• Korean Journal of Health Education and Promotion
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• v.24 no.5
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• pp.23-37
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• 2007

Background: Even though cervical cancer poses a significant global cancer burden, successful implementations for early detection offer an opportunity to prevent deaths and reduce the cancer burden. In Korea, cervical cancer is the most prevalent type of cancer among adult women, but it is one of the few cancers in which a consensus-approved screening test exists for early diagnosis, Pap test, that can be combined with highly efficacious treatment regimens for early-stage disease. Purpose: This study was carried out to identify the cognitive-behavioral factors associated with cervical cancer screening behavior among adult women, aged 40 to 59, and to develop tailored messages and to evaluate the effectiveness of stage-matched educational program. Method: A total of 283 women who aged 40 years or older was recruited in Seoul, from September, 1st to November, 14th, 2003. The intervention group (N=162) and the control group (N=121) were selected from five sub-districts in Seocho-gu, Seoul. Building on the TTM, a quasi-experimental study was conducted to test the effectiveness of stages-matched intervention addressed at the five stages of cervical cancer screening behavior. Women in the intervention group were randomly assigned to one of two conditions, internet or postal services. Results: In our results, 88.9% of participants had received a Pap test at least once in their life-time, and 65.4% had got it in the past two years. With regard to cognitive-behavioral factors, the stages-matched educational program increased attitude and process of change for cervical cancer screening. The percentage changed was the largest in maintenance stage. With regard to delivery methods for tailored messages, the print materials were more effective at increasing screening adherence than the e-mail. Whereas the postal service group showed remarkable the change of behavior stage, the internet service group did not. Also it was not shown any difference of the satisfaction with stages-matched educational program between internet and postal service groups. Conclusion: This study suggested that cervical cancer screening behavior could be changed by tailored messages which had developed with cognitive-behavioral factors. The stages-matched educational program was effective to promote the screening adherence for cervical cancer.

• Progress in Medical Physics
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• v.19 no.1
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• pp.14-20
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• 2008

Accounting for tumor motion in treatment planning and delivery is one of the most recent and significant challenges facing radiotherapy. The purpose of this study was to investigate the correlation and clarified the relationship between the motion of an external marker using the Real-Time Position Management (RPM) System and an internal organ motion signal obtained fluoroscope. We enrolled 10 patients with locally advanced lung cancer and liver cancer, retrospectively. The external marker was a plastic box, which is part of the RPM used to track the patient's respiration. We investigated the quantitatively correlation between the motions of an external marker with RPM and internal motion with fluoroscope. The internal fiducial motion is predominant in the caraniocaudal direction, with a range of $1.3{\sim}3.5cm$ with fluoroscopic unit. The external fiducial motion is predominant in the caraniocaudal direction, with a range of $0.43{\sim}2.19cm$ with RPM gating. The two measurements ratio is from 1.31 to 5.56. When the regularization guided standard deviation is from 0.08 to 0.87, mean 0.204 cm, except only for patients #3 separated by a mean 0.13 cm, maximum of 0.23 cm. This result is a good correlation between internal tumor motion imaged by fluoroscopic unit and external marker motion with RPM during expiration within 0.23 cm. We have demonstrated that gating may be best performed but special attention should be paid to gating for patients whose fiducials do not move in synchrony, because targeting on the correct phase difference alone would not guarantee that the entire tumor volume is within the treatment field.

• Clinical and Experimental Pediatrics
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• v.50 no.3
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• pp.268-271
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• 2007

Purpose : Premature narrowing of the foramen ovale is rare but serious clinical entity. Prenatal narrowing or obstruction of the foramen ovale shows symptoms such as right heart failure, fetal hydrops, triscupid regurgitation, left heart obstructive disease, and supraventricular tachycardia. This study aimed to assess the prenatal diagnosis and postnatal clinical course of restrictive foramen ovale in utero in otherwise normal heart. Methods : The subjects were five patients diagnosed with restrictive foramen ovale in utero from January 2001 to June 2005 at Chungnam National University Hospital. The diagnostic criteria was defined when the maximum diameter in a 4-chamber view is less than 2.5 mm and there is a continuous doppler velocity at the foramen ovale of more than 0.6m/s. Results : At the time of diagnosis of restrictive foramen ovale, gestation age was 34~37 wks, and chief complaints were fetal arrhythmia(2 cases), pericardial effusion, Ebstein anomaly and subaortic stenosis. Two cases which were diagnosed fetal hydrops and supraventricular tachycardia delivered by emergent cesarian section. Five cases were found to have right heart dilatation on echocardiogram after birth, but right heart dilatation became normalized at day 7 after birth and the clinical courses were not eventful. Conclusion : Identifying an obstructed foramen ovale in the fetus warrants the further search for additional cardiac and extracardiac anomalies, which may alter the prognosis. Delivery should be induced if possible in cases of foramen ovale obstruction with signs of cardiac decompensation.

