• The Journal of Korean Society for Radiation Therapy
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• v.24 no.2
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• pp.157-165
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• 2012

Purpose: We evaluated usefulness of abdominal compressor for stereotactic body radiotherapy (SBRT) with unresectable hepatocellular carcinoma (HCC) patients and hepato-biliary cancer and metastatic liver cancer patients. Materials and Methods: From November 2011 to March 2012, we selected HCC patients who gained reduction of diaphragm movement >1 cm through abdominal compressor (diaphragm control, elekta, sweden) for HT (Hi-Art Tomotherapy, USA). We got planning computed tomography (CT) images and 4 dimensional (4D) images through 4D CT (somatom sensation, siemens, germany). The gross tumor volume (GTV) included a gross tumor and margins considering tumor movement. The planning target volume (PTV) included a 5 to 7 mm safety margin around GTV. We classified patients into two groups according to distance between tumor and organs at risk (OAR, stomach, duodenum, bowel). Patients with the distance more than 1 cm are classified as the 1st group and they received SBRT of 4 or 5 fractions. Patients with the distance less than 1 cm are classified as the 2nd group and they received tomotherapy of 20 fractions. Megavoltage computed tomography (MVCT) were performed 4 or 10 fractions. When we verify a MVCT fusion considering priority to liver than bone-technique. We sent MVCT images to Mim_vista (Mimsoftware, ver .5.4. USA) and we re-delineated stomach, duodenum and bowel to bowel_organ and delineated liver. First, we analyzed MVCT images to check the setup variation. Second we compared dose difference between tumor and OAR based on adaptive dose through adaptive planning station and Mim_vista. Results: Average setup variation from MVCT was $-0.66{\pm}1.53$ mm (left-right) $0.39{\pm}4.17$ mm (superior-inferior), $0.71{\pm}1.74$ mm (anterior-posterior), $-0.18{\pm}0.30$ degrees (roll). 1st group ($d{\geq}1$) and 2nd group (d<1) were similar to setup variation. 1st group ($d{\geq}1$) of $V_{diff3%}$ (volume of 3% difference of dose) of GTV through adaptive planing station was $0.78{\pm}0.05%$, PTV was $9.97{\pm}3.62%$, $V_{diff5%}$ was GTV 0.0%, PTV was $2.9{\pm}0.95%$, maximum dose difference rate of bowel_organ was $-6.85{\pm}1.11%$. 2nd Group (d<1) GTV of $V_{diff3%}$ was $1.62{\pm}0.55%$, PTV was $8.61{\pm}2.01%$, $V_{diff5%}$ of GTV was 0.0%, PTV was $5.33{\pm}2.32%$, maximum dose difference rate of bowel_organ was $28.33{\pm}24.41%$. Conclusion: Despite we saw diaphragm movement more than 5 mm with flouroscopy after use an abdominal compressor, average setup_variation from MVCT was less than 5 mm. Therefore, we could estimate the range of setup_error within a 5 mm. Target's dose difference rate of 1st group ($d{\geq}1$) and 2nd group (d<1) were similar, while 1st group ($d{\geq}1$) and 2nd group (d<1)'s bowel_organ's maximum dose difference rate's maximum difference was more than 35%, 1st group ($d{\geq}1$)'s bowel_organ's maximum dose difference rate was smaller than 2nd group (d<1). When applicating SBRT to HCC, abdominal compressor is useful to control diaphragm movement in selected patients with more than 1 cm bowel_organ distance.

• Journal of Sasang Constitutional Medicine
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• v.8 no.1
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• pp.395-411
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• 1996

