• Proceedings of the Korean Society of Medical Physics Conference
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• 2003.09a
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• pp.44-44
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• 2003

As a basic measurement tool in the areas of animal models of human disease, gene expression and therapy, and drug discovery and development, small animal PET imaging is being used increasingly. An ideal small animal PET should have high sensitivity and high and uniform resolution across the field of view to achieve high image quality. However, the combination of long narrow pixellated crystal array and small ring diameter of small animal PET leads to the degradation of spatial resolution for the source located at off center. This degradation of resolution can be improved by determining the depth of interaction (DOI) in the crystal and by taking into account the information in sorting the coincident events. Among a number of 001 identification schemes, dual layer phsowich detector has been widely investigated by many research groups due to its practicability and effectiveness on extracting DOI information. However, the effects of each crystal length composing dual layer phoswich detector on DOI measurements and image qualities were not fully characterized. In order to minimize the DOI effect, the length of each layer of phoswich detector should be optimized. The aim of this study was to perform simulations using a simulation tool, GATE to design the optimum lengths of crystals composing a dual layer phoswich detector. The simulated small PET system employed LSO front layer LuYAP back layer phoswich detector modules and the module consisted of 8${\times}$8 arrays of dual layer crystals with 2 mm ${\times}$ 2 mm sensitive area coupled to a Hamamatsu R7600 00 M64 PSPMT. Sensitivities and variation of radial resolutions were simulated by varying the length of LSO front layer from 0 to 10 mm while the total length (LSO + LuYAP) was fixed to 20 mm for 10 cm diameter ring scanner. The radial resolution uniformity was markedly improved by using DOI information. There existed the optimal lengths of crystal layers to minimize the variation of radial resolutions. In 10 cm ring scanner configuration, the radial resolution was kept below 3.4 mm over 8 cm FOV while the sensitivity was higher than 7.4% for LSO 5 mm : LuYAP 15 mm phoswich detector. In this study, the optimal length of dual layer phoswich detector was derived to achieve high and uniform radial resolution.

• Journal of Dental Anesthesia and Pain Medicine
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• v.23 no.2
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• pp.91-99
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• 2023

Background: Extrusion of debris is a major factor that results in postoperative pain during root canal treatment with various instruments and instrumentation techniques. Therefore, instrumentation techniques that extrude minimal debris into the periapical area while reducing pain are desirable. This study aimed to compare the incidence of postoperative pain and intake of analgesic medication (frequency and quantity) after endodontic treatment of mandibular posterior teeth using two single files and full-sequence continuous rotary systems with different kinematic motions. Methods: Thirty-five of 105 patients were assigned equally to three groups according to the instrumentation system used: ProTaper Next (PN) X2, 25/06 (Dentsply, Maillefer, Ballaigues, Switzerland), One Shape (OS), #0.25/06 (Micro Mega, Besancon, France), and Wave One Gold (WG), Red - #0.25, 0.07 (Dentsply, Maillefer, Ballaigues, Switzerland). Five specialists were included in this study design; each professional prepared 21 teeth, and randomly selected 7 per instrument system. The VAS sheet ranging from 0 to 10 was used to record the initial and postoperative pains at 24, 48, and 72 h, and 7^th day after single visit endodontic treatment in mandibular premolars and molars with a diagnosis of asymptomatic irreversible pulpitis with or without apical periodontitis. Postoperatively, an analgesic, ibuprofen 400 mg was administered for intolerable pain at a dose of 1 tablet for 6 h. The patients were asked over the telephone regarding postoperative pain at intervals of 24, 48, and 72 h, and 7^th day using a visual analogue scale. Result: There were no statistically significant differences among the PN, OS, and WG systems (P > 0.05) with regard to the incidence of postoperative pain at any of the four time points assessed. Conclusion: The intensity of postoperative pain, frequency, and analgesic intake were similar across all three types of instrument systems; however, the reciprocating single file (WG) was associated with less postoperative pain than the full sequence continuous rotary file.