• The Journal of Korean Society for Radiation Therapy
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• v.18 no.1
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• pp.35-41
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• 2006

Purpose: A various find of radiotherapy treatment plans have been made to determine appropriate doses for breasts, chest walls and loco-regional lymphatics in the radiotherapy of breast cancers. The aim of this study was to evaluate the optimum radiotherapy plan technique method by analyzing dose distributions qualitatively and quantitatively. Materials and Methods: To evaluate the optimum breast cancer radiotherapy plan technique, the traditional method(two dimensional method) and computed tomography image are adopted to get breast volume, and they are compared with the three-dimensional conformal radiography (3DCRT) and the intensity modulated radiotherapy (IMRT). For this, the regions of interest (ROI) such as breasts, chest walls, loco-regional lymphatics and lungs were marked on the humanoid phantom, and the computed tomography(Volume, Siemens, USA) was conducted. Using the computed tomography image obtained, radiotherapy treatment plans (XiO 5.2.1, FOCUS, USA) were made and compared with the traditional methods by applying 3DCRT and IMRT. The comparison and analysis were made by analyzing and conducting radiation dose distribution and dose-volume histogram (DVH) based upon radiotherapy techniques (2D, 3DCRT, IMRT) and point doses for the regions of interest. Again, treatment efficiency was evaluated based upon time-labor. Results: It was found that the case of using 3DCRT plan techniques by getting breast volume is more useful than the traditional methods in terms of tumor delineation, beam direction and confirmation of field boundary. Conclusion: It was possible to present the optimum radiotherapy plan techniques through qualitative and quantitative analyses based upon radiotherapy plan techniques in case of breast cancer radiotherapy. However, further studies are required for the problems with patient setup reproducibility arising from the difficulties of planning target volume (PVT) and breast immobilization in case of three-dimensional radiotherapy planning.

• Journal of Preventive Medicine and Public Health
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• v.16 no.1
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• pp.135-152
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• 1983

Emergency medical service is an important part of the health care delivery system, and the optimal allocation of resources and their efficient utilization are essentially demanded. Since these conditions are the prerequisite to prompt treatment which, in turn, will be crucial for life saving and in reducing the undesirable sequelae of the event. This study, taking the hyperbaric chamber for carbon monoxide poisoning as an example, is to develop a stochastic approach for solving the problems of optimal allocation of such emergency medical facility in Korea. The hyperbaric chamber, in Korea, is used almost exclusively for the treatment of acute carbon monoxide poisoning, most of which occur at home, since the coal briquette is used as domestic fuel by 69.6 per cent of the Korean population. The annual incidence rate of the comatous and fatal carbon monoxide poisoning is estimated at 45.5 per 10,000 of coal briquette-using population. It offers a serious public health problem and occupies a large portion of the emergency outpatients, especially in the winter season. The requirement of hyperbaric chambers can be calculated by setting the level of the annual queueing rate, which is here defined as the proportion of the annual number of the queued patients among the annual number of the total patients. The rate is determined by the size of the coal briquette-using population which generate a certain number of carbon monoxide poisoning patients in terms of the annual incidence rate, and the number of hyperbaric chambers per hospital to which the patients are sent, assuming that there is no referral of the patients among hospitals. The queueing occurs due to the conflicting events of the 'arrival' of the patients and the 'service' of the hyperbaric chambers. Here, we can assume that the length of the service time of hyperbaric chambers is fixed at sixty minutes, and the service discipline is based on 'first come, first served'. The arrival pattern of the carbon monoxide poisoning is relatively unique, because it usually occurs while the people are in bed. Diurnal variation of the carbon monoxide poisoning can hardly be formulated mathematically, so empirical cumulative distribution of the probability of the hourly arrival of the patients was used for Monte Carlo simulation to calculate the probability of queueing by the number of the patients per day, for the cases of one, two or three hyperbaric chambers assumed to be available per hospital. Incidence of the carbon monoxide poisoning also has strong seasonal variation, because of the four distinctive seasons in Korea. So the number of the patients per day could not be assumed to be distributed according to the Poisson distribution. Testing the fitness of various distributions of rare event, it turned out to be that the daily distribution of the carbon monoxide poisoning fits well to the Polya-Eggenberger distribution. With this model, we could forecast the number of the poisonings per day by the size of the coal-briquette using population. By combining the probability of queueing by the number of patients per day, and the probability of the number of patients per day in a year, we can estimate the number of the queued patients and the number of the patients in a year by the number of hyperbaric chamber per hospital and by the size of coal briquette-using population. Setting 5 per cent as the annual queueing rate, the required number of hyperbaric chambers was calculated for each province and for the whole country, in the cases of 25, 50, 75 and 100 per cent of the treatment rate which stand for the rate of the patients treated by hyperbaric chamber among the patients who are to be treated. Findings of the study were as follows. 1. Probability of the number of patients per day follows Polya-Eggenberger distribution. $$P(X=\gamma)=\frac{\Pi\limits_{k=1}^\gamma[m+(K-1)\times10.86]}{\gamma!}\times11.86^{-{(\frac{m}{10.86}+\gamma)}}$$ when$${\gamma}=1,2,...,n$$$$P(X=0)=11.86^{-(m/10.86)}$$ when $${\gamma}=0$$ Hourly arrival pattern of the patients turned out to be bimodal, the large peak was observed in $7 : 00{\sim}8 : 00$ a.m., and the small peak in $11 : 00{\sim}12 : 00$ p.m. 2. In the cases of only one or two hyperbaric chambers installed per hospital, the annual queueing rate will be at the level of more than 5 per cent. Only in case of three chambers, however, the rate will reach 5 per cent when the average number of the patients per day is 0.481. 3. According to the results above, a hospital equipped with three hyperbaric chambers will be able to serve 166,485, 83,242, 55,495 and 41,620 of population, when the treatmet rate are 25, 50, 75 and 100 per cent. 4. The required number of hyperbaric chambers are estimated at 483, 963, 1,441 and 1,923 when the treatment rate are taken as 25, 50, 75 and 100 per cent. Therefore, the shortage are respectively turned out to be 312, 791. 1,270 and 1,752. The author believes that the methodology developed in this study will also be applicable to the problems of resource allocation for the other kinds of the emergency medical facilities.

