• Journal of agricultural medicine and community health
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• v.26 no.2
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• pp.15-41
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• 2001

Since medical clients and the community they live in are expected to be center of future public health and medical care system, new service programs must be developed with patients focused on in line with widening public access of information and social participation. Patients- focused service shall mean the area- oriented provision of public health service. In this study, health officers working at public health centers, public health sub- centers and medical offices in Jeonbuk- do area were taken for population in order to investigate their attitudes toward and knowledge about the service area assigning system under the public health programs. Findings from the survey to 260 health officers, divided by general category, are as follows : Government officers at public health organizations appeared to have high grade of understanding to the service area assigning system and also great appreciation for the necessity of it. Regarding the timing for the system to be introduced, they support the gradual implementation and, as for the type of service to be provided, they preferred home nursing and treatment of chronic diseases. Highly positive responses were centered on the health classes under the health promotion projects, and as far as health projects for the old are concerned, services for home nursing, for the disabled and for home- alone people are favored most. On the other hand, budgeting, manpower and reorganization are rated as prerequisite to establishment of the service area assigning system. From the viewpoint of system side, the improvement of working conditions is rendered as most urgent, while the information system for establishing the service area assigning system is conceived far from satisfactory. Proper assignment of specialists was noted as mostly important to establish the delivery system for medical service through the service area assigning system by team. As merits of the service area assigning system, it is pointed out that, through the system, health clients can better be managed and the nursing quality will be improved thank to the enhanced specialization. It is also perceived that the district health service is not well prepared to respond to the increased and diversified needs of community people and, furthermore, service programs of health centers have not been fully developed. The most serious problem standing in the way to expansion of health projects is, it is noted, uniformity (formality) of the project. Based on the results of the survey which suggest time has ripen to introduce the service area assigning system, following strategies are proposed to anchor down the system as soon as possible: First, we should introduce the system gradually, starting from the area selected, and in consideration of area specialities, refraining from the hitherto stereotyped way of providing health service. Second, we should seek to properly assign the specialists and improve the working conditions of the assigned officers by securing sufficient budget, since it is a most urgent step to lay foundation for the service area assigning system. Third, best service program should be developed to meet the satisfaction of community people by responding to their needs and solidifying the management of medical clients. Fourth, wide scope of study should further be conducted in order to help this system take roots in the central living of community residents since pilot project on the experimental base attended by specialists only can not win popularity among the masses.

• Progress in Medical Physics
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• v.26 no.3
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• pp.168-177
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• 2015

For evaluating the treatment planning accurately, the quality assurance for treatment planning is recommended when patients were treated with IMRT which is complex and delicate. To realize this purpose, treatment plan quality assurance software can be used to verify the delivered dose accurately before and after of treatment. The purpose of this study is to evaluate the accuracy of treatment plan quality assurance software for each IMRT plan according to MLC DLG (dosimetric leaf gap). Novalis Tx with a built-in HD120 MLC was used in this study to acquire the MLC dynalog file be imported in MobiusFx. To establish IMRT plan, Eclipse RTP system was used and target and organ structures (multi-target, mock prostate, mock head/neck, C-shape case) were contoured in I'mRT phantom. To verify the difference of dose distribution according to DLG, MLC dynalog files were imported to MobiusFx software and changed the DLG (0.5, 0.7, 1.0, 1.3, 1.6 mm) values in MobiusFx. For evaluation dose, dose distribution was evaluated by using 3D gamma index for the gamma criteria 3% and distance to agreement 3 mm, and the point dose was acquired by using the CC13 ionization chamber in isocenter of I'mRT phantom. In the result for point dose, the mock head/neck and multi-target had difference about 4% and 3% in DLG 0.5 and 0.7 mm respectively, and the other DLGs had difference less than 3%. The gamma index passing-rate of mock head/neck were below 81% for PTV and cord, and multi-target were below 30% for center and superior target in DLGs 0.5, 0.7 mm, however, inferior target of multi-target case and parotid of mock head/neck case had 100.0% passing rate in all DLGs. The point dose of mock prostate showed difference below 3.0% in all DLGs, however, the passing rate of PTV were below 95% in 0.5, 0.7 mm DLGs, and the other DLGs were above 98%. The rectum and bladder had 100.0% passing rate in all DLGs. As the difference of point dose in C-shape were 3~9% except for 1.3 mm DLG, the passing rate of PTV in 1.0 1.3 mm were 96.7, 93.0% respectively. However, passing rate of the other DLGs were below 86% and core was 100.0% passing rate in all DLGs. In this study, we verified that the accuracy of treatment planning QA system can be affected by DLG values. For precise quality assurance for treatment technique using the MLC motion like IMRT and VMAT, we should use appropriate DLG value in linear accelerator and RTP system.

