To treat nitrate and non-biodegradable organics effectively in sewage, industrial wastewater and livestock wastewater, the activated sludge process integrated by a membrane separation and a porous electrode- electrolysis was proposed and its efficiency was investigated. The proposed system was consisted of 3 processes; activated sludge, membrane filtration and electrolysis. In the study, the membrane filtration played a role in reducing the load of the electrolysis to operate the proposed process stably. The electrolysis consisted of a porous electrode to increase the efficiency due to the extension of the specific surface area. Additionally, redox reaction in the electrolysis was induced by decomposing influent water as current was applied. As a result, hydrogen free radicals and oxygen radicals as intermediates were produced and they acted as oxidants to play a role in decomposing non-degradable organics. It was environmentally-friendly process because intermediates produced by porous electrode were used to treat waste matters without supplying external reagent. Experimental data showed that the proposed process was more excellent than activated sludge process. SS removal efficiencies of the proposed process, membrane filtration and activated sludge process were about 100%, about 100% and about 90%, respectively. COD removal efficiencies of the proposed system, membrane filtration and activated sludge process were about 92%, about 84% and about 78%, respectively. T-N removal efficiencies of the proposed system, membrane filtration and activated sludge process were about 88%, about 67%, and about 58%, respectively. The SS data showed that SS was efficiently removed in the single of the membrane filtration. The COD/T-N data showed that COD/T-N of membrane hybrid process was treated by removing a little soluble organics and SS, and that COD/T-N of electrolysis hybrid process was treated by oxidize organics with high removal rate.
Lee, Sang Hyeon;Ahn, Woo Sang;Lee, Woo Seok;Choi, Jin Hyeok;Kim, Seon Yeon
The Journal of Korean Society for Radiation Therapy
/
v.29
no.2
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pp.65-73
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2017
Purpose: Machine Performance Check (MPC) is a self-checking software based on the Electronic Portal Imaging Device (EPID) to measure daily beam outputs without external installation. The purpose of this study is to verify the usefulness of MPC by comparing and correlating daily beam output of QA Beamchecker PLUS. Materials and Methods: Linear accelerator (Truebeam 2.5) was used to measure 10 energies which are composed of photon beams(6, 10, 15 MV and 6, 10 MV-FFF) and electron beams(6, 9, 12, 16 and 20 MeV). A total of 80 cycles of data was obtained by measuring beam output measurement before treatment over five months period. The Pearson correlation coefficient was used to evaluate the consistency of the beam output between the MPC and the QA Beamchecker PLUS. In this study, if the Pearson correlation coefficient is; (1) 0.8 or higher, the correlation is very strong (2) between 0.6 and 0.79, the correlation is strong (3) between 0.4 and 0.59, the correlation is moderate (4) between 0.2 and 0.39, the correlation is weak (5) lower than 0.2, the correlation is very weak. Results: Output variations observed between MPC and QA Beamchecker PLUS were within 2 % for photons and electrons. The beam outputs variations of MPC were $0.29{\pm}0.26%$ and $0.30{\pm}0.26%$ for photon and electron beams, respectively. QA Beamchecker PLUS beam outputs were $0.31{\pm}0.24%$ and $0.33{\pm}0.24%$ for photon and electron beams, respectively. The Pearson correlation coefficient between MPC and QA Beamchecker PLUS indicated that photon beams were very strong at 15 MV, and strong at 6 MV, 10 MV, 6 MV-FFF and 10 MV-FFF. For electron beams, the Pearson correlation coefficient were strong at 16 MeV and 20 MeV, moderate at 9 MeV and 12 MeV, and very weak at 6 MeV. Conclusion: MPC showed significantly strong correlation with QA Beamchecker PLUS when testing with photon beams and high-energy electron beams in the evaluation of daily beam output, but the correlation when testing with low-energy electron beams (6 MeV) appeared to be low. However, MPC and QA Beamchecker PLUS are considered to be suitable for checking daily beam output, as they performed within 2 % of beam output consistency during the observation. MPC which can perform faster than the conventional daily beam output measurement tool, is considered to be an effective method for users.
