Ahn Yong Chan;Cho Byung Chul;Choi Dong Rock;Kim Dae Yong;Huh Seung Jae;Oh Do Hoon;Bae Hoonsik;Yeo In Hwan;Ko Young Eun
Radiation Oncology Journal
/
v.18
no.2
/
pp.150-156
/
2000
Purpose : Stereotactic radiation therapy (SRT) can deliver highly focused radiation to a small and spherical target lesion with very high degree of mechanical accuracy. For non-spherical and large lesions, however, inclusion of the neighboring normal structures within the high dose radiation volume is inevitable in SRT This is to report the beam shaping using the partial closure of the independent jaw in SRT and the verification of dose calculation and the dose display using a home-made soft ware. Materials and Methods : Authors adopted the idea to partially close one or more independent collimator jaw(5) in addition to the circular collimator cones to shield the neighboring normal structures while keeping the target lesion within the radiation beam field at all angles along the arc trajectory. The output factors (OF's) and the tissue-maximum ratios (TMR's) were measured using the micro ion chamber in the water phantom dosimetry system, and were compared with the theoretical calculations. A film dosimetry procedure was peformed to obtain the depth dose profiles at 5 cm, and they were also compared with the theoretical calculations, where the radiation dose would depend on the actual area of irradiation. Authors incorporated this algorithm into the home-made SRT software for the isodose calculation and display, and was tried on an example case with single brain metastasis. The dose-volume histograms (DVH's) of the planning target volume (PTV) and the normal brain derived by the control plan were reciprocally compared with those derived by the plan using the same arc arrangement plus the independent collimator jaw closure. Results : When using 5.0 cm diameter collimator, the measurements of the OF's and the TMR's with one independent jaw set at 30 mm (unblocked), 15.5 mm, 8.6 mm, and 0 mm from th central beam axis showed good correlation to the theoretical calculation within 0.5% and 0.3% error range. The dose profiles at 5 cm depth obtained by the film dosimetry also showed very good correlation to the theoretical calculations. The isodose profiles obtained on the home-made software demonstrated a slightly more conformal dose distribution around the target lesion by using the independent jaw closure, where the DVH's of the PTV were almost equivalent on the two plans, while the DVH's for the normal brain showed that less volume of the normal brain receiving high radiation dose by using this modification than the control plan employing the circular collimator cone only. Conclusions : With the beam shaping modification using the independent jaw closure, authors have realized wider clinical application of SRT with more conformal dose planning. Authors believe that SRT, with beam shaping ideas and efforts, should no longer be limited to the small spherical lesions, but be more widely applied to rather irregularly shaped tumors in the intracranial and the head and neck regions.
Kim, Su-Jin;Park, Sung-Won;Sohn, Young-Bae;Jin, Dong-Kyu;Paik, Kyung-Hoon
Childhood Kidney Diseases
/
v.12
no.1
/
pp.38-46
/
2008
Purpose: Growth failure is a common problem in chronic renal failure(CRF). We studied the effect of growth hormone(GH) treatment and the factors influencing growth on chronic peritoneal dialysis patients. Methods: Seventeen patients who were treated with peritoneal dialysis and GH for more than one year were enrolled. Factors influencing growth such as age, height at start of GH treatment, total Kt/Vurea, residual renal Kt/Vurea, hemoglobin, albumin, BUN, creatinine, total $CO_2$, calcium, phosphate and iPTH during GH treatment were compared between the growth group (increase in height-standard deviation score(Ht-SDS) after one year of GH treatment, n=l1) and poor growth group(no increase in Ht-SDS after one year of GH treatment, n=6). Results: The mean age at the start of dialysis was 7.7${\pm}$5.2 years and the mean age at the start of GH treatment was 8.5${\pm}$4.8 years. In the growth group, Ht-SDS at start of GH treatment was smaller(-1.72${\pm}$1.00 vs. -0.77${\pm}$0.88, P=0.048) and residual renal Kt/Vurea was better (1.54${\pm}$0.51 vs. 0.15${\pm}$0.26, P=0.02) than the poor growth group. After three years of GH treatment, Ht-SDS of the growth group was better than the poor growth group. Conclusion: GH treatment in children with peritoneal dialysis was more effective on patients who had more severe growth retardation. The reservation of residual renal function was important for improvement of effect of GH treatment. And the growth response during the first year of GH treatment may be predicted as the indicator for long-term response.