• Journal of Radiation Protection and Research
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• v.31 no.4
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• pp.203-210
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• 2006

Purpose : To estimate the dose to the embryo/fetus of a pregnant patient with brain tumors, and to design an shielding device to keep the embryo/fetus dose under acceptable levels Materials and Methods : A shielding wall with the dimension of 1.55 m height, 0.9 m width, and 30 m thickness is fabricated with 4 trolleys under the wall. It is placed between a Patient and the treatment head of a linear accelerator to attenuate the leakage radiation effectively from the treatment head, and is placed 1 cm below the lower margin of the treatment field in order to minimize the dose to a patient from the treatment head. An anti-patient scattering neck supporters with 2 cm thick Cerrobend metal is designed to minimize the scattered radiation from the treatment fields, and it is divided into 2 section. They are installed around the patient neck by attach from right and left sides. A shielding bridge for anti-room scattered radiation is utilized to place 2 sheets of 3 mm lead plates above the abdomen to setup three detectors under the lead sheets. Humanoid phantom is irradiated with the same treatment parameters, and with and without shielding devices using TLD, and ionization chambers with and without a build-up cap. Results : The dose to the embryo/fetus without shielding was 3.20, 3.21, 1.44, 0.90 cGy at off-field distances of 30, 40, 50, and 60 cm. With shielding, the dose to embryo/fetus was reduced to 0.88, 0.60, 0.35, 0.25 cGy, and the ratio of the shielding effect varied from 70% to 80%. TLD results were 1.8, 1.2, 0.8, 1.2, and 0.8 cGy. The dose measured by the survey meter was 10.9 mR/h at the patient's surface of abdomen. The dose to the embryo/fetus was estimated to be about 1 cGy during the entire treatment. Conclusion : According to the AAPM Report No 50 regarding the dose limit of the embryo/fetus during the pregnancy, the dose to the embryo/fetus with little risk is less than 5 cGy. Our measurements satisfy the recommended values. Our shielding technique was proven to be acceptable.

• Journal of the Korean Society of Food Science and Nutrition
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• v.41 no.9
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• pp.1265-1273
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• 2012

The purpose of this study was to investigate the BMI, intake of snacks, and perceptions and use of food and nutrition labels by middle school students (144 boys and 189 girls) in Chuncheon area. The average height and weight of boys were $171.0{\pm}6.4$ cm and $61.0{\pm}11.4$ kg, respectively, whereas those of girls were $160.0{\pm}4.8$ cm and $50.8{\pm}6.6$ kg, respectively. Average body mass index (BMI) of boys and girls were $20.8{\pm}3.3$ and $19.8{\pm}2.4$, respectively (p<0.01). Dietary intake attitude score of girls ($34.39{\pm}5.66$) was higher than that of boys ($33.92{\pm}5.40$) (p<0.05). Subjects bought and ate snacks 1 to 3 times per week (40.2%) by themselves, and most consumed snacks were cookies (23.1%), instant noodles (16.2%), ice cream (13.2%), and candy and chocolates (13.2%). The most important factor in purchasing of snacks was 'taste' ($4.49{\pm}0.67$). When subjects bought processed foods, the rates of reading food labels was 86.6%. The most important factor of the food labels was 'expiration date' (42.9%). The degree of reading food labels on processed foods by girls ($22.70{\pm}5.72$) was higher than that of boys ($20.96{\pm}5.35$) (p<0.01). Of the 13.2% of subjects that did not read food labels, the reason why was that they were not interested (50.0%). Of the 78.4% of subjects that read nutrition labels, the most important component of the nutrition labels was 'calories' (75.9%). The main reason for reading nutrition labels was 'to control weight' (45.6%). In general, use of food labels correlated positively with dietary intake attitude score (p<0.05) and use of nutrition labels (p<0.01). Using multiple regression analysis, we found that 'usefulness of dietary life' was the most significant variable that affects the importance of food and nutrition labels. Therefore, development of an educational program on food and nutrition labels for adolescents will be effective in improving dietary life.