• Journal of Nutrition and Health
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• v.54 no.4
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• pp.383-397
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• 2021

Purpose: The purpose of this study was to evaluate the change in the use of home meal replacement (HMR) and delivered foods and food habits of college students due to coronavirus disease 2019 (COVID-19). Methods: A survey was conducted on 460 male and female college students in Chungcheong province in December 2020. Results: The methods of participation in classes in the 2nd semester of 2020 were 40.2% for '100% non-face-to-face' and 40.4% for 'more than 70.0% of non-face-to-face classes'. 52.8% of the subjects responded that their physical activity had decreased, while 36.1% of the subjects responded that their body weight had increased over the past 6 months. Regarding the use of HMR, 62.7% of the male students and 69.6% of the female students responded with '1-2 times a week or less' before the outbreak of COVID-19. After the outbreak, 57.4% of males and 46.7% of females responded with '3-4 times a week or more' (p < 0.05, p < 0.001). As for the use of delivered food, 58.3% of the females responded with '2-3 times a month or less' before the outbreak, whereas the rate of responding with '1 or more times a week' after the outbreak was 64.6% (p < 0.001). Negative changes in food habits caused by COVID-19 were in the order of irregular meals (56.7%), increased intake of delivered food (42.2%), increased intake of snacks (33.3%), and increased intake of processed foods such as HMR (30.4%). Conclusion: As mentioned above, many college students had non-face-to-face classes due to COVID-19. During this period, they experienced decreased physical activity, weight gain, and undesirable eating habits such as irregular meal time, and increased intake of processed foods, delivery foods, and snacks. Therefore, there is a high need for nutrition education and policy support for the prevention and management of health and nutrition problems of college students, which can be caused due to the COVID-19 pandemic.

