Cyberknife with small field size is more difficult and complex for dosimetry compared with conventional radiotherapy due to electronic disequilibrium, steep dose gradients and spectrum change of photons and electrons. The purpose of this study demonstrate the usefulness of Geant4 as verification tool of measurement dose for delivering accurate dose by comparing measurement data using the diode detector with results by Geant4 simulation. The development of Monte Carlo Model for Cyberknife was done through the two-step process. In the first step, the treatment head was simulated and Bremsstrahlung spectrum was calculated. Secondly, percent depth dose (PDD) was calculated for six cones with different size, i.e., 5 mm, 10 mm, 20 mm, 30 mm, 50 mm and 60 mm in the model of water phantom. The relative output factor was calculated about 12 fields from 5 mm to 60 mm and then it compared with measurement data by the diode detector. The beam profiles and depth profiles were calculated about different six cones and about each depth of 1.5 cm, 10 cm and 20 cm, respectively. The results about PDD were shown the error the less than 2% which means acceptable in clinical setting. For comparison of relative output factors, the difference was less than 3% in the cones lager than 7.5 mm. However, there was the difference of 6.91% in the 5 mm cone. Although beam profiles were shown the difference less than 2% in the cones larger than 20 mm, there was the error less than 3.5% in the cones smaller than 20 mm. From results, we could demonstrate the usefulness of Geant4 as dose verification tool.
Purpose : This study was done to analyze the changes in the clinical conditions and the diagnosis of hypertrophic pyloric stenosis. Methods : We report a retrospective clinical analysis of 39 patients with hypertrophic pyloric stenosis from Jan. 1992 to Aug. 2001. The age and sex distribution, family and birth history, clinical symptoms, the ultrasonographic and the operative sizes of pyloric canals were compared. Results : The body weight was below the 3 percentile at admission in eight cases(20.5%). "Olive like mass" in right upper quadrant was palpated during physical examination in 23 cases(59%) and gastric peristaltic wave observed in six cases(15%). The ultrasonographic measurements showed that the pyloric muscle thickness to be $4.95{\pm}0.99mm$($mean{\pm}SD$), pyloric diameter $14.42{\pm}2.64mm$, and pyloric length $20.17{\pm}3.92mm$. Fredet-Ramstedt pyloromyotomy was employed in all cases. The operative measurements of the pyloric muscle thickness was $5.11{\pm}1.01mm$, pyloric diameter $15.01{\pm}2.47mm$, and pyloric length $22.32{\pm}3.43mm$. Conclusion : There was no significant difference between the ultrasonographic and operative measurements. Currently, the hypertrophic pyloric stenosis patients showed lesser clinical hallmarks of the disease. The earlier diagnosis using imaging studies before development of significant metabolic abnormalities is becoming an important factor that change the future outcomes of hypertrophic pyloric stenosis.
Purpose : Electroencephalography (EEG) findings can play a critical role in a variety of decisions, including initiation and withdrawal of antiepileptic drugs (AEDs) therapy. Interictal epileptiform discharges (IEDs) are predictor of recurrent seizures. We investigated IEDs in EEG after AED therapy and related factors in epileptic children. Methods : The subjects were 257 children [151 males and 106 females; age, 6.79 (3.40) years; duration of therapy, 2.48 (1.85) years] diagnosed with epilepsy at the Department of Pediatrics, Pusan National University Hospital between January 2001 and December 2007, who received AEDs for more than 6 months. EEG was performed at the intervals of 6-12 months. We divided patients into 4 groups according to IED detection before and after AEDs treatment. Related clinical factors, including gender, age at the start of treatment, seizure type, cause of seizure, AED frequency, seizure control, duration of AED therapy, and background activity were investigated in the 4 groups. Results : Generalized epilepsy was relatively frequen in patients who did not show IEDs in last follow-up EEG. There were no clinically significant differences according to gender, age at the start of treatment, cause of seizure, AED frequency, seizure control, duration of AED medication, and background activity in the 4 groups ($P$>0.05). Conclusion : IEDs changed after AED treatment in one-third of the patients. Generalized epilepsy is positive factor for negative IEDs in last follow-up EEG.
