We evaluated on the calculation accuracy of treatment planning system (TPS) with phantom having convex and concave surface. The TPS is Eclipse (Varian, USA) using both algorithms AAA and PBC for photon dose calculations. PBC algorithms have three corrections of Batho, modified Batho (M-Batho), and equivalent TAR (E-TAR). The field sizes were $10{\times}10\;cm^2$ and $20{\times}20\;cm^2$, and MLC-shaped fields for these fields. We measured doses at three depths 5, 10 and 15cm in phantom of SSD=90cm in the condition of inserted farmer chamber. For given conditions, we have calculated dose with these algorithms and compared them with measured doses. In AAA the calculated doses (dose/MU) were agreed to measured doses within ${\pm}1%$ in flat and convex surface and were under estimated with -1.9% maximum in concave surface. In PBC the calculated doses were over estimated with +1.7% and +4.1% respectively in flat and convex surface and the differences were from -3.1% to +2.1% in concave surface. In comparison of criteria from AAPM and IAEA reports, and statistical analysis for these results, it is found that the AAA's results are in good agreement with measured values and the M-Batho's results are generally good agreed with measured values among PBC algorithms.
Purpose : Transient wall motion abnormality and contractile dysfunction of the left ventricle (LV) can be observed in patients with coronary artery disease due to post-stress myocardial stunning. To understand clinical characteristics of stress induced LV dysfunction, we have compared the findings of exercise stress test, myocardial perfusion SPECT and coronary angiography between subjects with and without post-stress LV dysfunction. Materials and Methods : Among subjects who underwent exercise stress test, myocardial perfusion SPECT and coronary angiography within a month of interval, we enrolled 36 patients with post-stress LV election fraction (LVEF) was $\geq5%$ lower than rest (stunning group) and 16 patients with difference of post-stress and rest LVEF was lesser than 1 %(non-stunning group) for this study. Treadmill exercise stress gated myocardial perfusion SPECT was performed with dual head SPECT camera using 740 MBq Tc-99m MIBI and coronary angiography was also performed by conventional Judkins method. Results : Stunning group had a significantly higher incidence of hypercholesterolemia than non-stunning group(45.5 vs. 7.1%, p=0.01). Stunning group also had higher incidence of diabetes mellitus and lower incidence of hypertension, but these were not statistically significant. Stunning group had larger and more severe perfusion defect in stress perfusion myocardial SPECT than non-stunning group(extent 18.2 vs. 9.2%, p=0.029; severity 13.5 vs. 6.9, p=0.040). Stunning group also had higher degree of reversibility of perfusion defect, higher incidence of positive exercise stress test and higher incidence of having severe stenosis ($80{\sim}99%$) in coronary angiography than non-stunning group, but these were not statistically significant. In stunning group, all of 4 patients without perfusion defect had significant coronary artery stenosis and had received revascularization treatment. Conclusion : Patients with post-stress LV dysfunction had larger and more severe perfusion defect and severe coronary artery stenosis than patients without post-stress LV dysfunction. All of the patients without perfusion defect in stunning group had significant coronary artery stenosis and needed revascularization. Therefore, we suggest that invasive diagnostic procedures and therapeutic interventions might be needed in patients with post-stress LV dysfunction.
Seo, Young-Jin;Song, Si Young;Kim, In Sung;Ahn, Jung Tae;Yoo, Yon-Sik
Journal of the Korean Arthroscopy Society
/
v.15
no.2
/
pp.99-107
/
2011
Purpose: The purpose of this study was to investigate the clinical results after a anatomical double bundle ACL reconstruction using a longitudinally split tibialis anterior allograft. Materials and Methods: We evaluated 24 patients with a minimum follow-up of 12 months who had undergone anatomical double bundle ACL reconstructions. The grafts utilized in all cases were tibialis anterior allografts which were longitudinally split into two strands. A standard rehabilitation protocol was applied in all patients. The pre- and post-operative data including Lysholm scores, International Knee Documentation Committee (IKDC) scores, Lachman test, pivot shift test and the side-to-side differences of anterior laxity measured by KT-2000 arthrometer were analyzed by use of a statistical method Results: The mean side-to-side instrumented laxity measured by the KT-2000 arthrometer significantly improved to a mean of $1.04{\pm}0.80\;mm$ (P < 0.001). The Lysholm knee scores also improved from $58.34{\pm}15.32$ to $86.25{\pm}6.48$ after surgery (P < 0.001). The patients exhibited improved IKDC scores (A: 15 cases, B; 9 cases) at the final follow-up, compared to preoperative scores (B: 5, C: 10, D: 9). Conclusion: Our data demonstrated that clinical results of anatomical double bundle ACL reconstruction with a split tibialis anterior allograft are encouraging with excellent side-to side laxity, significantly improved Lysholm knee score, IKDC score, Lachman and pivot shift data.
