• Title/Summary/Keyword: average value at risk

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Breast Cancer Clustering in Kanagawa, Japan: A Geographic Analysis

  • Katayama, Kayoko;Yokoyama, Kazuhito;Yako-Suketomo, Hiroko;Okamoto, Naoyuki;Tango, Toshiro;Inaba, Yutaka
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.1
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    • pp.455-460
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    • 2014
  • Background: The purpose of the present study was to determine geographic clustering of breast cancer incidence in Kanagawa Prefecture, using cancer registry data. The study also aimed at examining the association between socio-economic factors and any identified cluster. Materials and Methods: Incidence data were collected for women who were first diagnosed with breast cancer during the period from January to December 2006 in Kanagawa. The data consisted of 2,326 incidence cases extracted from the total of 34,323 Kanagawa Cancer Registration data issued in 2011. To adjust for differences in age distribution, the standardized mortality ratio (SMR) and the standardized incidence ratio (SIR) of breast cancer were calculated for each of 56 municipalities (e.g., city, special ward, town, and village) in Kanagawa by an indirect method using Kanagawa female population data. Spatial scan statistics were used to detect any area of elevated risk as a cluster for breast cancer deaths and/or incidences. The Student t-test was performed to examine differences in socio-economic variables, viz, persons per household, total fertility rate, age at first marriage for women, and marriage rate, between cluster and other regions. Results: There was a statistically significant cluster of breast cancer incidence (p=0.001) composed of 11 municipalities in southeastern area of Kanagawa Prefecture, whose SIR was 35 percent higher than that of the remainder of Kanagawa Prefecture. In this cluster, average value of age at first-marriage for women was significantly higher than in the rest of Kanagawa (p=0.017). No statistically significant clusters of breast cancer deaths were detected (p=0.53). Conclusions: There was a statistically significant cluster of high breast cancer incidence in southeastern area of Kanagawa Prefecture. It was suggested that the cluster region was related to the tendency to marry later. This study methodology will be helpful in the analysis of geographical disparities in cancer deaths and incidence.

Evaluating the Dosimetric Characteristics of Radiation Therapies according to Head Elevation Angle for Head and Neck Tumors (두 경부 종양 치료 시 거상각도에 따른 치료기법 별 선량특성 평가)

  • Cheon, Geum-Seong;Kang, Seong-Hee;Kim, Dong-Su;Kim, Tae-Ho;Suh, Tae-Suk
    • Progress in Medical Physics
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    • v.27 no.1
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    • pp.14-24
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    • 2016
  • Since the head and neck region is densely located with organs at risk (OAR), OAR-sparing is an important issue in the treatment of head and neck cancers. This study-in which different treatment plans were performed varying the head tilt angle on brain tumor patients-investigates the optimal head elevation angle for sparing normal organs (e.g. the hippocampus) and further compares the dosimetric characteristics of different types of radiation equipment. we performed 3D conformal radiation therapy (3D-CRT), intensity-modulated radiation therapy (IMRT), and tomotherapy on 10 patients with brain tumors in the frontal lobe while varying the head tilt angle of patients to analyze the dosimetric characteristics of different therapy methods. In each treatment plan, 95% of the tumor volume was irradiated with a dose of 40 Gy in 10 fractions. The step and shoot technique with nine beams was used for IMRT, and the same prescription dose was delivered to the tumor volume for the 3D-CRT and tomotherapy plans. The homogeneity index, conformity index, and normal tissue complication probability (NTCP) were calculated. At a head elevation angle of $30^{\circ}$, conformity of the isodose curve to the target increased on average by 53%, 8%, and 5.4%. In 3D-CRT, the maximum dose received by the brain stem decreased at $15^{\circ}$, $30^{\circ}$, and $40^{\circ}$, compared to that observed at $0^{\circ}$. The NTCP value of the hippocampus observed in each modality was the highest at a head and neck angle of $0^{\circ}$ and the lowest at $30^{\circ}$. This study demonstrates that the elevation of the patients' head tilt angle in radiation therapy improves the target region's homogeneity of dose distribution by increasing the tumor control rate and conformity of the isodose curve to the target. Moreover, the study shows that the elevation of the head tilt angle lowers the NTCP by separating the tumor volume from the normal tissues, which helps spare OARs and reduce the delivered dose to the hippocampus.