• Trans-
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• v.14
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• pp.35-63
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• 2023

Parkinson's disease is a degenerative neurological disease that affects even basic daily life movements due to impairment of body function caused by a lack of dopamine, which is charge of the body movement. Presently, it is hard to cure Parkinson's disease entirely with medical technology, so movement therapy as a solution to delay and prevent disease is getting more attention. Therefore, this study aims at desiging and disseminating a body movement program that concentrates on individual self-care and balacing the state of body and mind by applying the Feldenkrais Method® to patients with Parkinson's disease. The Feldenkrais Method® is a mind-body perceptual learning method using body movements. It is a methodology that re-educates the nervous system by connecting the brain and behavior as a function of neuroplasticity. In this study, the body movement program developed and verified by the researcher was modified and supplemented with a focus on the self-awareness of the Feldenkrais Method®. A 24-session physical exercise program was composed of 5 stages to improve the self-management ability of patients with Parkinson's disease. The stages include self-awareness, self-observation, self-organization, self-control, and self-care. The overall changes recognize one's condition and improve one's ability to detect modifications in the internal sense and external environment. In conclusion, the body movement program improves the body movement program improves mental and physical functions and self-care for Parkinson's disease patients through the Feldenkrais method. The availability of the program's on-site applicability remains a follow-up task. Furthermore, it is necessary to establish a systematic structure to spread it more widely through convergent cooperation with the scientific field applied with metaverse as a reference for the wellness of the elderly.

• 한국노년학
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• v.29 no.3
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• pp.987-1000
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• 2009

The purpose of the study was to examine the effect of resistance training on joint flexibility and muscle strength of upper extremities of institutionalized elderly with impaired cognition. The study design was pretest-posttest control group study and inclusion criteria were elderly aged 65-year older, MMSE score 23 or less, ones who had no serious physical and/or mental problem except impaired cognition, and were capable to carry out resistance training. After consents were obtained participants were randomly assigned. Pre-post evaluation was performed by staff nurses trained beforehand. Among those 4-week study period, experiment was carried out during 5 consecutive days a week for 3 weeks. ROM and extension range of shoulder joints and muscle strength of shoulders and hands for both sides were measured. Flexion, extension, abduction range of right shoulder joint was significantly improved. Flexion and extension muscle strength of left side shoulder and abduction muscle strength of both sides of shoulder were significantly improved. With the study result, it could be concluded that resistance training has therapeutic effects on joint flexibility and muscle strength. More studies adopted longer experimental period to evaluate timing of effect and extinction to refine the protocol are called for.

• The Journal of Korean Academy of Sensory Integration
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• v.22 no.1
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• pp.25-42
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• 2024

Objective : The aim of this study was to investigate the effects of a sensory integration intervention on the sensory processing and posture control of children with developmental delays and a simultaneous family-centered coaching intervention on their parents' parenting efficacy. Methods : This study adopted a multiple probe design across four children aged five to six with developmental delays and their parents. A sensory integration intervention and a family-centered coaching intervention were employed twice a week in a total of 16 sessions over 8 weeks. Sensory profiles were evaluated, and the Korean version of the Parenting Sense of Competence was used before and after the interventions, and changes in post-intervention posture control were measured using Biorescue equipment. Results : During the intervention period, weight support in the sitting, Sitting with eyes closed, and standing positions evaluated using Biorescue was higher than two standard deviations from the baseline. After the interventions, all children showed enhanced sensory processing. Conclusion : Sensory integration and family centered coaching interventions have positive effects on the sensory processing and posture control of children with developmental delays and on their parents' parenting efficacy.

