• Progress in Medical Physics
• /
• v.26 no.3
• /
• pp.168-177
• /
• 2015

For evaluating the treatment planning accurately, the quality assurance for treatment planning is recommended when patients were treated with IMRT which is complex and delicate. To realize this purpose, treatment plan quality assurance software can be used to verify the delivered dose accurately before and after of treatment. The purpose of this study is to evaluate the accuracy of treatment plan quality assurance software for each IMRT plan according to MLC DLG (dosimetric leaf gap). Novalis Tx with a built-in HD120 MLC was used in this study to acquire the MLC dynalog file be imported in MobiusFx. To establish IMRT plan, Eclipse RTP system was used and target and organ structures (multi-target, mock prostate, mock head/neck, C-shape case) were contoured in I'mRT phantom. To verify the difference of dose distribution according to DLG, MLC dynalog files were imported to MobiusFx software and changed the DLG (0.5, 0.7, 1.0, 1.3, 1.6 mm) values in MobiusFx. For evaluation dose, dose distribution was evaluated by using 3D gamma index for the gamma criteria 3% and distance to agreement 3 mm, and the point dose was acquired by using the CC13 ionization chamber in isocenter of I'mRT phantom. In the result for point dose, the mock head/neck and multi-target had difference about 4% and 3% in DLG 0.5 and 0.7 mm respectively, and the other DLGs had difference less than 3%. The gamma index passing-rate of mock head/neck were below 81% for PTV and cord, and multi-target were below 30% for center and superior target in DLGs 0.5, 0.7 mm, however, inferior target of multi-target case and parotid of mock head/neck case had 100.0% passing rate in all DLGs. The point dose of mock prostate showed difference below 3.0% in all DLGs, however, the passing rate of PTV were below 95% in 0.5, 0.7 mm DLGs, and the other DLGs were above 98%. The rectum and bladder had 100.0% passing rate in all DLGs. As the difference of point dose in C-shape were 3~9% except for 1.3 mm DLG, the passing rate of PTV in 1.0 1.3 mm were 96.7, 93.0% respectively. However, passing rate of the other DLGs were below 86% and core was 100.0% passing rate in all DLGs. In this study, we verified that the accuracy of treatment planning QA system can be affected by DLG values. For precise quality assurance for treatment technique using the MLC motion like IMRT and VMAT, we should use appropriate DLG value in linear accelerator and RTP system.

• Tuberculosis and Respiratory Diseases
• /
• v.54 no.3
• /
• pp.311-319
• /
• 2003

Background : Previous studies have suggested that a B-type natriuretic peptide(BNP) test can provide important information on diagnosis, as well as predicting the severity and prognosis of heart failure. Myocardial dysfunction is often observed in critically ill noncardiac patients admitted to the Intensive Care Unit, and the prognosis of the myocardial dysfunction needs to be determined. This study evaluated the predictability of BNP on the prognosis of critically ill noncardiac patients. Methods : 32 ICU patients, who were hospitalized from June to October 2002 and in whom the BNP test was evaluated, were enrolled in this study. The exclusion criteria included the conditions that could increase the BNP levels irrespective of the severity, such as congestive heart failure, atrial fibrillation, ischemic heart disease, and renal insufficiencies. A triage B-Type Natriuretic Peptide test with a RIA-kit was used for the fluorescence immunoassay of BNP test. In addition, the acute physiology and the chronic health evaluation (APACHE) II score and mortality were recorded. Results : There were 16 males and 16 females enrolled in this study. The mean age was 59 years old. The mean BNP levels between the ICU patients and control were significantly different ($186.7{\pm}274.1$ pg/mL vs. $19.9{\pm}21.3$ pg/mL, p=0.033). Among the ICU patients, there were 14(44----) patients with BNP levels above 100 pg/mL. The APACHE II score was $16.5{\pm}7.6$. In addition, there were 11 mortalities reported. The correlation between the BNP and APACHE II score, between the BNP and mortality were significant (r=0.443, p=0.011 & r=0.530, p=0.002). The mean BNP levels between the dead and alive groups were significantly different ($384.1{\pm}401.7$ pg/mL vs. $83.2{\pm}55.8$ pg/mL p=0.033). However, the $PaO_2/FiO_2$ did not significantly correlate with the BNP level. Conclusion : This study evaluated the BNP level was elevated in critically ill, noncardiac patients. The BNP level could be a useful, noninvasive tool for predicting the prognosis of the critically ill, noncardiac patients.