Purpose: Microfracture has been used as a first-line treatment to repair articular cartilage defects. In this study, a new technique using an extracelluar matrix biomembrane to cover the cartilage lesions after microfracture was evaluated in terms of cartilage repairability and clinical outcome compared with conventional microfracture technique in a prospective randomized trial. Materials and Methods: A total of 53 patients (59 cases) without osteoarthritis who had focal full thickness articular cartilage lesions were randomly assigned in two group. Seventeen patients (17 cases) underwent conventional microfracture procedure (control group) and thirty-six patients (42 cases) received microfracture and placing biomembrane cover (ArtiFilm$^{TM}$) concomitantly (experimental group). Clinical assessment was done through 6 months postoperatively using the subjective International Knee Documentation Committee IKDC questionnaire, and visual analog scale (VAS) for pain and satisfaction. Magnetic resonance imaging (MRI) was performed at 6 months after the operation in all patients. Results: In clinical outcomes, the significant difference was observed between both groups in IKDC, but not in VAS for pain and for satisfaction (final outcomes of IKDC, p=0.001; VAS for pain, p=0.074; VAS for satisfaction, p=0.194). The MRI showed good to complete defect fill (67 to 100%) in 33 patients (78.6%) of experimental group and 4 patients (23.5%) of control group, respectively. In control group, 9 of 17 patients (52.9%) showed poor defect fill (less than 33%), whereas 5 (11.9%) in experimental group (p=0.001). Assessment of peripheral integration revealed no gap formation in 35 patients (83.3%) in experimental group and 6 patients (35.3%) in control group (p=0.001). No serious complications or adverse effects related to the biomembrane were found. Conclusion: Good short-term follow-up clinical results were obtained in the group whose cartilage defects in the knee joint were covered with biomembrane after the microfracture, with the MRI findings confirming the excellent regeneration of the defective cartilage area. This suggests that the surgery to cover the defective area with biomembrane (ArtiFilm$^{TM}$) after the microfracture procedure is a safe, more effective treatment to induce cartilage regeneration.
The location and geometry of the Ulsan Fault play important roles in interpreting tectonic evolution of the southeastern part of the Korean Peninsula. Dipole-dipole electrical resistivity surveys and seismic refraction surveys were carried out in the Yaksoo area, Ulsan in order to measure the thickness of the alluvium covering the Ulsan Fault and to find associated fracture zones and possibly the location of its major fault plane. The collected data were analyzed and interpreted. Some results reported previously by others were also used in this interpretation. No low resistivity anomalies were found in the cross-sectional resistivity image of the survey line located in the east of the Dong River. In contrast, well-developed continuous low resistivity anomalies were detected in the west of the Dong River. This strongly suggests that the major fault plane of the Ulsan Fault is located under or in the west part of the Dong River. Two refraction boundaries corresponding to the underground water level and the bottom of the alluvium were found by refraction surveys carried out on the limited part of the east survey line. The thickness of the alluvium was found to be about 30 m. Small faults in the basement rock identified by reflection surveys were not detected by both resistivity and refraction seismic surveys. This might be explained by assuming that low resistivity anomaly is more closely related to the clay contents than the water contents. On the other hand, it may be resulted by the limited resolution of the resistivity and refraction surveys. Detailed study is required to clarify the reason. Resistivity survey is frequently considered to be a good exploration method to detect subsurface faults. However, it appears to be less useful than reflection seismic survey in this work. In dipole-dipole resistivity survey, the number of separation should be increased to survey deeper subsurface with the same resolution. However, signal to noise ratio decreases as the number of separation increases. In this survey area, the signal to noise ratio of up to sixteen separations was good enough based on the statistical properties of measurements.
