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Analysis of the major factors of influence on the conditions of the Intensity Modulated Radiation Therapy planning optimization in Head and Neck (두경부 세기견조방사선치료계획 최적화 조건에서 주요 인자들의 영향 분석)

  • Kim, Dae Sup;Lee, Woo Seok;Yoon, In Ha;Back, Geum Mun
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.1
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    • pp.11-19
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    • 2014
  • Purpose : To derive the most appropriate factors by considering the effects of the major factors when applied to the optimization algorithm, thereby aiding the effective designing of a ideal treatment plan. Materials and Methods : The eclipse treatment planning system(Eclipse 10.0, Varian, USA) was used in this study. The PBC (Pencil Beam Convolution) algorithm was used for dose calculation, and the DVO (Dose Volume Optimizer 10.0.28) Optimization algorithm was used for intensity modulated radiation therapy. The experimental group consists of patients receiving intensity modulated radiation therapy for the head and neck cancer and dose prescription to two planned target volume was 2.2 Gy and 2.0 Gy simultaneously. Treatment plan was done with inverse dose calculation methods utilizing 6 MV beam and 7 fields. The optimal algorithm parameter of the established plan was selected based on volume dose-priority(Constrain), dose fluence smooth value and the impact of the treatment plan was analyzed according to the variation of each factors. Volume dose-priority determines the reference conditions and the optimization process was carried out under the condition using same ratio, but different absolute values. We evaluated the surrounding normal organs of treatment volume according to the changing conditions of the absolute values of the volume dose-priority. Dose fluence smooth value was applied by simply changing the reference conditions (absolute value) and by changing the related volume dose-priority. The treatment plan was evaluated using Conformal Index, Paddick's Conformal Index, Homogeneity Index and the average dose of each organs. Results : When the volume dose-priority values were directly proportioned by changing the absolute values, the CI values were found to be different. However PCI was $1.299{\pm}0.006$ and HI was $1.095{\pm}0.004$ while D5%/D95% was $1.090{\pm}1.011$. The impact on the prescribed dose were similar. The average dose of parotid gland decreased to 67.4, 50.3, 51.2, 47.1 Gy when the absolute values of the volume dose-priority increased by 40,60,70,90. When the dose smooth strength from each treatment plan was increased, PCI value increased to $1.338{\pm}0.006$. Conclusion : The optimization algorithm was more influenced by the ratio of each condition than the absolute value of volume dose-priority. If the same ratio was maintained, similar treatment plan was established even if the absolute values were different. Volume dose-priority of the treatment volume should be more than 50% of the normal organ volume dose-priority in order to achieve a successful treatment plan. Dose fluence smooth value should increase or decrease proportional to the volume dose-priority. Volume dose-priority is not enough to satisfy the conditions when the absolute value are applied solely.

A study to 3D dose measurement and evaluation for Respiratory Motion in Lung Cancer Stereotactic Body Radiotherapy Treatment (폐암의 정위적체부방사선치료시 호흡 움직임에 따른 3D 선량 측정평가)

  • Choi, Byeong-Geol;Choi, Chang-Heon;Yun, Il-Gyu;Yang, Jin-Seong;Lee, Dong-Myeong;Park, Ju-Mi
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.1
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    • pp.59-67
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    • 2014
  • Purpose : This study aims to evaluate 3D dosimetric impact for MIP image and each phase image in stereotactic body radiotherapy (SBRT) for lung cancer using volumetric modulated arc therapy (VMAT). Materials and Methods : For each of 5 patients with non-small-cell pulmonary tumors, a respiration-correlated four-dimensional computed tomography (4DCT) study was performed. We obtain ten 3D CT images corresponding to phases of a breathing cycle. Treatment plans were generated using MIP CT image and each phases 3D CT. We performed the dose verification of the TPS with use of the Ion chamber and COMPASS. The dose distribution that were 3D reconstructed using MIP CT image compared with dose distribution on the corresponding phase of the 4D CT data. Results : Gamma evaluation was performed to evaluate the accuracy of dose delivery for MIP CT data and 4D CT data of 5 patients. The average percentage of points passing the gamma criteria of 2 mm/2% about 99%. The average Homogeneity Index difference between MIP and each 3D data of patient dose was 0.03~0.04. The average difference between PTV maximum dose was 3.30 cGy, The average different Spinal Coad dose was 3.30 cGy, The average of difference with $V_{20}$, $V_{10}$, $V_5$ of Lung was -0.04%~2.32%. The average Homogeneity Index difference between MIP and each phase 3d data of all patient was -0.03~0.03. The average PTV maximum dose difference was minimum for 10% phase and maximum for 70% phase. The average Spain cord maximum dose difference was minimum for 0% phase and maximum for 50% phase. The average difference of $V_{20}$, $V_{10}$, $V_5$ of Lung show bo certain trend. Conclusion : There is no tendency of dose difference between MIP with 3D CT data of each phase. But there are appreciable difference for specific phase. It is need to study about patient group which has similar tumor location and breathing motion. Then we compare with dose distribution for each phase 3D image data or MIP image data. we will determine appropriate image data for treatment plan.

