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Results of Preoperative Concurrent Chemoradiotherapy for Locally Advanced Rectal Cancer (국소진행성 직장암의 수술 전 동시화학방사선요법의 결과)

  • Choi, Sang-Gyu;Kim, Su-Ssan;Bae, Hoon-Sik
    • Radiation Oncology Journal
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    • v.25 no.1
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    • pp.34-42
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    • 2007
  • [ $\underline{Purpose}$ ]: We performed a retrospective non-randomized clinical study of locally advanced rectal cancer, to evaluate the anal sphincter preservation rates, down staging rates and survival rates of preoperative chemoradiotherapy. $\underline{Materials\;and\;Methods}$: From January 2002 to December 2005, patients with pathologically confirmed rectal cancer with clinical stage T2 or higher, or patients with lymph node metastasis were enrolled in this study. A preoperative staging work-up was conducted in 36 patients. All patients were treated with preoperative chemoradiotherapy, and curative resection was performed for 26 patients at Hallym University Sacred Heart Hospital. Radiotherapy treatment planning was conducted with the use of planning CT for all patients. A total dose of $45.0{\sim}52.2\;Gy$ conventionally fractionated three-dimensional radiotherapy was delivered to the whole pelvis. Chemotherapy was given at the first and fifth week of radiation therapy with continuous infusion i.v. 5-FU (Fluorouracil) and LV (Leucovorine). Surgical resection was performed 2 to 4 weeks after the completion of the chemoradiotherapy regimen. $\underline{Results}$: The complete resection rate with negative resection margin was 100% (26/26). However, a pathologically complete response was not seen after curative resection. Surgery was done by LAR (low anterior resection) in 23 patients and APR (abdomino-perineal resection) in 3 patients. The sphincter preservation rate was 88.5% (23/26), down staging of the tumor occurred in 12 patients (46.2%) and down-sizing of the tumor occurred in 19 patients (73%). Local recurrence after surgical resection developed in 1 patient, and distant metastasis developed in 3 patients. The local recurrence free survival rate, distant metastasis free survival rate, and progression free survival rate were 96.7%, 87% and 83.1%, respectively. Treatment related toxicity was minimal except for one grade 3, one grade 4 anemia, one grade 3 leukopenia, and one grade 3 ileus. $\underline{Conclusion}$: Preoperative concurrent chmoradiotherapy for locally advanced rectal cancer seems to have some potential benefits: high sphincter preservation and down staging. Treatment related toxicity was minimal and a high compliance with treatment was seen in this study. Further long-term follow-up with a larger group of patients is required.

Evaluation of the Wet Bulb Globe Temperature (WBGT) Index for Digital Fashion Application in Outdoor Environments

  • Kwon, JuYoun;Parsons, Ken
    • Journal of the Ergonomics Society of Korea
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    • v.36 no.1
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    • pp.23-36
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    • 2017
  • Objective: This paper presents a study to evaluate the WBGT index for assessing the effects of a wide range of outdoor weather conditions on human responses. Background: The Wet Bulb Globe Temperature (WBGT) index was firstly developed for the assessment of hot outdoor conditions. It is a recognised index that is used world-wide. It may be useful over a range of outdoor conditions and not just for hot climates. Method: Four group experiments, involving people performing a light stepping activity, were conducted to determine human responses to outside conditions in the U.K. They were conducted in September 2007 (autumn), December 2007 (winter), March 2008 (spring) and June 2008 (summer). Environmental measurements included WBGT, air temperature, radiant temperature (including solar load), humidity and wind speed all measured at 1.2m above the ground, as well as weather data measured by a standard weather station at 3m to 4m above the ground. Participants' physiological and subjective responses were measured. When the overall results of the four seasons are considered, WBGT provided a strong prediction of physiological responses as well as subjective responses if aural temperature, heart rate and sweat production were measured. Results: WBGT is appropriate to predict thermal strain on a large group of ordinary people in moderate conditions. Consideration should be given to include the WBGT index in warning systems for a wide range of weather conditions. However, the WBGT overestimated physiological responses of subjects. In addition, tenfold Borg's RPE was significantly different with heart rate measured for the four conditions except autumn (p<0.05). Physiological and subjective responses over 60 minutes consistently showed a similar tendency in the relationships with the $WBGT_{head}$ and $WBGT_{abdomen}$. Conclusion: It was found that either $WBGT_{head}$ or $WBGT_{abdomen}$ could be measured if a measurement should be conducted at only one height. The relationship between the WBGT values and weather station data was also investigated. There was a significant relationship between WBGT values at the position of a person and weather station data. For UK daytime weather conditions ranging from an average air temperature of $6^{\circ}C$ to $21^{\circ}C$ with mean radiant temperatures of up to $57^{\circ}C$, the WBGT index could be used as a simple thermal index to indicate the effects of weather on people. Application: The result of evaluation of WBGT might help to develop the smart clothing for workers in industrial sites and improve the work environment in terms of considering workers' wellness.

