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Evaluation of Corrected Dose with Inhomogeneous Tissue by using CT Image (CT 영상을 이용한 불균질 조직의 선량보정 평가)

  • Kim, Gha-Jung
    • The Journal of Korean Society for Radiation Therapy
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    • v.18 no.2
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    • pp.75-80
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    • 2006
  • Purpose: In radiation therapy, precise calculation of dose toward malignant tumors or normal tissue would be a critical factor in determining whether the treatment would be successful. The Radiation Treatment Planning (RTP) system is one of most effective methods to make it effective to the correction of dose due to CT number through converting linear attenuation coefficient to density of the inhomogeneous tissue by means of CT based reconstruction. Materials and Methods: In this study, we carried out the measurement of CT number and calculation of mass density by using RTP system and the homemade inhomogeneous tissue Phantom and the values were obtained with reference to water. Moreover, we intended to investigate the effectiveness and accuracy for the correction of inhomogeneous tissue by the CT number through comparing the measured dose (nC) and calculated dose (Percentage Depth Dose, PDD) used CT image during radiation exposure with RTP. Results: The difference in mass density between the calculated tissue equivalent material and the true value was ranged from $0.005g/cm^3\;to\;0.069g/cm^3$. A relative error between PDD of RTP and calculated dose obtained by radiation therapy of machine ranged from -2.8 to +1.06%(effective range within 3%). Conclusion: In conclusion, we confirmed the effectiveness of correction for the inhomogeneous tissues through CT images. These results would be one of good information on the basic outline of Quality Assurance (QA) in RTP system.

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Factors Influencing Swallowing-related Quality of Life in Patients with Dysphagia (연하장애 환자의 삶의 질 영향 요인)

  • Kim, Ju-Yeun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.11
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    • pp.421-431
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    • 2016
  • The purpose of this study was to identify the influence of depression, social isolation, and meaning in life on the swallowing related quality of life in patients with dysphagia. In this study, 87 the dysphagia patients diagnosed with stroke, degenerative disease, and neurological disorder in a general or rehabilitation hospital in Seoul, Gyeonggi, and Incheon were assessed. The data were collected between February and April, 2015 using CES-D, RULS, PIL, SWAL-QOL. The data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation, and stepwise multiple regression with SPSS 22.0. Of the participants, 20.7% reported having had depression, 92.0% middle-high social isolation and 64.4% existential vacuum. The mean scores were SWAL- QOL 158.89(35.97). Stepwise multiple regression revealed that tube feeding to have the greatest effect on SWAL-QOL(${\beta}=-0.57$, p<.001), followed in order by age (${\beta}=0.26$, p=.001), lower MIL (${\beta}=0.19$ p=.014), and education (${\beta}=0.17$, p=.032). The most influential factor to SWAL-QOL was tube feeding. These variables accounted for 50.7% of SWAL-QOL in dysphagia patients (F=28.84 p=.031). Therefore, it is essential to develop the intervention that can improve the meaning in life in patients with dysphagia. In addition there is a need to study the psychological factors and quality of life of tube feeding.

A Study of the Leader's Traits on the heirarchy of Nurse managers (간호관리자의 계층에 따른 지도자 특성에 관한 연구)

  • Hwang, Sung-Woo
    • Journal of Korean Academy of Nursing Administration
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    • v.4 no.1
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    • pp.5-17
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    • 1998
  • The Purpose of this study is to find out differences among the leader's traits on the hierarchy of Nurse managers in Nurse system of the hospital. In this study 152 managers over head nurse working in 6 University hospitals and 5 general hospitals were selected and the questionary paper answered by them was collected from 1st to 30th in September in 1997. The measuring instrument used in this study is the one integrated and classified by Stogdill (1981), which nurse professor and 2 students of the master's course translated and modified with myself. And its validity was verified through making a test on 130 nurses. The measuring instrument used in this study is made up of 4 items about physical characteristics, 3 items about social background, 4 items about intelligence and ability, 17 items about personaity, 6 items about task-related characteristics, 9 items about social characteristics and 8 items about general background in the triats of leader. And this instrument is made to be marked using five point Likert type. It's reliability is Cronbach's Alpha =.93. The data for study were analyzed through SPSS/PC+ The result of this study are as follows: 1. The order in importantly perceptible degree of the leader's traits showed like these: the intelligence and ability (M=4.683), the task-related characteristics (M=4.605), the personality (M=4.39), the social characteristics (M=4.327), the social back-ground (M=4.056), the physical characteristics (M=3.601). 2. The order in degree to percept the importance of 44 detailed items of the leader's traits showed like these: the judgement and decisiveness (M=4.967), the sense of responsibility (M=4.904), the activity and energy (M=4.796), the self-confidence (M=4.776), the creativity (M=4.748), the intelligence (M=4.743), the responsibility in the pursuit of objectives (M=4.743), the enthusiasm (M=4.717), the objectivity (M=4.704), the moral sense and ethical conduct (M=4.704), the ability to enlist cooperation (M=4.694), the strength of conviction (M =4.678), the enterprise (M=4.691), the administrative ability (M=4.678) and the cooperativeness (M=4.638) 3. As the result of analyzing the leader's trait differences on the hierarchy of nurse managers in six factors of the leader's traits, the social background showed the meaningful differences(F=4.983, P=0.008). 4. As the result of analyzing the leader's traits defferences made from the upper first to 15th rank among the detailed items of the leader's trait factors on the heirarchy of nurse managers, the meaningful defferences appeared in the following items: the objectivity(F=3.413, P=0.033), the creativity (F=3.550, P=0.031), the sense of responsibility(F=3.345, P=0.049), and the administrative ability (F=3.363, P=0.037). 5. As the result of analyzing the leader's trait factors in general background, only the social background of 6 leader's trait factors showed the meaningful differences according to the working place (F=4.057, P=0.008). The study shows that we should consider the above leader's trait factors in selecting nurse managers and that we should develop the educational program for hierarchy of nurse managers urgently.