Consumers of e-learning market differ from those of other markets in that they are replaced in a specific time scale. For example, e-learning contents aimed at highschool senior students cannot be consumed by a specific consumer over the designated period of time. Hence e-learning service providers need to attract new groups of students every year. Due to lack of information on products designed for continuously emerging consumers, the consumers face difficulties in making rational decisions in a short time period. Increased uncertainty of product purchase leads customers to herding behaviors to obtain information of the product from others and imitate them. Taking into consideration of these features of e-learning market, this study will focus on the online herding behavior in purchasing e-learning contents. There is no definite concept for e-learning. However, it is being discussed in a wide range of perspectives from educational engineering to management to e-business etc. Based upon the existing studies, we identify two main view-points regarding e-learning. The first defines e-learning as a concept that includes existing terminologies, such as CBT (Computer Based Training), WBT (Web Based Training), and IBT (Internet Based Training). In this view, e-learning utilizes IT in order to support professors and a part of or entire education systems. In the second perspective, e-learning is defined as the usage of Internet technology to deliver diverse intelligence and achievement enhancing solutions. In other words, only the educations that are done through the Internet and network can be classified as e-learning. We take the second definition of e-learning for our working definition. The main goal of this study is to investigate what factors affect consumer intention to purchase e-learning contents and to identify the differential impact of the factors between consumers with purchase experience and those without the experience. To accomplish the goal of this study, it focuses on herding behavior and perceived usefulness as antecedents to behavioral intention. The proposed research model in the study extends the Technology Acceptance Model by adding herding behavior and usability to take into account the unique characteristics of e-learning content market and e-learning systems use, respectively. The current study also includes consumer experience with e-learning content purchase because the previous experience is believed to affect purchasing intention when consumers buy experience goods or services. Previous studies on e-learning did not consider the characteristics of e-learning contents market and the differential impact of consumer experience on the relationship between the antecedents and behavioral intention, which is the target of this study. This study employs a survey method to empirically test the proposed research model. A survey questionnaire was developed and distributed to 629 informants. 528 responses were collected, which consist of potential customer group (n = 133) and experienced customer group (n = 395). The data were analyzed using PLS method, a structural equation modeling method. Overall, both herding behavior and perceived usefulness influence consumer intention to purchase e-learning contents. In detail, in the case of potential customer group, herding behavior has stronger effect on purchase intention than does perceived usefulness. However, in the case of shopping-experienced customer group, perceived usefulness has stronger effect than does herding behavior. In sum, the results of the analysis show that with regard to purchasing experience, perceived usefulness and herding behavior had differential effects upon the purchase of e-learning contents. As a follow-up analysis, the interaction effects of the number of purchase transaction and herding behavior/perceived usefulness on purchase intention were investigated. The results show that there are no interaction effects. This study contributes to the literature in a couple of ways. From a theoretical perspective, this study examined and showed evidence that the characteristics of e-learning market such as continuous renewal of consumers and thus high uncertainty and individual experiences are important factors to be considered when the purchase intention of e-learning content is studied. This study can be used as a basis for future studies on e-learning success. From a practical perspective, this study provides several important implications on what types of marketing strategies e-learning companies need to build. The bottom lines of these strategies include target group attraction, word-of-mouth management, enhancement of web site usability quality, etc. The limitations of this study are also discussed for future studies.