1. 연구배경 사상체질의학(四象體質醫學)을 창시하여 개인(個人)의 차별성(差別性)을 강조한 동무(東武) 이제마(李濟馬)는 양생(養生)의 방법(方法)에서도 체질별(體質別) 요법(療法)을 말하고 있는데 체질별(體質別)로 과소지장(過小之臟)의 기능(機能)이 정상적(正常的)으로 이루어지는 상황을 완실무병(完實無病)의 조건으로 제시(提示)하였고 이를 위한 수단(手段)으로 성정(性情)과 함께 약물(藥物), 식품(食品) 등을 이용하였다. 특히 식이요법(食餌療法)에 있어서도 체질(體質)에 따른 구별(區別)의 필요성(必要性)을 말하고 있는데 식품(食品)이라 하더라도 그 음식(飮食)을 섭취하여 과대(過大)한 장기(臟器)의 기능(機能)은 유제(柳制)하고 과소(過小)한 기능(機能)은 보완(補完)받음으로써 불균형(不均衡)을 조정(調整)한 것이다. 당뇨병의 식단 작성은 평생동안 열량(熱量)과 영양소(營養素) 필요치(必要置)을 맞출 것을 권장하고 당뇨병학회에서 편집한 식품교환표(食品交換表)를 사용(使用)하는 것이 일반적(一般的)인데 식품교환표(食品交換表)는 많은 식품(食品)들중에 같은 영양소를 가진 식품(食品)들을 한 그룹으로 묶어 환자(患者)의 기호(嗜好)에 따라 교환(交煥)해 가면서 먹을 수 있도록 고안(考案)한 것이니 이에 지시한 수량(數量)만 섭취해도 저(低)cal식(食)으로 관양(管養)의 균형(均衡)이 잘 이루어진다. 본 연구는 체질별로 이로운 식품표에 근거하여 식이요법(食餌療法)이 특히 강조되고 하루 섭취열량이 제한되는 성인병중의 하나인 당뇨병(糖尿病)의 식단(1800kcal)을 식단작성법에 따라 구성(構成)하여 몇가지 예를 제시해 보았다. 구체적으로 태음인(太陰人), 소음인(少陰人), 소양인(少陽人)의 당뇨 환자 1800kcal에 대한 식단을 구성하여 제시했는데 즉, 태음인(太陰人)의 식단은 태음인(太陰人)에 유리(有利)한 식품(食品)들로 구성하고 해(害)로운 식품(食品)들은 제외시키는 방법(方法)을 이용하였다. 이 식단은 다분히 이론적(理論的)인 식단으로 임상(臨床)에 이용(利用)하여 본 바는 없으나 동량(同量)의 열량(熱量)을 섭취(攝取)하더라도 체질(體質)에 적합(適合)한 식품(食品)으로 구성된 식사(食事)가 각 체질의 섭생(攝生)에 더 유리(有利)하지 않올까 하는 단순(單純)한 사고(思考)에 바탕을 둔 것이다. 2. 연구방법 1) 후세가(後世家)가 주장(主張)한 체질별(體質別) 식품(食品) 분류(分類)를 종합, 정리한 체질별(體質別) 식품표(食品表)를 제시한다. 박석언의 동의사상대전, 박인상의 동의사상요결, 송일병의 알기 쉬운 사상의학, 홍순용의 사상진료보원, 홍순용, 이을호의 사상의학원론에서 체질별로 유익한 식풍을 조사하여 곡류, 과일류, 채소류, 어패류, 육류로 분류하여 살펴본다. 2) 당뇨병(糖尿病) 식이요법의 식단 작성법의 개요(槪要)를 제시한다. 3) 1)의 체질별(體質別) 식품표(食品表)로 태음인(太陰人), 소음인(少陰人), 소양인(少陽人)의 당뇨 식단 1800kcal을 작성해 제시(提示)한다. 체질별(體質別)로 유익(有益)한 식품(食品)은 1)의 식품표에 근거(根據)하고 체질별(體質別)로 해(害)로운 식품(食品)은 노정우(盧正祐), 한동석(韓東錫)의 주장에 근거(根據)한다. 3. 