Multinational Corporate Linkage Stability in the Canadian Urban System (캐나다 도시체계에서의 다국적기업 연계패턴의 안정성)

  • Kee-Bom Nahm
    • Journal of the Economic Geographical Society of Korea
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    • v.1 no.1
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    • pp.151-172
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    • 1998
  • Over the past two decades, the process of globalization of multinational corporations has increased at a rapid rate. One manifestation of this process is the establishment of corporate head offices in a variety of international centers to administer and coordinate, the day-to-day operations in the host countries. In establishing a subsidiary overseas a firm creates a direct link between the operations of the domestic corporate center and the foreign host center This paper investigates elements of stability and change in the international linkage patterns among domestic parent corporations and host subsidiaries over the past several decades. In particular, it seeks answers to a number of question related to stability and change in linkages among foreign centers of control and those Canadian centers selected to administer the subsidiary operations from 1970 to 1991 over the four primary sectors, namely, resources, manufacturing, services, and finance. By confirming the core stability and dispersed linkages hypotheses, the papar offers some generalizations with respect to the location and stability of subsidiary headquarters centers in Canada and their respective subsector specialties. Finally, it addresses further research avenues fer the quaternary place study.

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Development of Technology·Home Economics teaching-learning plans using ARCS strategies to improve character for middle school students: Focusing on the unit of 'Understanding families' (인성교육을 위해 기술·가정교과 '가족의 이해' 단원에 ARCS 동기유발 전략을 적용한 교수·학습 과정안 개발 및 평가)

  • Kang, Jimin;Yu, Nan Sook
    • Journal of Korean Home Economics Education Association
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    • v.30 no.1
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    • pp.29-42
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    • 2018
  • The purposes of this study were to develop and apply teaching-learning plans using ARCS strategies to improve character of middle school students and analyze whether a home economics class helps to give positive effects on youth character change. Nine-period classes were conducted for 110 male students in 4 classes of M middle school in Gwangju metropolitan city for 5 weeks from March 6 through April 7 in 2017. The effectiveness of classes were examined with learners' class assessment and pre- and post- character index test. The research steps and results in this study are as follows. First, the teaching-learning plans for 9 periods were developed for the character education class of the chapter 'Understanding families'. These teaching and learning course plans were designed to enhance learner's interests in learning using ARCS motivational strategy and improve character of middle school students in consideration of character elements. In the chapter 'Understanding families' of Technology Home Economics in middle school, the teaching-learning plans for 9 periods, 14 student activity sheets, and 2 powerpoint materials for teaching and learning were developed. Second, students who had the character education classes using ARCS motivational strategy showed significant differences in all character elements. Therefore, the character education class using ARCS shows positive effects to build up character of middle school students. Third, the character education classes using ARCS motivational strategy increased the class satisfaction of learners. The character education class teaching and learning course plans and learning materials in Technology Home Economics using ARCS motivational strategy will be used as a basic resource to build up students' character in the future.

Effects of Usual Source of Care by Patients with Diabetes on Use of Medical Service and Medical Expenses (당뇨병 환자의 상용치료원 보유가 의료이용 및 의료비에 미치는 영향)

  • Lee, So Dam;Shin, Euichul;Lim, Jae-Young;Lee, Sang Gyu;Kim, Ji Man
    • Korea Journal of Hospital Management
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    • v.22 no.3
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    • pp.1-17
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    • 2017
  • Purposes: Diabetes is a metabolic disorder that requires continuous care in order to prevent complications, as it can impose a critical burden on families and society due to various complications, including terminal renal failure, non-traumatic lower extremity amputation, and adult blindness. The usual sources of care are "specified private clinics, public health centers, or other facilities to visit when ill or when health-related advice is needed". These usual sources of care offer preventative services, have a high overall satisfaction rate in terms of public health care, and decrease the inpatient rates and medical costs of medical aid recipients. This study analyzed the current status of diabetic patients over 20 years of age based on their possession of a usual source of care, and the effects of this possession on the frequency of their medical service usage and its costs. Methodology: Based on data from the 7th Korea Health Panel, a Tobit analysis was used to analyze the different factors that can affect the frequency of medical service usage and its costs for diabetic patients with and without a usual source of care. Findings: The medical costs of diabetic patients with a usual source of care decreased in terms of inpatient, and the outpatient visits and inpatient costs of the group with a usual source of care in the form of a mainly-visiting doctor decreased more than those of the group with a mainly-visiting medical institution only. Practical Implications: Having a usual source of care can increase the treatment continuity, leading to reduced inpatient, and having a mainly-visiting doctor as the usual source of care further increases the treatment continuity. Based on these results, a new policy is needed to increase and strengthen diabetic patients? possession of a usual source of care.