• Journal of the Korean Institute of Landscape Architecture
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• v.45 no.3
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• pp.41-53
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• 2017

This study was performed to determine what the plant material were selected to reflect in the 2016 Korea Garden Show designer's garden. It was analyzed that plant material was used to display the theme of the garden and to create a specific space. Under the given theme of 'K-Garden, Shinhallyu Garden(new style garden culture) with the most Korean taste', the plants were used to highlight the theme in two types: 'representation' and 'expression'. There were two 'representation' gardens that imitate a particular space of Korean taste and four 'expression' gardens that showcase the designer's thoughts with abstract concepts and concrete objects. Three gardens included both types of garden. The way of revealing the subject with plants was used more for 'expression' than for 'representation'. There were eleven spaces for 'representation' of the Korean taste, a vegetable garden, faucet, pond, field, nature, a Hanok court garden, groves of bamboo, tile roof, stone wall, rock and backyard of a Hanok connected to the mountain. The planting material was used in two ways: reflecting only the ecological characteristics of the plant, and considering the ecological and visual characteristics together. Vegetation plantings reflecting the ecological characteristics were observed in all eleven spaces. Nine of the spaces reflected the growth environment of the plants, but the other two did not reflect the ecological characteristics of the plants, unlike the designer's intention. In the case of the four spaces that considered the ecological and visual characteristics together, color and size were considered visual characteristics. The plants in the seven spaces that included 'expression' as the theme were selected to reflect the visual characteristics in the order of color, shape, texture, and size, rather than reflecting ecological characteristics. A group planting method was applied. When the plants were used as materials for creating space, Norman(1989) analyzed three enclosure factors(overhead, vertical, ground plane). Only two deciduous trees were used in the overhead plane while five species of evergreen shrubs and thirty species of various deciduous plants were used in the vertical plane. There were forty-five species (nine trees and thirty-six herbaceous plants) forming the ground plane, and various herbaceous plants were utilized without duplication in each garden. The designer's garden of the Garden Show played a role in introducing new groundcover plants to the public. Three of the nine gardens did not include ornamental plants, and the use of decorative plants in other gardens was few compared to the number of plantings. In the Korea Garden Show designer's garden, most of the plants were being used with the intention of exposing the theme or architectural uses. In the 2016 Korea Garden Show designer's garden, many species of plants were used as materials for showcasing themes rather than for creating spaces. Also, the method of 'expression' was used more than the method of 'representation' in order to highlight the theme. This indicates that the planting materials reflect visual characteristics such as color, shape, texture, size rather than ecological characteristics.

• Journal of Chest Surgery
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• v.33 no.7
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• pp.531-540
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• 2000