Analysis of the Risk Factors Influencing the Severity of Injury in Pediatric Multiple Trauma Patients (소아 다발성 외상 환자의 중증도에 영향을 미치는 위험인자에 관한 분석)

  • Lee, Gang-Wook;Kim, Sun-Pyo;Kim, Seong-Jung;Cho, Soo-Hyung;Cho, Nam-Soo
    • Journal of Trauma and Injury
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    • v.23 no.2
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    • pp.68-74
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    • 2010
  • Purpose: The purpose of this study is, first, to analyze the risk factors that influence the severity of injury in pediatric multiple trauma patients and, second, to present solutions for the problems related to the treatment of such patients. Our living situations are so complicated that the danger of accidents is truly open to children who are not prepared. We need to draw attention to the increased numbers of various accidents involving children. Methods: We studied patients who visited the Emergency Medical Center at Chosun University Hospital from January 1, 2006, to December 31, 2008. Using medical records, we evaluated the general characteristics: the mechanism of injury, the vital signs, the revised trauma score (RTS), the injury severity score (ISS), and the hemoglibin value, which was checked at the time of visit, and the presence or the absence of emergent on regular surgery. We divided the level of injury as follows: light level (1-8 points), mid level (9-15 points), and serious level (above 16 points). We analyzed the medical data by using SPSS 17.0 for windows. Results: The average age of the patients examined was 8.6 years. The number of 6- to 11-year-old patients was 96, which was the largest, but the degree of injury severity was the highest among infant (0-2 years), according to ISS 7.95(${\pm}6.85$). The frequency of accidents was highest on sunny days, and most accidents occurred from 16:00 to 20:00. The cause of multiple trauma for children was the greatest in the traffic accident, (95 patients, 49.0%). In addition, the trauma caused by traffic accidents showed the highest ISS value ($9.02{\pm}6.42$) and the most serious degree (P=0.004). The ISS level of injury ($8.40{\pm}6.64$) for patients moved from a secondary hospital was higher than that ($6.49{\pm}5.57$) for patients who visited the medical center directly. The severity of injury was highest for patients who used a 119 ambulance ($8.84{\pm}5.80$). According to the injured parts of body, Injuries to the arms and the feet most frequent (79 patients, 40.7%), but the level of injury was the highest for internal organs and chest, $16.42{\pm}8.56$ and $11.23{\pm}6.97$, respectively. Conclusion: We used Abbreviated Injury Scale (AIS) in order to examine the characteristics by injured body part for pediatric multiple trauma patients. Because the degree of injury was the highest for internal organs or the chest, we need to more seriously examine and provide for patients who are suspected of having injuries to the internal organs or the chest. We need to quickly determine the need for surgery in patients with serious injuries to the arms and the feet, which is the greatest in frequency. In particular, we need to consider the surgical care of patients who are not very high in the severity of injury to their brains.

Study on dose comparison using X-Jaw split in VMAT treatment planning for left breast cancer including supraclavicular lymph nodes. (쇄골 상부 림프절을 포함하는 왼쪽 유방암의 VMAT 치료계획시 X-Jaw split을 이용한 선량비교에 관한 연구)

  • Kim, Hak Jun;Lee, Yang Hoon;Min, Jae Soon
    • The Journal of Korean Society for Radiation Therapy
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    • v.33
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    • pp.137-144
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    • 2021
  • Purpose : The usability of X-Jaw split VMAT was evaluated by comparative analysis of the dose distribution between the treatment plan divided by X-Jaw and Full field VMAT treatment plan in left breast cancer treatment including supraclavicular lymph nodes. Materials and Methods : 10 patients with left breast cancer, including supraclavicular lymph nodes, were simulated using vacuum cushion, and 2 Full field Arc VMAT and 4 X-Jaw split Arc VMAT were planned The treatment plan was designed to include more than 95% of the Planning Target Volume (PTV) and to be minimally irradiated in the surrounding Organ at risk (OAR). Dose analysis of PTV and OAR was performed through dose volume histogram (DVH). Results : The Full field VMAT treatment plan and the X-Jaw split VMAT treatment plan of 10 patients were expressed as average values and compared. The difference between the two treatment plans was not large, with a Conformity index (CI) of 1.05±0.04, 1.04±0.03, and a Homogeneity index (HI) of 1.07±0.008, 1.07±0.009. For OAR, V5 in the left lung is 56.1±6.50%, 50.4±6.30%, and V20 is 20.0±4.15%, 13.52±3.61%. Compared to Full field VMAT, V5 decreased by 10.0% V20 by 32.6% in X-Jaw split VMAT. The V30 of the heart is 3.68±1.85%, 2.23±1.52%, and the Mean dose is 8.93±1.65 Gy, 7.67±1.52 Gy. In the X-Jaw split VMAT, V30 decreased by 39.3% and the Mean dose decreased by 14.1%. The left lung and heart, which are normal tissues, were found to have a statistical significance of that p-value is less than 0.05. Conclusion : In the case of left breast cancer treatment, which includes Supraclavicular lymph nodes with a large PTV volume and a length of X Jaw of 15 cm or more, the X-Jaw split VMAT shows improved dose distribution, which can reduce radiation dose of OAR such as lungs and heart, while maintaining similar PTV coverage with HI and CI equivalent to Full field VMAT. It is thought to be effective in reducing radiation complications.

