• Title/Summary/Keyword: 구조적 방법론

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The effect of global disaster competency development program on paramedic and nursing undergraduate students (글로벌 재난 역량 개발 프로그램이 응급구조과와 간호학과 학생에게 미치는 효과)

  • Kang, Sun-Joo;Piao, Mei-Hua
    • The Korean Journal of Emergency Medical Services
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    • v.18 no.1
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    • pp.83-94
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    • 2014
  • Purpose : This study assessed the improvement of competency levels for participants, as well as their satisfaction from completion of the special international disaster response program. Methods : The program structure followed an intensive two-week course that included a combination of lectures, discussions, case studies, and field trips. "ICN Framework of Disaster Nursing Competencies" was used for designing the program. A pre-post survey was done to measure the change in the competencies of students and assess their satisfaction after finishing the program. Focus group interviews were also performed to further understand the attitudes of participants toward the disaster issues. Results : The overall pre-program test score for disaster competency was $2.18{\pm}0.68$ and the post-program test score was $6.30{\pm}0.84$, which showed statistically significant gains in all competency items (p <.001). The general satisfaction of participants with the program was quite high, demonstrated by a mean score of $4.5{\pm}0.51$. The benefits for students from program participation included increased knowledge and better understanding of the important roles of international organizations and NGOs. Conclusion : The international disaster education programs are necessary to provide an opportunity for students to increase their disaster competency. In addition, future development of a unified educational competency framework is also necessary.

Development of Geometrical Quality Control Real-time Analysis Program using an Electronic Portal Imaging (전자포탈영상을 이용한 기하학적 정도관리 실시간 분석 프로그램의 개발)

  • Lee, Sang-Rok;Jung, Kyung-Yong;Jang, Min-Sun;Lee, Byung-Gu;Kwon, Young-Ho
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.2
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    • pp.77-84
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    • 2012
  • Purpose: To develop a geometrical quality control real-time analysis program using an electronic portal imaging to replace film evaluation method. Materials and Methods: A geometrical quality control item was established with the Eclipse treatment planning system (Version 8.1, Varian, USA) after the Electronic Portal Imaging Device (EPID) took care of the problems occurring from the fixed substructure of the linear accelerator (CL-iX, Varian, USA). Electronic portal image (single exposure before plan) was created at the treatment room's 4DTC (Version 10.2, Varian, USA) and a beam was irradiated in accordance with each item. The gaining the entire electronic portal imaging at the Off-line review and was evaluated by a self-developed geometrical quality control real-time analysis program. As for evaluation methods, the intra-fraction error was analyzed by executing 5 times in a row under identical conditions and procedures on the same day, and in order to confirm the infer-fraction error, it was executed for 10 days under identical conditions of all procedures and was compared with the film evaluation method using an Iso-align$^{TM}$ quality control device. Measurement and analysis time was measured by sorting the time into from the device setup to data achievement and the time amount after the time until the completion of analysis and the convenience of the users and execution processes were compared. Results: The intra-fraction error values for each average 0.1, 0.2, 0.3, 0.2 mm at light-radiation field coincidence, collimator rotation axis, couch rotation axis and gantry rotation axis. By checking the infer-fraction error through 10 days of continuous quality control, the error values obtained were average 1.7, 1.4, 0.7, 1.1 mm for each item. Also, the measurement times were average 36 minutes, 15 minutes for the film evaluation method and electronic portal imaging system, and the analysis times were average 30 minutes, 22 minutes. Conclusion: When conducting a geometrical quality control using an electronic portal imaging, it was found that it is efficient as a quality control tool. It not only reduces costs through not using films, but also reduces the measurement and analysis time which enhances user convenience and can improve the execution process by leaving out film developing procedures etc. Also, images done with evaluation from the self-developed geometrical quality control real-time analysis program, data processing is capable which supports the storage of information.

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Implementation of Man-made Tongue Immobilization Devices in Treating Head and Neck Cancer Patients (두 경부 암 환자의 방사선치료 시 자체 제작한 고정 기구 유용성의 고찰)