Park, Hoon-Hee;Oh, Ki-Beak;Lee, Seung-Jae;Bhan, Young-Kag;Kang, Chun-Goo;Lim, Han-Sang;Kim, Jae-Sam;Lee, Chang-Ho
The Korean Journal of Nuclear Medicine Technology
/
v.15
no.1
/
pp.45-50
/
2011
Purpose: It appears the different value when the injection dose is calculating for patients on each PET/CT systems. It directly affects the technologists' radiation exposed dose. We studied the effect of the variable injection doses from several PET/CT systems to exposure dose for technologists. Materials and Methods: Six technologists have worked for 5 months through unit rotations with 3 PET/CT systems {Scanner 1 (S1): 0.15 mCi/kg, Scanner 2 (S2): 0.17 mCi/kg, Scanner 3 (S3): 0.12 mCi/kg}. Eighteen to 19 patients have had examinations per a day on each PET/CT systems. Examination parameters were adjusted to the same. TLDs were used for checking the exposure dose of technologists. Results: Each technologists' the monthly average exposure dose was as follows; S1: 0.76 mSv, S2: 0.93 mSv, S3: 0.47 mSv. The maximum exposure dose was 1.12 mSv, and minimum was 0.42 mSv. The results showed significance in the correlation between the PET/CT system and the exposure dose (p<0.005). Conclusion: When the amount of injection dose was small, the exposure dose was decreased not only the patients but also the technologists. The exposure dose was decreased by the individual proficiency of technologists. However, the low injection dose can highly reduce the exposure dose for technologist so that there will be needed to following studies.
Purpose: Radio-isotopes (RI) use has been steadily developing due to industrial and technical development in the modern medical society. Particularly, popularization of domestic cyclotrons dramatically enable hospitals to produce and use diagnostic radio-isotopes. Generally, only specific facilities such as hospitals, research institutes, nuclear power plants and universities can use radio-isotopes, they are also responsible for ventilation system. The strength of radioactivity in the air is strongly regulated and controlled by korea atomic energy law in Korea Institue of Nuclear Safety (KINS), so that air radioactivity exposure can lead to environmental pollution surrounding places. In this study, we'd like to find out the investigation and the present condition of the controlled ventilation system in domestic hospitals by an emission standard from KINS, and try to reach an agreement about how to use the ventilation system. Result: Definition of filters, features and structures of pre-filters, hepa-filters, charcol filters, filter exchange procedures and precautions are explained. RI deflation concentration and filter exchange cycle have been presented as a standard prescribed in the rules of KINS. The Radiation Control Management System (RCMS) introduced by Seoul National University Bundang Hospital linking to digital pressure gauge with computer controller in another medical facilities were described in details. Conclusions: The system of medical facilities using RI has been remarkably developing in 21 century. Especially, radiation safety control system has also been grown rapidly into the subdivision, specialization, advanced technology along with international technical improvement. However, As far as current RI ventilation system is concerned, it has nothing better than doing in the past. Preferentially, to reinforce this, more sophisticated system with strict periodic filter exchange and exhaust air control guidance should be introduced by applying brilliant domestic information technology for RCMS and digital gauge method. From personal point of view as a radiation safety manager, I have provide with present problems and improvements. Futhermore, more improved guidance should be conducted.
Purpose: Whole body imaging with radioiodine can detect functioning metastases. Non-physiologic I-131 uptake detected on images usually is interpreted as suggesting functioning thyroid metastases. However, extra-thyroidal I-131 accumulation does not always imply thyroid cancer metastases and has been reported in many circumstances. In order to avoid unnecessary therapeutic interventions it is important to distinguish false-positive sites of I-131 localization. We study here to remove false-positive sites around esophagus region on I-131 whole body imaging in patients who were administrated thyroidectomy. Materials and Methods: From April to August in 2007, we had the patients who had visited our department after they received thyroidectomy due to thyroid cancer. They were given I-131, and performed radioiodine body scan after 41 to 50 hours. Patients were whole-body-scanned for the speed of 8 cm per minute. After that, we took anterior and posterior static images around the patients' neck measured by 300 thousand counts per image. We selected 44 patients who had hot spots around neck region, we divided the patients into two groups. One group was given 0.5 L of water and the other group was given 0.5 L of water with 1 g of Vitamin C dissolved. The patients were asked to drink the fluid for one minute in sitting position and after that, we measured 300 kilo counts per image again. We compared prior anterior, posterior static images with anterior, posterior images after the patients had water or water that Vitamin C resolved. Results: In using water, both observer 1 and 2 interpreted 6 patients were washed out. In the water with Vitamin C resolved, observer 1 and 2 interpreted 9 and 8 patients were washed out. Observer 1 and 2 interpreted 6 and 5 patients had 'indeterminate' when they used water. Both observer 1 and 2 interpreted 6 patients had 'indeterminate' when they used water with Vitamin C resolved. When they used water, observer 1 interpreted 10 patients had 'unchanged' and observer 2 interpreted 11 patients had 'unchanged'. Differently, when they used water with vitamin C resolved, observer1 had 8 patients having 'unchanged'and observer 2 had 9. Conclusion: As a result, by making patients drink 0.5 liter of water which has vitamin C resolved helped getting rid of false-positive sites in esophagus. Therefore, based on this study, we believe that drinking water with vitamin C dissolved is very in terms of reducing false-positive hot spot around the esophagus for the iodine-131 whole body scan.
