• The Journal of Korean Society for Radiation Therapy
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• v.27 no.2
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• pp.175-181
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• 2015

Purpose : To evaluate Contralateral Breast Doses with Supine and Prone Positions for tangential Irradiation techniques for left-sided breast Cancer Materials and Methods : We performed measurements for contralateral doses using Human Phantom at each other three plans (conventional technique, Field-in-Field, IMRT, with prescription of 50 Gy/25fx). For the measurement of contralateral doses we used Glass dosimeters on the 4 points of Human Phantom surface (0 mm, 10 mm, 30 mm, 50 mm). For the position check at every measurements, we had taken portal images using EPID and denoted the incident points on the human phantom for checking the constancy of incident points. Results : The contralateral doses in supine position showed a little higher doses than those in prone position. In the planning study, contralateral doses in the prone position increased mean doses of 1.2% to 1.8% at each positions while those in the supine positions showed mean dose decreases of 0.8% to 0.9%. The measurements using glass dosimeters resulted in dose increases (mean: 2.7%, maximum: 4% of the prescribed dose) in the prone position. In addition, the delivery techniques of Field-in-field and IMRT showed mean doses of 3% higher than conventional technique. Conclusion : We evaluated contralateral breast doses depending on different positions of supine and prone for tangential irradiations. For the phantom simulation of set-up variation effects on contralateral dose evaluation, although we used humanoid phantom for planning and measurements comparisons, it would be more or less worse set-up constancy in a real patient. Therefore, more careful selection of determination of patient set-up for the breast tangential irradiation, especially in the left-sided breast, should be considered for unwanted dose increases to left lung and heart. In conclusion, intensive patient monitoring and improved patient set-up verification efforts should be necessary for the application of prone position for tangential irradiation of left-sided breast cancer.

• The Journal of Korean Society for Radiation Therapy
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• v.23 no.1
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• pp.51-58
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• 2011

Purpose: In this study, we tried to check the usefulness of two Linear Accelerators, Clinac IX and 21EX (Varian, Palo Alto, CA), which are equipped in Ajou Medical Center. From 2008 to 2010, we evaluated the error range of Absolute Dose based on the daily output, which was measured by CHECKMATE$^{TM}$ (Sun Nuclear, Melbourne, FL). Materials and Methods: For Daily Q.A, photon beams of two linear accelerators, 21EX and IX (6 MV and 10 MV, respectively) were measured daily by using CHECKMATE$^{TM}$ just before the treatment began, while the absolute dose was measured biweekly by using water phantom. We analyzed the data of measured values from the daily Q.A and the absolute dose from 2008 to 2010 for 21EX, and from 2009 to 2010 for IX. We utilized Excel 2007 (Microsoft, USA) to evaluate Average, Standard deviation and Confidence level of the data. Furthermore, in order to check the measured values of CHECKMATE$^{TM}$ and the significance of absolute dose, each error value was compared and analyzed. Results: During the observation period, the output of two equipment's absolute dose increased in process of time and in both 6 MV and 10 MV, there was a similar increasing trend. In addition, the error rate of the measured value of CHECKMATE$^{TM}$ and the value of absolute dose were under 0.34, which means that there is a similarity relationship between the two measured values. After checking that the measured value of CHECKMATE$^{TM}$ increased, We measured the absolute dose to adjust that. When the error range was close to 2~3%, the number of changing the output was four for 21EX and three for IX. Conclusion: As a result of measuring and analyzing the daily output changes for two years by using CHECKMATE$^{TM}$, we could find that there is a significance between the output which we should obey during Q.A, and the measured value of absolute dose within the error tolerance of 2~3%. Thus, the use of CHECKMATE$^{TM}$ can be positively considered for more efficient and reliable daily output verification of linear accelerator. It can also be a good standard for other medical centers to understand the trends of linear accelerator and to refer to for the correction of each output.