Kim, Min Seok;Jeon, Soo Dong;Bae, Sun Myeong;Baek, Geum Mun;Song, Heung Gwon
The Journal of Korean Society for Radiation Therapy
/
v.29
no.2
/
pp.43-51
/
2017
Purpose: The purpose of this study is to evaluate the dosimetric effects of couch attenuation and air gaps using 3D phantom for prone breast radiation therapy. Materials and method: A 3D printer(Builder Extreme 1000) and computed tomography (CT) images of a breast cancer patient were used to manufacture the customized breast phantom. Eclipse External Beam Planning 13.6 (Varian Medical Systems Palo Alto, CA, USA) was used to create the treatment plan with a dose of 200 cGy per fraction with 6 MV energy. The Optically Stimulated Luminescence Detector(OSLD) was used to measure the skin dose at four points (Med 1, Med 2, Lat 1, Lat 2) on the 3D phantom and ion-chamber (FC65-G) were used to perform the in-vivo dosimetry at the two points (Anterior, Posterior). The Skin dose and in-vivo dosimetry were measured with reference air gap (3 cm) and increased air gaps (1, 2, 3, 4, 5, 6 cm) from reference distance between the couch and 3D phantom. Results: As a result, measurement for the skin dose at lateral point showed a similar value within ${\pm}4%$ compared to the plan. While the air gap increased, skin dose at medial 1 was reduced. And it was also reduced over 7 % when the air gap was more than 3 cm compared to radiation therapy plan. At medial 2 it was reduced over 4 % as well. The changes of dose from variety of the air gap showed similar value within ${\pm}1%$ at posterior. As the air gap was increased, the dose at anterior was also increased and it was increased by 1 % from the air gap distance more than 3 cm. Conclusion: Dosimetrical measurement using 3D phantom is very useful to evaluate the dosimetric effects of couch attenuation and air gaps for prone breast radiation therapy. And it is possible to reduce the skin dose and increase the accuracy of the radiation dose delivery by appling the optimized air gap.
External stimuli increases intracellular (IC) $Ca^{2+}$, which increases extracellular (EC) $K^{+}$. To verify $K^{+}$ effects on the vascular contraction, we performed an experiment using mouse aortic endothelial cell. Meterial and Method: We examined the mouse aortic contractility changes as we measured the IC $Ca^{2+}$ change and ionic current by using the voltage clamp technique under different conditions such as: increasing EC $K^{+}$, removing endothelial cell, giving L-NAME (N-nitro-L-arginine methyl ester) which suppress nitric oxide formation, Ouabain which control N $a^{+}$ - $K^{+}$ pump and N $i^{2+}$ which repress N $a^{+}$-C $a^{2+}$ exchanger Result: When we increased EC $K^{+}$ from 6 to 12 mM, there was no change in aortic contractility. Aorta contracted with more than 12 mM of EC $K^{+}$. Ace-tylcholine (ACh) induced relaxation was inhibited with EC $K^{+}$ from 6 to 12 mM, but was not found after de-endothelialization or L-NAME treatment. ATP or ACh increased IC $Ca^{2+}$ in cultured endothelium. After maximal increase of IC $Ca^{2+}$, increasing EC $K^{+}$ from 6 to 12 mM made IC $Ca^{2+}$ decrease and re-decreasing EC $K^{+}$ to 6 mM made IC $Ca^{2+}$ increase. Ouabain and N $i^{2+}$ masked the inhibitory effect of endothelium dependent relaxation by increased EC $K^{+}$. Conclusion: These data indicate that increase in EC $K^{+}$ relaxes vascular smooth muscle and reduces $Ca^{2+}$ in the endothelial cells which inhibit endothelium dependent relaxation. This inhibitory mechanism may be due to the activation of N $a^{+}$- $K^{+}$ pump and N $a^{+}$-C $a^{2+}$ exchanger. $a^{+}$-C $a^{2+}$ exchanger.r.
