French dimension centers around energy and enthusiasm, the Canadian version is more laid-back and relaxed. There is extroversion in the French dimension to introversion in the Canadian dimension. This could be explained by differences on the Uncertainty Avoidance dimension as outlined by Hofstede (1991). The fourth dimension seems to confirm previously outlined cultural differences. Whereas Canadians, being a bit lower on uncertainty avoidance and power distance, prefer an intimate and private experience, the French continue to expect extraversion and inclusive features to their experience. The fifth dimension is in the French personality structure a clear expression of the high power distance society, where the roles of the players in the restaurant experience are clearly defined and the rules of engagement preserved. This study demonstrates that different cultures clearly do relate to different expectations regarding interpersonal services. This is apparent in the dimensions that come up in both the French and the Canadian personality structures, not only in terms of how different they are but also in with which cultural dimensions these can be explained. For interpersonal servicescapes, the use of personality traits is interesting as it allows for both physical and service features to be accounted for. Furthermore, the social component inherent to interpersonal servicescapes surfaces in most of the dimensions of the service personality structures. The quality of social exchanges is extremely important, and this even more so in cross-cultural situations, where the expec tations regarding the service experience may vary. As demonstrated by this research and using Hofstede's (1991) paradigm, not all societies will have the same expectations pertaining to the interpersonal services. Furthermore, the traditions surrounding the type of service can also have an impact on the service evaluations and differ between countries and cultures. However, using personality traits may also allow for retailers to see which service traits are common to two or more cultures where they seek to be present, and focus on these in the offering. The findings demonstrate the importance of the individualist and collectivist dimension for interpersonal servicescapes. This difference between the French and the Canadian personality structure is apparent in the most dominant dimension as well as within others. The findings are a step in explaining how retailers can transfer and then measure interpersonal services across cultures.