• Title/Summary/Keyword: Systemic approach

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Patient Specific Quality Assurance of IMRT: Quantitative Approach Using Film Dosimetry and Optimization (강도변조방사선치료의 환자별 정도관리: 필름 선량계 및 최적화법을 이용한 정량적 접근)

  • Shin Kyung Hwan;Park Sung-Yong;Park Dong Hyun;Shin Dongho;Park Dahl;Kim Tae Hyun;Pyo Hongryull;Kim Joo-Young;Kim Dae Yong;Cho Kwan Ho;Huh Sun Nyung;Kim Il Han;Park Charn Il
    • Radiation Oncology Journal
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    • v.23 no.3
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    • pp.176-185
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    • 2005
  • Purpose: Film dosimetry as a part of patient specific intensity modulated radiation therapy quality assurance (IMRT QA) was peformed to develop a new optimization method of film isocenter offset and to then suggest new quantitative criteria for film dosimetry. Materials and Methods: Film dosimetry was peformed on 14 IMRT patients with head and neck cancers. An optimization method for obtaining the local minimum was developed to adjust for the error in the film isocenter offset, which is the largest part of the systemic errors. Results: The adjust value of the film isocenter offset under optimization was 1 mm in 12 patients, while only two patients showed 2 mm translation. The means of absolute average dose difference before and after optimization were 2.36 and $1.56\%$, respectively, and the mean ratios over a $5\%$ tolerance were 9.67 and $2.88\%$. After optimization, the differences in the dose decreased dramatically. A low dose range cutoff (L-Cutoff) has been suggested for clinical application. New quantitative criteria of a ratio of over a $5\%$, but less than $10\%$ tolerance, and for an absolute average dose difference less than $3\%$ have been suggested for the verification of film dosimetry. Conclusion: The new optimization method was effective in adjusting for the film dosimetry error, and the newly quantitative criteria suggested in this research are believed to be sufficiently accurate and clinically useful.

A RESEARCH ON THE EVALUATION OF THE NEW PATIENTS FOR THE LAST 8 YEARS IN DEPT. OF PEDIATRIC DENTISTRY OF CHONBUK UNIVERSITY (최근 8년간 전북대학교치과병원 소아치과에 내원한 초진환자에 관한 실태조사)

  • Ko, Young-Han;Kim, Jae-Gon;Yang, Yeon-Mi;Baik, Byeoug-Ju
    • Journal of the korean academy of Pediatric Dentistry
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    • v.34 no.2
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    • pp.292-298
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    • 2007
  • In order to thoroughly understand change patterns and to set up an appropriate approach the direction of future treatment towards children in Chonbuk area, we carried out this research. we could draw below conclusions from the studies based on researches of distribution of new patients visited Dept. of Pediatric Dentistry, Chonbuk Nat' university from 1998 to 2005 and current changes in dental treatment. 1. There was an increase in the number of patients until 2004 but it decreased in 2005. Boys took higher portion. 2. Number of patients increased during school holidays. 3. 97.7% of patients were urbanites. 4. An age group from 31 months to 6 years showing 48.2% was the highest, each percentage of $7{\sim}13$ years, $13{\sim}30$ months showed 31.3%, 17.2%. 5. 33.8% of patients were referred from local dental clinics and among them, an age group from 31 months to 6 years showing 49.5% was the highest, each percentage of $7{\sim}13$ years, $13{\sim}30$ months showed 35.2%, 12.9%. 6, 5.5% of patients who had systemic diseases, among them, each percentage of cardiovascular disease, mental retardation, respiratory disease showed 21.8%, 13.6%, and 11.0%. 7. According to the distribution of chief complaints, dental caries showing 42.9% was the highest. 8. Root canal treatment, restoration, prosthesis showing 42.6% were the highest of all treatments.

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Bladder Preservation by Combined Modality Therapy for Invasive Bladder Cancer : A Five-Year Follow-up (근침윤성 방광암에서 화학방사선 병용을 통한 방광보존치료)