Analysis of Hydraulic Effect by River Dredging in a Meandering Channel (하도준설이 사행하천에 미치는 수리학적 영향 분석)

  • KIM, Tae-Hyeong;KIM, Byung-Hyun;HAN, Kun-Yeun
    • Journal of the Korean Association of Geographic Information Studies
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    • v.18 no.4
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    • pp.14-30
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    • 2015
  • This paper attempted to analyze the hydraulic effects that the dredging can take as an alternative to reduce possible damages of flooding due to the overflow of river levee in meandering rivers, where riverbed aggradation, seepage and erosion may occur. In order to make a hydraulic analysis in a section of meandering rivers, a two-dimensional hydraulic analysis model, RMA-2, was selected. The GIS was applied to construct two-dimensional finite element grids to consider the hydraulic conditions before and after dredging. The water surface elevations, depths, velocities, and tractive forces were compared before and after the dredging. The difference of water surface elevation between the inside and outside of river was turned out to be the maximum value of 0.58m under the design flood condition. It could be evaluated that the tractive force at the bank decreased about 42 to 67% on average for all the sections. These results could give valuable information that the dredging of the stream channel at the meandering sections decreased the risk of overflow, seepage and erosion of the banks. The methodologies given in this study will contribute to mitigating the flood damages in the surrounding farmlands.

Characteristics of Humidifier Use in Korean Pregnant Women: The Mothers and Children's Environmental Health (MOCEH) Study

  • Chang, Moon-Hee;Park, Hye-Sook;Ha, Min-A;Kim, Yang-Ho;Hong, Yun-Chul;Ha, Eun-Hee
    • Environmental Analysis Health and Toxicology
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    • v.27
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    • pp.3.1-3.4
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    • 2012
  • Objectives: The current use of humidifier detergent and its harmful impact on humans has arisen as a societal environmental health issue. Therefore, in this study we aimed to explore the relationship between demo-socio characteristics and humidifier use, as well as the monthly usage changes in pregnant women; thus, we report the actual status of humidifier usage of Korea's pregnant population. Methods: From a birth cohort of a Mothers and Children's Environmental Health (MOCEH) study, 1,144 pregnant women who responded through questionnaires including demo-socio characteristics, obstetric status and household environment including whether they use humidifier and frequency of use were included in this study. Statistical analyses were performed to explore the relationship between maternal characteristics and the relevance of the use of humidifiers was performed using a chi-square test, a t-test and univariate logistic regression analysis. The monthly usage rate was demonstrated in the graph. Results: The humidifier usage rate in pregnant women was 28.2%. The average frequency of humidifier usage was 4.6 days per week, 7.3 hours per day. The usage rate was higher in the multipara group and the above the age of 34 age group than in the primipara and below the age of 34 groups. Seoul showed a higher usage rate than Cheonan and Ulsan and as the education level and income increased, the usage rate of humidifiers among pregnant women also increased. In the monthly trend of usage rate, the winter season showed the highest usage rate of over 45% and the lowest in late summer and beginning of fall with a value of 12% or less. Conclusions: During pregnancy, the mother's body is especially vulnerable to hazardous environmental exposure that not only affects the pregnant woman but also the fetus. Further research is still needed to elucidate the route and effect of environmental risk factors. Therefore, based on precautionary and preventive principles, special interest and caution in harmful environments are strongly needed not only at an individual level but also at a national level.

