• Title/Summary/Keyword: Care system

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Independent Verification Program for High-Dose-Rate Brachytherapy Treatment Plans (고선량률 근접치료계획의 정도보증 프로그램)

  • Han Youngyih;Chu Sung Sil;Huh Seung Jae;Suh Chang-Ok
    • Radiation Oncology Journal
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    • v.21 no.3
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    • pp.238-244
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    • 2003
  • Purpose: The Planning of High-Dose-Rate (HDR) brachytherapy treatments are becoming individualized and more dependent on the treatment planning system. Therefore, computer software has been developed to perform independent point dose calculations with the integration of an isodose distribution curve display into the patient anatomy images. Meterials and Methods: As primary input data, the program takes patients'planning data including the source dwell positions, dwell times and the doses at reference points, computed by an HDR treatment planning system (TPS). Dosimetric calculations were peformed in a $10\times12\times10\;Cm^3$ grid space using the Interstitial Collaborative Working Group (ICWG) formalism and an anisotropy table for the HDR Iridium-192 source. The computed doses at the reference points were automatically compared with the relevant results of the TPS. The MR and simulation film images were then imported and the isodose distributions on the axial, sagittal and coronal planes intersecting the point selected by a user were superimposed on the imported images and then displayed. The accuracy of the software was tested in three benchmark plans peformed by Gamma-Med 12i TPS (MDS Nordion, Germany). Nine patients'plans generated by Plato (Nucletron Corporation, The Netherlands) were verified by the developed software. Results: The absolute doses computed by the developed software agreed with the commercial TPS results within an accuracy of $2.8\%$ in the benchmark plans. The isodose distribution plots showed excellent agreements with the exception of the tip legion of the source's longitudinal axis where a slight deviation was observed. In clinical plans, the secondary dose calculations had, on average, about a $3.4\%$ deviation from the TPS plans. Conclusion: The accurate validation of complicate treatment plans is possible with the developed software and the qualify of the HDR treatment plan can be improved with the isodose display integrated into the patient anatomy information.

A study on the CRM strategy for medium and small industry of distribution (중소유통업체의 CRM 도입방안에 관한 연구)

  • Kim, Gi-Pyoung
    • Journal of Distribution Science
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    • v.8 no.3
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    • pp.37-47
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    • 2010
  • CRM refers to the operating activities that always maintain and promote good relationship with customers to ultimately maximize the company's profits by understanding the value of customers to meet their demands, establishing a strategy which may maximize the Life Time Value and successfully operating the business by integrating the customer management processes. In our country, many big businesses are introducing CRM initiatively to use it in marketing strategy however, most medium and small sized companies do not understand CRM clearly or they feel difficult to introduce it due to huge investment needed. This study is intended to present CRM promotion strategy and activities plan fit for the medium and small sized companies by analyzing the success factors of the leading companies those have already executed CRM by surveying the precedents to make the distributors out of the industries have close relation with consumers to overcome their weakness in scale and strengthen their competitiveness in such a rapidly changing and fiercely competing market. There are 5 stages to build CRM such as the recognition of the needs of CRM establishment, the establishment of CRM integrated database, the establishment of customer analysis and marketing strategy through data mining, the practical use of customer analysis through data mining and the implementation of response analysis and close loop process. Through the case study of leading companies, CRM is needed in types of businesses where the companies constantly contact their customers. To meet their needs, they assertively analyze their customer information. Through this, they develop their own CRM programs personalized for their customers to provide high quality service products. For customers helping them make profits, the VIP marketing strategy is conducted to keep the customers from breaking their relationships with the companies. Through continuous management, CRM should be executed. In other words, through customer segmentation, the profitability for the customers should be maximized. The maximization of the profitability for the customers is the key to CRM. These are the success factors of the CRM of the distributors in Korea. Firstly, the top management's will power for CS management is needed. Secondly, the culture across the company should be made to respect the customers. Thirdly, specialized customer management and CRM workers should be trained. Fourthly, CRM behaviors should be developed for the whole staff members. Fifthly, CRM should be carried out through systematic cooperation between related departments. To make use of the case study for CRM, the company should understand the customer and establish customer management programs to set the optimal CRM strategy and continuously pursue it according to a long-term plan. For this, according to collected information and customer data, customers should be segmented and the responsive customer system should be designed according to the differentiated strategy according to the class of the customers. In terms of the future CRM, integrated CRM is essential where the customer information gathers together in one place. As the degree of customers' expectation increases a lot, the effective way to meet the customers' expectation should be pursued. As the IT technology improved rapidly, RFID (Radio Frequency Identification) appears. On a real-time basis, information about products and customers is obtained massively in a very short time. A strategy for successful CRM promotion should be improving the organizations in charge of contacting customers, re-planning the customer management processes and establishing the integrated system with the marketing strategy to keep good relation with the customers according to a long-term plan and a proper method suitable to the market conditions and run a company-wide program. In addition, a CRM program should be continuously improved and complemented to meet the company's characteristics. Especially, a strategy for successful CRM for the medium and small sized distributors should be as follows. First, they should change their existing recognition in CRM and keep in-depth care for the customers. Second, they should benchmark the techniques of CRM from the leading companies and find out success points to use. Third, they should seek some methods best suited for their particular conditions by achieving the ideas combining their own strong points with marketing. Fourth, a CRM model should be developed that will promote relationship with individual customers just like the precedents of small sized businesses in Switzerland through small but noticeable events.