  • Cho Jae Ho;Lim Jihoon;Seong Jinsil;Pyo Hong Ryull;Koom Woong Soup;Suh Chang Ok;Hong Sung Jun
    • Radiation Oncology Journal
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    • v.19 no.4
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    • pp.359-368
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    • 2001
  • Purpose : To determine the long-term results of bladder-preserving approach by transurethral resection of the bladder (TURB), systemic chemotherapy, and radiation therapy for muscle-invasive bladder cancer Methods and materiaals : From 1991 Jan. through 1994 Dec., 25 patients with muscle invading clinical stage T2 to T4NxM0 bladder cancer were treated with induction by maximal TURB and (arm 1, n=4) three cycles of chemotherapy [MVAC(methotrexate, vincristine, adriamycin, ciplatin)] followed by 64.8 Gy of radiation with concomitant cisplatin, or two cycles of chemotherapy [MCV (methotrexate, ciplatin, vincristine)] after irradiation with concomitant cisplatin (arm 2, n=14), or concurrent chemoradiation only (arm 3, n=7). Tumor response was scored as a clinical complete response (CR) when the cystoscopic tumor-site biopsy and urine cytology results were negative. Those with less than a CR underwent cystectomy. The median follow-up of all patients was 70 months. Resulst : Most treatment toxicities were mild to moderate. Grade 3 acute hematologic toxicity and chronic cystitis were observed in only 1 and 2 patients, respectively. Overall 5 year survival was $67.3\%$. Complete remission rate was $80\%$ (20/25). Sixty-three percent of all survivors retained their bladders. In multivariate analysis, prognostic factors that significantly affect survival were T-stage (p=0.013) and Complete remission (p=0.002). Conclusion : Combined modality therapy with TURB, chemotherapy, and radiation has a $67.3\%$ overall 5 year survival rate. This result is similar to cystectomy-based studies for patients of similar clinical stages.

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Therapeutic Results of Radiotherapy in Nonsmall Cell Lung Cancers (비소세포성 폐암의 방사선치료 성적)

  • Shin, Sei-One;Kim, Sung-Kyu;Kim, Myung-Se
    • Journal of Yeungnam Medical Science
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    • v.11 no.1
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    • pp.72-81
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    • 1994
  • Total 55 patients with nonsmall cell lung cancer treated with radiation therapy at Department of Therapeutic Radiology, Yeungnam University Hospital, between May-1 1986 and April-30 1993 were retrospectively analyzed by clinical characteristics, failure patterns, follow up duration and survival ratio according to prognostic factors. Obtained results were as follows : 1. Male to female ratio was 17.3 2. Sixth and seventh decades were predominant age group. 3. The patients were 8 in stage I-II, 34 in stage IIIA, 13 in stage IIIb, respectively. 4. Forty five patients out of 55 were squamous cell carcinoma. 5. Primary tumor were originated from upper lobe bronchi predominantly. 6. The size of the primary tumor, lymph node involvement and the degree of differentiation were important in evaluation of prognosis. 7. In conclusion, for patients with poor prognostic factors systemic chemotherapy and multidisciplinary approach were recommended for better treatment outcome and improvement of survival.

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A Study on Pulmonary Toxic Effect of High-Dose Cisplatin Administered by Isolated Lung Perfusion in Dogs (잡견에서 분리폐관류 방법으로 투여된 고농도 cisplatin의 페독성에 관한 연구)

  • 김관민;한정호;김주현
    • Journal of Chest Surgery
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    • v.33 no.9
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    • pp.697-706
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    • 2000
  • Background: Isolated lung perfusion(ILP) was developed as a new treatment approach to non-resectable primary or metastatic lung cancer, because of its ability to reduce systemic toxicity while delivering high-dose chemotherapeutic agents to the target organs. This research was planned to evaluate the direct toxic effect of high-dose cisplatin to the lung tissue during isolated lung perfusion. Material and Method: Fifteen mongrel dogs were divided in the perfusate for 40 minutes. The second group was composed of 5 mongrel dogs which underwent ILP with cisplatin 2.5 mg/Kg added to the perfusate for 30 minutes and 10 minutes with washing solution without cisplatin. The third group underwent the same procedure as the second group except cisplatin 5.0 mg/Kg in the perfusate. Activities of serum angiotensin converting enzyme(ACE), tumor necrosis factor-$\alpha$(TNF-$\alpha$), and concentration of serum lactate dehydrogenase(LDH) and blood urea nitrogen/creatinine (BUN/Cr) were analyzed in each groups at the time of pre-perfusion, 1 hour, 1 day, 1 week, and 2 weeks after ILP. Result: Serum ACE activities before and 1 hour, 1 day, 1 week, and 2 weeks after ILP in control group were 45.1$\pm$6.3, 44.6$\pm$9.3, 46.7$\pm$9.5, 50.8$\pm$9.1, 46.1$\pm$4.3 U/L. Those in cisplatin 2.5 and 5.0 mg/Kg groups were 49.4$\pm$12.6, 39.0$\pm$8.6, 42.3$\pm$15.9, 50.0$\pm$2.6, 53.8$\pm$8.3 and 55.5$\pm$12.3, 47.0$\pm$6.3, 45.1$\pm$6.9, 74.8$\pm$19.5, 60.2$\pm$12.0 U/L, respectively. Serum TNF-$\alpha$ activities in each group before and after ILP were 5.0$\pm$1.5 / 7.7$\pm$2.2 / 6.6$\pm$2.5 / 4.3$\pm$1.3 / 5.2$\pm$1.1(control), 8.7$\pm$1.6 / 9.9$\pm$2.2 / 7.9$\pm$1.5 / 6.3$\pm$2.2 / 7.4$\pm$2.4 (cisplatin 2.5 mg/Kg), and 6.9$\pm$0.7 / 8.9$\pm$3.4 / 7.9$\pm$4.0 / 3.3$\pm$0.9 / 5.8$\pm$1.3 pg/ml(cisplatin 5.0 mg/Kg). Mean LDH levels of each group were 225.7 / 271.3 / 328.9 / 350.8 / 255.7(control), 235.7 / 265.7 / 336.0 / 379.5 / 299.2 (cisplatin 2.5 mg/Kg), and 259.6 / 285.2 / 340.6 / 433.4 / 292.4 IU/L(cisplatin 5.0 mg/Kg). So there was no significant difference in serum ACE, TNF-$\alpha$, and LDH activity changes after ILP between the 3 groups. And, there was no significant changes in BUN/Cr in each groups, which was independent of ILP and perfused concentration of cisplatin. In addition, all dogs survived the ILP and there was no significant evidence of pulmonary vascular injury after 2 weeks of ILP with cisplatin. Conclusion: There was no harmful effect of cisplatin to the lund tissue of the mongrel dog up to 5.0 mg/Kg in perfusate. Therefore, it is perceived to be safe and effective to deliver high-dose cisplatin to the lung without pulmonary toxicity and renal damage with ILP.