Effect of Liquefied Digestive Medicine on the Surface of Composite Resin

  • Kim, Min-Young;Lim, Hee-Jung;Kim, Ha-Eun;Kim, Hyun-Jeong;Yu, Hye-Kang;Choi, Soo-Jin;Lim, Do-Seon
    • Journal of dental hygiene science
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    • v.22 no.1
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    • pp.20-29
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    • 2022
  • Background: The purpose of this study is to investigate the effect of liquefied digestive medicines on the composite resin surface. Methods: Three types of liquefied digestive medicines (Gashwalmyeongsu, Wicheongsu, and Saengrokcheon) were selected as experimental groups, Samdasoo and Chamisul as negative controls, and Trevi as positive controls were selected to measure pH and titratable acidity. The samples filled with resin at acrylic were made total 300, 50 per group. To evaluate the erosion risk of the composite resin, the specimens were immersed in a liquefied medicine for 1, 3, 5, 15, and 30 minutes, and then the surface microhardness was measured using the Vickers Hardness Number, and the surface change was observed with scanning electron microscope (SEM). Results: The average pH of the three liquefied medicine was 3.75±0.30, the Saengrokcheon was the lowest at 3.45±0.01, and the Trevi was 4.66 and Samdasoo and Chamisul were 7.40 and 8.58, respectively. The amount of NaOH reaching pH 5.5 and 7.0 was the lowest in the order of Trevi, Gashwalmyeongsu, Wicheongsu, and Saengrokcheon. The largest surface hardness reduction value was shown in Gashwalmyeongsu (-11.85±3.73), followed by Saengrokcheon (-9.79±3.11) and Wicheongsu (-8.28±2.83), and Samdasoo (-0.84±1.56) and Chamisul (-6.24±0.42) had relatively low surface hardness reduction values. However, Trevi (-16.67±5.41), a positive control group containing carbonic acid, showed a higher decrease in surface hardness than the experimental group. As a result of observation with SEM, experimental group and positive control group, showed rough surfaces and irregular cracks, and negative control groups showed smooth patterns similar to before immersion. Conclusion: The liquefied digestive medicine with low pH could weaken the composite resin surface, and the carbonic acid component could more effect on the physical properties of the composite resin than pH.

Feasibility of Mixed-Energy Partial Arc VMAT Plan with Avoidance Sector for Prostate Cancer (전립선암 방사선치료 시 회피 영역을 적용한 혼합 에너지 VMAT 치료 계획의 평가)

  • Hwang, Se Ha;NA, Kyoung Su;Lee, Je Hee
    • The Journal of Korean Society for Radiation Therapy
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    • v.32
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    • pp.17-29
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    • 2020
  • Purpose: The purpose of this work was to investigate the dosimetric impact of mixed energy partial arc technique on prostate cancer VMAT. Materials and Methods: This study involved prostate only patients planned with 70Gy in 30 fractions to the planning target volume (PTV). Femoral heads, Bladder and Rectum were considered as oragan at risk (OARs). For this study, mixed energy partial arcs (MEPA) were generated with gantry angle set to 180°~230°, 310°~50° for 6MV arc and 130°~50°, 310°~230° for 15MV arc. Each arc set the avoidance sector which is gantry angle 230°~310°, 50°~130° at first arc and 50°~310° at second arc. After that, two plans were summed and were analyzed the dosimetry parameter of each structure such as Maximum dose, Mean dose, D2%, Homogeneity index (HI) and Conformity Index (CI) for PTV and Maximum dose, Mean dose, V70Gy, V50Gy, V30Gy, and V20Gy for OARs and Monitor Unit (MU) with 6MV 1 ARC, 6MV, 10MV, 15MV 2 ARC plan. Results: In MEPA, the maximum dose, mean dose and D2% were lower than 6MV 1 ARC plan(p<0.0005). However, the average difference of maximum dose was 0.24%, 0.39%, 0.60% (p<0.450, 0.321, 0.139) higher than 6MV, 10MV, 15MV 2 ARC plan, respectively and D2% was 0.42%, 0.49%, 0.59% (p<0.073, 0.087, 0.033) higher than compared plans. The average difference of mean dose was 0.09% lower than 10MV 2 ARC plan, but it is 0.27%, 0.12% (p<0.184, 0.521) higher than 6MV 2 ARC, 15MV 2 ARC plan, respectively. HI was 0.064±0.006 which is the lowest value (p<0.005, 0.357, 0.273, 0.801) among the all plans. For CI, there was no significant differences which were 1.12±0.038 in MEPA, 1.12±0.036, 1.11±0.024, 1.11±0.030, 1.12±0.027 in 6MV 1 ARC, 6MV, 10MV, 15MV 2 ARC, respectively. MEPA produced significantly lower rectum dose. Especially, V70Gy, V50Gy, V30Gy, V20Gy were 3.40, 16.79, 37.86, 48.09 that were lower than other plans. For bladder dose, V30Gy, V20Gy were lower than other plans. However, the mean dose of both femoral head were 9.69±2.93, 9.88±2.5 which were 2.8Gy~3.28Gy higher than other plans. The mean MU of MEPA were 19.53% lower than 6MV 1 ARC, 5.7% lower than 10MV 2 ARC respectively. Conclusion: This study for prostate radiotherapy demonstrated that a choice of MEPA VMAT has the potential to minimize doses to OARs and improve homogeneity to PTV at the expense of a moderate increase in maximum and mean dose to the femoral heads.