  • Baek, Jong-Geal;Kim, Joo-Ho;Lee, Sang-Kyu;Lee, Won-Joo;Yoon, Jong-Won;Cho, Jeong-Hee
    • The Journal of Korean Society for Radiation Therapy
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    • v.20 no.1
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    • pp.1-9
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    • 2008
  • Purpose: For head and neck cancer patients treated with radiation therapy, proper immobilization of intra-oral structures is crucial in reproducing treatment positions and optimizing dose distribution. We produced a man-made tongue immobilization device for each patient subjected to this study. Reproducibility of treatment positions and dose distributions at air-and-tissue interface were compared using man-made tongue immobilization devices and conventional tongue-bites. Materials and Methods: Dental alginate and putty were used in producing man-made tongue immobilization devices. In order to evaluate reproducibility of treatment positions, all patients were CT-simulated, and linac-gram was repeated 5 times with each patient in the treatment position. An acrylic phantom was devised in order to evaluate safety of man-made tongue immobilization devices. Air, water, alginate and putty were placed in the phantom and dose distributions at air-and-tissue interface were calculated using Pinnacle (version 7.6c, Phillips, USA) and measured with EBT film. Two different field sizes (3$\times$3 cm and 5$\times$5 cm) were used for comparison. Results: Evaluation of linac grams showed reproducibility of a treatment position was 4 times more accurate with man-made tongue immobilization devices compared with conventional tongue bites. Patients felt more comfortable using customized tongue immobilization devices during radiation treatment. Air-and-tissue interface dose distributions calculated using Pinnacle were 7.78% and 0.56% for 3$\times$3 cm field and 5$\times$5 cm field respectively. Dose distributions measured with EBT (international specialty products, USA) film were 36.5% and 11.8% for 3$\times$3 cm field and 5$\times$5 cm field respectively. Values from EBT film were higher. Conclusion: Using man-made tongue immobilization devices made of dental alginate and putty in treatment of head and neck cancer patients showed higher reproducibility of treatment position compared with using conventional mouth pieces. Man-made immobilization devices can help optimizing air-and-tissue interface dose distributions and compensating limited accuracy of radiotherapy planning systems in calculating air-tissue interface dose distributions.

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A Study on the Neutron in Radiation Treatment System and Related Facility (방사선치료 장치 및 관련시설에서의 산란 중성자에 관한 연구)

  • Kim Dae-Sup;Kim Jeong-Man;Lee Hee-Seok;Lim Ra-Seung;Kim You-Hyun
    • The Journal of Korean Society for Radiation Therapy
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    • v.17 no.2
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    • pp.141-145
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    • 2005
  • Purpose : It is known that the neutron is generally generated from the photon, its energy is larger than 10 MV. The neutron is leaked in the container inspection system installed at the customs though its energy is below 9 MV. It is needed that the spacial effect of the neutrons released from radiation treatment machine, linac, installed in the medical canter. Materials and Methods : The medical linear accelerator(Clinac 1800, varian, USA) was used in the experiment. Measuring neutron was used bubble detector(Bubble detector, BDPND type, BTI, Canada) which was created bubble by neutron. The bubble detector is located on the medical linear accelerator outskirt in three different distance, 30, 50, 120 cm and upper, lower four point from the iso-center. In addition, for effect on protect material we have measured eight points which are 50 cm distance from iso-center. The SAD(source-axis-distance), distance from photon source to iso-center, is adjusted to 100 cm and the field size is adjusted to $15{\times}15cm^2$. Irradiate 20 MU and calculate the dose rate in mrem/MU by measuring the number of bubble. Results : The neutron is more detected at 5 position in 30, 50 cm, 7 position in 120 cm and with wedge, and 2 position without mount. Conclusion : Though detection position is laid in the same distance in neutron measurement, the different value is shown in measuring results. Also, neutron dose is affected by the additional structure, the different value is obtained in each measurement positions. So, it is needed to measure and evaluate the neutron dose in the whole space considering the effect of the distance, angular distribution and additional structure.

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Surgical Clues of Distal Anterior Cerebral Artery(DACA) Aneurysms (원위부 전대뇌 동맥류 수술의 실마리)

  • Kim, Sung Bum;Yi, Hyeong Joong;Kim, Jae Min;Bak, Koang Hum;Kim, Choong Hyun;Oh, Suck Jun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.12
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    • pp.1555-1562
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    • 2000
  • Objects : Surgical management of the distal anterior cerebral artery(DACA) aneurysms presents several unique problems to surgeons, such as difficulty in early identification of parent arteries, high incidence of rebleeding and premature rupture, and requirement of unfamiliar approach other than conventional frontotemporal craniotomy. Therefore, preoperative anatomical knowledge of anterior interhemispheric fissure and entry point of dissection is prerequisite. Authors utilized a frontobasal approach for DACA aneurysms by using consistent external landmark for guidance to the deep structure. Materials and Methods : From Nov. 1995 to Jun. 1999, a surgical clipping of DACA aneurysms was carried out in 9 patients among a total 131 patients with intracranial aneurysms. In each case, the clinical and aneurysmal features were carefully reviewed through the angiograms, medical records, and intraoperative findings. Results : The incidence of DACA aneurysms was 6.9% from our series. All cases were arisen from juxtacallosal por-tion ; 6 cases from pericallosal-callosomarginal(PC-CM) junction and 3 from pericallosal-frontopolar(PC-FP) junction. Associated vascular anomalies were noted in 3 cases and multiple aneurysms in 3 cases, respectively. The preoperative clinical grades were generally poor. An early surgery was performed in 7 cases and frontobasal interhemispheric approaches in 7 cases. Postoperatively, two patients died of complications ; one delayed ischemic vasospasm and one aspiration pneumonia but remaining patients recovered well. Conclusion : The frontobasal interhemispheric approach was useful for DACA aneurysms in early surgery. Division of superior sagittal sinus(SSS) enabled a minimal retraction of brain on both sides, and prevention of intraoperative rupture was possible. Authors suggest the frontopolar(first frontal bridging) vein as a constant external landmark for approaching the genu of the corpus callosum and juxtacallosal DACA aneurysms.