This study was carried out to investigate the effects of grape seed oil on quality characteristics of pressed ham. Five different treatments were tested based on differences in the amount of grape seed oil added to the pressed ham. As a control, 10% back fat was added without any grape seed oil. For the first treatment, 10% grape seed oil replaced a portion of the lard component added to the pressed ham. For the 2nd, 3rd and 4th treatments, 20%, 30% and 40% of grape seed oil were substituted for lard, respectively. Pressed ham manufactured with grape seed oil was vacuum packaged and stored for 1, 7, 14,21 and 28 d at $4^{\circ}C$. Samples were analyzed for chemical composition, physico-chemical properties (pH, color) and texture characteristics. Typical chemical composition characteristics (crude protein, crude fat, crude ash) were not significantly different between control and grape seed oil treatment groups. Moisture content of grape seed oil treatment groups (GSO 30% and 40%) was significantly lower than that of controls (p<0.05). There was a not clear difference in pH between control and grape seed oil treatment groups. In the 21 d of storage, pH values of all treatments were significantly higher than those of other storage days. Meat color $(CIEL^*\;and\;b^*)$ of grape seed oil treatment group (GSO 40%) was significantly higher than that of control. Whereas meat color a value of GSO 40% treatment was significantly lower than that of control. It was not clearly changed as storage time increased. There was no significant difference in texture between control and grape seed oil treatment groups, and appeared to be unaffected by storage length. Based on these findings, we conclude that the chemical composition and texture characteristics of manufactured pressed ham were not affected by grape seed oil addition. These results also indicate that high-quality pressed ham can be manufactured with increased polyunsaturated fatty acid content.
Purpose : This study aims to verify the effectiveness of initial empirical antibiotic choice recommended by the International Society for Peritoneal Dialysis(ISPD) guide among Korean children. Methods : We have collected data on peritonitis from January 2001 to December 2007 in Samsung Medical Center. Results : Of the 42 patients, 48 episodes of peritonitis had occurred in 21 patients. The rate of peritonitis was one episode over 35.3 patient-months. Mean dialysis duration before peritonitis was 18.06$\pm$15.81 months. Gram-positive organisms accounted for 58.3% of all episodes. Of the gram-positive organisms, the most common pathogen was Staphylococcus aureus(29.2%), the next common pathogens were Coagulase negative staphylococcus(14.6%) and Streptococcus species(6.3%). 35.7% of gram-positive pathogens were resistant to 1st cephalosporin. However, in patients younger than 4 years old, 50% of gram-positive pathogens were resistant to 1st generation cephalosporin. 10 episodes of peritonitis were methicillin-resistant and were treated by vancomycin. Of the gram-negative organisms, E. coli was the most common (8.3%). 64.8% of all pathogens were sensitive to cephalothin or ceftazidime. Conclusion : The empirical therapy with 1st generation cephalosporin and ceftazidime can be also effective to peritoneal dialysis associated peritonitis in Korean children. However, in patients younger than 4 years old, glycopeptide should be considered as the first empirical therapy in Korean children.