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Study on Computerized Treatment Plan of Field-in-Field Intensity Modulated Radiation Therapy and Conventional Radiation Therapy according to PBC Algorithm and AAA on Breast Cancer Tangential Beam (유방암 접선조사에서 PBC 알고리즘과 AAA에 따른 Field-in-Field Intensity Modulated Radiation Therapy와 Conventional Radiation Therapy 전산화 치료계획에 대한 고찰)

  • Yeom, Mi-Suk;Bae, Seong-Soo;Kim, Dae-Sup;Back, Geum-Mun
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.1
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    • pp.11-14
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    • 2012
  • Purpose: Anisotropic Analytical Algorithm (AAA) provides more accurate dose calculation regarding impact on scatter and tissue inhomogeneity in comparison to Pencil Beam Convolution (PBC) algorithm. This study tries to analyze the difference of dose distribution according to PBC algorithm and dose calculation algorithm of AAA on breast cancer tangential plan. Materials and Methods: Computerized medical care plan using Eclipse treatment planning system (version 8.9, VARIAN, USA) has been established for the 10 breast cancer patients using 6 MV energy of Linac (CL-6EX, VARIAN, USA). After treatment plan of Conventional Radiation Therapy plan (Conventional plan) and Field-in-Field Intensity Modulated Radiation Therapy plan (FiF plan) using PBC algorithm has been established, MU has been fixed, implemented dose calculation after changing it to AAA, and compared and analyzed treatment plan using Dose Volume Histogram (DVH). Results: Firstly, as a result of evaluating PBC algorithm of Conventional plan and the difference according to AAA, the average difference of CI value on target volume has been highly estimated by 0.295 on PBC algorithm and as a result of evaluating dose of lung, $V_{47Gy}$ and $V_{45Gy}$ has been highly evaluated by 5.83% and 4.04% each, Mean dose, $V_{20Gy}$, $V_{5Gy}$, $V_{3Gy}$ has been highly evaluated 0.6%, 0.29%, 6.35%, 10.23% each on AAA. Secondly, in case of FiF plan, the average difference of CI value on target volume has been highly evaluated on PBC algorithm by 0.165, and dose on ipsilateral lung, $V_{47Gy}$, $V_{45Gy}$, Mean dose has been highly evaluated 6.17%, 3.80%, 0.15% each on PBC algorithm, $V_{20Gy}$, $V_{5Gy}$, $V_{3Gy}$ has been highly evaluated 0.14%, 4.07%, 4.35% each on AAA. Conclusion: When calculating with AAA on breast cancer tangential plan, compared to PBC algorithm, Conformity on target volume of Conventional plan, FiF plan has been less evaluated by 0.295, 0.165 each. For the reason that dose of high dose region of ipsilateral lung has been showed little amount, and dose of low dose region has been showed much amount, features according to dose calculation algorithm need to be considered when we evaluate dose for the lungs.