결과 체질별(體質別) 식품표(食品表)는 후세가의 연구를 종합하여 제시(提示)하였고, 식품(食品)을 분류(分類)한 후(後) 약명(藥名)과 성미(性味), 귀경(歸經)을 찾아 도표화 하였다. 체질별 식품들은 대부분 소음인(少陰人)의 경우 신감(辛甘) 온열(溫熱)하며 비위(脾胃)로 귀경(歸經)하고 태음인(太陰人)의 경우 감신(甘辛) 온열(溫熱)하며 폐간(肺肝)으로 귀경(歸經)하고 소양인(少陽人)의 산고(酸苦) 양한(凉寒)하고 신(腎)으로 귀경(歸經)함이 우세(優勢)함을 알 수 있다. 즉, 체질적으로 양성(陽性)인 소양인(少陽人)은 식품의 성질이 음성(陰性)인 것이 유리(有利)하고 체질적으로 음성(陰性)인 태음인(太陰人), 소음인(少陰人)은 식품의 성질이 양성(陽性)인 것이 유리(有利)하다. 다양한 식품(食品)을 섭취하고자 하는 환자의 욕구(慾求)에 맞추면서도 식품교환의 범위를 체질별로 유익한 식품들로 제한하여 동일(同一)한 열량(熱量)의 식단이라도 체질에 맞는 식품으로 차별성(差別性)을 두었는데 식단의 작성은 전문 영양사의 의견을 거쳤다. 제시된 식단은 다소 이론적(理論的)으로 작성(作成)된 단계이고 임상적(臨床的) 검증을 거친 바 없으나 활용하기에 따라 실용성을 얻을 수 있으리라 본다. <식단예> 태음인의 식단: 곡류 : 콩, 율무, 밀가루, 밀, 수수, 들깨, 고구마, 땅콩, 기장, 옥수수, 두부, 설탕등 태음인에 유리한 식품으로 교환한다 어때류 : 우렁이, 대구, 조기, 민어, 청어, 오정어, 낙지, 미역, 김, 다시마등으로 교환한다 육류 : 소고기, 우유등으로 교환한다 과일류 : 밤, 배, 호도, 은행, 잣, 살구, 매실, 자두등으로 교환한다 채소류 : 무우, 도라지, 연근, 토란, 마, 고사리, 더덕, 목이버섯, 송이버섯, 석이버섯등으로 교환한다 해로운 음식 : 닭, 돼지, 모밀, 배추, 사과, 염소고기, 조개, 계란, 곳감, 커피등은 피한다 * 아침 ; 콩나물죽, 대구포묶음, 우령이무침, 갓김치, 우유, 자두 점심 ; 기장밥, 콩나물두부찌게, 장어양념구이, 도라지나물, 열무김치, 배 저녁 ; 수수밥, 두부명란, 더덕양념구이, 깍두기 * 아침 ; 비빔국수, 토란국, 알타리김치, 두유, 살구주스 점심 ; 율무밥, 낙지전골, 김무생채, 느타리나물무침, 동치미, 귤 저녁 ; 콩밥, 감자북어국, 두부묶음, 열무김치 소음인의 식단: 곡류 : 찹쌀, 좁쌀, 차조, 감자등 소음인에 유익한 식품으로 교환한다 어패류 : 명태, 미꾸라지, 뱀장어, 뱀, 메기등 육류 : 닭, 개, 꿩, 염소, 양, 참새고기등 과일류 : 사과, 귤, 복숭아, 대추등 채소류 : 미나리, 파, 마늘, 후추, 시금치, 양배추, 생강, 고추, 당근, 양파, 감자, 쑥갓등 해로운 음식 : 메밀, 호도, 계란, 고구마, 녹두, 돼지고기, 밤, 배, 배추, 보리, 쇠고기, 수박, 오이, 참외, 팥등은 피한다. * 아침 ; 찰밥, 닭찜, 감자전, 쑥갓나물, 부추김치, 사과 점심 ; 감자밥, 메기매운탕, 명태조림, 미나리, 고들빼기김치, 사과주스 저녁 ; 좁쌀밥, 양배추감자국, 병어양념구이, 연근양념조림, 귤, 인삼차.