Baclgrpimd; Recent studies have suggested that the cardioprotective effect of ischemic preconditioning(IP) is closely related to glycogen depletion and attenuation of intracellular acidosis. In the present study, the authors tested this hypothesis by perfusion isolated rabbit hearts with glucose(G) is closely related to glycogen depletion and attenuation of intracellular acidosis. In the present study, the authors tested this hypothesis by perfusion isolated rabbit hearts with glucose(G)-free perfusate. Material and Method; Hearts isolated from New Zealand white rabbits(1.5~2.0 kg body weight) were perfused with Tyrode solution by Langendorff technique. After stabilization of baseline hemodynamics, the hearts were subjected to 45 min global ischemia followed by 120 min reperfusion with IP(IP group, n=13) or without IP(ischemic control group, n=10). IP was induced by single episode of 5 min global ischemia and 10 min reperfusion. In the G-free preconditioned group(n=12), G depletion was induced by perfusionwith G-free Tyrode solution for 5 min and then perfused with G-containing Tyrode solution for 10 min; and 45 min ischemia and 120 min reperfusion. Left ventricular functionincluding developed pressure(LVDP), dP/dt, heart rate, left ventricular end-distolic pressure(LVEDP) and coronary flow (CF) were measured. Myocardial cytosolic and membrane PKC activities were measured by 32P-${\gamma}$-ATP incorporation into PKC-specific peptide and PKC isozymes were analyzed by Western blot with monoclonal antibodies. Infarct size was determined by staining with TTC(tetrazolium salt) and planimetry. Data were analyzed by one-way analysis of variance (ANOVA) and Turkey's post-hoc test. Result ; In comparison with the ischemic control group, IP significantly enhanced functional recovery of the left ventricle; in contrast, functional significantly enhanced functional recovery of the left ventricle; in contrast, functional recovery were not significantly different between the G-free preconditioned and the ischemic control groups. However, the infarct size was significantly reduced by IP or G-free preconditioning(39$\pm$2.7% in the ischemic control, 19$\pm$1.2% in the IP, and 15$\pm$3.9% in the G-free preconditioned, p<0.05). Membrane PKC activities were increased significantly after IP (119%), IP and 45 min ischemia(145%), G-free [recpmdotopmomg (150%), and G-free preconditioning and 45 min ischemia(127%); expression of membrane PKC isozymes, $\alpha$ and $\varepsilon$, tended to be increased after IP or G-free preconditioning. Conclusion; These results suggest that in isolated Langendorff-perfused rabbit heart model, G-free preconditioning (induced by single episode of 5 min G depletion and 10 min repletion) colud not improve post-ischemic contractile dysfunction(after 45-minute global ischemia); however, it has an infarct size-limiting effect.

• Tuberculosis and Respiratory Diseases
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• v.49 no.3
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• pp.332-342
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• 2000

Background : The importance of pro-inflammatory cytokines, especially tumor necrosis factor $\alpha$ (INF-$\alpha$) and interleukin-1$\beta$ (IL-1$\beta$), have been extensively documented in the generation of inflammatory lung disease. Lung epithelial cells are also actively involved in initiating and maintaining inflammation by producing pro-inflammatory mediators. Understanding the mechanism of pro-inflammatory cytokine expression in lung epithelial cells is crucial to the development of new therapeutic modalities for inflammatory lung disease. Transcription of most pro-inflammatory cytokines is dependent on the activation of NF-${\kappa}B$. However, the relationship between pro-inflammatory cytokine expression and NF-${\kappa}B/I{\kappa}B$ pathway in lung epithelial cells is not clear. Methods : BEAS-2B, A549, Na-H157, NCI-H719 cells were stimulated with IL-$1{\beta}$ or TNF-$\alpha$ at various times, and then IL-8 and TNF-$\alpha$mRNA expressions were assayed by Northern blot analysis. IL-$1{\beta}$ or TNF-$\alpha$-induced NF-${\kappa}B$ activation was assessed by the nuclear translocation of p65 NF-${\kappa}B$ subunit. The degradation of $I{\kappa}B{\alpha}$ and $I{\kappa}B{\beta}$ by IL-$1{\beta}$ or TNF-$\alpha$stimulation was assayed by Western blot analysis. The phosphorylation of $I{\kappa}B{\alpha}$ was evaluated by Western blot analysis after pre-treating cells with proteasome inhibitor followed by IL-$1{\beta}$ or TNF-$\alpha$ stimulation. The basal level of IKK $\alpha$ expression was evaluated by Western blot analysis. Results: $I{\kappa}B{\alpha}$ and $I{\kappa}B{\alpha}$ was rapidly degraded after 5 minutes of incubation with IL-$1{\beta}$ or TNF-$\alpha$ in BEAS-2B, A549, and NCI-H157 cells. The activation of NF-${\kappa}B{\alpha}$ and the induction of IL-8 and TNF-$\alpha$ mRNA expression were observed by IL-$1{\beta}$ or TNF-$\alpha$ stimulation in these cells. In contrast, neither the changes in NF-${\kappa}B/I{\kappa}B$ pathway nor IL-8 and TNF-$\alpha$mRNA expression was induced by IL-$1{\beta}$ or TNF-$\alpha$ stimulation in NCI-H719 cells. IL-$1{\beta}$ and TNF-$\alpha$-induced $I{\kappa}B$ phosphorylation was observed in BEAS-2B, A549, and NCI-H157 cells, but not in NCI-H719 cells. The basal level of IKK$\alpha$ expression was not different between cell. Conclusion : NF-${\kappa}B/I{\kappa}B$ pathway plays an important role in the expression of pro-inflammatory cytokine in most lung epithelial cells. The absence of the effect on NF-${\kappa}B/I{\kappa}B$ pathway in NCI-H719 cells sæms to be due to the defect in the intracellular signal transduction pathway upstream to IKK.