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The Effect of the Integrated Therapy of Neurofeedback, Brain Gymnastics, and Oriental Herbal Tea on the Improvement of Brain Functions and the Quality of Life of Elders living alone (뉴로피드백·뇌체조·한방차를 병행한 통합요법이 독거노인의 뇌기능 향상 및 삶의 질에 미치는 영향)

  • Jeong, Eun-sil;Lee, Jung-eun;Jung, Hyun-mo;Kim, Soo-Kyung;Youn, Mee-Kyung;Lee, Eun-han
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.12
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    • pp.569-581
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    • 2016
  • This experimental study employs a pretest -posttest method concerning the integrated therapy of neurofeedback training, brain gymnastics, and oriental herbal tea effects on seniors living alone. The purpose of the study is to identify effects on brain functions and quality of life. The study participants included 23 seniors living alone (male 10, female 13), ranging in age from 65~90. The experiment lasted 8 weeks, from December 22, 2014, to February 28, 2015. The neurofeedback training utilized the 2 Channel neurofeedback system by Braintech Corporation and was conducted a total of 16 times over 8 weeks, having two sessions per week lasting for 30 minutes focusing on relaxation, concentration and memory. Brain gymnastics, developed by the Korean Science Institute of Psychiatry, ran for 30 minutes, twice a week for a total of 16 sessions administered over 8 weeks. Participants were required to drink 3 cups of oriental herbal tea developed according to Donguibogam for 8 weeks. The results of applying integrated therapy found positive effects on brain function resulting from changes in level of tension and anti-stress quotient. Quality of life, daily life basic measurements, and depression symptoms were significantly influenced by decreases in blood pressure and blood sugar. Results of this study find the integrated therapy of neurofeedback training, brain gymnastics, and oriental herbal tea can significantly enhance brain functions and quality of life within seniors living alone. Therefore integrated therapy involving neurofeedback, brain gymnastics, and oriental herbal tea is a necessary intervention to improve the quality of life of seniors living alone, and will improve the quality of life through healing both mind and body in a more practical and systematical manner.

User Behavior and Improvement for Kumgang Pine Eco-Forest in Uljin (울진금강송 생태숲의 이용자 행태분석과 개선방안)

  • Oh, Nam-Hyun
    • Korean Journal of Environment and Ecology
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    • v.22 no.3
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    • pp.249-259
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    • 2008
  • The purpose of this study was to analyze the users' behaviors and to suggest development strategies in Uljin Kumgang pine tree(Pinus densiflora for. erecta) eco-forest(UKPEF), which is located in Kyeongbuk. The data were collected by interviewing 122 visitors to september 3 from august 29, 2007 with a constructed questionnaire. The results of the analysis are as follows. 1. The major visitors of UKPEF are male and the age between 20 to 30, the residents of the Uljin county with relatively high academic background. 2. The motive of visiting UKPEF is mainly by the beauty and taste of Kumgang pine tree and the condition of the forest. The visitors are mainly composed of family, not big group. 3. The visitors of UKPEF have obtained information about the Kumgang fine tree forest mainly from friends, not from the internet or travel agency. 4. The visitors of UKPEF pointed out lack of convenient facilities such as toilets and water-supply facilities. However, visitors are satisfied by the condition of the forest. 5. The visitors of UKPEF set a high value on Kumgang fine tree, So, more active marketing strategy about Uljin Kumgang pine tree has to be established. 6. The visitors of UKPEF are more satisfied by the Uljin Kumgang pine tree forest than expected. The development strategies of UKPEF are suggest as follows. (1) Auto tram system has to be set up and new trail should be constructed to attract more visitors and people of other regions. (2) To attract group tourists, new program should be developed. (3) Advertisement through internet or travel agency has to be developed. (4) Government(local) should make a plan to register the forest as World natural heritage. (5) Monitoring and evaluation system has to be developed to satisfy tourists. In conclusion, the efforts of taking care of and preserving the UKPEF should be made at the national level. I hope that more Koreans can have chance to feel and experience the value and excellence ofthe Uljin Kumgang pine tree(Pinus densiflora for. erecta)

Measurement of Radiation Using Tissue Equivalent Phantom in ICR Treatment (자궁강내 근접방사선조사시 인체조직등가 팬톰을 이용한 방사선량 측정)