This study examined the dosimetric influence of implanted gold markers in proton therapy and the effects of their positions in the spread-out Bragg peak (SOBP) proton beam. The implanted cylindrical gold markers were 3 mm long and 1.2 mm in diameter. The dosimetric influence of the gold markers was determined with markers at various locations in a proton-beam field. Spatial dose distributions were measured using a three-dimensional moving water phantom and a stereotactic diode detector with an effective diameter of 0.5 mm. Also, a film dosimetry was performed using Gafchromic External Beam Treatment (EBT) film. The GEANT4 simulation toolkit was used for Monte-Carlo simulations to confirm the measurements and to construct the dose-volume histogram with implanting markers. Motion data were obtained from the portal images of 10 patients to investigate the effect of organ motions on the dosimetric influence of markers in the presence of a rectal balloon. The underdosed volume due to a single gold marker, in which the dose was less than 95% of a prescribed amount, was 0.15 cc. The underdosed volume due to the presence of a gold marker is much smaller than the target volume. However, the underdosed volume is inside the gross tumor volume and is not smeared out due to translational prostate motions. The positions of gold markers and the conditions of the proton-beam field give different impacts on the dose distribution of a target with implanted gold markers, and should be considered in all clinical proton-based therapies.
Journal of the Korea Academia-Industrial cooperation Society
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v.11
no.12
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pp.4863-4872
/
2010
This study examined the disease conditions of patients from a farming and fishing village area. In order to analyze the medical service utilization, the necessary data were obtained from established health and medical care service plans from medical treatment related organizations. The following results were based on the analysis of data from the medical records of 2,365 discharged patients during a six months period from July to December 2009 at a general hospital in an aging farming and fishing village area. Results: The sex of the patients investigated was male 55.3%, female 44.7%, and the most frequent age category at 42.0% was 70 years of age or older. Based on type of hospital admission, 65.5% of patients who were admitted were originally outpatients. Patients were admitted according to the following departments: 49.7% for the department of internal medicine, 16.7% for the department of orthopedics, and 13.8% for the department of neurosurgery. The average number of days hospitalized was 14.8 days. The following ranks the principal diagnosis among patients in this study: S00-T98 18.4%, J00-J99 15.5%, and I00-I99 11.5%. The average number of diagnosis listed per patient was 5.6. There was a statistically significant difference for the following general characteristics according to principal diagnosis list: gender, type of insurance, admission process, and age category distribution had statistically significant differences. Monthly distribution of principal diagnoses were statistically significant difference. There was a statistically significant difference for principal diagnosis lists according to the average number of days admitted and the number of diagnosis. The results of this study showed the types of disease from typical farming and fishing village regions as disease from external injury due to the work environment of farming and fishing village regions and excessive labor throughout the year, respiratory disease, and various chronic disease from aging.
