• Clinics in Shoulder and Elbow
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• v.14 no.2
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• pp.229-235
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• 2011

Purpose: To compare the clinical and radiological result of arthroscopic Mattress Locking suture repair to that of a Simple suture repair with small and medium-sized rotator cuff tears. Materials and Methods: Among 92 patients who were followed up after arthroscopic repair in patients with small and medium-sized rotator cuff tear from April 2007 to October 2010, 27 patients who took Arthroscopic Mattress Locking suture were set as group I and 65 patients who took Simple suture were set as Group II. The average age of patients were 58 years old and average follow-up period was 30 months. For analysis, VAS, ASES and KSS were used to analyze the range of joint movement and pain. And, for the image result, MRI performed after operation were evaluated. Results: The average VAS, KSS, UCLA score and ASES prior to surgery improved in the last follow-up (p<0.001), while was no difference in two groups (p>0.001). In MRI follow-up examination, the 2 cases (7.41%) of group 1 showed increased rupture lesions with improved symptoms. And the 12 cases (18.47%) of group 2 showed increased rupture lesions with improved symptoms. Retears in the group I were significant less than the group II (p<0.001). Conclusion: Comparing patients with small and medium-sized rotator cuff tear who took arthroscopic mattress locking suture repair to those who took simple suture repair after over one year follow up period, the clinical result showed no significant difference between two groups. However, Mattress Locking suture repair showed excellent radiological result compared to simple suture repair when comparing rerupture.

• The Journal of Korean Society for Radiation Therapy
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• v.27 no.2
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• pp.107-113
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• 2015

Purpose : The measurement of skin dose is very important that treatment of breast cancer. On account of the cold or hot dose as compared with prescription dose, it is necessary to analyse the skin dose occurring during the various plan of the breast cancer treatment. At our hospital, we want to apply various analyses using a diversity of dosimeters to the breast cancer treatment. Subjectss and Methods : In the study, the anthropomorphic phantom is used to find out the dose difference of the skin(draining site), scar and others occurring from the tangential treatment plan of breast cancer. We took computed tomography scan of the anthropomorphic phantom and made plans for the treatment planing using open and wedge, Field-in-Field, Dose fluence. Using these, we made a comparative analysis of the dose date points by using the Eclipse. For the dose comparison, we place the anthropomorphic phantom in the treatment room and compared the measurement results by using the TLD and MOSFET on the dose data points. Results : On the central point of treatment planing basis, the upward and downward skin dose measured by the MOSFET was the highest when the fluence was used. The skin dose of inner and outer was distinguished from the figure(5.7% ~ 10.3%) when the measurements were fulfilled by using TLD and MOSFET. The other side of breast dose was the lowest in the open beam, on the other hand, is highest in the Dose fluence plan. In the different kinds of treatment, the dose deviation of inner and outer was the highest, and so this was the same with the TLD and MOSFET measurement case. The outer deviation was highest in the TLD, and the Inner'was highest in the MOSFET. Conclusion : Skin dose in relation to the treatment plan was the highest in the planing using the fluence technique in general and it was supposed that the high dose had been caused by the movement of the MLC. There's some differences among the all the treatment planning, but the sites such as IM node occurring the lack of dose, scar, drain site are needed pay close attention. Using the treatment planning of dose fluence is good to compensate the lack of dose, but It increases the dose of the selective range rather than the overall dose. Therefore, choosing the radiotherapy technique is desirable in the lights of the age and performance of the patient.

• The Journal of Korean Society for Radiation Therapy
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• v.24 no.1
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• pp.39-43
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• 2012

Purpose: In hospital image-guided radiation therapy in patients with bladder cancer to enhance the reproducibility of the appropriate amount, depending on the patient's condition, and image-guided injection of saline system (On-Board Imager system, OBI, VARIAN, USA) three of the Cone-Beam CT dimensional matching (3D-3D matching) to be the treatment. In this study, the treatment of patients with bladder cancer at Cone-Beam CT image obtained through the analysis of the bones based matching and matching based on the bladder to learn about the differences, the bladder's volume change injected saline solution by looking at the bladder for the treatment of patients with a more appropriate image matching is to assess how the discussion. Materials and Methods: At our hospital from January 2009 to April 2010 admitted for radiation therapy patients, 7 patients with bladder cancer using a Folly catheter of residual urine in the bladder after removing the amount determined according to individual patient enough to inject saline CT-Sim was designed after the treatment plan. After that, using OBI before treatment to confirm position with Cone-Beam CT scan was physician in charge of matching was performed in all patients. CBCT images using a total of 45 bones, bladder, based on image matching and image matching based on the difference were analyzed. In addition, changes in bladder volume of Eclipse (version 8.0, VARIAN, USA) persuaded through. Results: Bones, one based image matching based on the bladder and re-matching the X axis is the difference between the average $3{\pm}2mm$, Y axis, $1.8{\pm}1.3mm$, Z-axis travel distance is $2.3{\pm}1.7mm$ and the overall $4.8{\pm}2.0mm$, respectively. The volume of the bladder compared to the baseline showed a difference of $4.03{\pm}3.97%$. Conclusion: Anatomical location and nature of the bladder due to internal movement of the bones, even after matching with the image of the bladder occurred in different locations. In addition, the volume of saline-filled bladder showed up the difference between the 4.03 percent, but matched in both images to be included in the planned volumes were able to confirm. Thus, after injection of saline into the bladder base by providing a more accurate image matching will be able to conduct therapy.