• Journal of the Korean Society of Radiology
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• v.18 no.4
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• pp.383-389
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• 2024

In this study, we aimed to analyze the probability of secondary cancer occurring in the abdomen, a normal organ, due to photoneutron exposure during intensity-modulated radiotherapy for prostate cancer. The design of the radiation treatment plan for prostate cancer was established as a daily prescription dose of 220 cGy, a total of 35 treatments, and 7700 cGy. The experimental equipment was a True Beam STx (Varian, USA) linear accelerator from Varian. The energy used in the experiment was 15 MV, and the treatment plan was designed so that the photoneutron dose would be generated within the planning target volume (PTV). The radiation treatment plan was an Eclipse System (Varian Ver. 10.0, USA), and the number of irradiation portals was set to 5 to 9. The irradiation angle was designed so that 95% of the prescription dose area was set to 0 to 320°, and the number of beamlets per irradiation portal was set to 100. The optically stimulated luminescence dosimeter used in this study to measure the dose of photoneutrons was designed to measure photoneutron doses by coating ⁶LiCO₃ on a device containing aluminum oxide components. It was studied that there is a minimum of 7.07 to 11 cases per 1,000 people with secondary cancer due to the photoneutron dose to the abdomen during intensity-modulated radiotherapy. In this study, we studied the risk of secondary radiation dose that may occur during intensity-modulated radiotherapy, and we expect that this will be used as meaningful data related to the probabilistic effects of radiation in the future.

• Journal of East-West Nursing Research
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• v.1 no.1
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• pp.22-39
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• 1997

Purpose: The purpose of this study is to evaluate the effect of rehabilitation education on the reduction of the stress of family members who have patients suffering from stroke and to find a new way to nurse the patients and their family. Subjects & Methods: The subjects were sixty-one family members with the patients who had been hospotalized in K hospital of oriental medicine from september the 9th, 1996 to september the fourteen, 1996. This study was performed by simulated control group pretest-posttest design; pretest was done on the control group through a questionnaire, counselling and observation while posttest was done on the experimental group 1-2 days after systemic rehabilitation education. To teach the patients and their family, the amended version of a book written by Lee Hae-jin was used as a tool for systemic rehabilitation education. As a method to estimate ADL score, modified Kang's method was applied and ADL score was measured by well-trained technician. As for the tool to estimate the degree of family stress, Choi's method adjusted to this study was applied. In the analysis of the data, social property of the patient and the characteristic of the disease were surveyed in $X^2$ examination to confirm the consistency between the experimental group and the control group. The diffrence in the degree of the stress, which is a dependent factor, was examined by t-test. The difference in ADL score between the experimental group and the control group was examined by t-test. The difference in the degree of the stress according to the general feature of the family with stroke patient, social property of the patients and the characteristic of the disease were surveyed by F examination. The difference in family stress according to the degree of ADL was surveyed by F examination. RESULTS: 1. After hypothetically-examined systemic rehabilitation education, the total of the score of family stress surveyed in 34 items of three domains was compared between the experimental group and the control group. There was no statistically significant difference between two groups; mean score of experimental group=2.28, that of control group=2.93(t=.17, df=59, p=. 66). 2. In the survey on family stress in 34 items, the items over mean score 3.0 were firstly the anxiety of possible disability and relapse of the disease and secondly to watch the patient's suffering without doing anything in the domain of the change of the disease and the difficulty in caring. And the items of the lowest stress with less than mean 2.0 score were little chance to meet the relative and friends, inconsistent treatment and attitude of the medical workers and the change of the attitude of the relative due to the patient orderly in the domain of social and personal relation and the responsibility as the family. The items which showed the difference between two groups were aggravation of neighboring patient(t=3.36, df= 59, p=.001) and the possibility of patient's death(t=2.19, df=58.38, p=.033) in the domain of the change of the disease and the difficulty in caring. 3. In the study on the stress difference according to general features of the family with the stroke patient, the score of family stress with the occupation was higher with mean 2.49 than that of the family stress without occupation with mean 2.16, but there was no significant difference. (F=5.21, df=1/59, p=.026). 4. In the study on the stress difference according to social property of the patient and the characteristic of the disease, there was significant difference in the age of the patients (F=2.98, df=3/57, p=.039). These results show that even if there is no statistically significant difference between two groups, sixteen of the experimental group are less than 3.0 in ADL score(standard 6 score)while eight of the control group are less than 3.0 and that ten of the experimental group are in the year range of 39-49 while four of the control group are in the year range of 39-49 which showed significant difference in family stress. These imply that there is a possibility that the experimental group have serious and fundamental stress resulting in high pretest stress compared with the control group. It might be due to the characteristic of simulated control group pretest-posttest design that the psychologic-supportive effect by the education was not observed. On the basis of these results, the followings are suggested. 1) A study on the nursing-mediated method to reduce the stress in the items which are not resolved by rehabilitation education, a study on nursing according to the patient's age and a study on the supportive nursing toward the family with occupation are required. 2) More than two times consecutive nursing-mediated rehabilitation education to measure the family stress is required. 3) Comprehensive and multilateral systemic education program including the instruction on western-eastern medicine, physical therapy, exercise and diet through collaboration of the experts in each field is required. 4) Family stress at home as well as in the hospital needs to be estimated and home rehabilitation and home-nursing needs to be continued.