• Progress in Medical Physics
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• v.23 no.1
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• pp.15-25
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• 2012

The aim of this study is to evaluate plan quality and dose accuracy for Volumetric Modulated Arc Therapy (VMAT) on the TG-119 and is to investigate the effects on variation of the selectable optimization parameters of VMAT. VMAT treatment planning was implemented on a Varian iX linear accelerator with ARIA record and verify system (Varian Mecical System Palo Alto, CA) and Oncentra MasterPlan treatment planning system (Nucletron BV, Veenendaal, Netherlands). Plan quality and dosimetric accuracy were evaluated by effect of varying a number of arc, gantry spacing and delivery time for the test geometries provided in TG-119. Plan quality for the target and OAR was evaluated by the mean value and the standard deviation of the Dose Volume Histograms (DVHs). The ionization chamber and $Delta^{4PT}$ bi-planar diode array were used for the dose evaluation. For treatment planning evaluation, all structure sets closed to the goals in the case of single arc, except for the C-shape (hard), and all structure sets achieved the goals in the case of dual arc, except for C-shape (hard). For the variation of a number of arc, the simple structure such as a prostate did not have the difference between single arc and dual arc, whereas the complex structure such as a head and neck showed a superior result in the case of dual arc. The dose distribution with gantry spacing of $4^{\circ}$ was shown better plan quality than the gantry spacing of $6^{\circ}$, but was similar results compared with gantry spacing of $2^{\circ}$. For the verification of dose accuracy with single arc and dual arc, the mean value of a relative error between measured and calculated value were within 3% and 4% for point dose and confidence limit values, respectively. For the verification on dose accuracy with the gantry intervals of $2^{\circ}$, $4^{\circ}$ and $6^{\circ}$, the mean values of relative error were within 3% and 5% for point dose and confidence limit values, respectively. In the verification of dose distribution with $Delta^{4PT}$ bi-planar diode array, gamma passing rate was $98.72{\pm}1.52%$ and $98.3{\pm}1.5%$ for single arc and dual arc, respectively. The confidence limit values were within 4%. The smaller the gantry spacing, the more accuracy results were shown. In this study, we performed the VMAT QA based on TG-119 procedure, and demonstrated that all structure sets were satisfied with acceptance criteria. And also, the results for the selective optimization variables informed the importance of selection for the suitable variables according to the clinical cases.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.4
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• pp.307-313
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• 2008

Purpose: Vascular endothelial growth factor (VEGF) and its receptor, fetal liver kinase 1 (Flk-1), play an important role in vascular permeability and tumor angiogenesis. The aim of this study is to evaluate the therapeutic efficacy of $^{131}I$ labeled anti-Flk-1 monoclonal antibody (DC101) on the growth of melanoma tumor, which is known to be very aggressive in vivo. Materials and Methods: Balb/c nude mice were injected subcutaneously with melanoma cells in the right flank. Tumors were allowed to grow up to $200-250\;mm^3$ in volume. Gamma camera imaging and biodistribution studies were performed to identify an uptake of $^{131}I$-DC101 in various organs. Mice with tumor were randomly divided into five groups (10 mice per group) and injected intravenously; control PBS (group 1), $^{131}I$-DC101 $50\;{\mu}g/mouse$ (group 2), non-labeled DC101 $50\;{\mu}g/mouse$ (group 3), $^{131}I$-DC101 $30\;{\mu}g/mouse$ (group 4) and $15\;{\mu}g/mouse$ (group 5) every 3 or 4 days for 20 days. Tumor volume was measured with caliper twice a week. Results: In gamma camera images, the uptake of $^{131}I$-DC101 into tumor and thyroid was increased with time. Biodistribution results showed that the radioactivity of blood and other major organ was gradually decreased with time whereas tumor uptake was increased up to 48 hr and then decreased. After 4th injection of $^{131}I$-DC101, tumor volume of group 2 and 4 was significantly smaller than that group 1. After 5th injection, the tumor volume of group 5 also significantly reduced. Conclusion: These results indicated that delivery of $^{131}I$ to tumor using FlK-1 antibody, DC101, effectively blocks tumor growth in aggressive melanoma xenograft model.

• Journal of agricultural medicine and community health
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• v.26 no.2
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• pp.15-41
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• 2001