• Journal of the East Asian Society of Dietary Life
• /
• v.20 no.2
• /
• pp.218-230
• /
• 2010

This study was conducted to survey isoflavone intake among adult women in menopause with diseases such as metabolic syndrome and osteoporosis and to analyze the relationship between each of these chronic diseases followed by isoflavone intake and the related health risk index. The average age of the subjects was 49.97 years old, while that of the pre-menopausal subjects was 45.14 years, and the post-menopausal subjects was 55.99 years. The average body mass index (BMI), waist-hip circumference, body fat percentage, blood pressure, blood sugar and blood lipid content of the post-menopausal subjects were higher in significant difference than those of the pre-menopausal subjects. The bone density of the hip and spine in post-menopausal subjects was lower in significant difference than that of the pre-menopausal subjects. After menopause, the subjects had a lower ratio of individuals at risk of anemia when compared with the subjects before menopause, but had higher health risk ratio related to each type of chronic disease, including obesity, hypertension, high cholesterol and osteoporosis than the subjects before menopause. The intake frequency of each soybean food was similar among subjects before/after menopause. The most common soybean based foods consumed by the subjects were soybean, soybean curd and soybean paste. The average daily intake level of isoflavone among subjects before menopause was 25.48 mg, while that of subjects after menopause was 32.25 mg. Evaluation of the distribution of the isoflavone level revealed that the pre-menopausal subjects consumed 3.29~78.36 mg and the post-menopausal subjects consumed 3.18~116.59 mg. The intake level by each individual varied greatly. The pre-menopausal subjects had a low BMI index and systolic blood pressure as much as their isoflavone intake level was high. Additionally, the post-menopausal subjects had a low menarche age and high menopause age when their isoflavone intake level was high, the BMI index and waist-hip circumference ratio was highest among individuals with lowest isoflavone intake level. This study showed that there was a possible relationship between soybean isoflavone intake and health problems such as obesity, high cholesterol, and osteoporosis in women after menopause with diseases such as metabolic syndrome and osteoporosis, even if this relationship was not great.

• Journal of the Korean earth science society
• /
• v.23 no.6
• /
• pp.461-473
• /
• 2002

Concept mapping is a device for representing the conceptual structure of a subject discipline in a two dimensional form which is analogous to a road map. In the teaching and learning of earth science, each concept depends on its relationships to many others for meaning. Using concept mapping in teaching helps teachers and students to be more aware of the key concepts and relationships among them. The purpose of this study is to investigate the effect of the use of concept mapping on science achievement and the scientific attitude in ocean units of earth science. The results of this study are as follows; first, the science achievement of a group of concept mapping teaching is significantly higher than that of the group of traditional teaching. Also, when the achievement levels are compared among different cognitive ability groups, the effect is more significant in mid or lower level student groups than in high level groups. The use of concept mapping is more effective when the concepts have a distinct concept hierarchy. Second, the scores of the test of ‘attitude toward scientific inquiry’ and ‘application of scientific attitude’ of the group of concept mapping teaching are significantly higher than those of the group of traditional teaching, whereas the scores of the test of ‘interest in science learning’ of concept mapping teaching is not different from those of group of traditional teaching. Third, the survey on the use of concept mapping shows a positive response across the tested groups. The use of concept mapping is more beneficial in fostering the comprehension of the topic. A concept map of student's own construction facilitates the assessment of learning, thus promising the usefulness of concept mapping as a means of evaluation. In regard to retention aspect, concept mapping is considered to be more effective in confirming and remembering the topic, while less effective in the aspects of activity and interest. In conclusion, the use of concept maps makes learning an active meaningful process and improves student's academic achievement and scientific attitude. If the concept mapping is more effectively as an active teaching strategy, more meaningful learning will be attained.