A Study on the State of Smoking and Smoking-Related Oral Health Knowledge Level among Some Adolescents (일부 청소년의 흡연 실태와 흡연 관련 구강건강지식수준에 관한 연구)

  • Lee, Hyun-Ok;Chun, Ju-Yeon;Ju, On-Ju
    • Journal of dental hygiene science
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    • v.11 no.6
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    • pp.535-542
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    • 2011
  • The purpose of this study was to examine the state of smoking among adolescents and their smoking-related oral health knowledge. The subjects in this study were the teens who were selected by convenience sampling from among the students who were in their first, second and third years in four different middle schools in the city of Iksan, North Jeolla Province. A self-administered survey was conducted from June 14 to July 12, 2011, and the answer sheets from 1,219 respondents were selected for analysis. The collected data were analyzed by the statistical package 12.0, and the findings of the study were as follows: 1. The smoker students accounted for 10.6 percent. The boys and girls who smoked respectively represented 16.0 and 5.4 percent. 2. As for the period of smoking, the largest group that accounted for 51.6 percent smoked for less than a year. Concerning the amount of daily smoking, the greatest group that accounted for 91.9 percent smoked less than 10 cigarettes. As to the motivation of smoking, the biggest group that represented 52.8 percent started to smoke out of curiosity. 3. Regarding smoking-related oral health knowledge, they got a mean of 0.85. Their scores in knowledge of oral malodor(0.95), oral cavity cancer(0.94) and periodontal diseases(0.93) were above the average, and their scores in knowledge of dental caries(0.70) and blunting of taste(0.77) were below the average. 4. The seventh graders got the best score of 5.28 in smoking-related oral health knowledge(p<0.01), and the students who were more satisfied with their life had a better oral health knowledge(p<0.05). 5. The senior students were more dependent on nicotine(p<0.01), and the number of smoking days(${\beta}=0.407$, p<0.001) and the period of smoking(${\beta}=0.235$, p<0.01) affected their nicotine dependence.

당말녕(糖末寧)을 위주(爲主)로 당뇨병(糖尿病)의 주위신경병변(周圍神經病變)을 치료(治療)하는 임상연구(臨床硏究)

