Background: To investigate the impact of the breast size, shape, maximum heart depth (MDH), and chest wall hypotenuse (the distance connecting middle point of the sternum and the length of lung draw on the selected transverse CT slice) on the volumetric dose to heart with whole breast irradiation (WBI) of left-sided breast cancer patients. Materials and Methods: Fifty-three patients with left-sided breast cancer undergoing adjuvant intensity-modulated radiotherapy (IMRT) were enrolled in the study. The primary breast size and shape, MHD and DCWH (chest wall hypotenuse) were contoured on radiotherapy (RT) planning CT slices. The dose data of hearts were obtained from the dose-volume histograms (DVHs). Data were analyzed by one-way analysis of variance (ANOVA), Student's t-test and linear regression analysis. Results: Breast size was independent of heart dose, whereas breast shape, MHD and DCWH were correlated with heart dose. The shapes of breasts were divided into four types, as the flap type, hemisphere type, cone type and pendulous type with heart mean dose being $491.8{\pm}234.6cGy$, $752.7{\pm}219.0cGy$, $620.2{\pm}275.7cGy$, and $666.1{\pm}238.0cGy$, respectively. The flap type of breasts shows a strong statistically reduction in heart dose, compared to others (p=0.008 for V30 of heart). DCWH and MHD were found to be the most important parameters correlating with heart dose in WBI. Conclusions: More attention should be paid to the heart dose of non-flap type patients. The MHD was found to be the most important parameter to correlate with heart dose in tangential WBI, closely followed by the DCWH, which could help radiation oncologists and physicsts evaluate heart dose and design RT plan in advance.
The aim of this research was to examine the management practices related to foodservice.clinical nutrition service provided by hospital foodservice operations. A survey of 30 hospital food nutrition service departments was undertaken and detailed information was collected from each, including surveys of 176 dietitians and 30 foodservice managers. Statistical data analysis was completed using the SAS/win 6.11 package for descriptive analysis and t-test. The results of this study can be summarized as follows : Out of 30 hospitals, 73.3%(22) were directly operated and 26.7%(8) were under contract foodservice management. Licensed number of beds were 768.7, with an average length of 11.4 days. The general characteristics of the dietitians were that 49.4% were aged between 25-29, and 60.8% were ordinary dietitians. 76.7% had bachelor's degree, 15.9% with master's degree and 7.4% were college graduates. Most hospital dietitians had internship training and 35.2% took a training course of 6 to 12 months. The average space of kitchen was 452.52 $m^2$, with 133.63$m^2$ for modified diet space and 18.13$m^2$ for nutrition counselling room space. The total number of normal meals was 1,255.47, with 502.93 of modified meals. The average calorie of normal meals was 2,145.04kcal, with 91.9g of protein contained in normal meal. The total food waste was 351.40kg. An average monthly cost for disposing food waste was 745,171.67 won. 83.3% of the kitchens were on the 1st basement and only 66.7%(20) of 30 hospitals had its own nutrition counselling room. 80% used dishwashers and 66.7% had an exclusive elevator for delivering meals. 80.0% of hospitals used centralized delivery service. 90% had established an area for hygiene division, 70% used dry zone within the dishwashers for sterilization, 66.7% provided spoon and chopstick, and 100% used dish cover. As means of food waste treatment, most hospitals(56.7%) used animal feed by contracters, followed by means of collection by contracters(30%) and in-house high speed fermentation machines(13.3%). It was found that only 33.3% hospitals regularly checked temperatures of the meals given to patients. Total productivity index was 3.72(meals/hour) in average, with an average productivity index for normal diet of 5.41. Average productivity index for modified diet was 4.62. Productivity indices for patient meals and clinical nutrition were 5.01(meals/hour) and 1.12(cases/hour) respectively and hospitals under self-operated foodservice management received higher points on clinical nutrition productivity index(P<0.01) than hospitals under contract foodservice management.