• The Journal of Korean Society for Radiation Therapy
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• v.18 no.2
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• pp.81-87
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• 2006

Purpose: Few researches have been peformed on the dose distribution of the moving organ for radiotherapy so far. In order to simulate the organ motion caused by respiratory function, multipurpose phantom and moving device was used and dosimetric measurements for dose distribution of the moving organs were conducted in this study. The purpose of our study was to evaluate how dose distributions are changed due to respiratory motion. Materials and Methods: A multipurpose phantom and a moving device were developed for the measurement of the dose distribution of the moving organ due to respiratory function. Acryl chosen design of the phantom was considered the most obvious choice for phantom material. For construction of the phantom, we used acryl and cork with density of $1.14g/cm^3,\;0.32g/cm^3$ respectively. Acryl and cork slab in the phantom were used to simulate the normal organ and lung respectively. The moving phantom system was composed of moving device, moving control system, and acryl and cork phantom. Gafchromic film and EDR2 film were used to measure dose ditrbutions. The moving device system may be driven by two directional step motors and able to perform 2 dimensional movements (x, z axis), but only 1 dimensional movement(z axis) was used for this study. Results: Larger penumbra was shown in the cork phantom than in the acryl phantom. The dose profile and isodose curve of Gafchromic EBT film were not uniform since the film has small optical density responding to the dose. As the organ motion was increased, the blurrings in penumbra, flatness, and symmetry were increased. Most of measurements of dose distrbutions, Gafchromic EBT film has poor flatness and symmetry than EDR2 film, but both penumbra distributions were more or less comparable. Conclusion: The Gafchromic EBT film is more useful as it does not need development and more radiation dose could be exposed than EDR2 film without losing film characteristics. But as response of the optical density of Gafchromic EBT film to dose is low, beam profiles have more fluctuation at Gafchromic EBT. If the multipurpose phantom and moving device are used for treatment Q.A, and its corrections are made, treatment quality should be improved for the moving organs.

• Radiation Oncology Journal
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• v.23 no.3
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• pp.169-175
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• 2005

Purpose: Although computed tomography (CT) simulators are commonly used in radiation therapy department, many Institution still use conventional CT for treatments. In this study the setup errors that occur during simulation, CT scan (diagnostic CT scanner), and treatment were evaluated for the twenty one breast cancer patients. Materials and Methods: Errors were determined by calculating the differences in isocenter location, SSD, CLD, and locations of surgical clips implanted during surgery. The anatomic structures on simulation film and DRR image were compared to determine the movement of isocenter between simulation and CT scan. The isocetner point determined from the radio-opaque wires placed on patient's surface during CT scan was moved to new position if there was anatomic mismatch between the two images Results: In 7/21 patients, anatomic structures on DRR Image were different from the simulation Image thus new isocenter points were placed for treatment planning. The standard deviations of the diagnostic CT setup errors relative to the simulator setup in lateral, longitudinal, and anterior-posterior directions were 2.3, 1.6, and 1.6 mm, respectively. The average variation and standard deviation of SSD from AP field were 1.9 mm and 2.3 mm and from tangential fields were 2.8 mm and 3.7 mm. The variation of the CLD for the 21 patients ranged from 0 to 6 mm between simulation and DRR and 0 to 5 mm between simulation and treatment. The group systematic errors analyzed based on clip locations were 1.7 mm in lateral direction, 2.1 mm in AP direction, and 1.7 mm in SI direction. Conclusion: These results represent that there was no significant differences when SSD, CLD, clips' locations and isocenter locations were considered. Therefore, it is concluded that when a diagnostic CT scanner is used to acquire an image, the set-up variation is acceptable compared to using CT simulator for the treatment of breast cancer. However, the patient has to be positioned with care during CT scan in order to reduce the setup error between simulation and CT scan.