To confirm the application of a newer in vitro assays to determining the nutritional value of marine crustaceans (mainly shrimps and crabs), which have been considered to be highly nutritive depending on their levels of the essential amino acids and digestibility, their C-PERs and DC-PERs were determined and studied the factors influencing their in vitro results. Four species of seawater shrimps and 2 species of seawater crabs were used in this experiment. The in vitro digestibilities showed $83{\sim}86\%$ for raw shrimps and the trypsin indigestibile substrate content (TIS) was ranged from 1.32 to 3.33 mg/g solid expressed quantitatively as mg of purified soybean trypsin inhibitor. The smaller size of shrimps revealed a greater in vitro digestibility and a lower contents of TIS. It was noted that the in vitro digestibility of raw blue crab meat was around $85\%$ while boiled tenner crab meat showed $86\%$ or above, and the leg meat had the greatest in vitro digestibility in the various parts of crab meats. The poor in vitro digestibilities for shrimp's and crab's meat, compared with that of the other seafoods as noted in previous reports, suggest that the drop in pH, due to the change in their freshness during harvesting and frozen storage, resulted in underestimating their digestibilities using four-enzyme digestion technique. The lysine contents in all samples were higher than that of ANRC casein but they contained a slightly lower sulfur-containing amino acids than those in ANRC casein. But the other EAA, such as valine, tyrosine and phenylalanine, were found to be a half as little as that in casein and played a key-factor in calculation of C-PER or DC-PER. It was observed that the value of C-PER and DC-PER for all samples ranged from 2.1 to 2.4, and the predicted digestibilities showed $90\%$ or above in all samples. It was a different results from the fact that the animal proteins bear a higher values and predicted digestibilities than those of C-PER values. The lack of correlation between C-PER and DC-PER values is attributable to the fact that the lower content of valine, tyrosine and phenylalanine, and drop in pH owing to the changes of freshness in marine crustacea proteins. Therefore, if a newer in vitro digestion technique-which are taken into account the pH drop before digestion, TIS content and released free amino acids and/or peptides-developed, C-PER assays can provide more advantages in assessing the protein nutritional value of marine crustacea than any other in vitro assays.
This study examines the changes of income, everyday life and living condition of consumer in the aftermath of financial crisis. In this period financial crisis was the crucial factor behind various social problems such as the dissolution of families and individuals. This research explores the range and degree of impact on individuals and social groups after the financial crisis. We explore the social mobility in terns of maintaining middle class and falling into the lower class measured by middle class identification. The 60% of the middle class before the financial crisis maintained the middle class position and the rest of people left out of middle class and fell into lower class. The 60% of those who has been maintained and has just became the members of middle class were college - educated people. The great part of people whose income and assets has increased after financial crisis belongs to college - educated group. Many of those whose income have decreased belong to the high school educated group and blow, the older than 50 years old, self - employed without employee and unpaid family employee. Those whose income and assets decreased and those who experienced downward mobility have undergone changes in everyday life and living conditions as a consumer. Many of them experienced the unemployment, nonpayment or credit - delinquency, dissolution of family, worsening health condition, depression, feeling the impulse to commit suicide simultaneously. The poor consumer disposition, reduction of living expenses, sound consumer culture have expanded to people since economic crisis. The middle class reported that the cost of private education often goes beyond the family ability to pay. The lower class has suffered from the cost of living. In a meanwhile luxury goods preference, consumer consciousness for status symbol have continuously increased among all the classes since 1997. Thus fluctuations of one's income and social mobility during past 10 years were some of the major determinants which brought about the various damaging life events, changes of living conditions and everyday lives as a consumer.
This paper aims to show the various aspects of migration in Kwangju merropolitan area, southwestern Korea, for a period of years 1980-1985. Migratory patterns are spatially extensive in countryside around Kwanfju, and due to high accessibility to the metropolitan area urban implosion emerges in the city. In Chonnam province where Kwangju is loca-ted, all cities and counties except for such in-dustrial areas as Yochon, and Kwangyang are experiencing population losses in terms of net migration by survival rate methods. Kwangju is the exceptionally one of in-migration areas in Chonnam, though its central part(Dong-Gu) is also an out-migrated area. Predominantly in-migration urban areas have high proportions of a student age group between 15-19 years, and that reflects the importance of the educational factor in migration analysis. The municipal authorities of Kwangju are planning to block the way of the middle sxhool students who live in the outskirts of Kwangju to entrance to high school in the city. Thant may stir up migrations into Kwangju for the elementary and middle school students, because the city id expected to provide educational opportunities higher and better than remaining Chonnam areas. Population of Kwangju would, therefore, grow as the students migrate into the city. The findings on the residential intra-city movement in selected 5 Dongs indicate that implications of a short-distance movement re noteworthy; neighbour to neighbour, and the nearest stop in the way from the outer Kwangju as well. Trends in a short-distance movement are in accord with Ravensteins's "law of migra-tion". But in casw of the inter-provincial migra-tion to Kwangju, the number of in-migrants from remoter