Local Cooling of the Limbs in $37^{\circ}C$ Ambient Temperature (사지부의 냉각효율성에 관한 연구)

  • Hwang, Kyoung-Sook;Choi, Jeong-Wha;Lee, Kyung-Suk
    • The Korean Journal of Community Living Science
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    • v.18 no.1
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    • pp.87-95
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    • 2007
  • This study was to determine the effect of cooling parts of the limbs without harm to health. The results provide basic data for the development of clothing which could increase work efficiency and reduce body strain in hot environments. Five male adults took part in the study, conducted in a climate chamber with an ambient temperature of $37^{\circ}C$ and a relative humidity of 50%. The limbs were divided into six areas to be cooled: upper arm, forearm, thigh, calf, hand, and foot. According to preceding studies, permissible cooling safety limits of skin temperature for each part of the body for one-hour were $20^{\circ}C$ on the upper arm, forearm, thigh, and calf, and $23^{\circ}C$ on the hand and foot. For this reason, cooling the skin of each region was carried out at the above mentioned temperatures. In conclusion, cooling the hand and foot reduced perspiration, rectal temperature and heart rate. Therefore, the heat stress of workers exposed to hot environments would be reduced by decreased subjective sensations of heat and increased comfort. The effectiveness of cooling was better on the arm than on the leg.

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Physiological Changes According to Workload Wearing Aluminized Firefighter's Protective Clothing (소방방열복 착용시 작업강도에 따른 신체변화)

  • Bang, Chang-Hoon;Lee, Jun-Kyoung;Kwan, Jung-Suk
    • Fire Science and Engineering
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    • v.27 no.4
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    • pp.56-60
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    • 2013
  • The aim of study intends to investigate physiological changes according to workload wearing aluminized firefighter's protective clothing and to provide the base data for the safety of firefighter. The results of the study are as follows. To increase work intensity 4 to 8 METs after experiment (20 min), mean skin temperature change (33.3 %), tympanic temperature change (57.1 %) heart rate (32.5 %), RPE (75.6 %) is statistically significantly higher and thermal Sensation, weight loss are not statistically significant. It was concluded that physiological changes of human body varied considerably by increase of workload wearing aluminized firefighter's protective clothing.

Design of Wearable IoT based Smart Mask (웨어러블 IoT기반 스마트 마스크 설계)

  • Park, Yonghyun;Jeong, SeongWoon;Jung, Kyung Kwon
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2021.10a
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    • pp.300-302
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    • 2021
  • Usage of a face mask has become mandatory in many countries after the COVID-19. This paper described to develop a IoT based smart mask system for monitoring face mask. The system developed in this paper has two main units, a sensor module, and a smartphone application. The sensor module consists of four components: temperature and humidity sensor, a heart rate sensor, and a BLE chip. This components work as a unit to collect data and stream them through an I2C port over BLE to a connected mobile device. The smartphone application is an Android application developed for smart phones. It enables the Android device to communicate with the sensor to receive sensor data, process, store and display results.