Purpose: Despite the advance of medical science, the number of cancer patient have increased and the mortality rate is also on the rise. Therefore, a perfect cure for cancer is crucial, but the value and meaning of the remaining life for the patient are also becoming more and more important. The principal aim of this study is to examine the differences in the quality of life, physical and psychosocial symptoms according to the performance status of terminal cancer patients. Methods: We evaluated the performance status, demographical data, blood analysis and quality of life of cancer patients who visited the Department of family Medicine at Myoung-ji Hospital in Korea between September 1, 2003 and August 31, 2005. Their performance status (ECOG) was divided into two groups ($ECOG\;0{\sim}1/ECOG\;2{\sim}4$) and analyzed by ANOVA to see if there was a difference in their blood analysis and quality of life. A P value of less than 0.05 was considered to be significant. Results: A total of 104 patients were evaluated, among which 71 patients (23 male and 48 female) scored $0{\sim}1$, and 33 patients (8 males and 25 females) scored $2{\sim}4$ in the ECOG. The blood analysis showed that patients whose performance status was $2{\sim}4$ had lower levels of lymphocytes, hemoglobin, protein, albumin and sodium. The evaluation on their quality of life showed that the overall health status of patients with $2{\sim}3$ functional ability were poor (P=0.02). Also, from a functional perspective, these patients had poor physical (P=0.05) and role (P=0.01) scores, and in terms of symptoms, they showed a significant loss of appetite. Conclusion: If a patient's performance status was poor, levels related to certain nutritions were also found to fall in blood tests, thereby leading to an overall weakened state of health. However, there was no difference in symptoms except for a loss of appetite. In conclusion, it is most important to increase the appetite in patients with poor performance status.
The purpose of this study is to devise a Small-Scale Chemistry (SSC) lab program for primary school learners and to examine its effects on science learning achievement. In addition, it will be examined whether the type of learning groups affects the achievement or not. The participants in the current study were 173 6th graders from 6 classes of Y elementary school in Changwon city, Gyeongnam. Three classes(86) were assigned to the experimental group and the other three, the comparative group after checking the pre-homogeneity between the two groups through t-test on the scores of the science mid-term exam. We conducted five experimental sessions on the Acid and Base in the science textbook for the sixth graders. The students of one experimental class worked in pairs and another class worked individually, but the students of the comparative classes were divided into groups of six(one group with pair, another group with individual work in the SSC program, and the other group conducting the traditional experiment with groups of six students). The data were analyzed by t-test and ANOVA. The results showed that experimental learning using individual work in the SSC program compared to traditional experimental learning was effective in improving science learning achievement. also it was indicated that the teachers could reduce their burden of preparing for classes and of school hours when they utilized the SSC laboratory learning program. Teachers could also actively support students' experimental activities in employing the program. Based on the results, we suggest that the development of the SSC laboratory learning program is meaningful in the sense that this program can help elementary schoolers to improve science learning achievements more than the existing traditional experimental methods.
In the implementation of a P300 speller, rows and columns paradigm (RCP) is most commonly used. However, the RCP remains subject to adjacency-distraction error and double-flash problems. This study suggests a novel P300 speller stimuli presentation-the sub-block paradigm (SBP) that is likely to solve the problems effectively. Fifteen subjects participated in this experiment where both SBP and RCP were used to implement the P300 speller. Electroencephalography (EEG) activity was recorded from Fz, Cz, Pz, Oz, P3, P4, PO7, and PO8. Each paradigm consisted of a training phase to train a classifier and a testing phase to evaluate the speller. Eighteen characters were used for the target stimuli in the training phase. Additionally, 5 subjects were required to spell 50 characters and the rest of the subjects were to spell 25 characters in the testing phase. Classification accuracy results show that average accuracy was significantly higher in SBP as of 83.73% than that of RCP as of 66.40%. Grand mean event-related potentials (ERPs) at Pz show that positive peak amplitude for the target stimuli was greater in SBP compared to that of RCP. It was found that subjects tended to attend more to the characters in SBP. According to the participants' ratings on how comfortable they were with using each type of paradigm on 7-point Likert scale, most subjects responded 'very difficult' in RCP while responding 'medium' and 'easy' in SBP. The result showed that SBP was felt more comfortable than RCP by the subjects. In sum, the SBP was more correct in P300 speller performance as well as more convenient for users than the RCP. The actual limitations in the study were discussed in the last part of this paper.