Nho Young Ju;Cho Jeong Gill;Ahn Seung Do;Choi Eun Kyung;Kim Jong Hoon;Kang One Chul;Chang Hyesook
Radiation Oncology Journal
/
v.15
no.4
/
pp.305-313
/
1997
Purpose : This is a retrospective study to evaluate the results of radiation therapy and prognostic factors influencing the results in nasopharyngeal carcinoma. Materials and Methods: From October 1989 to May 1996. 56 Patients were treated for nasopharyngeal carcinoma at Department of Radiation On-cology. According to stage, patients were distributed as follows : stage I (2), II (13). II (11), IV (30). Twenty-eight patients were treated with radiation therapy only, 7 patients were treated with neoadiuvant chemotherapy followed by radiation therapy. Twenty-one Patients were treated with radiation therapy and weekly CDDP. After external beam radiotherapy of 60Gy, 46Patients received boost dose with intracavitary radiation and 9 Patients with 3D conformal therapy. One patient received boost dose with 2 dimensional Photon beam therapy. The tumor dose ranged from 69.4Gy to 86.2Gy with median dose of 74.4Gy. The follow-up Period ranged from 5 months to 92 months with a median of 34 months. Results : Forty-seven patients achieved complete response and 8 Patients showed partial response. One Patient showed minimal response. Patterns of failure were as follows : locoregional recurrence (8) and distant metastasis (18). Among these patients, 2 patients failed locoregionally and distantly. The sites of distant metastasis were bone (8), lung (8) and liver (4). Five years survival rate was $67.2\%$ and 5 years disease-free survival rate was $53.6\%$. KPS (P=0.005) and response ol radiation therapy (P=0.0001) were significant prognostic factors for overall survival. KPS (P= 0.02) and response of radiation therapy (P=0.005) were significant Prognostic factors for disease-free survival. Conclusion : This retrospective study showed that distant metastasis was the Predominant pattern of relapse in nasopharyngeal cancer Neoadiuvant chemotherapy or weekly CDOP did not influence the distant metastasis-free survival. For advanced T stage, 3D conformal therapy Provided an improved dose coverage compared to ICR But further follow-up was needed in Patients with 3D conformal therapy to assess the efficacy of this therapy. Development of techniques of radiation therapy to improve locoregional control and of more effective systemic chemotherapy regimen are needed.
Kim, Kyung-Ah;Shin, Son-Moon;Moon, Han-Ku;Park, Young-Hoon
Journal of Yeungnam Medical Science
/
v.16
no.1
/
pp.60-68
/
1999
A nationwide survey was conducted to investigate the annual occurrence rate of neonatal sepsis, maternal risk factors in neonatal sepsis, localized infection in neonates, causative organisms in nosocomial infection and the most common causative organism for neonatal sepsis in Korea. Clinical and bacteriological data wele collected from 37 neonatal units to perform retrospective review of the medical records of the newborn infants who were confirmed as having neonatal sepsis and whose blood culture was collected to isolate organisms for one year study period from January to December in 1997. 78,463 neonates were born at 37 hospital in 1997, and 20,869 neonates were admitted to the neonatal units, During this period, 772 episodes of neonatal sepsis were recorded in 517 neonates. The occurrence rate of neonatal sepsis was 0.73%(0~2.95%). Male to female ratio was 1.15:1, and 303 cases(42.1%) were born prematurely. The main pathogens of early onset of sepsis were S. aureus(20%), S. epidermidis(14.4%) and coagulase negative staphylococcus(14. 4%). Gram negative bacilli including Enterobacter spp (7.2%), E. coli(5.1%), Klepstella(4.5%), Pseudomonas(3.7%) and Enterobacter faectum(3.6%) accounted for 24.1% of sepsis. Group B beta-hemolytic streptococcus were isolated only in two cases. Common obstetric factors were PROM(21.1%), difficulty delivery(18.7%), fetal tachycardia(5.3%), chorioamnionitis(4.9%), and maternal fever(4.7%). The main pathogens of late-onset sepsis were S. aureus(22.3%), S. epidermidis(20.4%) and CONS(9.9%). There were 6 cases(1.0%) of Candida sepsis, Frequent focal infections accompanying sepsis were pneumonia(26.1%), urinary tract infection(10.5%), meningitis(8.2%), and arthritis(3.6%), S. epidermidis(22.0%) and s. aureus(21.7%) were also the most common pathogens in 373 nosocomial infection.
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