Seoul is more than that from nearer Chonbuk province. Therefore it supports the fact that the movement between capital region and far off local cities overcomes a distance barrier. The temporary mobility for a day has been increased as the standard of living has improved and it reaches a peak on weekend or on con-secutive holidays. The number of temporal movers to Kwangju from capital region and Yongnam area, southeastern Korea has a greatincrease in terms of the frequency of the passengers' mobility, in particular on Myongjol(the ethnic and traditional festival day) in com-parison with on weekdays. By comparison with two largest Myongjols, the number of movers is more on Chusok(The Full Moon festival on lunar August) than on Sol (lunar new year's day). Annual peak point of weekday movers appears in August because of summer vacation. But the lowest one appears in June, which is related to the busy farming season. A patients' move for medical services in on the increase with a change of living conditions. It is especially true in the industrial counties such as Kwangyang and Yochon. By way of conclusion, it should be pointed out that one of the problems we face in survey of migration volume by the survival rate method is that the survival rate somtimes exceeds the value 1.0, in normal states of which should be under 1.0. it may be due to the shortcoming from the census statistics. We should not give therefore too much stress on the importance of migrations or moves as an element of changes in spatial pattern. In cinclusion, the results of the study show some geographic facts as the followings: 1. One of the outstanding phenomena in all types of movement is the seletivity of ages. The most important factors are related to education and employment. 2. Short-distance movement is carried out in accordance with Ravenstein's law, but in case long-distance movement, in-migration from capital region is prominent in spite of remoten-ces. The gravity between large cities such as Kwangju and Seoul, which has a frequent human movenent, causes urban implosion of small cities between those cities. 3. The temporary mobility for a day, in con-trast to that of permanent movement, is more related to transportation, and its volumes and annual variations are a large-scale. 4. Passengers' mobility is high in industrial cities. And the scope of patients' mobility is narrower than passengers'.
Lee Sang Rok;Jeong Deok Yang;Lee Byoung Koo;Kwon Young Ho
The Journal of Korean Society for Radiation Therapy
/
v.15
no.1
/
pp.19-27
/
2003
I. Purpose In special cases of Total Body Irradiation(TBI), Half Body Irradiation(HBI), Non-Hodgkin's lymphoma, E-Wing's sarcoma, lymphosarcoma and neuroblastoma a large field can be used clinically. The dose distribution of a large field can use the measurement result which gets from dose distribution of a small field (standard SSD 100cm, size of field under $40{\times}40cm2$) in the substitution which always measures in practice and it will be able to calibrate. With only the method of simple calculation, it is difficult to know the dose and its uniformity of actual body region by various factor of scatter radiation. II. Method & Materials In this study, using Multidata Water Phantom from standard SSD 100cm according to the size change of field, it measures the basic parameter (PDD,TMR,Output,Sc,Sp) From SSD 180cm (phantom is to the bottom vertically) according to increasing of a field, it measures a basic parameter. From SSD 350cm (phantom is to the surface of a wall, using small water phantom. which includes mylar capable of horizontal beam's measurement) it measured with the same method and compared with each other. III. Results & Conclusion In comparison with the standard dose data, parameter which measures between SSD 180cm and 350cm, it turned out there was little difference. The error range is not up to extent of the experimental error. In order to get the accurate data, it dose measures from anthropomorphous phantom or for this objective the dose measurement which is the possibility of getting the absolute value which uses the unlimited phantom that is devised especially is demanded. Additionally, it needs to consider ionization chamber use of small volume and stem effect of cable by a large field.
Between April 1981 and June 1996, 65 patients had aortic root replacement at our institution. Disease entities were pure aortic annuloectasia in 31 patients(47.7%), Stanford type A aortic dissection with annuloectasia in 8(43.1%), atherosclerotic aneurysm with aortic regurgitation in 4(6.2%), and paravalvular leakage after aortic valve replacement in 2(3.1 %). 34 patients(52.3%) had the clinical stigmata of the Marfan syndrome. The operative procedures were Bentall operation in 61 patients(93.8%); 3 of conventional procedure and 58 of Cabrol's modification, aortic valve-sparing operation in 2(3.1 %), and root replacement with homograft in 2(3.1%). Hospital deaths occurred in 3 patients(4.8%) because of uncontrolled bleeding(1) and bypass weaning failure due to low cardiac output(2), and all had emergency operation with Cabrol's procedure. Postoperative complications developed in 19(29.2%) patients and most of them were transient. Surviving 62 patients have been followed up to cumulative total 315.0 patient-years(mean 60.2 $\pm$42.4 months). Late deaths occurred in 7 patients(11.3%), aneurysmal changes of remaining aorta were detected in 12 patients(19.4%). Actuarial survival rate at 10 years was 72.0 $\pm$ 9.7%, and the subsequent aortic operation-free rate at 10 years was 68.0$\pm$ 8.9% In a multivariate analysis, Marfan syndrome, emergency operation, preoperative dissection, combined arch replacement, and total circulatory arrest emerged as significant risk factors for hospital death or subsequent aortic operation. Over 60 years of age was the only risk factor for late death. Our 16 years'cummulative experience shows that aortic root replacement, mainly by means of Cabrol's procedure, can be applied successfully to variety of aortic root disease. However, long-term follow up will be needed to determine the late result of aortic valve-saving operation and root replacement with homograft. When dissection is present or the distal native aorta is diseased in'Marfan patients, close follow-up is necessary because of the subsequent aneurysmal change of remaining aorta.