• Journal of the Korean Society of Food Science and Nutrition
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• v.41 no.3
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• pp.408-417
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• 2012

This study examined the satisfaction of a school milk program as well as the preference of school milk and flavored milk. The subjects of this study were $4^{th}$ , $5^{th}$ and $6^{th}$ grade students in 4 different elementary schools, who were attending the school milk program in Ulsan. The survey was conducted from April 10, 2009 to April 30, 2009. Of the 403 questionnaires distributed, 347 responded and analyzed (usage rate: 86%). The results were as follows. Of the 347 respondents, 53.9% were boys and 46.1% were girls. 34%, 31.1% and 34.9% of the students were $4^{th}$, $5^{th}$ and $6^{th}$ graders, respectively. Second, 80.1% of the students reported 'have milk everyday', and 89.9% of the students reported 'have milk as it is'. Third, the overall satisfaction with the school milk program was 3.32 based on a 5-point likert scale, the 'guidance of nutrition teachers and class teacher' was 3.21 and 'taste of school milk' was 3.37. There were significant positive correlations between the school milk satisfaction variables and overall satisfaction (p<0.01). Fourth, the preference for school milk was 3.33. The preference for flavored-milk were 3.63 (coffee milk), 4.44 (chocolate milk), 4.16 (strawberry milk), 4.26 (banana milk) and 3.53 (black bean milk). Fifth, to improve the school milk program, 85.9% of students wanted a provision for flavored milk. In conclusion, schools need to find a way to increase the satisfaction of the school milk program and the preference of school milk to increase the milk intake of students. Nutrition education for students and parents should be conducted systematically and choices for various kinds of milk and milk products should be given to the students.

• Tuberculosis and Respiratory Diseases
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• v.50 no.4
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• pp.450-461
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• 2001

Background : The underlying pathogenesis of radiation-induced lung fibrosis (RTLF) has not been very well defined. However, the role of TGF-$\beta$ in the generation of RTLF has been a major focus because there is an increase in the expression of both the TGF-${\beta}m$-RNA and its protein preceding RTLF lesions. The down stream signal after a TGF-$\beta$ stimulated lung fibrosis includes the activation of many mediators such as Smad and c-Jun N-terminal kinase (JNK) through TAK1. It is we hypothesized that JNK activation may play a pivotal role in RTLF pathogenesis through increased transcription of the fibrogenic cytokines. The present study evaluates JNK activity in alveolar macrophages after irradiation and the relationship between JNK activity and the amount of collagen in the lung tissues. Methods : C57BL/6 mice(20-25 gr, males) received chlorotetracycline(2g/L) in their drinking water 1 week prior to irradiation and continuously there after. The mice were irradiated once with 1400 cGy of $60CO{\gamma}$-ray over the whole chest. The cellular composition of the whole lung bronchoalveoalr lavage fluids(BALF), elastin expression in the lung tissues, the level of hydroxyproline in lung tissues, and an in vitro JNK assay was measured before irradiation and one, four, and eight weeks after irradiation (RT). Results : The volumes of BALF retrieved from instilled 4 mL of saline with 2% heparin were 3.7-3.8 mL for each group. The cell numbers were similar before($4.1{\times}10^4{\pm}0.5{\times}10^4/mL$) and 1 week($3.1{\times}10^4{\pm}0.5{\times}10^4/mL$) after RT. At four and eight weeks after RT, the cell number reached to $14.0{\times}10^4{\pm}1.5{\times}10^4mL$ and $10.0{\times}10^4{\pm}1.3{\times}10^4/mL$, respectively. There we no changes in the lymphocytes and neutrophils population observed in the BALF after RT. The H-E stain of the lung tissues did not show any structural and fibrotic change in the lung tissues at 4 and 8 weeks after RT. In addition, the amount of elastin and collagen were not different on Verhoeff staining of the lung tissues before RT to eight weeks after RT. The hydroxyproine content was measured with the left lung dissected from the left main bronchus. The lung were homogenized and hydrolyzed with 6 N Hel for 12 hours at $110^{\circ}C$ then measured as previously described. The content of hydroxyproline, standardized with a lung protein concentration, reached a peak 4 weeks after RT, and thereafter showed a plateau. AnIn vitro JNK assay using c-$Jun_{1-79}$-GST sepharose beads were performed with the alveolar macrophages obtained from the BAL. JNK activity was not detected prior to RT, However, the JNK activity increased from one week after RT and reached a peak four weeks after RT. Conclusion : JNK may be involved in the pathogenesis because the JNK activity showed similar pattern observed with the hydroxyproine content. However, it is necessary to clarify that the JNK increases the transcription of fibrogenic cyiokines through the transcription factor.