As the society is being industrialized, the fast-paced economic development that has caused substantial increase in cerebrovascular and coronary artery diseases and the industrial development and increased use of means of transportation have resulted in the rapid rise of incidents in external injuries as well. So the pubic has become acutely aware of the need for fast and effective emergency care delivery system. The goal of emergency care delivery system is to meet the emergency care needs of patients. The emergency care delivery system is seeking to efficiently satisfy the care needs of people. Therefore the purpose of this study is designed to develop an effective programs for emergency care delivery system in Korea. The following specific objectives were investigated. This emergency care delivery system must have the necessary man power, for transfering the patients, communication net work, and emergency care facilities. 1) Man power Emergency care requires n0t only specialized traning in the emergency treatment but also knowledge and experience i11 other related area, so emergency care personnel traning program should be designed in order to adapt to the specific need of emergency patients. It will be necessary to ensure professional personnel who aquires the sufficient traning and experience for emergency care and to look for legal basis. We have to develop re-educational programs for emergency nurse specialist. They should be received speciality of emergency nursing care so that they will work actively and positively in emergency part. Emergency medical doctor and nurse specialist should be given an education which is related in emergency and critical care. Emergency care personnel will continue to provide both acute and continuing care as partner with other medical team. 2) Transfering the patients. Successful management of pre-hospital care requires adequate traning for the emergency medical technician. Traning program should be required to participate in a actual first aids activites in order to have apportunities to acquire practical skills as well as theoretical knowledge. The system of emergency medical technician should be remarkablly successful with first responder firefighters. Establishing this system must add necessary ambulances operating at any given time. It will be necessary to standardize the ambulance size and equipment. Ambulance should be arranged with each and every fire station. 3) Communication net work. The head office of emergency commumication network should be arranged with the head office of fire station in community. It is proposed that Hot-line system for emergency care should be introduce. High controlled ambulance and thirtial emergency center should simultaneously equip critical-line in order to communication with each other. Ordinary ambulance and secondary emergency facility should also simultaneously equip emergency-line in order to communication with each other. 4) Emergency care facilities. Primary emergency care facilities should be covered with the ambulatory emergency patients-minor illness and injuires. Secondary emergency care facilities should be covered with the emergency admission patients. Third emergency care center should be covered with the critical patients who need special treatments and operation. Secondary and third emergency care facilities should employ emergency medical doctor and emergency nurse specialist to treat in-patients with severe and acute illness and multiple injuires. It should be fashioned for a system of emergency facilities that meets emergency patients needs. Provide incentives for increased number of emergency care facilities with traning in personal/clinical emergency care. 5) Finance It is recommended to put the finance of a emergency care on a firm basis. The emergency care delivery system should be managed by the government or accreditted organizations. In order to facilitate this relevant program the fund is needed for more efficient and effective emergency researchs, service, programs, and policy. 6) Gaining understanding and co-operation of pubic It is also important to undertake pubic education to improve understanding of first aids and C. P. R of individuals, communities and business. It is proposed that teachers and health officers be certified in C. P. R. The C. P. R education can be powerful influence save lives. Lastly appropriate emergency care information must be provided to the pubic for assisting them in choosing emergency care.
Purpose : To compare birth weight between infants with a single umbilical artery (SUA) and normal infants, investigate the associated anomalies of infants with SUA and isolated SUA (no abnormality of external appearance on birth, except SUA), and determine the prognosis of infants with isolated SUA. Methods : Live-born infants with SUA (n=59) detected by physical examination from among 15,193 live births in seven university hospitals in Korea between January 1, 2004, to August 1, 2007, were reviewed retrospectively, with 236 normal infants serving as the control group. Results : A statistical difference was observed between the groups in birth weight and in vitro fertilization. The incidence of infants with SUA was 0.37%. Congenital malformations were observed in 21 infants with cardiovascular (n=15, 25.4%), gastrointestinal (n=2, 3.4%), genitourinary (n=9, 15.3%), neuromusculoskeletal (n=6, 10.2%), central nervous system (n=1, 1.7%), chromosomal (n=1, 1.7%), and other (n=3, 5.1%) abnormalities. There were 49 (83.1%) infants with isolated SUA in this study population; among them, the associated congenital malformations were cardiovascular (n=6, 12.2%) and genitourinary (n=6, 12.2%) abnormalities. Two infants with cyanotic heart disease were operated and four infants with acyanotic heart disease showed improvements without any treatment. Six infants with genitourinary abnormalities on renal ultrasound had mild hydronephrosis without further consequences. Conclusion : The incidence of structural abnormalities in the cardiovascular and genitourinary systems is high and the genitourinary anomalies associated with isolated SUA have relatively good prognosis.