• The korean journal of orthodontics
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• v.31 no.3 s.86
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• pp.335-346
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• 2001

The purpose of this study was to investigate the ideal clinical torque(In the SWA rectangular wire, the torque by the angle between the plane part and twisted part to move the tooth) of the orthodontic rectangular wire which produce the proper labiolingual movement of the single tooth during finishing stage of the orthodontic treatment. The clinical torque is the sum of the play and the active torque which generates the moment at the bracket. The play is calculated by the formula and the active torque is calculated by the computer aided three-dimensional finite element method. The finite element model was consist of the three brackets which formed a row and 3 kinds of orthodontic rectangular wire(stainless steel, TMA, NiTi) which inserted in brackets. Both sides of the model were twisted and the moment generated in the center bracket was calculated. The sizes of seven wires which were used commonly were .016'X.022', .017'X.022', .017'X.025', .018'X.025', .019'X.025', .020'X.025', .021'X.025'. In 018' bracket, 016'X.022', .017'X.022', .017'X.025' wires were inserted and in 022' bracket, all the sizes of wires except .016'X.022' were inserted and tested. The following conclusions could be drawn from this study. 1. The moments generated on the same size of the wires by the same active torque were equal regardless of the bracket slot size. 2. The moments were increased with the size of the wires. The moment generated on the .021'X.025' wire was about 1.75 times as large as that on the .016'X.022' wire regardless of the material. 3. The moments were increased in the order of the NiTi, TMA stainless steel. The moment of the TMA wire was 0.35 times as small as that of the stainless steel wire and the moment of the NiTi was0.16 times as small as that of the stainless steel wire. 4. The moment was decreased as the interbracket distance was increased. 5. To get a desired moment with the specific size and material of the wire on the specific bracket slot, the formula and the results were displayed.

• Journal of the Korean Institute of Landscape Architecture
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• v.41 no.1
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• pp.21-33
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• 2013

The purpose of this study is to find applicabilities of human bioclimatic maps, using human thermal sensation(comfort) in summer, with microclimatic in situ data and computer simulation results at the study site of downtown Daegu. This includes the central business district(CBD) area and two urban parks, the Debt Redemption Movement Memorial Park and the 2.28 Park, for urban and landscape planning and design. Climatic data and urban setting information for the analysis of human thermal sensation were obtained from in situ measurement and the geographic information system data. As a result, the CBD had higher air temperature than the parks when the wind speed was low. Relative humidities were opposite to the air temperature. Especially, same directional streets with local wind direction had lower air temperature than streets perpendicular to the wind direction. The most important climatic variable of human thermal sensation in summer was direct beam solar radiation. Also, creating shadow areas would be the most relevant method for modifying hot thermal environments in urban areas. The most effective method of creating shadow patterns was making a tree shadow over a pergola, and the second best one was making a tree shadow on the front of north directional building walls. Moreover, how to plant trees for creating shadow patterns was important as well as what kind of trees should be planted. The results of human thermal sensation were warm to very hot at sunny areas and neutral to warm at shaded ones. At the sunny areas, wide, squared shape areas had a little bit higher thermal sensation than those of narrow streets. The albedo change of building walls 0.15 and ground surface 0.1 could change 1/6 of a sensation level at the shaded areas and 1/3 at the sunny ones. These microclimatic approaches will be useful to find appropriate methods for modifying thermal environments in urban areas.

• Journal of muscle and joint health
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• v.1 no.1
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• pp.1-30
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• 1994