Since medical clients and the community they live in are expected to be center of future public health and medical care system, new service programs must be developed with patients focused on in line with widening public access of information and social participation. Patients- focused service shall mean the area- oriented provision of public health service. In this study, health officers working at public health centers, public health sub- centers and medical offices in Jeonbuk- do area were taken for population in order to investigate their attitudes toward and knowledge about the service area assigning system under the public health programs. Findings from the survey to 260 health officers, divided by general category, are as follows : Government officers at public health organizations appeared to have high grade of understanding to the service area assigning system and also great appreciation for the necessity of it. Regarding the timing for the system to be introduced, they support the gradual implementation and, as for the type of service to be provided, they preferred home nursing and treatment of chronic diseases. Highly positive responses were centered on the health classes under the health promotion projects, and as far as health projects for the old are concerned, services for home nursing, for the disabled and for home- alone people are favored most. On the other hand, budgeting, manpower and reorganization are rated as prerequisite to establishment of the service area assigning system. From the viewpoint of system side, the improvement of working conditions is rendered as most urgent, while the information system for establishing the service area assigning system is conceived far from satisfactory. Proper assignment of specialists was noted as mostly important to establish the delivery system for medical service through the service area assigning system by team. As merits of the service area assigning system, it is pointed out that, through the system, health clients can better be managed and the nursing quality will be improved thank to the enhanced specialization. It is also perceived that the district health service is not well prepared to respond to the increased and diversified needs of community people and, furthermore, service programs of health centers have not been fully developed. The most serious problem standing in the way to expansion of health projects is, it is noted, uniformity (formality) of the project. Based on the results of the survey which suggest time has ripen to introduce the service area assigning system, following strategies are proposed to anchor down the system as soon as possible: First, we should introduce the system gradually, starting from the area selected, and in consideration of area specialities, refraining from the hitherto stereotyped way of providing health service. Second, we should seek to properly assign the specialists and improve the working conditions of the assigned officers by securing sufficient budget, since it is a most urgent step to lay foundation for the service area assigning system. Third, best service program should be developed to meet the satisfaction of community people by responding to their needs and solidifying the management of medical clients. Fourth, wide scope of study should further be conducted in order to help this system take roots in the central living of community residents since pilot project on the experimental base attended by specialists only can not win popularity among the masses.

• Journal of Intelligence and Information Systems
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• v.21 no.4
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• pp.53-77
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• 2015

Mobile commerce provides a convenient shopping experience in which users can buy products without the constraints of time and space. Mobile commerce has already set off a mega trend in Korea. The market size is estimated at approximately 15 trillion won (KRW) for 2015, thus far. In the Korean market, social commerce and open market are key components. Social commerce has an overwhelming open market in terms of the number of users in the Korean mobile commerce market. From the point of view of the industry, quick market entry, and content curation are considered to be the major success factors, reflecting the rapid growth of social commerce in the market. However, academics' empirical research and analysis to prove the success rate of social commerce is still insufficient. Henceforward, it is to be expected that social commerce and the open market in the Korean mobile commerce will compete intensively. So it is important to conduct an empirical analysis to prove the differences in user experience between social commerce and open market. This paper is an exploratory study that shows a comparative analysis of social commerce and the open market regarding user experience, which is based on the mobile users' reviews. Firstly, this study includes a collection of approximately 10,000 user reviews of social commerce and open market listed Google play. A collection of mobile user reviews were classified into topics, such as perceived usefulness and perceived ease of use through LDA topic modeling. Then, a sentimental analysis and co-occurrence analysis on the topics of perceived usefulness and perceived ease of use was conducted. The study's results demonstrated that social commerce users have a more positive experience in terms of service usefulness and convenience versus open market in the mobile commerce market. Social commerce has provided positive user experiences to mobile users in terms of service areas, like 'delivery,' 'coupon,' and 'discount,' while open market has been faced with user complaints in terms of technical problems and inconveniences like 'login error,' 'view details,' and 'stoppage.' This result has shown that social commerce has a good performance in terms of user service experience, since the aggressive marketing campaign conducted and there have been investments in building logistics infrastructure. However, the open market still has mobile optimization problems, since the open market in mobile commerce still has not resolved user complaints and inconveniences from technical problems. This study presents an exploratory research method used to analyze user experience by utilizing an empirical approach to user reviews. In contrast to previous studies, which conducted surveys to analyze user experience, this study was conducted by using empirical analysis that incorporates user reviews for reflecting users' vivid and actual experiences. Specifically, by using an LDA topic model and TAM this study presents its methodology, which shows an analysis of user reviews that are effective due to the method of dividing user reviews into service areas and technical areas from a new perspective. The methodology of this study has not only proven the differences in user experience between social commerce and open market, but also has provided a deep understanding of user experience in Korean mobile commerce. In addition, the results of this study have important implications on social commerce and open market by proving that user insights can be utilized in establishing competitive and groundbreaking strategies in the market. The limitations and research direction for follow-up studies are as follows. In a follow-up study, it will be required to design a more elaborate technique of the text analysis. This study could not clearly refine the user reviews, even though the ones online have inherent typos and mistakes. This study has proven that the user reviews are an invaluable source to analyze user experience. The methodology of this study can be expected to further expand comparative research of services using user reviews. Even at this moment, users around the world are posting their reviews about service experiences after using the mobile game, commerce, and messenger applications.