  • 우세가
    • Journal of Haehwa Medicine
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    • v.5 no.2
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    • pp.501-501
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    • 1997
  • 당뇨병성(糖尿病性) 주위신경병변(周圍神經病變)은 당뇨병(糖尿病)에서 가장 많이 볼 수 있는 삼대합병증(三大合倂症) 중(中)의 하나이다. 환자(患者)의 임상표현(臨床表現)은 사고(四股) 및 구간부(軀幹部)가 마목(麻木)하고,동통(疼痛)이 칼로 베는 듯하거나 침(鍼)으로 찌르는 듯하여 참기 힘들며, 환자(患者)로 하여금 작업능력(作業能力)을 상실(喪失)하게 하고 휴식(休息)과 수안(睡眼)에 엄중(嚴重)한 영향(影響)을 준다. 지금까지 국내외(國內外)에서는 아직 효과적(效果的)인 치료방법(治療方法)이 없다. 우리는 임상(臨床)에서 관찰(觀察)해 본 결과(結果), 이 병(病)의 임상표현(臨床表現)인 "사고마목(四股麻木), 자통(刺痛), 야간가중(夜間加重), 통처고정(痛處固定)"의 특징(特徵)이 중의임상(中醫臨床)에서 표현(表現)되는 "혈어형(血瘀型)" 동통(疼痛)과 완전(完全)히 상동(上同)하였다. 우리는 "활혈화어(活血化瘀), 통락지통(通絡止痛), 거어생신(祛瘀生新)"을 치료원칙(治療原則)으로 중약복방(中藥復方) 제제(制劑) "당말녕(糖末寧)"을 제조(製造)하여 이 병(病)을 치료(治療)하는데 만족(滿足)스러운 임상치료효과(臨床治療效果)를 거두었다. 전체(全體)의 병례(病例)는 모두 우리 과(科)의 입원환자(入院患者)로써 모두 45례(例)인데, 병기(病機)에 따라 양조(兩組)로 나누었다. 관찰조(觀察組) 30례(例) 중(中)에는 남성(男性)이 19례(例)이고 여성(女性)이 12례(例)이며, 年齡(연령)은 25세(歲)에서 68세(歲)까지로 평균연령(平均年齡)이 49.8세(歲)이다. I형(型) 당뇨병(糖尿病)이 10례(例)이고 II형(型) 당뇨병(糖尿病)이 20례(例)이며, 당뇨병(糖尿病)의 병정(病程)은 6개월(個月)에서 17년(年)사이로 평균(平均) 7.1 년(年)이다. 주위신경병변(周圍神經病變)의 병정(病程)은 2주(周)에서 3년(年)까지로 평균(平均) 1년(年)이다. 대조조(對照組)는 15례(例)로 남성(男性)이 8례(例)이고 여성(女性)이 7례(例)이며, 연령(年齡)은 20세(歲)에서 65세(歲)까지로 평균(平均) 49세(歲)이다. I형(型) 당뇨병(糖尿病)이 7례(例)이고 II형(型) 당뇨병(糖尿病)이 8례(例)이며, 橋民病의 병정(病程)은 3개월(個月)에서 12년(年)까지로 평균(平均) 7.5년(年)이다. 주위신경병변(周圍神經病變)의 병정(病程)은 1개월(個月)에서 3년(年)까지로 평균병정(平均病程)은 11.6개월(個月)이다. 양조(兩組)사이의 병정(病程)은 현저(顯著)한 차이는 없으나 서로 비교(比較)해 볼만하다. 당말녕(糖末寧)은 주(主)로 삼궁(三芎),원호(元胡), 당귀(當歸), 계혈승 등(等)의 약물(藥物)로 조성(組成)되었고, 약제실(藥劑室)에서 濃縮液(농축액)(매(每) ml당(當) 생약량(生藥量) 2.5g 함유(含有))으로 제조(製造)하였다. 관찰조(觀察組)는 매차례(每次例) 당말녕(糖末寧) 50ml를 하루 세번씩 복용(服用)하였고; 대조조(對照組)는 비타민 $B_1$, 비타민 $B_6$을 각각(各各) 20mg씩 하루 세차례 복용(服用)하였다. 양조(兩組) 모두 사주(四周)를 한번의 치료료정(治療療程)으로 하였다. 우리는 모두 45례(例)의 환자(患者)를 관찰(觀察)하였는데, 그 중(中) 관찰조(觀察組)가 30례(例)이고 대조조(對照組)가 15례(例)이다. 임상표현(臨床表現) 분급(分級)과 신경근전도(神經筋電圖)(운동신경(運動神經)과 감각신경(感覺神經)의 전도(電圖) 속도(速度))를 치료(治療) 전(前)과 후(後)의 대조지표(對照指標)로 하였고. 매(每) 4주(周)를 한개의 료정(療程)으로 총(總) 1-2개(個)의 료정(療程)을 진행(進行)하여 比較硏究(비교연구)하였다. 총유효율(總有效率)은 96.7%이고 총현효율(總顯效率)은 50%로써 대조조(對照組)보다 뚜렷하게 높았다. 치료전(治療前) MNCV와 SNCV를 측정(測定)한 것은 당말녕(糖末寧)이 당뇨병(糖尿病) 주위신경병변(周圍神經病變) 환자(患者)의 신경전도속도(神經電圖速度)를 명확(明確)하게 개선(改善)하였음을 표현(表現)하고 있다. 신경근전도(神經筋電圖)에서 자발전위(自發電位)는 눈에 띄게 감소(減少)되고 소력수축(小力收縮)의 평균시한(平均時限)은 명확(明確)히 연장(延長)되었으며 다상전위(多相電位)는 명확(明確)하게 증가(增加)되었는데, 이는 신경지측(神經支測)이 재생(再生)되고 회복(恢復)하였음을 설명(說明)하고 있다. 중약복방제제(中藥復方制劑) "당말녕(糖末寧)"이 본병(本病)을 치료(治療)하는 기전(機轉)은 여러 방면(方面)일 것이다. 그 중(中) 微循環(미순환)을 개선(改善)하고 적혈구(赤血球)의 변형성(變形性)을 향상(向上)하여 신경세포(神經細胞)에 혈액(血液)과 산소공급(酸素供給) 및 영양공급(營養供給)을 향상(向上)함으로써 神經損傷(신경손상)의 수정(修整)과 회복(恢復)을 촉진(促進)하는 것이 주요(主要)한 일환(一環)이 될 것이다.