• Journal of Astronomy and Space Sciences
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• v.26 no.4
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• pp.451-466
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• 2009

While substorms are known to generally occur under southward IMF conditions, they can sometimes occur even under northward IMF conditions. In this paper, we studied the substorms that occurred in May, 2000 to 2002 to examine some statistical characteristics of the IMF and solar wind associated with northward IMF substorms. We focused on the cases where two or more substorms occurred successively under northward IMF conditions. Also, by checking Sym-H index associated with each of the substorms we determined whether or not there is any association of such northward IMF substorm occurrence with storm times. We also examined statistical properties at geosynchronous altitude in terms of magnetic field dipolarization and energetic particle injection. The following results were obtained. (i) Most of the northward IMF substorms occurred under average solar wind conditions. The majority of them occurred within 2 hrs duration of northward IMF Bz state, but there are also a nonnegligible number of substorms that occurred after a longer duraiton of northward IMF Bz state. (ii) While most of the substorms occurred as isolated from a magnetic storm time, those that occurred in a magnetic storm time show a higher average value of IMF and solar wind than that for the isolated substorms. (iii) About 55% of the substorms were associated with the IMF clock angle that can possibly allow dayside reconnection, and the other 45% were associated with more or less pure northward IMF conditions. Therefore, for the latter cases, the energy input from the solar wind into the magnetosphere should be made by other way than the dayside reconnection. (iv) For most of the substorms, the magnetic field dipolarizations and energetic particle injections at geosynchronous altitude were identified to be generally weak. But, several events indicated strong magnetic field dipolarizations and energetic particle injections.

• Journal of Nutrition and Health
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• v.51 no.2
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• pp.177-185
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• 2018

Purpose: This study analyzed the perception and importance of country-of-origin labeling at restaurants in 500 college students in Jeju surveyed from April 15 to May 5, 2016 with the aim of providing basic data. A total of 465 questionnaires out of 500 were used as base data for this study. Methods: The data were analyzed using descriptive analysis, ${\chi}^2-test$, and t-test using the SPSS Win program (version 21.0). Results: Regarding food safety-related dietary behaviors, average score was 3.65 points (out of 5), and 'put the food in a refrigerator or freezer immediately (4.07)' showed the highest score, whereas 'cool rapidly hot food prior to putting it in the refrigerator (3.08)' showed the lowest score. Regarding the awareness of country-of-origin labeling at restaurants, 67.5% of subjects were aware of it. With regard to dietary behavior of food safety, the high group showed a higher score than the low group (p < 0.001). Regarding reliability of the system, 4.9% of subjects indicated 'very reliable' and 45.4% 'somewhat reliable'. For perception of subject's country-of-origin labeling, the average score was 3.77 (out of 5). Regarding checking country-of-origin labeling at restaurants, 68.0% of subjects checked country-of-origin labeling, and the high group in the safety-related dietary behavior score ranking showed a higher rate (79.3%) than the low group (57.1%) (p < 0.001). With regard to importance by item, 'honest country-of-origin labeling of restaurants' showed the highest score at 4.27 (out of 5). Conclusion: It is necessary to provide continuing education for college students in order to enhance their perception of country-of-origin labeling at restaurants. Moreover, a systematic and appropriate support and control system by the government and local government needs to be developed in order to improve country-of-origin labeling at restaurants.

• Journal of Distribution Science
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• v.10 no.2
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• pp.43-52
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• 2012

As experiential education services are growing, the need for proper management is increasing. Considering that adequate measures are an essential factor for achieving success in managing something, it is important for managers to use a proper system of metrics to measure the performance of experiential education services. However, in spite of this need, little research has been done to develop a valid and reliable set of metrics for assessing the quality of experiential education services. The current study aims to develop a multi-item instrument for assessing the service quality of experiential education. The specific procedure is as follows. First, we generated a pool of possible metrics based on diverse literature on service quality. We elicited possiblemetric items not only from general service quality metrics such as SERVQUAL and SERVPERF but also from educational service quality metrics such as HEdPERF and PESPERF. Second, specialist teachers in the experiential education area screened the initial metrics to boost face validity. Third, we proceeded with multiple rounds of empirical validation of those metrics. Based on this processes, we refined the metrics to determine the final metrics to be used. Fourth, we examined predictive validity by checking the well-established positive relationship between each dimension of metrics and customer satisfaction. In sum, starting with the initial pool of scale items elicited from the previous literature and purifying them empirically through the surveying method, we developed a four-dimensional systemized scale to measure the superiority of experiential education and named it "Experiential Education PERFormance" (EEPERF). Our findings indicate that students (consumers) perceive the superiority of the experiential education (EE) service in the following four dimensions: EE-empathy, EE-reliability, EE-outcome, and EE-landscape. EE-empathy is a judgment in response to the question, "How empathetically does the experiential educational service provider interact with me?" Principal measures are "How well does the service provider understand my needs?," and "How well does the service provider listen to my voice?" Next, EE-reliability is a judgment in response to the question, "How reliably does the experiential educational service provider interact with me?" Major measures are "How reliable is the schedule here?," and "How credible is the service provider?" EE-outcome is a judgmentin response to the question, "What results could I get from this experiential educational service encounter?" Representative measures are "How good is the information that I will acquire form this service encounter?," and "How useful is this service encounter in helping me develop creativity?" Finally, EE-landscape is a judgment about the physical environment. Essential measures are "How convenient is the access to the service encounter?,"and "How well managed are the facilities?" We showed the reliability and validity of the system of metrics. All four dimensions influence customer satisfaction significantly. Practitioners may use the results in planning experiential educational service programs and evaluating each service encounter. The current study isexpected to act as a stepping-stone for future scale improvement. In this case, researchers may use the experience quality paradigm that has recently arisen.