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The Effects of Posture and Sleep Deprivation on Heart Rate Variability (자세와 수면 박탈이 심박 변이도에 미치는 영향)

  • Shim, Young-Woo;Yang, Dong-In;Kim, Nam-Hyun;Kim, Deok-Won
    • Journal of the Institute of Electronics Engineers of Korea SC
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    • v.47 no.2
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    • pp.43-49
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    • 2010
  • Autonomic nervous system (ANS) acts as a control system functioning largely below the level of consciousness, and controls visceral functions. The activity of the ANS has been assessed by means of the heart rate variability (HRV). It has been reported that HRV is dependent on sex, age, body mass index, and smoking, etc. However, the effects of posture and sleep deprivation on HRV have rarely been reported. Objective of our work was to find out which posture is appropriate for stable HRV. We measured the number of sleep deprivation and HRV using power spectrum in six stages for 30 minutes. Increased low frequency (LF) power and high frequency (HF) power indicate enhanced sympathetic and parasympathetic activity, respectively. We determined the LF/HF ratio to minimize individual difference. It was found that sleep deprivation by awakening up subjects was affected by posture, which resulted in changes of LF/HF. Although LF/HF varied with time, it was more stable in sitting than in supine. In conclusion, we recommend sitting posture when measuring HRV because of less sleep deprivation resulting in less variation in LF/HF.

A Comparison of Clinical Efficacy of Weaning Method Between the Mode of Intermittent Mandatory Ventilation and Intermittent Mandatory Ventilation Plus Pressure Support (기계적 호흡 치료로부터의 이탈방법으로서 Intermittent Mandatory Ventilation 단독 사용과 Pressure Support를 병용한 Intermittent Mandatory Ventilation의 비교)

  • Choi, Jeong-Eun;Koh, Youn-Suck;Cho, Won-Kyoung;Lim, Chae-Man;Kim, Woo-Sung;Park, Pyung-Hwan;Choi, Jong-Moo;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.4
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    • pp.372-378
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    • 1994
  • Background: Pressure support ventilation(PSV) is a new form of mechanical ventilatory support that assists spontaneous inspiraory effort of an intubated patient with a clinician-selected amount of positive airway pressure. Low level pressure support during inspiration can overcome the resistive component of inspiratory work imposed by an endotracheal tube. However the clinical efficacy of PSV as a weaning method has not been established yet. Object: The aim of study was to evaluate the efficacy of PSV when it is added to intermittent mandatory ventilation(IMV) in facilitating weaning precess compaired to IMV mode alone. Method: When the subject patients became clinically stable with their arterial blood gas analysis in acceptable range, they underwent weaning process either by IMV alone or by IMV plus PSV. The level of pressure support was held constant throught the weaning period. For the patients who required mechanical ventilation for less than 72 hr, 2h weaning trial was performed with IMV rate starting from 6/min. For the patients who required mechanical ventilation more than 72 hr, 7 hr weaning trial was performed with IMV rate starting from 8/min. For the patients who failed three consecutive trials of weaning, retrial of weaning was attempted over 3 days with IMV rate starting from 8/min. Clinical characteristics, APACHE II score and nutritional status were compared. For all patients, heart rate, mean blood pressure and respiratory rate were mornitored for 48 hrs after weaning trial started. Results: The total number of weaning trial was 37 in 23 patients(18 by IMV, 19 by IMV+PSV). Total ventilation time, APACHE II score and nutritional status were not statistically different between the two groups. The weaning success rate were not statistically different(38.3% by IMV, 42.1% by IMV+PSV) and the changes of mean blood pressure, heart rate, respiratory rate during first 48 hours were not different between the two groups. Conclusion: Low level PSV when added to IMV for weaning trial does not seem to improve the success rate of weaning from mechanical ventilation. PSV at 10cm $H_2O$ did not induce significant physiologic changes during weaning process.