• Journal of the Korean Arthroscopy Society
• /
• v.7 no.2
• /
• pp.160-168
• /
• 2003

Purpose : To analyze the anterior stability and functional results after the arthroscopic ACL reconstruction and meniscectomy based on meniscus status at the time of surgery. Materials and Methods : From October 1997 to October 2002, 78 patients (male 64 female 14) were treated by arthroscopic ACL reconstruction and meniscectomy and followed more than 12 months (range, $12\~72$ months, average: 32 months). Average age was 32 years old (range, $18\~57$ years old). We divided the patients into 4 groups; Both menisci was intact (BMI, control group), lateral meniscus removed (LMR), medial meniscus removed (MMR) and both menisci removed (BMR). Anterior passive displacement (objective stability) was estimated using KT-2000 arthrometer under the loading of 15lb,20lb and 30lb and evaluated anterior drawer test, Lachman test, range of motion, thigh circumference. Functional evaluation system of IKDC, OAK and Lysholm knee score was used. Results : Average anterior displacement under the loading of 30lb were 2.47 mm, 2.96 mm, 2.96 mm and 3.57 mm in each group(BMI, LMR, MMR, BMR) and it was statistically significant difference (p<0.05). There is no statistically significant difference in average anterior displacement under the loading of 15lb and 20lb in each group but it has showed decreasing tendency in meniscal removed groups. The mean anterior displacement was within 3 mm in 21 cases, 15 cases, 24 cases and 12 cases (total 72 cases, $94\%$) under the loading of 15lb and 20 cases, 15 cases, 24 cases and 11 cases (total 70 cases, $91\%$) under the loading 20lb of in each group and postoperative knee joint stability has showed increasing tendency (p>0.05). The mean score was 94.5, 93.2, 92.2 and 90.4 points in each group and 71 cases $(91\%)$ were more than excellent or good with a OAK score and fair results were noted 4 cases in both meniscal removed group. There were 65 cases $(83\%)$ with a Lysholm knee score more than excellent or good, and IKDC grading were more than normal or nearly normal in 74 cases $(95\%)$ except 4 cases (2 cases in MMR group and 2 cases in BMR group). Conclusion : Long-term anterior stability and functional results of a successful ACL reconstruction affected by tile status of the menisci at the time of surgery and KT-2000 arthrometer was good for estimation of objective follow up.

• Current Research on Agriculture and Life Sciences
• /
• v.19
• /
• pp.45-54
• /
• 2001

This study was carried out to provide fundamental data for prospective forest-road project and forest-road network arrangement through appraising existing forest-road network with density, extension distance, maximum yarding distance and yarding area, position of forest-road line considered above foundation of two theories, one is "theory of optimal forest-road density" which has expense for yarding cost and constructing forest-road minimized, the other is "theory of optimal forest-road arrangement" which has investment effect maximized. The results are as follows. 1. In density and extension distance of the forest-road by site, it was showed up that density of existing forest-road is lower than that of calculated forest-road. So, it is thought that some additional forest-roads have to be constructed. 2. In the arrangement of the forest-road network by site, it was showed up that the arrangement of calculated forest-road is higher than that of existing forest-road arrangement for the forestry and yarding function. So, it is thought that the arrangement of forest-road network have to be considered to maximize the investment effect. 3. In "mean maximum distance for yarding" and "mean area which yarding can be done" by horizontal and inclined distance, the existing forest-road networks were different from those of calculated forest-road network. So, calculated forest-road network making investment effect maximize is more effective than existing forest-road network. Hence, in prospective forest-road project, it is needed that forest-road network having "area which yarding can be done" maximized through considering function for yarding have to be constructed.