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A Study of Job Stress and Turnover Intention related to Transfer of Duty Post of Staff Nurses in the General Hospitals (종합병원 일반 간호사의 근무지 이동과 관련된 직무 스트레스 및 이직의도)

  • Kwon, Deok-Wha;Koh, Hyo-Jung
    • Journal of Korean Academy of Nursing Administration
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    • v.9 no.1
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    • pp.141-150
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    • 2003
  • Purposes : This study was to investigate the job stress and turnover intention related to transfer of duty post of staff nurses working in general hospitals. Method : The subjects of this study were 384 staff nurses working in 6 general hospitals, with more than 200 beds, in Daegu and Kungbuk province in Korea. Data were collected through questionnaires and from Sep. 15 to Oct. 6, 2001. The used tool for measuring the degree of job stress was developed by Kim and Gu(1984) and the used tool for measuring the degree of turnover intention was developed Kim and Lee(2001). The data were analyzed into frequency, percentage, mean, standard deviation, t-test, ANOVA, Tukey's post hoc contrast, Pearson's correlation coefficient according to the purpose of study by use SPSS Win 10.0 statistical program. Results : The following are the results of the study: (1) Average score of the job stress, turnover intention of resignation of the subjects were 2.64 and 4.44. (2) The result of the analysis of job stress related to transfer of duty post was higher in job stress; not satisfaction of current duty post(t=-2.06, p=0.04). (3) The result of the analysis of turnover intention related to transfer of duty post was higher in turnover intention; period of the an advance notice when transfer to current duty post less than 7day(F=3.55, p=0.02), not satisfaction of current duty post(t=-2.45, p=0.02), want the transfer from current duty post(t=3.68, p=0.00). (4) The study reveals that there was statistically significant positive correlation relationship between job stress factors and turnover intention(r=.183, p=.000). Conclusion : The study which relating to period of the an advance when transfer and satisfaction of current duty post and reconsideration of transfer of duty post shows statistically significant difference between job stress and turnover intention. Therefore it is regarded that is needed to set a period of profer advance notice, grip on unsatisfactory factor of current duty post and intervention and management of the subjects were wanted transfer of duty post.

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A Pilot Study for Thermal Threshold Test of Trigeminal Nerve Injuries (삼차신경손상의 온도역치검사에 대한 예비연구)

  • Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.37 no.4
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    • pp.243-250
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    • 2012
  • Trigeminal nerve injuries due to invasive dental procedures such as implant surgery and extraction is one of the most serious issues in dentistry and may provoke medico-legal problems. Thus, for objective and reliable assessment of nerve injury, a need of QST (quantitative sensory testing) is emphasized and thermal threshold test is an essential part of QST, reported to have acceptable reliability in the orofacial region. This pilot study aimed to evaluate thermal thresholds for limited cases of trigeminal nerve injures. The study investigated 18 clinical cases with trigeminal nerve injuries who visited Department of Oral Medicine, Dankook Univeristy Dental Hospital during the period from May 2011 to Oct 2012. Thermal thresholds was measured by Thermal Sensory Analyzer, TSA-II (Medoc, Israel). Their CDT(cold detection threshold) was significantly decreased in the affected sides compared to the unaffected sides. Other parameters such as WDT(warm detection threshold), CPT(cold pain threshold) and HPT(heat pain threshold) did not show statistical difference between the affected and unaffected sides. Further researches are required to compare thermal thresholds relative to types of nerve deficits such as thermal hyper- or hypoesthesia and hyper- or hypoalgesia for larger sample.