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A Study on the Field Data Applicability of Seismic Data Processing using Open-source Software (Madagascar) (오픈-소스 자료처리 기술개발 소프트웨어(Madagascar)를 이용한 탄성파 현장자료 전산처리 적용성 연구)

  • Son, Woohyun;Kim, Byoung-yeop
    • Geophysics and Geophysical Exploration
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    • v.21 no.3
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    • pp.171-182
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    • 2018
  • We performed the seismic field data processing using an open-source software (Madagascar) to verify if it is applicable to processing of field data, which has low signal-to-noise ratio and high uncertainties in velocities. The Madagascar, based on Python, is usually supposed to be better in the development of processing technologies due to its capabilities of multidimensional data analysis and reproducibility. However, this open-source software has not been widely used so far for field data processing because of complicated interfaces and data structure system. To verify the effectiveness of the Madagascar software on field data, we applied it to a typical seismic data processing flow including data loading, geometry build-up, F-K filter, predictive deconvolution, velocity analysis, normal moveout correction, stack, and migration. The field data for the test were acquired in Gunsan Basin, Yellow Sea using a streamer consisting of 480 channels and 4 arrays of air-guns. The results at all processing step are compared with those processed with Landmark's ProMAX (SeisSpace R5000) which is a commercial processing software. Madagascar shows relatively high efficiencies in data IO and management as well as reproducibility. Additionally, it shows quick and exact calculations in some automated procedures such as stacking velocity analysis. There were no remarkable differences in the results after applying the signal enhancement flows of both software. For the deeper part of the substructure image, however, the commercial software shows better results than the open-source software. This is simply because the commercial software has various flows for de-multiple and provides interactive processing environments for delicate processing works compared to Madagascar. Considering that many researchers around the world are developing various data processing algorithms for Madagascar, we can expect that the open-source software such as Madagascar can be widely used for commercial-level processing with the strength of expandability, cost effectiveness and reproducibility.

4-Dimensional dose evaluation using deformable image registration in respiratory gated radiotherapy for lung cancer (폐암의 호흡동조방사선치료 시 변형영상정합을 이용한 4차원 선량평가)

  • Um, Ki Cheon;Yoo, Soon Mi;Yoon, In Ha;Back, Geum Mun
    • The Journal of Korean Society for Radiation Therapy
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    • v.30 no.1_2
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    • pp.83-95
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    • 2018
  • Purpose : After planning the Respiratory Gated Radiotherapy for Lung cancer, the movement and volume change of sparing normal structures nearby target are not often considered during dose evaluation. This study carried out 4-D dose evaluation which reflects the movement of normal structures at certain phase of Respiratory Gated Radiotherapy, by using Deformable Image Registration that is well used for Adaptive Radiotherapy. Moreover, the study discussed the need of analysis and established some recommendations, regarding the normal structures's movement and volume change due to Patient's breathing pattern during evaluation of treatment plans. Materials and methods : The subjects were taken from 10 lung cancer patients who received Respiratory Gated Radiotherapy. Using Eclipse(Ver 13.6 Varian, USA), the structures seen in the top phase of CT image was equally set via Propagation or Segmentation Wizard menu, and the structure's movement and volume were analyzed by Center-to Center method. Also, image from each phase and the dose distribution were deformed into top phase CT image, for 4-dimensional dose evaluation, via VELOCITY Program. Also, Using $QUASAR^{TM}$ Phantom(Modus Medical Devices) and $GAFCHROMIC^{TM}$ EBT3 Film(Ashland, USA), verification carried out 4-D dose distribution for 4-D gamma pass rate. Result : The movement of the Inspiration and expiration phase was the most significant in axial direction of right lung, as $0.989{\pm}0.34cm$, and was the least significant in lateral direction of spinal cord, as -0.001 cm. The volume of right lung showed the greatest rate of change as 33.5 %. The maximal and minimal difference in PTV Conformity Index and Homogeneity Index between 3-dimensional dose evaluation and 4-dimensional dose evaluation, was 0.076, 0.021 and 0.011, 0.0 respectfully. The difference of 0.0045~2.76 % was determined in normal structures, using 4-D dose evaluation. 4-D gamma pass rate of every patients passed reference of 95 % gamma pass rate. Conclusion : PTV Conformity Index was more significant in all patients using 4-D dose evaluation, but no significant difference was observed between two dose evaluations for Homogeneity Index. 4-D dose distribution was shown more homogeneous dose compared to 3D dose distribution, by considering the movement from breathing which helps to fill out the PTV margin area. There was difference of 0.004~2.76 % in 4D evaluation of normal structure, and there was significant difference between two evaluation methods in all normal structures, except spinal cord. This study shows that normal structures could be underestimated by 3-D dose evaluation. Therefore, 4-D dose evaluation with Deformable Image Registration will be considered when the dose change is expected in normal structures due to patient's breathing pattern. 4-D dose evaluation with Deformable Image Registration is considered to be a more realistic dose evaluation method by reflecting the movement of normal structures from patient's breathing pattern.