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Efficacy of Cooling Vests for Alleviating Heat Strain of Farm Workers in Summer (여름철 농민의 서열 부담 경감을 위한 냉각조끼의 성능 평가)

  • Choi Jeong-Wha;Kim Myung-Ju;Lee Joo-Young
    • Journal of the Korean Society of Clothing and Textiles
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    • v.29 no.8 s.145
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    • pp.1176-1187
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    • 2005
  • The purpose of this study was to evaluate the efficiency of cooling vests developed for farm workers harvesting red pepper in summer. The study was performed using the following two steps: 1) Climatic chamber test, 2) Field test. For the chamber test, a work environment was simulated as $33^{\circ}C$ and $65\%$RH, and the thermo-physiological and subjective responses were measured with and without cooling vests. Twelve young males participated as subjects. For the field test, three farmers participated while harvesting red pepper on the form, in summer. The measurements used were same as in the chamber test. Subjects were tested without any cooling vests, as a control. They were tested wearing vests with 2 frozen gel packs (CV2: Cooling area, $308cm^2$), and vests with 4 frozen gel packs (CV4: Sooting area, $616cm^2$). As a result of the chamber test, rectal temperature($T_{re}$) and mean skin temperature( $T_{sk}$) were lower in both CVs than in Control, and this tendency was statistically significant in CV4 (p<.05). Clothing microclimate temperature ($T_{clo}$) and total sweat rate (TSR) were significantly lower when wearing cooling vests (p<.05) Heart rate (HR) was also lower in wearing cooling vests than in Control, and the speed of recovery to the comfort level was faster when the subjects wore cooling vests. In addition, subjects felt 'less hot, less humid, and less uncomfortable' in both CVs than in Control. Field tests showed a similar tendency with the chamber tests. In particular, wearing the cooling vest was effective in restraining the raise of $T_{clo}$ on the back. It can be concluded that the cooling vest was effective in alleviating heat strain and discomfort in both the chamber test and the field test, despite the cooling area of the cooling vest being just $3.4\%$ of the body surface area ($616cm^2$).

Effect of Frequency of Using Forest Environment on Workers' Stress: a Comparative Study on Workers in Medical and Counseling Service Institution (산림환경 이용 빈도가 근로자의 스트레스에 미치는 영향: 의료 및 상담서비스기관 종사자에 대한 비교 연구)

  • Jung, Won Hee;Woo, Jong-Min;Ryu, Jee Soo
    • Journal of Korean Society of Forest Science
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    • v.103 no.1
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    • pp.129-136
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    • 2014
  • This study aims to investigate the effect of frequency of using forest environment on workers' stress. Workers in medical and counseling industry, which is recently known to require heavy emotional burden and thus cause a lot of stress and burnout syndrome, participated in the study. We classified 370 subjects, who were working at medical and counseling service institutions in Seoul metropolitan area, into two groups according to frequency of using forest environment by conducting a screening survey. 69 subjects submitted written consent and were recruited for either forest therapy program or control-group test; the "high" group (n=27) at the high frequency of using forest environment and the "low" group (n=42) at the low level. We measured the level of stress by using psychosocial indicators such as Worker's Stress Response Inventory (WSRI), Recovery Experience Questionnaire (REQ), and Maslach Burnout Inventory-General Survey (MBI-GS) and biological ones such as heart rate variability (HRV), cortisol, and Natural Killer cell (NK cell). The results suggested that the level of stress differed by frequency. The "high" group showed significantly low scores in the depression and work sub-scale and the total score of WSRI, emotional exhaustion, professional efficacy and total score of MBI-GS, and high scores in the total score of REQ. Similar tendencies were observed in the most of other indicators of psychosocial measures. Regarding the biological indicators, the "high" group showed the highest SDNN, RMSSD and TP measures of HRV and NK Cell activity and the low cortisol, although the statistical power did not reach the significant level. Our results suggest that the subjects who use forest environment frequently show favorable stress level both psychologically and biologically.