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A study on design process for public space by users behavioral characteristics (이용자 행태 특성에 의한 공용공간의 디자인 프로세스 연구)

  • 김개천;김범중
    • Archives of design research
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    • v.17 no.1
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    • pp.89-98
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    • 2004
  • A systemic approach to behavior on the basis of human psychology is needed for behavior-centered space design. Also, the recognition that human and environment, in all, have complementarity is needed- human and space shall be understood as a general phenomenon, supposing interaction. Design of behavior-oriented space means configuration and coordination of physical subjects as well as understanding, analysis and reflection of psychological and behavioral phenomena. It is analysis of a private individual as well as understanding of interaction between human groups, as well. In respect of space recognition, analysis not on material movement but on energy circulation and variable is important. It means that the understanding of user's behavior and psychology does not orient reasonable purpose just for convenience. That is, such understanding intends to understand behavioral patterns and psychological phenomena between space and human beyond the decomposition of structure of human and space into physical elements and the design based on standardized data. Thereby, more human-oriented space design might be implemented by the understanding of behavioral essence. Also, a user-centered design process from another viewpoint might be created, and the general amenity among man, space and environment - better environmental quality - might be produced. For this, the consciousness of human activity that is, activity system shall be ahead of it, and the approaches for design shall be implemented into a process not in predictive ideas but in semi-scientific system. On the basis of the above view, this study was attempted to investigate the orientation of design to recognize space as another life, and explore a process where it is drawn into a design language on the basis of human behavior. If the essence of space behavior and the activity system are analyzed through user observation and it is reflected upon a space design program and then developed into a formative language, a new design process on human and environment might be produced. In conclusion, the reflection of user's behavior and psychology into design, contrary to existing public space design based on physical data, can orient quality improvement of human life and ultimately be helpful to the proposition, 'humanization of space'.

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The Application of the Forensic Dental Identification to Unidentified Individual Remains in Korea (신원불명 사망자의 개인식별에서 법치의학적 방법의 활용성에 관한 연구)

  • Park, Hee-Kyung
    • Journal of Oral Medicine and Pain
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    • v.31 no.1
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    • pp.27-36
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    • 2006
  • The cases of unidentified individual remains submitted to Forensic dentistry section in National Institute of Scientific Investigation, Korea were analyzed to study the application of forensic dental identification into individual identification in the period 2002-2005. The identification cases of unidentified remains were 405 out of 493, which accounted about 82% of whole cases. The incidence of submission of skeletons at least including the skull was increased from 58% in 2002 to 80% in 2005. The numbers of cases for the full examinations were 4 times more than that for age estimation in 2005. Twenty-four cases were submitted for skull to photographic superimposition and 15 out of 24 cases were examined, and the other 9 cases were examined by DNA analysis only. The submitted cases for dental comparison were 23 cases, 9 cases were positively identified, 4 cases were possible, 7 cases were excluded, and 3 cases ended up with insufficient evidences. The proportion of positive identification by dental methods was increased gradually from 9% in 2002 to 46% in 2005. Forensic dental identification has become important and useful because the availability of dental records and radiographs has been increasing. Compared to DNA analysis, forensic dental identification has several advantages such as no needs for high cost equipments and low expenses. And the interpretation of results is straightforward and speedy. These advantages are based on using primary their own dental records of the individuals rather than secondary DNA reference samples from family members. The application of the forensic dental identification to unidentified individual remains will be increased because the dental comparison can complement the limitation of DNA analysis and skull to photographic superimposition in many cases. In order to obtain positive identifications of unidentified remains, a close collaboration between the police and forensic scientists is important. The systemic approach including legislation to preserve dental records of unidentified remains and missing persons for the identification of unidentified remains should be needed.