Korean Journal of Agricultural and Forest Meteorology
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v.15
no.4
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pp.245-263
/
2013
This study was conducted to find out the influence of elevated atmospheric $CO_2$ concentrations and air temperature on photosynthesis and fruit quality of 'Fuji'/M.9 apple trees and to investigate these to the effects of climate change during the last four years (2009-2012). The treatments employed were: 'Ambient' (ambient temperature + ambient $CO_2$ concentration); 'High $CO_2$' (ambient temperature + elevated $CO_2$ concentration); 'High Temp'. (elevated temperature + ambient $CO_2$ concentration); and 'High $CO_2$ + High Temp'. (elevated temperature + elevated $CO_2$ concentration). The elevated temperature plots were maintained at $4^{\circ}C$ higher than ambient air temperature, while the elevated $CO_2$ plots were maintained at 700 ${\mu}mol{\cdot}mol^{-1}$. Annual treatment period was applied from end of April to beginning of November for four years. Results showed that elevated $CO_2$ decreased stomatal conductance and leaf SPAD value, but increased photosynthetic rate, intercellular $CO_2$ concentration (Ci), and starch content of mesophyll tissue. In the vegetative growth, elevated temperature increased total number of shoot and total shoot growth per tree, but elevated $CO_2$ decreased average shoot length. In the fruit quality, elevated $CO_2$ increased soluble solid content, fruit red color, and ethylene production. In conclusion, elevated $CO_2$ increased photosynthetic rate of apples during the early growth, but effect of increased photosynthetic rate due to elevated $CO_2$ was decreased during latter growth stage. Elevated temperature, on the other hand, tended to decrease photosynthetic rate of apples during the early growth, but that tended to increase during latter growth stage. Both elevated $CO_2$ and temperature tended to decrease the degree of decreased photosynthetic rate due to each factor.
Lee, Bo Young;Kim, Chun Soo;Ryu, Seong Yeol;Kwon, Ki Yung;Lim, Jung Geun;Lim, Tae Jin;Min, Byung Woo;Ryoo, Nam Hee;Cha, Soon Do
Pediatric Infection and Vaccine
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v.13
no.2
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pp.155-162
/
2006
Purpose : Appropriate use of antimicrobials is an essential factor to treat infectious diseases and prevent acquisition of antimicrobial resistant pathogens. This study was undertaken to search that application of computerized management program for restriction of antimicrobials use in a hospital is helpful to decrease antimicrobial use density. Methods : Antibiotics utilization committee decided to restrict the use of 16 antimicrobials(14 expensive drugs having fear of drug resistance by pathogens and additional two drugs with inappropriate using tendency). Retrospective evaluation of antimicrobial user numbers between May and July of 2004 and 2005(study group) was conducted to compare with previous use density during same period of 2002 and 2003(control group). Results : Inpatients number of control group($823.5{\pm}37.1$ persons) was more than study group($809.2{\pm}39.3$ persons, P<0.001), but, outpatients number and hospitalized duration were equal in two groups. Antimicrobial user number/100 inpatients per day of glycopeptides and antifungal agents was equal in two groups, and study group was significantly higher density than control group in the use of carbapenems, piperacillin-tazobactam and quinolones(P<0.001). But study group was significantly lower density than control group in the use of drugs with inappropriately using tendency and expensive cephalosporins having broad antimicrobial spectrum(P<0.001). Conclusion : Application of computerized management program for restriction of antimicrobials use in a hospital is effective to decrease the use density of antimicrobials with inappropriately using tendency, but it is an insufficient measures for the restricted use of other antimicrobials on the whole.
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