THE CURRENT STATUS OF BIOMEDICAL ENGINEERING IN THE USA

  • Webster, John G.
    • Proceedings of the KOSOMBE Conference
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    • v.1992 no.05
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    • pp.27-47
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    • 1992
  • Engineers have developed new instruments that aid in diagnosis and therapy Ultrasonic imaging has provided a nondamaging method of imaging internal organs. A complex transducer emits ultrasonic waves at many angles and reconstructs a map of internal anatomy and also velocities of blood in vessels. Fast computed tomography permits reconstruction of the 3-dimensional anatomy and perfusion of the heart at 20-Hz rates. Positron emission tomography uses certain isotopes that produce positrons that react with electrons to simultaneously emit two gamma rays in opposite directions. It locates the region of origin by using a ring of discrete scintillation detectors, each in electronic coincidence with an opposing detector. In magnetic resonance imaging, the patient is placed in a very strong magnetic field. The precessing of the hydrogen atoms is perturbed by an interrogating field to yield two-dimensional images of soft tissue having exceptional clarity. As an alternative to radiology image processing, film archiving, and retrieval, picture archiving and communication systems (PACS) are being implemented. Images from computed radiography, magnetic resonance imaging (MRI), nuclear medicine, and ultrasound are digitized, transmitted, and stored in computers for retrieval at distributed work stations. In electrical impedance tomography, electrodes are placed around the thorax. 50-kHz current is injected between two electrodes and voltages are measured on all other electrodes. A computer processes the data to yield an image of the resistivity of a 2-dimensional slice of the thorax. During fetal monitoring, a corkscrew electrode is screwed into the fetal scalp to measure the fetal electrocardiogram. Correlations with uterine contractions yield information on the status of the fetus during delivery To measure cardiac output by thermodilution, cold saline is injected into the right atrium. A thermistor in the right pulmonary artery yields temperature measurements, from which we can calculate cardiac output. In impedance cardiography, we measure the changes in electrical impedance as the heart ejects blood into the arteries. Motion artifacts are large, so signal averaging is useful during monitoring. An intraarterial blood gas monitoring system permits monitoring in real time. Light is sent down optical fibers inserted into the radial artery, where it is absorbed by dyes, which reemit the light at a different wavelength. The emitted light travels up optical fibers where an external instrument determines O2, CO2, and pH. Therapeutic devices include the electrosurgical unit. A high-frequency electric arc is drawn between the knife and the tissue. The arc cuts and the heat coagulates, thus preventing blood loss. Hyperthermia has demonstrated antitumor effects in patients in whom all conventional modes of therapy have failed. Methods of raising tumor temperature include focused ultrasound, radio-frequency power through needles, or microwaves. When the heart stops pumping, we use the defibrillator to restore normal pumping. A brief, high-current pulse through the heart synchronizes all cardiac fibers to restore normal rhythm. When the cardiac rhythm is too slow, we implant the cardiac pacemaker. An electrode within the heart stimulates the cardiac muscle to contract at the normal rate. When the cardiac valves are narrowed or leak, we implant an artificial valve. Silicone rubber and Teflon are used for biocompatibility. Artificial hearts powered by pneumatic hoses have been implanted in humans. However, the quality of life gradually degrades, and death ensues. When kidney stones develop, lithotripsy is used. A spark creates a pressure wave, which is focused on the stone and fragments it. The pieces pass out normally. When kidneys fail, the blood is cleansed during hemodialysis. Urea passes through a porous membrane to a dialysate bath to lower its concentration in the blood. The blind are able to read by scanning the Optacon with their fingertips. A camera scans letters and converts them to an array of vibrating pins. The deaf are able to hear using a cochlear implant. A microphone detects sound and divides it into frequency bands. 22 electrodes within the cochlea stimulate the acoustic the acoustic nerve to provide sound patterns. For those who have lost muscle function in the limbs, researchers are implanting electrodes to stimulate the muscle. Sensors in the legs and arms feed back signals to a computer that coordinates the stimulators to provide limb motion. For those with high spinal cord injury, a puff and sip switch can control a computer and permit the disabled person operate the computer and communicate with the outside world.

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