• Radiation Oncology Journal
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• v.21 no.4
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• pp.291-298
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• 2003

Purpose: We report upon a web-based system for Patterns of Care Study (PCS) devised for Korean radiation oncology. This PCS was designed to establish standard tools for clinical quality assurance, to determine basic parameters for radiation oncology processes, to offer a solid system for cooperative clinical studies and a useful standard database for comparisons with other national databases. Materials and Methods: The system consisted of a main server with two back-ups in other locations. The program uses a Linux operating system and a MySQL database. Cancers with high frequencies in radiotherapy departments in Korea from 1998 to 1999 were chosen to have a developmental priority. Results: The web-based clinical PCS .system for radiotherapy in www.pcs.re.kr was developed in early 2003 for cancers of the breast, rectum, esophagus, larynx and lung, and for brain metastasis. The total number of PCS study items exceeded one thousand. Our PCS system features user-friendliness, double entry checking, data security, encryption, hard disc mirroring, double back-up, and statistical analysis. Alphanumeric data can be input as well as image data. In addition, programs were constructed for IRB submission, random sampling of data, and departmental structure. Conclusion: For the first time in the field of PCS, we have developed a web-based system and associated working programs. With this system, we can gather sample data in a short period and thus save, cost, effort and time. Data audits should be peformed to validate input data. We propose that this system should be considered as a standard method for PCS or similar types of data collection systems.

• Journal of Home Health Care Nursing
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• v.3
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• pp.53-66
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• 1996

Home Health Care is one part of the total health care system. It includes health care services that link the hospital to the community. While it is important for early discharge patients, home care is also important for people with chronic illnesses or handicapping conditions. In 1989 the Korean government passed a law that opened the way for formal development of home health care services beginning with education programs to certify nurses for home care, and then demonstration home care services. Part of the mandate of the demonstration projects was evaluation of home care services. This study was done in order to provide basic data that would contribute to the development of records that could be used for evaluation through a retrospective audit and to examine the care that had been given in Home Care at Wonju Christian Hospital over a twenty year period from 1974 to 1994. The purposes of the study were : to identify to characteristics of the clients who had received home care, to identify the reasons for client referrals, to identify the nursing problems of these clients, to identify the nursing care provided to these clients, and to identify differences in these areas over the twenty year period. The study was a descriptive study involving a retrospective audit of the client records. Demographic data on all clients were included : 4,171 clients from 2,564 families. Data on referrals, nursing diagnosis and nursing interventions were from even numbered records which had a patient problem list included in the record, 2,801 clients, Frequencies and ANOVA were used in the analysis. The results of the study showed that the majority of the clients were from Wonju city /county. There were more women than men related to the high number of postpartum clients(1,300). The high number of postparttum clients and newborns was also evident in the age distribution. An the number of maternal-child clients decreased over the 20 years, the mean age of the clients increased significantly. Other factors also contributed to this change ; as increasing number of clients with brain injuries or with cancer, and fewer children with burns, osteomyelitis and tuberculosis. There was a decrease in the mean number of visits and mean length of coverage, reflecting a movement towards a short term acute care model. The number of new clents dropped sharply after 1985. The reasons for this are : the development of other treatment alternatives for clients, the establishment of an active wellbaby clinic, many more options plus a decreasing number of new cases of Hansen's Disase, and insurance that allows people with burns to be kept in hospital until skin grafts are healed. Socioeconomic changes have resulted in an increase in the number of cases of cancer, stroke, head injuries following car accidents, and of diabetes. Of the 2,801 client records, 2,541(60.9%) contained a written referral but for 1,802 it contained only the medical diagnosis. The number of records with a referral requesting specific nursing care was 739(29.1%). Many family members who were identified as in need of nursing care had no written referral. Analysis of the patient problem list showed that 41.9% of the enteries were nursing diagnoses. Others incuded medical diagnosis, symptoms, and plans. The most frequently used diagnoses were alteration in nutrition, less than body requirements(115 entries), alteration in skin integrity(114), knowledge deficit(111), pain(78), self-care deficit(66), and alteration in pattern of urinary elimination(50). These are reflected in the NANDA categories for which the highest number of diagnosis was in the Exchanging pattern(446), followed by Moving(178), Feeling(136) and Knowing (115). Analysis of the frequency of interventions showed that exercise and teaching about exercise was the most frequent intervention, followed by teaching concering the need for follow-up care, checking vital signs, managing nutritional problems, managing catheters, giving emotional support, changing dressings, teaching about medication, teaching (subject not specified), teaching about diet, IM and IV medications or fluid, and skin care, in that order. Recommendations included: development of a record that would allow for efficient recording of frequently used nursing diagnoses and nursing interventions: expansion of the catchment area for Home Care at Wonju Christian Hospital ; expansion of the service to provide complication prevention, rehabilitation services, and support to increase the health maintenance /health promotion of the people being served as well as providing client dentered care ; and development of a clinical record that will allow efficient data collection from records, even though the recording is done by a variety of health care providers.