The purpose of this study was to analyse the gait characteristics of stroke patients walking on a Zebris system, through quantitative three-dimensional biomechanical analysis. They underwent a continuous rehabilitation training program (RTP). A comparison was made between 3 month and 6 month RTP participants. Their ages were between 60 and 65. The data were analyzed by t-test. The result of comparative analysis of the two groups can be summarized as below. Temporal-spatial data, sagittal plane angular kinematics data, and peak ground reaction force and max pressure data showed that there were no significant differences between the 3 month RTP group and the 6month RTP group (Table 2, Table3, Table 4). It can be suggested that patients with hemiplegia after stroke can improve their walking function through continuous RTP participation.
Ko, Gyoung Min;Moon, Sung Je;Sohn, Min Sung;Lee, Sol;Go, Dun sol;Yoon, Seok Jun
Korea Journal of Hospital Management
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v.25
no.2
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pp.1-13
/
2020
Purpose: The purpose of this study is to identify the effect of the disease duration on depression change in cancer survivors between the middle and old age groups. Methodology: To that end, we analyzed 275 patients using the Korea welfare panel survey from 2011 to 2016 jointly developed by the Korea Institute for Health and Social Affairs and Seoul National University. The duration of the elapsed and the experienced was measured as a independent variable. CES-D was used as a dependent variable. Frequency, paired t-test, ANOVA, and logistic regression analysis were conducted using Stata 14.0 for statistical analysis. Findings: Studies have shown that as the duration of the elapsed and the experienced increases, people under 65 are 1.17 times and 1.84 times each more likely to be included in depression-increase group than in depression-reduction group. The group that has been maintaining economic activities continuously since 2011 was significantly less likely to belong to the depression-increase group than the group that did not have economic activities in 2016. For those aged 65 and older, there was no significant difference in the duration of the elapsed and the experienced. The higher the likelihood of low-income households being included in the family of depression was 2.58 times higher than for ordinary households. Practical Implications: It is suggested that close policy management of the employment and working environment of cancer survivors is necessary, as both cancer survivors of productive age as well as older cancer survivors are analyzed to be beneficial to depression management. In addition, a systematic management program related to the mental health of cancer survivors is believed to be necessary for normal social recovery in the future.
PURPOSE. To evaluate the effects of surface treatments on shear bond strength (SBS) between microwave and conventionally sintered zirconia core/veneers. MATERIALS AND METHODS. 96 disc shaped Noritake Alliance zirconia specimens were fabricated using YenaDent CAM unit and were divided in 2 groups with respect to microwave or conventional methods (n=48/group). Surface roughness (Ra) evaluation was made with a profilometer on randomly selected microwave (n=10) and conventionally sintered (n=10) cores. Specimens were then assessed into 4 subgroups according to surface treatments applied (n=12/group). Groups for microwave (M) and conventionally (C) sintered core specimens were as follows; $M_C$,$C_C$: untreated (control group), $M_1,C_1:Al_2O_3$ sandblasting, $M_2,C_2$:liner, $M_3,C_3:Al_2O_3$ sandblasting followed by liner. Veneer ceramic was fired on zirconia cores and specimens were thermocycled (6000 cycles between $5^{\circ}-55^{\circ}C$). All specimens were subjected to SBS test using a universal testing machine at 0.5 mm/min, failure were evaluated under an optical microscope. Data were statistically analyzed using Shapiro Wilk, Levene, Post-hoc Tukey HSD and Student's t tests, Two-Way-Variance- Analysis and One-Way-Variance-Analysis (${\alpha}$=.05). RESULTS. Conventionally sintered specimens ($1.06{\pm}0.32{\mu}m$) showed rougher surfaces compared to microwave sintered ones ($0.76{\pm}0.32{\mu}m$)(P=.046), however, no correlation was found between SBS and surface roughness (r=-0.109, P=.658). The statistical comparison of the shear bond strengths of $C_3$ and $C_1$ group (P=.015); $C_C$ and $M_C$ group (P=.004) and $C_3$ and $M_3$ group presented statistically higher (P=.005) values. While adhesive failure was not seen in any of the groups, cohesive and combined patterns were seen in all groups. CONCLUSION. Based on the results of this in-vitro study, $Al_2O_{3-}$ sandblasting followed by liner application on conventionally sintered zirconia cores may be preferred to enhance bond strength.