• Journal of radiological science and technology
• /
• v.30 no.3
• /
• pp.205-212
• /
• 2007

To evaluate the feasibility and efficacy of a pulsatile aortic aneurysm phantoms for in-vitro study. The phantoms consisted of a pulsating motor part(heart part) and an aortic aneurysm part, which mimicked true physiologic conditions. The heart part was created from a high-pressured water pump and a pulsatile flow solenoid valve for the simulation of aortic flow. The aortic aneurysm part was manufactured from paper clay, which was placed inside a acrylic plastic square box, where liquid silicone was poured. After the silicone was formed, the clay was removed, and a silicone tube was used to connect the heart and aneurysm part. We measured the change in pressure as related to the opening time(pulse rate, Kruskal-Wallis method) and pressure before and after the stent-graft implantation(n = 5, Wilcoxon's signed ranks test). The changes in blood pressures according to pulse rate were all statistically significant(p<0.05). The systolic/diastolic pressures at the proximal aorta, the aortic aneurysm, and the distal aorta of the model were $157.80{\pm}1.92/130.20{\pm}1.92$, $159.40{\pm}1.14/134.00{\pm}2.92$, and $147.20{\pm}1.480/129.60{\pm}2.70\;mmHg$, respectively, when the pulse rate was 0.5 beat/second. The pressures changed to $161.40{\pm}1.34/90.20{\pm}1.64$, $175.00{\pm}1.58/93.00{\pm}1.58$, and $176.80{\pm}1.48/90.80{\pm}1.92\;mmHg$, respectively, when the pulse rate was 1.0 beat/second, and $159.40{\pm}1.82/127.20{\pm}1.48$, $166.60{\pm}1.67/138.00{\pm}1.87$, and $161.00{\pm}1.22/135.40{\pm}1.67\;mmHg$, respectively, when it was 1.5 beat/second. When pulse rate was set at 1.0 beat/second, the pressures were $143.60{\pm}1.67/90.20{\pm}1.64$, $147.20{\pm}1.92/84.60{\pm}1.82$, and $137.40{\pm}1.52/88.80{\pm}1.64\;mmHg$ after stent-graft implantation. The changes of pressure before and after stent-graft implantation were statistically significant(p<0.05) except the diastolic pressures at the proximal(p =1.00) and distal aorta(p=0.157). The aortic aneurysm phantoms seems to be useful for the evaluation of the efficacy of stent-graft before animal or clinical studies because of its easy reproducibility and ability to display a wide range of pressures.

• Radiation Oncology Journal
• /
• v.25 no.2
• /
• pp.70-78
• /
• 2007

[ $\underline{Purpose}$ ]: This study analyzed the tumor response, overall survival, progression free survival and related prognostic factors in patients with muscle invasive bladder cancer subjected to bladder preserving treatment. $\underline{Materials\;and\;Methods}$: Between August 1995 and June 2004, 37 patients with muscle invasive (transitional cell carcinoma, clinically stage T2-4) bladder cancer were enrolled for the treatment protocol of bladder preservation. There were 33 males and 4 females, and the median age was 67 years (range $38{\sim}86\;years$). Transurethral resection of the bladder (TURB) was performed in 17 patients who underwent complete resection. The median radiation dose administered was 64.8 Gy (range $55.8{\sim}67\;Gy$). The survival rate was calculated by the Kaplan-Meier method. $\underline{Results}$: An evaluation of the response rate was determined by abdomen-pelvic CT and cystoscopy at three months after radiotherapy. A complete response was seen in 17 patients (46%). The survival rate at three years was 54.7%, with 54 months of median survival (range $3{\sim}91$ months). During the study, 17 patients died and 13 patients had died from bladder cancer. The progression free survival rate at three years was 37.2%. There were 24 patients (64.9%) who had disease recurrence: 16 patients (43.2%) had local recurrence, 6 patients (16.2%) had a distant recurrence, and 2 patients (5.4%) had both a local and distant recurrence. The survival rate (p=0.0009) and progression free survival rates (p=0.001) were statistically significant when compared to the response rate after radiotherapy. $\underline{Conclusion}$: The availability of complete TURB and appropriate chemoradiotherapy were important predictors for bladder preservation and survival.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.12 no.3
• /
• pp.222-228
• /
• 2008