Site Selection of Wildlife Passage for Leopard Cat in Urban Area using Space Syntax (공간구문론을 이용한 도시 내 삵 이동통로 적지선정)

  • Park, Jong-Jun;Woo, Dong-Geol;Oh, Dae-Hyun;Park, Chong-Hwa
    • Journal of the Korean Institute of Landscape Architecture
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    • v.40 no.1
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    • pp.92-99
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    • 2012
  • Many wildlife habitats have been destroyed and fragmented during the rapid industrialization and urbanization process in Korea. It is essential to connect these fragmented habitats to reduce road-kill of many types of endangered urban wildlife. The site selection for wildlife passages must take into account the behavior of the wildlife species for safe crossing utilizing many artificial barriers in urban areas. This study attempted to identify potential wildlife passage sites for the endangered and protected leopard cats of Gangseo Ecological Park in Seoul, Korea. A space syntax analysis, an analytical technique to objectively evaluate the spatial configurations related to passage selection, found that the integration value represents the accessibility and connectivity of spaces. In this paper, this means that the bigger the integration value, the more frequently the leopard cat passes through. The leopard cats were captured and radio-tracked for 72 hours once a month from March to June of 2009. The ArcGIS and Animal Movement of Hawth Tools were used to analyze the home range and movement paths, and Axwoman 4.0 was used to analyze space syntax. The daily average movement distance was $2.099{\pm}1.08km$. During the survey period, the leopard cats crossed over an urban expressway more than 20 times, running the risk of road-kill. The range of global integration values was 0.458~1.834, while that of the local integration was 0.210~6.061. Five sites that met across the leopard cats' movement routes and roads were selected to measure the local and global integrate values. Among these sites, the higher the integration value, the higher the road-kill possibility. Thus, two of five sites with high global and local integration values were suggested as potential wildlife passage sites for the leopard cats. Now, three tunnel passages are under construction at the suggested sites for which local integration value was highest (LI=4.369). Further studies are scheduled to verify these potential sites as suitable wildlife passages.

An Influence of Private Brand′s Perceived Cues on It′s Proneness (유통업체 상표의 지각된 정보단서가 이의 지각품질, 지각희생 및 선호에 미치는 영향)

  • 김성배;전인수
    • Journal of Distribution Research
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    • v.6 no.2
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    • pp.19-40
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    • 2002
  • According to the secondary data, private brand(PB)'s share of retail sales is 25-30% in the USA, but about 45 in Korea. In Korea PB's average price is 23.3% less than manufacturer brand. It is very interest that PB's price advantage doesn't have a good effect on it's share of retail sales. This research's objective is to study why Korean consumers don't purchase private brand cheaper than manufacturer brand. A theoretical reasoning depends on information cue theory and means-ends model of perceived value. A unit of analysis is consumers who purchase private brand at E-mart in Pusan city, one of largest discount store in Korea. Hypothesis tested by Lisrel's structural equation model and interesting results as follows: First, favorable brand image among extrinsic cues is most positively correlated with perceived quality/sacrifice and intrinsic cues is also statistically significant. This fact imply that intrinsic cues; package, logo, country of origin are very important in the adoption of private brand in Korea. Second, compared with manufacturer's brand, PB's perceived price is positively correlated with perceived quality/sacrifice. This fact imply a assimilation effect between manufacturer's brand and private brand. Finally, a correlation between perceived sacrifice and PB proneness is satistically insignificant, but perceived quality has a significant effect on its proneness. this fact imply that innovators(about 4% of potential consumer) are risk-taker.

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