Park, Do-Hyun;Park, Ji-Man;Choi, Jae-Won;Kang, Eun-Sook;Bae, Eun-Bin;Jeon, Young-Chan;Jeong, Chang-Mo;Yun, Mi-Jung;Huh, Jung-Bo
The Journal of Advanced Prosthodontics
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v.9
no.5
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pp.341-349
/
2017
PURPOSE. This study evaluated the accuracies of different bite registration techniques for implant-fixed prostheses using three dimensional file analysis. MATERIALS AND METHODS. Implant fixtures were placed on the mandibular right second premolar, and the first and second molar in a polyurethane model. Aluwax (A), Pattern Resin (P), and Blu-Mousse (B) were used as the bite registration materials on the healing abutments (H) or temporary abutments (T). The groups were classified into HA, HP, HB, TA, TP, and TB according to each combination. The group using the bite impression coping was the BC group; impression taking and bite registration were performed simultaneously. After impression and bite taking, the scan bodies were connected to the lab analogs of the casts. These casts were scanned using a model scanner. The distances between two reference points in three-dimensional files were measured in each group. One-way ANOVA and Duncan's test were used at the 5% significance level. RESULTS. The smallest distance discrepancy was observed in the TB group using the temporary abutments. The Blu-Mousse and HP groups showed the largest distance discrepancy. The TB and BC groups showed a lower distance discrepancy than the HP group (P=.001), and there was no significant difference between the groups using the temporary abutments and healing abutments (P>.05). CONCLUSION. Although this study has limitations as an in-vitro investigation, the groups using the temporary abutments to hold the Blu-Mousse record and bite impression coping showed greater accuracy than the group using the healing abutments to hold the pattern resin record.
Purpose: Dr. Marquardt made the facial 'phi' mask using golden ratio. Most class III patients have bulky faces and want a smaller face. Using a facial golden mask, this study estimated and compared frontal photographs before and after operation for soft tissue measurement. The golden mask can be considered as a reference tool for facial esthetic analyses especially in lower face. Methods: Forty patients who had undergone orthognathic surgery at Samsung Medical Center from January 2006 to December 2009 were included in this study. These patients had Class III malocclusion. Lateral cephalometric radiographs, frontal clinical photos of pre-op and 8~12 month later post-op, and the facial 'phi' mask using golden ratio, were used for analysis. Reduction of the lower face area, occlusal plane changes, amounts of mandible setback and amounts of maxilla posterior impaction were estimated. Results: Lower facial reduction ratio and mandibular setback amounts were significantly different between 1-jaw and 2-jaw groups. Average postoperative changes in the area of lower face between bilateral sagittal split ramus osteotomy (BSSRO) and BSSRO combined maxilla posterior impaction were compared by using an independent simple t-test and $P$ value was 0.016. Therefore, the lower facial reduction ratio and mandibular setback amount were significantly different in maxilla posterior impaction. Conclusion: The two-jaw surgery group showed more reduction of the lower facial area than the 1-jaw surgery group. The amount of lower facial reduction was more related with the amount of mandibular setback. There was no significant relation in lower facial reduction with amount of maxilla posterior impaction, pre-op occlusal plane, post-op occlusal plane and the mandibular angle. A relationship between the change in the lower facial area and the amount of maxilla posterior impaction or the change of mandibular angle occlusal plane at pre-op could not be found because of the difference in the amount of setback between two groups.