• Journal of Applied Tourism Food and Beverage Management and Research
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• v.13 no.2
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• pp.45-69
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• 2002

This study is designed to examine feasibility and limitation of outsourcing in cooking Western food in a hotel, to interpret importance of outsourcing(eg. outside order, outside procurement, outside supply) in a broad sense in order to reinforce the core capacity in the cooking department, and to know whether the cooking human power is efficiently used and how much the chefs recognize outsourcing of food materials. As many companies conduct restructuring to cut down its size, the reduction of human power led the Western food cooking in the hotel to lower core capacities, lower quality, and lower efficiency. In addition, the sagging morale of chefs undermined creativity. To change from the traditional kitchen to an economic kitchen needs to look into importance of outsourcing, cognitive attitude of chefs, relation with outside suppliers. Here suggests performance of positive changes in the structure The study examined feasibility and limitation of outsourcing in the hotel kitchen as well as chefs' cognitive attitude toward outsourcing of food materials to reinforce core capabilities of the hotel kitchen. 1. Companies of outsourcing are selected according to variability of price conditions, flexibility of contract conditions, popularity of the outsourcing company, and reputation of the outsourcing company. 2. The importance of outsourcing in the Western food cooking is divided into 4 factors such as standard of selecting outsourcing companies, policies of cooking manu, quality of cooking, and quantity of cooking. 3. The most feasible section in outsourcing of food materials is a process of kneading flour for bread, which shows that many Western-food chefs expect to put higher possibility of outsourcing on the kneading. In other words, when it comes to confectionery and bakery, there are many outside expert processing companies supplying high quality products. In the order of outsourcing feasibility, sauce is followed by processed vegetable, garnish of main dish, and soup. The least feasible section in outsourcing of food materials is appetize. Appetize includes a concept of a improvised dish and needs speed. Due to its color, freshness, and sensibility of taste, the appetize plays a key role in the Western food cooking. 4. When outsourcing is taken in place, the highest risk is to lower the inner cooking skills. Therefore chefs in charge of the Western food sequently recognize both internal problems including storage of cooking skills, unstability of layoffs, and loss of cooperation between departments, and external problems including inferior goods, difficulty of differentiating manu, delay of delivery, and expiration date. It shows that most of the Western food chefs consider risks of the internal problems at first. 5. A effective outsourcing needs appropriate selection of outsourcing companies, maintenance of credibility, active communication, check and management of hygiene. However regardless of their position or career, chefs in charge of the Western food have the same cognitive attitude toward selecting successful outsourcing companies after the outsourcing system is enforced. The core of cooking, or a final stage in the full process of so-called artistic cooking, should be treated with insourcing. Reduction of several cooking processes resulted in shortened cooking time, increased efficiency, faster cooking, cutting the waiting-lines, and finally more room for customers. The outsourcing system can reduce or eliminate the following processes in cooking: buying various food materials, checking, storing, preparing, and processing. Especially in the Western food cooking department of a hotel, the outsourcing system should be enforced to make an economic kitchen and to efficiently manage it. Wow it's time to change from the traditional kitchen to an economic kitchen in the hotel cooking department. For that, the cooking department should become a small but strong organization by outsourcing except its core work.