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Construction and Validation of a Data Synchronization Server supporting OMA DS Standards (OMA DS 표준을 지원하는 자료동기화 서버 구축 및 적합성 검증)

  • Pak, Ju-Geon;Park, Kee-Hyun
    • Journal of the Korea Society of Computer and Information
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    • v.16 no.5
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    • pp.79-91
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    • 2011
  • In this paper, a DS (Data Synchronization) server for mobile communication environments is constructed and the suitability and the performance of its operations are validated. The DS server provides a way to update the newest data and keep data consistency for clients (mobile devices). In addition, the DS server constructed in this paper supports various synchronization types, and detects all changes and conflicts. In case of data conflicts, the DS server resolves the conflicts according to the several policies implemented in this work. The DS server conforms to the OMA(Open Mobile Alliance) DS standard protocol for interoperability with other mobile devices and servers. In addition to the transmission-by record scheme proposed by the OMA DS standard protocol, the DS server constructed in this paper also provides the transmission-by field scheme for the enhancement transmission performance between the server and clients. In order to validate its operations, data synchronization between the DS server and the SCTS (SyncML Conformance Test Suit), the suitability validation tool provided by the OMA, is performed. The validation results show that the DS server constructed in this paper satisfies all of the test cases except the Large Object function. The Large Object function will be implemented later because the function is not needed for the personal information synchronization process which this paper aims for. Also, synchronization times of the DS server are measured while increasing the number of data and clients. The results of the performance evaluations demonstrate that the DS server is scalable, in the sense that it has not suffered from any serious bottlenecks with respect to the number of data and clients. We expect that this work will provide a framework for various studies in the future for improving mobile DS operations.

Development and Application Effect of Design-based STEAM Program for Boosting the Career Consciousness of 5~6th Grade Elementary School Students for Natural Sciences and Engineering (이공계 진로의식 신장을 위한 초등 5~6학년용 설계기반 미래 유망직업 STEAM 프로그램 개발 및 적용 효과)

  • Lim, Yoo-Na;Min, Bu-Ja;Hong, Hoo-Jo
    • Journal of The Korean Association For Science Education
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    • v.35 no.1
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    • pp.73-84
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    • 2015
  • In this research, two careers connectable with the contents of the curriculum of fifth to sixth grade elementary school students were selected among other promising future careers in biotechnology and medical engineering fields. 'Design-based promising future career STEAM program' was developed and its validity and effectiveness were verified. Reflecting recent issues, and complying with the STEAM standard (frame) instructional materials were developed through group deliberations for nine months, based on the achievement standards through an analysis of subject curriculum revised in 2009. This was prepared so that students are able to experience biotechnology and medical engineering related careers in a simulational form emphasized with creative design to make them prefer natural sciences and engineering careers and draw their interests and recognition of the relevant careers under the two disciplines. As a result of such application to STEAM Leader School students at the verification stage of the program, the contents and level of the program were verified suitable, receiving favorable reviews. And as a result of applying the developed program on other elementary school students, it was discovered that significant improvements were found in their career consciousness. Through this research, it was suggested that there is a need for a simplification of the curriculum content standards, a provision of 'standard for integration,' development of teachers' ability in reconstituting or organizing the STEAM and proceeding classes, continuous long-term support to see the effects of a policy or a program, and a reinforcement of career education integrated in the curriculum.

Quality Characteristics of Jochung Containing Various Level of Letinus edodes Powder (표고버섯 가루를 이용한 조청의 품질 특성)

  • Park, Jung-Suk;Na, Hwan-Sik
    • Korean Journal of Food Science and Technology
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    • v.37 no.5
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    • pp.768-775
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    • 2005
  • Lentinus edodes powder was added at 1-3%(w/w) to improve functional properties of jocheong. Content of crude protein, ash, crude lipids, total mineral, free sugar and reducing sugar increased with increasing amount of L. edodes powder, while viscosity and solid and carbohydrate contents decreased. Through amino acid analysis, 17 amino acids were identified and quantified, glutamic acid being the major amino acid. No significant differences were observed in fatty acid composition and pH between control and L. edodes powder-added jocheong. Addition of mushroom powder in jocheong decreased lightness, yellowness and redness in Hunter's color value. Sensor score of jucheong containing 1% of L. edodes powder was similar to that of control. Results showed jocheong containing less than 2% L. edodes powder gave highest scores in quality characteristics and sensory evaluation.