  • Jang, Hong-Seok;Suh, Tae-Suk;Yoon, Sei-Chul;Ryu, Mi-Ryeong;Bahk, Yong-Whee;Shinn, Kyung-Sub
    • Journal of Radiation Protection and Research
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    • v.20 no.1
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    • pp.45-52
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    • 1995
  • This study is to compare A point doses in human pelvic phantom by film dosimetry, computer planning and manual calculation by using of along-away table. We developed tissue equivalent human pelvic phantom composed of four pieces of cylindrical acryl tubes with water, to simulate intracavitary radiation (ICR) in patients with cervix cancer. When the phantom assembled from 4 pieces, it has a small space for inserting Fletcher-Suit-Delclos applicator like a human vagina. Fletcher-Suit-Delclos applicator inserted into the space was packed tightly with furacin gauzes, and three $^{137}Cs$ sources with radioactivity of $15.7mg\;Ra-eq$ were inserted into the tandem. For the film dosimetry, two pieces of X-OMAT V film (Kodak Co.) of which planes include point A, were arranged orthogonally in the slits between phantoms. A point dose and iso-dose curves were measured by means of optical densitometer. A point doses by film dosimetry, RTP system and manual calculation by using of along-away table were compared, and iso-dose curves by film dosimetry and computer planning were also compared. The dose of A point was 51.2cGy/hr by film dosimetry, 46.7cGy/hr by RTP system and 47.9 cGy/hr by along-away table. A point dose by computer planning was similar to the dose by calculation using of along-away table with acceptable accuracy $({\pm}3%)$, however, the dose by film dosimetry was different from two others with about 10% error. Since most clinical beams contains a scatter component of low energy photons, the correlation between optical density and dose becomes tenuous. In addition, film suffers from several potential errors such as changes in processing conditions, interfilm emulsion differences, and artifacts caused by air pockets adjacent to the film. For these reasons, absolute dosimetry with film is impractical, however, it is very useful for checking qualitative patterns of a radiation distribution. In future, solid state dosimeter such as TLD must be used for the dosimetry of ionizing radiation. When considerable care is used, precision of approximately 3% may be obtained using TLD.

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Structural Relationships Among Factors to Adoption of Telehealth Service (원격의료서비스 수용요인의 구조적 관계 실증연구)

  • Kim, Sung-Soo;Ryu, See-Won
    • Asia pacific journal of information systems
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    • v.21 no.3
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    • pp.71-96
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    • 2011
  • Within the traditional medical delivery system, patients residing in medically vulnerable areas, those with body movement difficulties, and nursing facility residents have had limited access to good healthcare services. However, Information and Communication Technology (ICT) provides us with a convenient and useful means of overcoming distance and time constraints. ICT is integrated with biomedical science and technology in a way that offers a new high-quality medical service. As a result, rapid technological advancement is expected to play a pivotal role bringing about innovation in a wide range of medical service areas, such as medical management, testing, diagnosis, and treatment; offering new and improved healthcare services; and effecting dramatic changes in current medical services. The increase in aging population and chronic diseases has caused an increase in medical expenses. In response to the increasing demand for efficient healthcare services, a telehealth service based on ICT is being emphasized on a global level. Telehealth services have been implemented especially in pilot projects and system development and technological research. With the service about to be implemented in earnest, it is necessary to study its overall acceptance by consumers, which is expected to contribute to the development and activation of a variety of services. In this sense, the study aims at positively examining the structural relationship among the acceptance factors for telehealth services based on the Technology Acceptance Model (TAM). Data were collected by showing audiovisual material on telehealth services to online panels and requesting them to respond to a structured questionnaire sheet, which is known as the information acceleration method. Among the 1,165 adult respondents, 608 valid samples were finally chosen, while the remaining were excluded because of incomplete answers or allotted time overrun. In order to test the reliability and validity of the assessment scale items, we carried out reliability and factor analyses, and in order to explore the causal relation among potential variables, we conducted a structural equation modeling analysis using AMOS 7.0 and SPSS 17.0. The research outcomes are as follows. First, service quality, innovativeness of medical technology, and social influence were shown to affect perceived ease of use and perceived usefulness of the telehealth service, which was statistically significant, and the two factors had a positive impact on willingness to accept the telehealth service. In addition, social influence had a direct, significant effect on intention to use, which is paralleled by the TAM used in previous research on technology acceptance. This shows that the research model proposed in the study effectively explains the acceptance of the telehealth service. Second, the research model reveals that information privacy concerns had a insignificant impact on perceived ease of use of the telehealth service. From this, it can be gathered that the concerns over information protection and security are reduced further due to advancements in information technology compared to the initial period in the information technology industry, and thus the improvement in quality of medical services appeared to ensure that information privacy concerns did not act as a prohibiting factor in the acceptance of the telehealth service. Thus, if other factors have an enormous impact on ease of use and usefulness, concerns over these results in the initial period of technology acceptance may become irrelevant. However, it is clear that users' information privacy concerns, as other studies have revealed, is a major factor affecting technology acceptance. Thus, caution must be exercised while interpreting the result, and further study is required on the issue. Numerous information technologies with outstanding performance and innovativeness often attract few consumers. A revised bill for those urgently in need of telehealth services is about to be approved in the national assembly. As telemedicine is implemented between doctors and patients, a wide range of systems that will improve the quality of healthcare services will be designed. In this sense, the study on the consumer acceptance of telehealth services is meaningful and offers strong academic evidence. Based on the implications, it can be expected to contribute to the activation of telehealth services. Further study is needed to assess the acceptance factors for telehealth services, such as motivation to remain healthy, health care involvement, knowledge on health, and control of health-related behavior, in order to develop unique services according to the categorization of customers based on health factors. In addition, further study may focus on various theoretical cognitive behavior models other than the TAM, such as the health belief model.