Rheumatoid arthritis is a chronic systematic disease with unpredictable course of exacerbation and remission, characterized by pain, joint deformity and reduced activity by joint limitation. The growing public awareness of the need for health management of chronic illnesses, provides impetus for nursing to demonstrate social effectiveness by active nursing intervention in this vast area in general, and with rheumatoid condition in particular. However, nursing interventions to date have not demonstrated its active participation in the management of chronic conditions. Nursing intervention for the patients having rheumatoid arthritis is one such area that needs to be studied intensively and to demonstrate their effectiveness empirically. The purposes of this study were two fold : first, to develop a comprehensive program that was intensified with therapeutic joint exercises in water, self-help group activities and utilization of self-efficacy promoting strategies : and secondly, to determine the effect of aquatic exercise program on pain, physiological changes and quality of life in the rheumatoid arthritis patients. Thirty five female subjects participating in this study were selected from outpatients in the Rheumatism Center, Hanyang University hospital. The period of data collection was from December, 1992 to March, 1993 in seoul and Taejeon. Subjects in Taejeon were assigned to the experimental group. The comprehensive aquatic exercise program for the experimental group was carried out three times a week for 6 weeks in regular swimming pool. Subjects in Seoul did not participated in the program, and treated as the control group. Data were analyzed with repeated measure MANCOVA, t-test, ANCOVA, percentage of change, Kruskal-Wallis 1-Way ANOVA using SPSS $PC^+$ program. Results were obtained as follows : 1) Scores on Korean pain scale, Numeric pain score, and RAI score of the experimental group were significantly lower than those of the control group (t=2.11, p=0.022 ; F=4.40, p=0.044 : t=3.10, p=0.002). 2) There was significant improvement in the physiological parameters (higher joint movement parameters, F=15.64, p=0.024 ; higher lean body mass, percentage of change=+12.2, lower body weight, t=1.01, p=0.026 : lower ESR, t=1.69, p=0.001) in the experimental group compaired with subjects In the control group. 3) There was significant improvement in the specific self-efficacy score through the comprehensive aquatic exercise program(t=2.73, p=0.011), but not in the general self- efficacy score(t=0.62, p=0.113). 4) The quality of life failed to show significant improvement in the experimental group as compaired with the control group (F=3.69, p=0.064). 5) In the experimental group, findings from additional analysis showed no significant difference in the specific self-efficacy between those who continued to aquatic exercise after completing 6 week program and those who stopped (X2=0.086, p=0.690). Therefore, adherence to aquatic exercise program for 6 weeks seem to be affected mainly by self-help group activities. An indepth study to delve into articulation of mechanisms affecting the effect of aquatic exercise program be recommended. A further study is necessary to determine the difference in the effect of group and individual aquatic exercise program, to assess factors affecting adherence to exercise for an extended length of time.

• 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.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.18 no.2
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• pp.122-128
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• 2007

This study aims to analyze the voices of the patients with voice disorders including vocal fold paralysis, vocal fold cyst and vocal nodule/polyp in the aspect of acoustic phonetics. This study intends to collect subsidiary acoustic data in order to make a speech treatment and an standardization of vocal disorders. Subjects and Methods: The subjects of this study were 64 adult patients who underwent indirect laryngoscopy and laryngostroboscopy, and were diagnosed as vocal fold paralysis, vocal fold cyst or vocal nodule/polyp. Experimental group consisted of 20 patients who were diagnosed as vocal fold paralysis, 21 patients who were diagnosed as vocal fold cyst and had the average age of 42.0 $({\pm}10.03)$ ; and 23 patients who were diagnosed as vocal nodule/polyp and had the average age of 40.9 $({\pm}13.75)$. For the methodology of this study, the patients listed above were asked to sit in a comfortable position at intervals of 10cm apart from the patient's mouth and a microphone, and subsequently to phonate a vowel sound /e/ for the maximum phonation time with natural tone and vocal volume then the sound was directly inputted on a computer. During recording, sampling rate was set to 44,100Hz and the 1-second area corresponding to stable zone except the first and the last stage of waveform of the vowel sound /e/ vocalized by the individual patients was analyzed. Results: First, there was no statistically significant difference in jitter and shimmer between vocal fold paralysis and vocal fold cyst, while there was highly statistically significant difference in them between vocal fold paralysis and vocal nodule/polyp. Second, looking into the mean values obtained from NNE, HNR and SNR results associated with noise ratio, the disease showing the most abnormal characteristics was vocal fold paralysis, followed by cyst and nodule/polyp in order. For NNE, there was statistically significant difference between vocal nodule/polyp, and cyst or paralysis. In other words, it was found that the NNE of vocal nodule/polyp was weaker than that of cyst or paralysis. Similarly, HNR and SNR also showed the same characteristics; there was statistically significant difference between vocal fold paralysis and vocal fold cyst or nodule/polyp, and HNR and SNR values of vocal fold paralysis were lower than those of vocal fold cyst or nodule/polyp. Conclusion: For vocal fold paralysis, the abnormal values of acoustic parameters associated with frequency, amplitude and noise ratio were statistically significantly higher than those of vocal fold cyst and nodule/polyp. This finding suggests that the voices of the patients with vocal fold paralysis are the most severely injured due to less stability of vocal fold movement, asymmetry and incomplete glottic closure. In addition, there was no statistically significant difference in the acoustic parameters of tremor among vocal fold paralysis, vocal fold cyst and vocal nodule/polyp. Further studies need to ascertain reasonable acoustic parameters with various vocal disorders as well as to clarify the correlation between acoustics-based objective tools and subjective evaluations.