A Study Concerning the Background of Formation in Deleuze's System (들뢰즈 체계의 형성 배경에 대한 연구 - 칸트 선험철학 체계 그 심연으로부터의 역류 -)

  • Kim, Dae-hyeon
    • Journal of the Daesoon Academy of Sciences
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    • v.37
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    • pp.329-355
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    • 2021
  • The objective of this paper is to reveal that the formation of Deleuze's system is a result of a back flow of the 'ideal of pure reason' in Kant's system. I will try to seize upon the keyword in his main book, Difference and Repetition, and examine the aspect of mutual transformation between Deleuze's transcendental empiricism and Kant's transcendentalism. When analyzing Deleuze's system, most researchers tend to focus on anti-Hegelianism, but it is proper that Kant be adopted as the start when tracing the way of deployment directly. Fundamentally, Deleuze is different from Hegel in his approach to observing entire ground of thought. Even if Deleuze surely has the capability of becoming in the dialectical context, his systemic environment wherein dialectics is applied is different even at the onset. While Hegel follows the way of origin and copy or a system that begins from a preceding point of origin, Deleuze follows a way of copy and recopy or a system that begins without a point of origin. This characteristic of Deleuze's system originates directly from idealistic play. In fact, we can anticipate and identify in his book that he refers to Kant who accepted the tradition of empiricism. Therefore, the main contents of this paper is to present an overview of Kant's influence on Deleuze's system. While tracing ideas back to Kant's system, the cohabitation of empiricism and rationalism, which Kant felicitously revoiced, there emerges a definitude of world recognition. This occurs through cohabitation, and this is both deconstructed and integrated by Deleuze, and therein definitude is turned into a vision of prosperity. To the vision of prosperity that spans definitude to recognition, a philosopher has the right to select a philosophical system because selection methodology in philosophy is not a problem of legitimacy so much as the needs of the times. Deleuze's choice resulted in the opening of pandora's box in an abyss and secret contents have in turn risen sharply.

Efficacy of Three Antiviral Agents and Resistant Cultivars on Tomato Yellow Leaf Curl Virus in Tomato (토마토황화잎말림바이러스병에 대한 저항성 품종과 항바이러스 활성 물질 3종의 효과 검증)

  • Kwon, Yongnam;Cha, Byeongjin;Kim, Mikyeong
    • Research in Plant Disease
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    • v.28 no.2
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    • pp.82-91
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    • 2022
  • Recently, several in vitro studies have reported antiviral activity of agents of systemic acquired resistance against plant virus infection, but the approach has not been applied in a wide range of agricultural fields. The objective of this study was to evaluate the inhibitory effect of the exogenous application of salicylic acid (SA), chitosan (CH), or eugenol (EG) in tomato yellow leaf curl virus (TYLCV) infection of greenhouse-grown tomato plants. In vitro, the initial time of symptom was observed in TYLCV-infected plants (VP) of the resistant cultivar 'Superdotaerang' at 12 days post inoculation (dpi) after application of antiviral agents. At 32 dpi, the disease rate of TYLCV in the CHT+VP (0.1% chitosan and virus infected control) treated plants was 87.5%, lower than that of the other treatment. However, the virus content in the CHT+VP treated plants was higher than those of the other treatments, and SA, EG, and CH did not show significant effect on plant height or shoot and root fresh weight. Our results from summer-cultivated greenhouse-grown tomatoes show that none of the tested agents had an inhibitory activity on viral infection or yield of tomato 'Dotaerangsola'cultivar. In contrast, all treated 'TY Giants' cultivars that possessed TYLCV resistance genes Ty-1 and Ty-3a did not show typical symptoms and the virus content was remarkably lower than those in the TYLCV treated plants in 'Superdotaerang'. The results of this research indicated that the planting of resistant tomato cultivars was effective method instead of using SA, EG, and CH (known as resistance-inducing factors for control) of TYLCV in the field.