The Study on the Interest of Professional Physical Therapy (The undergraduate students of dept. of physical therapy in Busan, Ulsan and Kyungnam) (부산.울산.경남 지역 졸업반 물리치료(학)과 학생들의 전문물리치료 영역에 대한 인식 및 관심도 조사)

  • Kim, Chi-Hyok;Lee, Geon-Chul;Kwon, Hyuk-Soo
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.10 no.1
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    • pp.129-145
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    • 2004
  • Many physical therapy who graduate department of physical therapy interested in physical therapy specialist. The boundary of physical therapy specialist is consist of 7 parts; CCS(Cardiopulmonary Certified Specialist), ECS(Clinical Electrophysiologic Certified Specialist), GCS(Geriatric Certified Specialist), NCS(Neurologic Certified Specialist), NCS(Neurologic Certified Specialist), OCS(Orthopaedic Certified Specialist), PCS(Pediatric Certified Specialist), SCS(Sports Certified Specialist). So the purpose of this study was to investigate of undergraduate student's interest about the area of special physical therapy and its academy. The data were collected from May 17 to 24, 2004 and 158 valid questionnaires were obtained and analyzed. It was for undergraduate students who major in physical therapy in college and university which are located in Busan, Ulsan and Kyoungnam province. The result is follows: 1. The research about the study of physical therapy after graduation was that 45.5% of female thought that they going to study as possible as they can was the best. In the case of men, 54.3% of male thought that they going to study was the best. 2. The result about recognition of special physical therapy was that 62.0% of people answered CCS, 69.6% of people answered GCS. The most familiar part of special physical therapy at course of school curriculum was that 88.0% of people answered OCS, and 84.2% of people answered NCS. 3. The result about the most interesting part of special physical therapy was that 68.6% of male and 36.1% of female answered OCS. On the other hand, the least part that people doesn't care was that 41.2% of male answered PCS, and 41.0% of female answered CCS. 4. About educational matters of special physical therapy and its academy was that 60% of answered 'Not enough'. An answer to question of special physical therapy and its academy's educational necessity. At the a course of faculty and clinical practice was that 58.9% of answered 'somewhat necessary'. After graduation, study a plan of special physical therapy was that 59.5% of answered 'immediate academy'. 5. Recognize scale in alternation physical therapy, think of extend physical therapy's territory is 'necessary of extend territory' was 78% the highest answer. 57.6% of answered was concerned about alternating physical therapy, and want to study.

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Needs of Parents Who have the Child with Congenital Heart Disease Related to the Informed Consent (선천적 심질환아의 수술동의서 작성과 관련된 부모의 요구)

  • Choi, Mi-Young
    • Korean Parent-Child Health Journal
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    • v.6 no.1
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    • pp.18-30
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    • 2003
  • Congenital heart disease is the most frequently shown congenital disease among children, most of them can be corrected with operation. However, Patients and their parents need nursing intervention when they face this risky incident of operation. Therefore, parents' experiences are absolutely needed to plan nursing intervention to give practical help to the patients and their parents. The purpose of this study is to provide basic resources to develop a feasible intervention program for the parents by understanding the experiences related to the informed consent of cardiac surgery of their child. From January to June 2003, 10 parents of children patients with congenital heart disease were interviewed who filled out Operation Agreement before the primary operation after they are diagnosed as congenital heart disease in pediatric chest surgery of A hospital in Seoul. They were asked to give opinion regarding pre-operation needs and the interviewed information was analyzed. The results of this study are as follows : Firstly, they were asked what they felt before they were told about the operation of their children from the doctor before filling out the informed consent of operation. They felt 1) vague, 2) confusion of choose, 3) risky, 4) resented, 5) uneasy, 6) guilty, and 7) the burden of operation. Secondly, they were asked what they felt after they filled out the informed consent of operation and the doctor gave them detailed information on the operation of their children. They felt 1) confused, 2) responsible, 3) rejected, 4) angry, 5) plain, 6) to have hope, 7) trying to trust medical people, 8) that consolation is needed, and 9) conditional reduction of the burden of operation. Thirdly, followings are the categories of congenital parents' demand before operation based on the analysis of experiences related to the preparation of the informed consent of operation. 1) Information Demand (1) Anticipatory information (2) Concrete and precise information (3) Individual information 2) Support (1) Empathy (2) Parental supporting (3) Support of parents in the same situation 3) Education and consulting (1) Children-oriented Education (2) Consultation Considering the results of this study, parents of the child with congenital heart disease seem to have various emotional experiences related to filling out the informed consent and they need concrete and practical helps before cardiac surgery. This study proposes that systematic nursing intervention is needed according to the needs of the parents who have the child with congenital heart disease before operation in the field of child health nursing.