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Evaluation on the Accuracy of the PPS in the Proton Therapy System, Which Uses the Self Made QA Phantom (자체 제작한 QA Phantom을 이용한 양성자 PPS (Patient Positioning System)의 정확성 평가)

  • Lee, Ji-Eun;Kim, Jae-Won;Kang, Dong-Yoon;Choi, Jae-Hyeok;Yeom, Du-Seok
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.2
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    • pp.115-121
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    • 2012
  • Purpose: The process of the proton treatment is done by comparing the DRR and DIPS anatomic structure to find the correction factor and use the PPS to use this factor in the treatment. For the accuracy of the patient set up, the PPS uses a 6 axis system to move. Therefore, there needs to be an evaluation for the accuracy between the PPS moving materialization and DIPS correction factor. In order to do this, we will use a self made PPS QA Phantom to measure the accuracy of the PPS. Materials and Methods: We set up a PPS QA Phantom at the center to which a lead marker is attached, which will act instead of the patient anatomic structure. We will use random values to create the 6 axis motions and move the PPS QA Phantom. Then we attain a DIPS image and compare with the DRR image in order to evaluate the accuracy of the correction factor. Results: The average correction factor, after moving the PPS QA Phantom's X, Y, Z axis coordinates together from 1~5 cm, 1 cm at a time, and coming back to the center, are 0.04 cm, 0.026 cm, 0.022 cm, $0.22^{\circ}$, $0.24^{\circ}$, $0^{\circ}$ on the PPS 6 axis. The average correction rate when moving the 6way movement coordinates all from 1 to 2 were 0.06 cm, 0.01 cm, 0.02 cm, $0.1^{\circ}$, $0.3^{\circ}$, $0^{\circ}$ when moved 1 and 0.02 cm, 0.04 cm, 0.01 cm, $0.3^{\circ}$, $0.5^{\circ}$, $0^{\circ}$ when moved 2. Conclusion: After evaluating the correction rates when they come back to the center, we could tell that the Lateral, Longitudinal, Vertical were all in the acceptable scope of 0.5 cm and Rotation, Pitch, Roll were all in the acceptable scope of $1^{\circ}$. Still, for a more accurate proton therapy treatment, we must try to further enhance the image of the DIPS matching system, and exercise regular QA on the equipment to reduce the current rate of mechanical errors.

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Evaluation of Target Position's Accuracy in 2D-3D Matching using Rando Phantom (인체팬톰을 이용한 2D-3D 정합시 타켓위치의 정확성 평가)