Purpose : Suprapubic aspiration(SPA) has been considered the "gold standard" for obtaining urine in non-toilet trained infants. Ultrasound(US)-guided SPA improves the success rate of the procedure and reduces the complications. However, many physicians perceive SPA as invasive and prefer the use of urethral catheterization (Ucat). We compared the success rate, complications and accuracy of US-guided SPA and Ucat. Methods : 121 infants who visited Ewha Womans University Mokdong Hospital with suspected urinary tract infection(UTI) were investigated. For the first study, the study infants were randomly assigned to either the US-guided SPA(n=32) or Ucat(n=32) groups. The success rate and complications of both procedures were compared. For the second study, US-guided SPA and Ucat were performed simultaneously(n=57). The accuracy of urethral catheterization was subsequently analyzed. The criteria for success was defined as the collection of more than 0.5 mL of urine. UTI was diagnosed by the presence of uropathogens over 105 colony-forming units (CFU)/mL. Results : The overall success rate of the US-guided SPA was 96.9%(71.9% in first attempts, 25.0% in second attempts) which was not significantly different compared to 96.9%(90.6% in first attempts, 6.3% in second attempts) in the Ucat(P>0.05) group. The aspirated urine volume was $7.4{\pm}3.7mL$ in the US-guided SPA group, which was not significantly different to $4.5{\pm}2.6mL$ in the Ucat(P>0.05) group. The accuracy of Ucat in comparison to the US guided SPA was low with sensitivity 59.5%, specificity 86.6%, false-positive rate 13.3% and false-negative rate 40.5%. Conclusion : US-guided SPA should be encouraged as the best method to collect the urine in non-toilet trained infants with UTI.
It has been well documented that white egg layers are far more resistant to fowl typhoid than the brown egg layers. In Korea, however, most consumers prefer brown eggs to white ones. Therefore, a study was conducted to Produce fowl typhoid-resistant crossbred layers producing somewhat brown-colored eggs. Several crossbred strains were obtained from crossbreeding white egg lines (W) with brown egg lines (B). These crossbred layers (W${\times}$B) produced eggs with varying degrees of brown-colored shells between the white eggs obtained from W (White) and the brown eggs from B (Brown). Eggs from the peak stage of production were collected and their eggshell color values were measured. The mean eggshell color values of White and Brown were 81.9 and 36.4, respectively. Eggs from the crossbred lines (W${\times}$B) were collected, and their eggshell color values were measured to re-group these eggs according to their color. The mean eggshell color values of Trt-White, Middle, and Trt-Brown were 70, 60, and 50, respectively (Fig. 1). A total of 247 people living in Daejeon area, mainly housewives, took part in this survey. First, they were offered eggs with varying degrees of eggshell color in a paper egg-tray, together with a questionnaire. After they filled out the first questionnaire, they were instructed that the eggshell color has nothing to do with its nutritive value. In the second questionnaire, their preference on both eggshell color and price, i.e., purchasing will, were investigated. In the first questionnaire, the Brown (eggshell color lightness 36.4) were most preferred, and the Trt-white (eggshell color lightness 70) were least preferred. No statistical significance was detected between Brown and Trt-Brown, and White and Trt-White. In the second questionnaire, the trend was the same as in the first. Although no significant difference was found between Trt-Brown and Brown, however, the Trt-Brown were most preferred, surpassing the Brown. In conclusion, regardless of the nutritive values, the Korean consumers prefer brown eggs to white ones, and this trend could be changed gradually through consumer education.
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