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A COMPARISON OF THE CHARACTERISTICS OF CHILDREN WITH TOURETTE AND CHRONIC TIC DISORDER ACCORDING TO THEIR BIRTH ORDERS (뚜렛 및 만성 틱 아동의 출생순위에 따른 특성 비교)

  • Kim, Ja-Sung;Hong, Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.4 no.1
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    • pp.124-132
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    • 1993
  • We studied the clinical characteristics of 45 children with tic symptoms, and a comparison was made according to their birth order patterns. The results were as follows. Sex ration was 14:1 higher for boys. The eldest children were 46.7%, single children, 15.6%, the youngest children, 33.3%, and twins 4.4% of all Organicity was suggested in 37.8%, early developmental problems in 71.1%, and family problems were in 89.9%. Among the co-existing problems, ADHD 46.7%, OCD 17.7%, Separation anxiety disorder 24.4%, GAD or anxiety dreams 17.8%, somatization disorder and enuresis 13.3% each, stuttering 8.9%, and other conditions. Overall, 84.4% of the patients have one or more co-existing conditions other than tic symptoms. When compared according to birth order patterns, the most significant difference was the time of onset The youngests have more incidences around the entrance period for elementary school(p<0.01). Among the twins, the lower birth-weight child was the patient. Summing up these findings, we concluded there were significant environmental factors working on the manifestation of tic and tourette disorders.

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The Effect of Group Treatment Based on Occupational Therapy for Children : A Systematic Review (아동 그룹 작업치료의 효과 : 체계적 고찰)

  • Lee, Ga-Young;Lee, Ji-Ho;Kim, Bo-Ram;Kim, Kyeong-Mi
    • The Journal of Korean Academy of Sensory Integration
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    • v.14 no.2
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    • pp.33-45
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    • 2016
  • Objective : The purpose of this article is to study the effectiveness of a group occupational therapy for children via systematic review, and to provide clinical evidences. Methods : The systematic review initially included articles in Pubmed, Ovid, RISS, KISS, and DBpia, published until 2014. Total 14 articles have been chosen, using different keyword of each domestic/foreign studies. Selected articles were divided depending on the level of evidence, and eventually been organized into group PICO (Patient, Intervention, Comparison, Outcome). Results : The results indicated that there are more diagnosed children than normal in participants and especially children with sensory integration disorder (28.6%) appeared to be the most common. In intervention, group sensory integrative intervention had the largest frequency, and instruments measuring social skills were used most for analyzing the intervention results. The effectiveness of interventions showing statistically significant results were 40.7% of Total. Conclusion : Group occupational therapy for children should be provided to various diagnosis with widely better quality of interventions providing the enough support for the evidence level.

Clinical Efficacy of Individual Cognitive Behavioral Therapy for Patients with Primary or Secondary Insomnia (일차성 및 이차성 불면증 환자에서의 개별 인지행동치료의 임상적 효능)

  • Shin, Youn-Mi;Cha, Bo-Seok;Lim, Chae-Mi;Shin, Hong-Beom
    • Sleep Medicine and Psychophysiology
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    • v.17 no.1
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    • pp.34-40
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    • 2010
  • Objectives: This study aimed to evaluate the clinical efficacy of individual cognitive behavioral therapy (CBT) for Patients with Primary or Secondary Insomnia. Methods: Participants were recruited from a primary care sleep clinic from January 2008 to June 2009. The study sample included 64 outpatients with primary insomnia (n=30) and secondary insomnia (n=34) according to the criteria of DSM-IV. Participants completed sleep diaries, Dysfunctional Beliefs and Attitudes about Sleep Scale-16 (DBAS), State-Trait Anxiety Inventory (STAI) before CBT and shortly after completion of CBT. CBT was provided in 7 weekly, 40-50-minute individual therapy sessions. Results: Both groups of patients with primary and secondary insomnia showed significant improvement in the DBAS and sleep parameters including sleep onset latency, total sleep time, and sleep efficiency. Repeated-measures ANOVA of the DBAS and sleep parameters showed no significant group-by-time interactions between patients with primary and secondary insomnia, suggesting the efficacy of CBT for patients with secondary insomnia was equivalent to that of CBT for patients with primary insomnia. Conclusion: This study suggests that CBT is effective for the management of primary and secondary insomnia in a primary care setting.

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