  • Jang, Eun-Sung;Kang, Soo-Man;Lee, Chul-Soo
    • The Journal of Korean Society for Radiation Therapy
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    • v.21 no.1
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    • pp.33-39
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    • 2009
  • Purpose: The aim of this study is to compare patient's body posture and its position at the time of simulation with one at the treatment room using On-board Imaging (OBI) and CT (CBCT). The detected offsets are compared with position errors of Rando Phantom that are practically applied. After that, Rando Phantom's position is selected by moving couch based on detected deviations. In addition, the errors between real measured values of Rando Phantom position and theoretical ones is compared. And we will evaluate target position's accuracy of KV X-ray imaging's 2D and CBCT's 3D one. Materials and Methods: Using the Rando Phantom (Alderson Research Laboratories Inc. Stanford. CT, USA) which simulated human body's internal structure, we will set up Rando Phantom on the treatment couch after implementing simulation and RTP according to the same ways as the real radioactive treatment. We tested Rando Phantom that are assumed to have accurate position with different 3 methods. We measured setup errors on the axis of X, Y and Z, and got mean standard deviation errors by repeating tests 10 times on each tests. Results: The difference between mean detection error and standard deviation are as follows; lateral 0.4+/-0.3 mm, longitudinal 0.6+/-0.5 mm, vertical 0.4+/-0.2 mm which all within 0~10 mm. The couch shift variable after positioning that are comparable to residual errors are 0.3+/-0.1, 0.5+/-0.1, and 0.3+/-0.1 mm. The mean detection errors by longitudinal shift between 20~40 mm are 0.4+/-0.3 in lateral, 0.6+/-0.5 in longitudinal, 0.5+/-0.3 in vertical direction. The detection errors are all within range of 0.3~0.5 mm. Residual errors are within 0.2~0.5 mm. Each values are mean values based on 3 tests. Conclusion: Phantom is based on treatment couch shift and error within the average 5mm can be gained by the diminution detected by image registration based on OBI and CBCT. Therefore, the selection of target position which depends on OBI and CBCT could be considered as useful.

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A Study on Recent Research Trend in Management of Technology Using Keywords Network Analysis (키워드 네트워크 분석을 통해 살펴본 기술경영의 최근 연구동향)

  • Kho, Jaechang;Cho, Kuentae;Cho, Yoonho
    • Journal of Intelligence and Information Systems
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    • v.19 no.2
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    • pp.101-123
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    • 2013
  • Recently due to the advancements of science and information technology, the socio-economic business areas are changing from the industrial economy to a knowledge economy. Furthermore, companies need to do creation of new value through continuous innovation, development of core competencies and technologies, and technological convergence. Therefore, the identification of major trends in technology research and the interdisciplinary knowledge-based prediction of integrated technologies and promising techniques are required for firms to gain and sustain competitive advantage and future growth engines. The aim of this paper is to understand the recent research trend in management of technology (MOT) and to foresee promising technologies with deep knowledge for both technology and business. Furthermore, this study intends to give a clear way to find new technical value for constant innovation and to capture core technology and technology convergence. Bibliometrics is a metrical analysis to understand literature's characteristics. Traditional bibliometrics has its limitation not to understand relationship between trend in technology management and technology itself, since it focuses on quantitative indices such as quotation frequency. To overcome this issue, the network focused bibliometrics has been used instead of traditional one. The network focused bibliometrics mainly uses "Co-citation" and "Co-word" analysis. In this study, a keywords network analysis, one of social network analysis, is performed to analyze recent research trend in MOT. For the analysis, we collected keywords from research papers published in international journals related MOT between 2002 and 2011, constructed a keyword network, and then conducted the keywords network analysis. Over the past 40 years, the studies in social network have attempted to understand the social interactions through the network structure represented by connection patterns. In other words, social network analysis has been used to explain the structures and behaviors of various social formations such as teams, organizations, and industries. In general, the social network analysis uses data as a form of matrix. In our context, the matrix depicts the relations between rows as papers and columns as keywords, where the relations are represented as binary. Even though there are no direct relations between papers who have been published, the relations between papers can be derived artificially as in the paper-keyword matrix, in which each cell has 1 for including or 0 for not including. For example, a keywords network can be configured in a way to connect the papers which have included one or more same keywords. After constructing a keywords network, we analyzed frequency of keywords, structural characteristics of keywords network, preferential attachment and growth of new keywords, component, and centrality. The results of this study are as follows. First, a paper has 4.574 keywords on the average. 90% of keywords were used three or less times for past 10 years and about 75% of keywords appeared only one time. Second, the keyword network in MOT is a small world network and a scale free network in which a small number of keywords have a tendency to become a monopoly. Third, the gap between the rich (with more edges) and the poor (with fewer edges) in the network is getting bigger as time goes on. Fourth, most of newly entering keywords become poor nodes within about 2~3 years. Finally, keywords with high degree centrality, betweenness centrality, and closeness centrality are "Innovation," "R&D," "Patent," "Forecast," "Technology transfer," "Technology," and "SME". The results of analysis will help researchers identify major trends in MOT research and then seek a new research topic. We hope that the result of the analysis will help researchers of MOT identify major trends in technology research, and utilize as useful reference information when they seek consilience with other fields of study and select a new research topic.