• Journal of Radiation Protection and Research
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• v.20 no.1
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• pp.45-52
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• 1995

This study is to compare A point doses in human pelvic phantom by film dosimetry, computer planning and manual calculation by using of along-away table. We developed tissue equivalent human pelvic phantom composed of four pieces of cylindrical acryl tubes with water, to simulate intracavitary radiation (ICR) in patients with cervix cancer. When the phantom assembled from 4 pieces, it has a small space for inserting Fletcher-Suit-Delclos applicator like a human vagina. Fletcher-Suit-Delclos applicator inserted into the space was packed tightly with furacin gauzes, and three $^{137}Cs$ sources with radioactivity of $15.7mg\;Ra-eq$ were inserted into the tandem. For the film dosimetry, two pieces of X-OMAT V film (Kodak Co.) of which planes include point A, were arranged orthogonally in the slits between phantoms. A point dose and iso-dose curves were measured by means of optical densitometer. A point doses by film dosimetry, RTP system and manual calculation by using of along-away table were compared, and iso-dose curves by film dosimetry and computer planning were also compared. The dose of A point was 51.2cGy/hr by film dosimetry, 46.7cGy/hr by RTP system and 47.9 cGy/hr by along-away table. A point dose by computer planning was similar to the dose by calculation using of along-away table with acceptable accuracy $({\pm}3%)$, however, the dose by film dosimetry was different from two others with about 10% error. Since most clinical beams contains a scatter component of low energy photons, the correlation between optical density and dose becomes tenuous. In addition, film suffers from several potential errors such as changes in processing conditions, interfilm emulsion differences, and artifacts caused by air pockets adjacent to the film. For these reasons, absolute dosimetry with film is impractical, however, it is very useful for checking qualitative patterns of a radiation distribution. In future, solid state dosimeter such as TLD must be used for the dosimetry of ionizing radiation. When considerable care is used, precision of approximately 3% may be obtained using TLD.

• Journal of Gastric Cancer
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• v.4 no.3
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• pp.156-163
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• 2004

Purpose: While E-cadherin in normal cells induces calciumdependent cell-cell adhesion, in malignant cell, it plays a role in invasion and metastasis with a reduction of adhesion. Serum soluble E-cadherin is a result of the reduction of the cellular E-cadherin molecule and is found in the circulation of normal individuals, but it is particularly known to be increased in patients with malignancies. Accordingly, through checking the level of serum soluble E-cadherin in patients with gastric cancer and analyzing it in the view of clinicopathology, we investigated whether serum soluble E-cadherin could be translated into a clinicopathologic esult and used as a tumor marker. Materials and Methods: The investigation targeted 88 patients who had been diagnosed as having gastric cancer by the Department of Surgery, St. Mary's Hospital, from October 1, 2002, to July 30, 2003, and who had under gone performed surgery. We measured the level of preoperative serum E-cadherin in the 88 patients by unsing ELISA. Among them, we collected gastric cancer tissues from 54 patients and executed immunohistochemistry for E-cadherin. The samples were compared with normal tissues in terms of both serum E-cadherin level and immunohistochemistry level, as well as with other clinicopathologic factors. Result: The mean serum E-cadherin level of the 88 patients was 4368.7 ng/ml and was significantly higher than the level in 12 normal control patients, 3335.5 ng/ml (P=0.016). In terms of clinicopathology, the serum level of E-cadherin was significantly correlated with increasing age (P=0.0006) and was higher in positive venous invasion patients (P=0.0005). When the E-cadherin immunohistochemical stain was compared with the serum E-cadherin level in 54 patients, no significant statistically meaningful result was obtained (P=0.2881). However, 4 patients with serum E-cadherin levels about 6000 ng/ml were classified into the lower expression group ($<80\%$ of E-cadherin immunohistochemicals stain. In the analysis for 36 patients who were early gastric cancer patients, the serum E-cadherin level in lymph-node-metastatic patients was higher than it was in the other patients (P=0.0442). Conclusion: The serum E-cadherin level in gastric cancer patients was higher than the level in normal control patients. In advanced gastric cancer patients, that the difference was increased. Also, since the E-cadherin level correlated with the serum E-cadherin level with venous invasion, it can be used as an effective tumor marker for gastric cancer. Particularly, in that the serum E-cadherin level correlated with lymph node metastasis in early gastic cancer, it can be used when a therapeutic method for early gastric cancer is selected.