• The Journal of Korean Society for Radiation Therapy
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• v.26 no.1
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• pp.127-135
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• 2014

Purpose : By taking advantage of each imaging modality, the use of fused CT/MRI image has increased in prostate cancer radiation therapy. However, fusion uncertainty may cause partial target miss or normal organ overdose. In order to complement such limitation, our hospital acquired MRI image (Planning MRI) by setting up patients with the same fixing tool and posture as CT simulation. This study aims to evaluate the usefulness of the Planning MRI through comparing and analyzing the diagnostic MRI image and Planning MRI image. Materials and Methods : This study targeted 10 patients who had been diagnosed with prostate cancer and prescribed nonhormone and definitive RT 70 Gy/28 fx from August 2011 to July 2013. Each patient had both CT and MRI simulations. The MRI images were acquired within one half hour after the CT simulation. The acquired CT/MRI images were fused primarily based on bony structure matching. This study measured the volume of prostate in the images of Planning MRI and diagnostic MRI. The diameters at the craniocaudal, anteroposterior and left-to-right directions from the center of prostate were measured in order to compare changes in the shape of prostate. Results : As a result of comparing the volume of prostate in the images of Planning MRI and diagnostic MRI, they were found to be $25.01cm^3$(range $15.84-34.75cm^3$) and $25.05cm^3$(range $15.28-35.88cm^3$) on average respectively. The diagnostic MRI had an increase of 0.12 % as compared with the Planning MRI. On the planning MRI, there was an increase in the volume by $7.46cm^3$(29 %) at the transition zone directions, and there was a decrease in the volume by $8.52cm^3$(34 %) in the peripheral zone direction. As a result of measuring the diameters at the craniocaudal, anteroposterior and left-to-right directions in the prostate, the Planning MRI was found to have on average 3.82cm, 2.38cm and 4.59cm respectively and the diagnostic MRI was found to have on average 3.37cm, 2.76cm and 4.51cm respectively. All three prostate diameters changed and the change was significant in the Planning MRI. On average, the anteroposterior prostate diameter decrease by 0.38cm(13 %). The mean right-to-left and craniocaudal diameter increased by 0.08cm(1.6 %) and 0.45cm(13 %), respectively. Conclusion : Based on the results of this study, it was found that the total volumes of prostate in the Planning MRI and the diagnostic MRI were not significantly different. However, there was a change in the shape and partial volume of prostate due to the insertion of prostate balloon tube to the rectum. Thus, if the Planning MRI images were used when conducting the fusion of CT/MRI images, it would be possible to include the target in the CTV without a loss as much as the increased volume in the transition zone. Also, it would be possible to reduce the radiation dose delivered to the rectum through separating more clearly the reduction of peripheral zone volume. Therefore, the author of this study believes that acquisition of Planning MRI image should be made to ensure target delineation and localization accuracy.