Functional Magnetizing Treatment of Natural Quartz and Volcanic Lava Scoria (내추럴 퀄쯔와 화산암재 스코리아의 기능성 마그네타이징 처리)

  • 소대화;소현준;배두안;김정희
    • Journal of the Speleological Society of Korea
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    • no.63
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    • pp.1-8
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    • 2004
  • The non-magnetic materials with non-conductive showing high structure dispersity were developed on the base of natural quartz and lava-scoria which was collected from Je-ju island in Korea, and treated by methane-chemical technology those were obtained novel properties of magnetization through the analyzing. Depending on the processing conditions and subsequent applications the materials produced by strong methane-chemical reaction (MCR) in alcohol solution showed concurrently magnetic, dielectric and electrical properties. The obtained magnetic-electrical powders classified by aggregate complex of their features as segnetomagnetics, containing a dielectric material as a carrying nucleus, particularly the quartz on that surface one or more layers of different compounds were synthesized having thickness up to 10~50 nm and showing magnetic, electrical and other properties. It was confirmed in magnetizing process that powders of quartz and lava-scoria produced by MCR were better oil adsorbent as of oleophilic and floating matter on water surface although their specific gravities are comparably more than 1 in quartz or less than unity, as that of water, in lava-scoira. Therefore, it will be Possible and very useful to remove low density and light gravity oil spillage in difficult recovery from sea and inland water contamination spread on water surface, by marine accident and ship sinking accident occurring frequently in recent years, by way of magnetic adsorbent conveyer system in continuous, if it could be built up the mass Production system of water-floating magnetizable oleophilic adsorbent materials with use of iow cost and good Qualify lava-scoria spread on volcano district in Je-ju island. And, there will also be urgent advent of necessity with strong possibility to develop useful applications of various magnetic functional materials include oleophilic adsorbent for removal of sea oil-contaminants and maritime pollutants, and other kinds of various utilities in industrial applications and practical uses of novel functional materials in the fields of environments and health care applications with in deep expectation.