The purpose of this study was to find the factors affecting the bum out syndrome and its degree in terms of personal, organizational and clients characteristics, and then to find the ways to reduce or eliminate those factors. The 228 doctors and the nurses who worked at the emergency departments in 6 general hospitals with more than 700 beds in Seoul were surveyed from April 15, 2002 for 15 days. A structured self-recording questionnaire was used; the t-test and ANOVA was used to analyse the median difference between the occupation, and multiple regression was employed to find the factors affecting the bum-out syndrome. The summary of this research analysis is as follows : First, of several variables, the highest frequency of the burn-out was the emotional burn-out followed by lack in personal touch toward the patients, decrease in sense of personal achievement. These results indicate that the doctors and nurses in emergency departments experience higher degree of burn-out than the social workers and the nurses who work at other departments in heath care environment as other studies revealed. Second, the analysis of the total burn-out factors showed the lower self respect, younger age, heavier work load, higher dissatisfaction rate toward remuneration and not-so-smooth relationship with the patients and their relatives the higher burn out rate. These variables explained 54% of the total variables. Third, the nurses experienced more burn-out syndrome than the doctors. The degree of self-respect, work pattern, relationship with the clients, age and remuneration were the causes of the burn-out. The doctors recorded lack in personal touch toward the patients more, while the nurses more to emotional exhaustion. The limitations of this research are the subjective answers of the respondents to certain questions and differences in sample numbers of each hospital in which some reservation can be exercised in explaining statistical significance of the data, and generalizing the conclusion. Despite of its limitation, this research has its own merit as an unpreceded research in this field, and provision of the basic materials to prevent and find causes of the burn-out syndrome among the doctors and nurses in the emergency departments.
The objective of this study was to provide baseline information useful for developing education programs to prevent sexual harassment in schools. Survey of recognition and experiences of sexual harassment and analysis of factors associated with sexual harassment were conducted. The data were collected using questionnaires from December 9 through 28, 2002. A total of 737 female teachers in Daegu participated in the survey. The data were analyzed with descriptive analysis, ANOVA, and T-test using SPSS /WIN 11.0. The study results were as follows: 1. As to the characteristics related to sexual harassment, $51.3\%$ of the female teachers had no experience of preventive education about sexual harassment, $37.2\%$ of the female teachers perceived that enactment of related laws had little influence on the prevalence of sexual harassment, and $59.8\%$ thought strict punishments are required. For teachers who have experienced sexual harassment in schools, $39.8\%$ thought that they must report to the counseling office or female teachers' meeting. On the other hand, $35.7\%$ answered that they would take passive actions such as talking to their friends or colleagues. 2. As to the mode of sexual harassment, participants regarded physical harassment $(4.06\pm0.78)$ as the prominent forms of sexual harassment, followed by visual harassment $(4.04\pm0.77)$, and verbal harassment $(3.86\pm0.81)$. Among physical harassment. 'touching a body part (shoulder, hip, hand, etc)(4.58) was recognized as prominent forms of physical harassment, while 'blocking one's path or impeding one's movement (3.48)' was recognized as least prominent forms of physical harassment. 3. As to the experiences of sexual harassment, $79.8\%$ of the female teachers had experienced sexual harassment. According to the characteristics of schools. public junior high school $(87.8\%)$, private high school $(83.4\%)$ and bisexual school $(82.5\%)$ had higher rates of sexual harassment. 4. As to the characteristics of experiences in sexual harassment. $65.3\%$ thought that sexual harassment was not serious, but $18.9\%$ thought it was serious and $2.2\%$ thought as very serious. 5. As to the characteristics of sexual harassers, $378.6\%$ were 'colleague teachers' and $8.6\%$ were 'principals and/or vice-principals'. Ninety-three percent of sexual harassers were , male' and $40.2\%$ of them were 'in their 40s'. In most cases. the offender of the sexual harassment was male teachers in the same schools. And more than half of the female teachers replied they had never had any education related to sexual harassment. which means that systematic education is quite urgent.
This study applies the Technology Acceptance Model to grasp the effect of the food traceability system on consumer confidence and usage intention. To verify the causal relationships between the factors, the consumers who use grocery stores in Seoul were selected. From February 20, 2011 to February 28, 2011, a total of 300 copies of the questionnaire were distributed, and 284 copies except for those unsuitable for analysis were collected. SPSS 12.0 and AMOS 5.0 factors analysis and a reliability test were conducted, in older to validate the proposed hypotheses. The results are summarized as follows. First, the food traceability system bad a significant effect on the technology acceptance model. Second, the food traceability system bad a significant affect on consumer confidence. Third, the food traceability system bad a significant effect on usage intention. Fourth, the technology acceptance model didn't have a significant effect on consumer confidence. Fifth, the technology acceptance model and consumer confidence bad significant effects on usage intention. Based on these results, this study suggests useful implications for the food traceability system.
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