Purpose: The objectives of this study were to compare the left ventricle ejection fraction (LVEF) from gated cardiac blood pool scan (GCBP) for analysis auto-drawing region of interest mode (AROI) and manual-drawing region of interest mode (MROI), respectively. To evaluation the relationships between values produced by both ROI modes. Materials and Methods: Gated cardiac blood pool scan using in vivo method Tc-99m Red Blood Cell were performed for 33 patients (mean age: $53.2{\pm}13.2\;y$) with objective of chemotherapy using single head gamma camera (ADAC Laboratories, Milpitas, CA). Left ventricular ejection fraction was automatically and manually measured, respectively. Results: There was significant difference statistically between AROI and MROI ($LVEF^{AROI}$: $71.4{\pm}12.4%$ vs. $LVEF^{MROI}$: $65.8{\pm}5.9%$, p=0.003). Intra-observer agreements in AROI was higher than MROI ($\gamma^{AROI}=0.964$, Cronbach's $\alpha^{AROI}=0.986$ vs. $\gamma^{MROI}=0.793$, Cronbach's $\alpha^{MROI}=0.911$), either. Additionally, there was no significant difference statistically at best septal view (${\Delta}LVEF^{BSV}=0.7{\pm}2.3%$, p=0.233), however statistically significant difference was found at badly separated septal view (${\Delta}LVEF=10.9{\pm}11.4%$, p=0.001). Moreover, Intra-observer agreements in best septal view was higher than badly separated septal view ($\gamma^{BSV}=0.939$, Cronbach's $\alpha^{BSV}=0.978$; $\gamma=0.948$, Cronbach's $\alpha=0.981$ at AROI, $\gamma^{BSV}=0.836$, Cronbach's $\alpha^{BSV}=0.936$; $\gamma=0.748$, Cronbach's $\alpha=0.888$ at MROI). Conclusion: When best septal view was acquired, LVEF by AROI and MROI indicated not different. Comparing Intra-observer agreements with AROI and MROI, the AROI tended to show higher. Therefore, it is considered that the AROI than MROI is valuable in reproducibility and objective when ROI analysis by acquire left ventricular of best septal view.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.12 no.3
• /
• pp.235-240
• /
• 2008

Purpose: At the beginning of PET/CT, Computed Tomography was mainly used only for Attenuation Correction (AC), but as the performance of the CT have been increase, it could give improved diagnostic information with Contrast Media. But it was controversial that Contrast Media could affect AC on PET/CT scan. Some submitted thesis' show that Contrast Media could overestimate when it is for AC data processing. On the contrary, the opinion that Contrast Media could be possible to affect the alteration of SUV because of the overestimated AC. But it does not have a definite effect on the diagnosis. Thus, the affection of Contrast Media on AC was investigated in this study. Materials and Methods: Patient inclusion criteria required a history of a malignancy and performance of an integrated PET/CT scan and contrast- enhanced CT scan within a 1-day period. Thirty oncologic patients who had PET/CT scan from December 2007 to June 2008 underwent staging evaluation and met these criteria. All patients fasted for at least 6 hr before the IV injection of approximately 5.6 MBq/kg (0.15 mCi/kg) of $^{18}F$-FDG and were scanned about 60 min after injection. All patients had a whole body PET/CT performed without IV contrast media followed by a contrast-enhanced CT on the Discovery STe PET/CT scanner. CT data were used for AC and PET images came out after AC. The ROIs drew and measured SUV. A paired t-test of these results was performed to assess the significance of the difference between the SUV obtained from the two attenuation corrected PET images. Results: The mean and maximum Standardized Uptake Values (SUV) for different regions averaged over all Patients. Comparing before using Contrast Media and after using, Most of ROIs have the increased SUV when it did Contrast Enhanced CT compare to Non-Contrast enhanced CT. All regions have increased SUV and also their p value was under 0.05 except the mean SUV of the Heart region. Conclusion: In this regard, the effect on SUV measurements that occurs when a contrast-enhanced CT is used for attenuation correction could have significant clinical ramifications. But some submitted thesis insisted that the percentage change in SUV that can determine or modify clinical management of oncology patients is small. Because there was not much difference that could be discovered by interpreter. But obviously the numerical change was occurred and on the stage finding primary region, small change would be base line, such as the region of liver which has greater change than the other regions needs more attention.