Monitoring on Dose Index Analyzed in the Mammography (유방촬영검사에서 선량지표분석에 대한 모니터링)

  • Cho, Ji-Hwan;Lee, Hyo-Yeong;Im, In-Chul
    • Journal of the Korean Society of Radiology
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    • v.10 no.7
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    • pp.477-482
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    • 2016
  • This study is tried to determine whether the management of medical radiation is well handled by comparison the guidelines of KFDA(korea food & drug administration) with analysis of dose indicator in mammography. As a method, it is analysed that kVp, exposure time, mAs, compressed breast thickness, average glandular dose and body mass index that were classified in the examination of both breasts by CC(cranio-caudal) and MLO(medio-lateral oblique) with EMR(electronic medical record) and dose report that were sent to the PACS(picture archiving communication system). As a result, in the site inspection according to the age, Compressed breast thickness in CC and MLO were the thickest of 45.6 mm and 49.6 mm in the 50-59 year old respectively. In the overall average compressed breast thickness, CC were 44.2 mm and MLO were 48.9 mm. MLO has more thick by 4.7 mm. In average glandular dose, CC were 1.05 mGy and MLO were 1.14 mGy. MLO has higher by 0.09 mGy than CC. As the compressed breast thickness increases 10mm, CC and MLO increases 0.15 mGy and 0.17 mGy respectively. When it was compared with the average glandular dose of 1.16 mGy per 1 film presented by KFDA, CC was showed 1.05 mGy. However, the 60 mm or more was found to exceed a 1.30 mGy. Also, As the compressed breast thickness was higher, body mass index showed high score. And in the case of 25 or more in the obese body index according to body mass index, it was showed obesity in case of the compressed breast thickness was more than 50mm.

Clinical Usefulness of PET-MRI in Lymph Node Metastasis Evaluation of Head and Neck Cancer (두경부암 림프절 전이 평가에서 PET-MRI의 임상적 유용성)

  • Kim, Jung-Soo;Lee, Hong-Jae;Kim, Jin-Eui
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.1
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    • pp.26-32
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    • 2014
  • Purpose: As PET-MRI which has excellent soft tissue contrast is developed as integration system, many researches about clinical application are being conducted by comparing with existing display equipments. Because PET-MRI is actively used for head and neck cancer diagnosis in our hospital, lymph node metastasis before the patient's surgery was diagnosed and clinical usefulness of head and neck cancer PET-MRI scan was evaluated using pathological opinions and idiopathy surrounding tissue metastasis evaluation method. Materials and Methods: Targeting 100 head and neck cancer patients in SNUH from January to August in 2013. $^{18}F-FDG$ (5.18 MBq/kg) was intravenous injected and after 60 min of rest, torso (body TIM coil, Vibe-Dixon) and dedication (head-neck TIM coil, UTE, Dotarem injection) scans were conducted using $Bio-graph^{TM}$ mMR 3T (SIEMENS, Munich). Data were reorganized using iterative reconstruction and lymph node metastasis was read with Syngo.Via workstation. Subsequently, pathological observations and diagnosis before-and-after surgery were examined with integrated medical information system (EMR, best-care) in SNUH. Patient's diagnostic information was entered in each category of $2{\times}2$ decision matrix and was classified into true positive (TP), true negative (TN), false positive (FP) and false negative (FN). Based on these classified test results, sensitivity, specificity, accuracy, false negative and false positive rate were calculated. Results: In PET-MRI scan results of head and neck cancer patients, positive and negative cases of lymph node metastasis were 49 and 51 cases respectively and positive and negative lymph node metastasis through before-and-after surgery pathological results were 46 and 54 cases respectively. In both tests, TP which received positive lymph node metastasis were analyzed as 34 cases, FP which received positive lymph node metastasis in PET-MRI scan but received negative lymph node metastasis in pathological test were 4 cases, FN which received negative lymph node metastasis but received positive lymph node metastasis in pathological test was 1 case, and TN which received negative lymph node metastasis in both two tests were 50 cases. Based on these data, sensitivity in PET-MRI scan of head and neck cancer patient was identified to be 97.8%, specificity was 92.5%, accuracy was 95%, FN rate was 2.1% and FP rate was 7.00% respectively. Conclusion: PET-MRI which can apply the acquired functional information using high tissue contrast and various sequences was considered to be useful in determining the weapons before-and-after surgery in head and neck cancer diagnosis or in the evaluation of recurrence and remote detection of metastasis and uncertain idiopathy cervical lymph node metastasis. Additionally, clinical usefulness of PET-MRI through pathological test and integrated diagnosis and follow-up scan was considered to be sufficient as a standard diagnosis scan of head and neck cancer, and additional researches about the development of optimum MR sequence and clinical application are required.

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