• Radiation Oncology Journal
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• v.16 no.1
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• pp.17-25
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• 1998

Purpose : Although local recurrence rates of stomach cancer after radiocal surgery have been reported in the range of $30-70\%$, the role of postoperative adjuvant therapy has not been established. We report the result of radiotherapy in resected stomach cancer with positive surgical margin to elucidate the role of postoperative radiotherapy. Materials and Methods : From June 1991 to August 1996, twenty five patients with positive surgical margins after radical gastrectomy were treated with postoperative radiotherapy and chemotherapy. Median dose of radiation was 55.8Gy and the range was 44.6-59.4Gy. Second cycle of chemotherapy was delivered concurrently with radiation and total number of six cycles were delivered. Twenty three had adenocarcinoma and the other two had leiornyosarcoma. The numbers of patients with stage I B, II, III A, III B, and IV were 1, 2, 11, 10 and 1 respectively. Positive margins at distal end of the stomach were in 17 patients and proximal in 5. The other three patients had positive margin at the sites of adjacent organ invasion Minimum and median follow-up periods were 12 months and 18 months, respectively, Results : Twenty-four of 25 patients received prescribed radiation dose and RTOG grade 3 toxicity of UGI tract was observed in 3, all of which were weight loss more than $15\%$ of their pretreatment weight. But hematemesis. melena, intestinal obstruction or grade 4 toxicity were not found. Locoregional failure within the radiation field was observed in 7 patients, and distant metastasis in 10 patients. Sites of locoregional recurrences involve anastomosis/remnant stomach in 3, tumor bed/duodenal stump in 3, regional lymph node in 1 patient Peritoneal seeding occurred in 6, liver metastases months and median disease free survival time was 26 months. Stages andradiation dose were not significant prognostic factors for locoregional in 2, and distant nodes in 2 patients. Four year disease specificsurvival rate was $40\%$ and disease free survival was $48\%$. Median survival was 35 failures. Conculsion : Although all patients in this study had positive surgical margins, locoregional failure rate was $28\%$, and 4 year disease specific survival rate was $40\%$. Considering small number of patients and relatively short follow-up period, it is not certain that postoperative radiotherapy lowered locoregional recurrences. but we could find a Possibility of the role of postoperative radiotherapy in Patients with high risk factors.

• Asia-Pacific Journal of Business Venturing and Entrepreneurship
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• v.19 no.1
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• pp.75-91
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• 2024

Recently, global business environment is changing dramatically along with the acceleration of technological innovation amid the war, climatic change, and geopolitical instability. Accordingly, it is difficult to predict or plan for the future as the volatility, complexity, ambiguity, and uncertainty of the industrial ecosystem continue to increase. Therefore, organizations are undergoing inevitable restructuring in accordance with their survival strategy, for instance, removing marginal businesses or firing. Accordingly, office workers are seeking a startup as an alternative for their continuous economic activity amid rising anxiety factors that make them think they would lose their jobs unintentionally. Here, this study is aimed to verify through what paths office workers' self-determination influences the process of converting to a startup. For this study, an online survey was carried out, and 310 respondents' valid data were analyzed through SPSS and AMOS. To sum up the results, first, office workers' self-determination did not have significant effects on entrepreneurial intention. However, it was confirmed that self-determination had positive (+) effects on innovativeness and perception of the startup support system. This result shows that their psychology works to prepare step by step by accumulating innovative experiences and increasing perception of the startup support system from a long-term life path perspective rather than challenging startups right way. Second, innovativeness is found to have positive (+) effects on entrepreneurial intention. Also, perception of the startup support system had positive (+) effects on entrepreneurial intention. This implies that when considering startups, they are highly aware of the government's various startup support systems. Third, innovativeness is found to have positive (+) effects on perception of the startup support system. It is judged that perception of the startup support system is valid for prospective founders to exhibit their innovativeness and realize new ideas. Fourth, it was confirmed that innovativeness and perception of the startup support system mediated correlation between self-determination and entrepreneurial intention, and perception of the startup support system mediated correlation between innovativeness and entrepreneurial intention, which shows that it is a crucial factor in entrepreneurial intention. Although previous studies related to startups deal with students mostly, this study targets office workers who form a great part in economic activities, which makes it academically valuable in terms of being differentiated from others and extending the scope of research. Also, when we consider the fact that the motivation for self-determination alone fails to stimulate entrepreneurial intention and the complete mediation of innovativeness and the startup support system, it has great implications in practical aspects such as the government's human and material support systems. In the selection and analysis of samples, this study exhibits a limitation that the problem of common method bias is not completely resolved. Also, additional definitive research is needed on whether entrepreneurial intention is formed and converted into startup behavior. Academically and practically, this study deals with the relationship between humans' psychological motives and startups which has not been handled sufficiently in previous studies. The conversion of office workers to startups is expected to have effects on individuals' economic stability and the state's job creation; therefore, it needs to be investigated continuously for its great value.