Ji, Jong-Hun;Park, Sang-Eun;Kim, Young-Yul;Shin, Eun-Su;Park, Bo-Youn;Jeong, Jae-Jung
Clinics in Shoulder and Elbow
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v.13
no.1
/
pp.20-26
/
2010
Purpose: To evaluate clinical features and surgical results for rotator cuff tear secondary to shoulder dislocation in middle-aged and elderly patients. Materials and Methods: We reviewed 19 patients over 50 years of age who had rotator cuff tears combined with shoulder dislocation between October 2004 and October 2008. There were 7 males and 12 females with a mean age 64.7 years (range, 50 to 78 years). The average follow-up duration was 22 months (range, 8 to 56 months). We investigated the number of dislocations, the size of the cuff tear, the presence of Bankart lesions and the time interval from dislocation to surgery. We also investigated the ASES score, UCLA score, SST score, and shoulder range of motion before and after surgery. We analyzed clinical outcomes and contributing factors. Results: ASES scores improved from 30.2 preoperatively to 72.3 postoperatively; UCLA scores improved from 12.9 to 26.5; SST scores improved from 2.4 to 7.3. Range of motion improved significantly: forward flexion, abduction, external rotation and internal rotation were, respectively, $110.8({\pm}39.3)^{\circ}$, $107.7({\pm}40)^{\circ}$, $22.5({\pm}17.6)^{\circ}$ and L5 level preoperatively; postoperatively they were $153.6({\pm}20.6)^{\circ}$, $152.1({\pm}20.8)^{\circ}$, $36.4({\pm}22.7)^{\circ}$ and L1 level. Age, the presence of Bankart lesions and the number of dislocations were not correlated with clinical outcomes. But the size of the cuff tear was correlated with clinical results. Also, the duration from dislocation to surgery was correlated with postoperative UCLA and SST scores (p=0.039, p=0.038). Conclusion: For shoulder dislocation, it is important to achieve early diagnoses of rotator cuff tears in middle-aged and elderly patients. If these injuries are both present, early rotator cuff repair should be performed for better clinical results.
Purpose: The purpose of this study is to report a result of the technique that reconstruct posterior cruciate ligament (PCL) and posterolateral corner (PLC) simultaneously using a fresh-frozen Achilles tendon allograft. Materials and Methods: Forty two patients (45 legs) underwent PCL and PLC reconstruction were included. There were 38 males and 4 females. Mean age was 39 years. Used graft was a fresh frozen Achilles tendon allograft, which was divided by two size, larger one (${\emptyset}$ 10 mm) for PCL reconstruction and smaller one (${\emptyset}$ 8 mm) for PLC reconstruction. Arthroscopic reconstruction of the PCL was performed using transtibial, single incision, and single bundle technique with 10mm fresh frozen Achilles allograft tendon first. After PCL reconstruction, reconstruction procedure for posterolateral instability was performed using modified figure of "8" technique using smaller gtaft. For clinical evaluation, range of motion, posterior drawer test, varus stress test, prone external rotation (dial) test, Lysholm score, Tegner activity scale and posterior stress radiograph were used. Mean follow up period was 25 months. Results: Preoperatively posterior drawer test was 5 cases in grade II and 40 cases in grade III posterior instability. At final follow-up 22 cases returned within normal condition, 18 cases grade I and 5 cases grade II posterior instability. Though all patients showed positive result over 10 degrees in dial and varus stress test preoperatively, but only 9 cases showed positive both test at final follow-up. The range of motion deficit over $10^{\circ}$ flexion was 3 cases. Lysholm score was improved from mean 50 preoperatively to mean 83(p<0.05) and Tegner activity scale improved from mean 2.1 preoperatively to mean 4.6(p<0.05). In posterior stress radiographs, posterior displacement was improve from mean 16mm preoperatively to 4.1mm after treatment(p<0.05). All patients had improved compared to their pre-operative status as measured by physical examination such as posterior drawer test, varus stress test, dial test. Conclusion: We had successful results by combined reconstruction of the PCL & PLC with a fresh frozen Achilles tendon allograft in patients with PCL and posterolateral rotatory instability at a time.
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