• Progress in Medical Physics
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• v.26 no.3
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• pp.143-152
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• 2015

In this study, we aim to design the architecture of the kV imaging system for tumor tracking in the dual-head gantry system and analyze its accuracy by simulations. We established mathematical formulas and algorithms to track the tumor position with the two-pair kV imaging systems when they are in the non-orthogonal positions. The algorithms have been designed in the homogeneous coordinate framework and the position of the source and the detector coordinates are used to estimate the tumor position. 4D XCAT (4D extended cardiac-torso) software was used in the simulation to identify the influence of the angle between the two-pair kV imaging systems and the resolution of the detectors to the accuracy in the position estimation. A metal marker fiducial has been inserted in a numerical human phantom of XCAT and the kV projections were acquired at various angles and resolutions using CT projection software of the XCAT. As a result, a positional accuracy of less than about 1mm was achieved when the resolution of the detector is higher than 1.5 mm/pixel and the angle between the kV imaging systems is approximately between $90^{\circ}$ and $50^{\circ}$. When the resolution is lower than 1.5 mm/pixel, the positional errors were higher than 1mm and the error fluctuation by the angles was greater. The resolution of the detector was critical in the positional accuracy for the tumor tracking and determines the range for the acceptable angle range between the kV imaging systems. Also, we found that the positional accuracy analysis method using XCAT developed in this study is highly useful and will be a invaluable tool for further refined design of the kV imaging systems for tumor tracking systems.

• Journal of Hospice and Palliative Care
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• v.11 no.3
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• pp.147-155
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• 2008

Purpose: This study aimed to assess the educational needs for nurses who care for terminal cancer patients and their families. To identify top needs along with key issues in consideration to develope hospice training program and provide specific recommendations. Methods: A cross-sectional design with nurses from nine universities' hospice specialist courses and seven cancer centers was used. Data were collected via e-mail or mail service from March to April in 2008. One hundred seventy three questionnaires were returned (return rate: 73.6%), and 156 questionnaires were eventually analyzed. The questionnaire consisted of Mason and Ellershaw's The Self-efficacy in Palliative Care (SEPC) and self-reporting confidence and educational needs in hospice care. Results: The mean age of the participants was 37.94 years, 82.1% were staff nurses, and 44.9% completed over six months hospice education. Mean$\pm$standard deviation score for total SEPC was $2.67{\pm}.62$, which was lower than average (score 3), with communication score being the lowest ($2.49{\pm}.69$). The lowest self-reporting confidence score was $2.03{\pm}.77$ in hospice administration and management, followed by providing complement therapy ($2.34{\pm}.77$), bereavement care ($2.34{\pm}.71$), lymph edema management ($2.35{\pm}.79$), and care planning ($2.36{\pm}.81$). The participants reported that additional education is needed in all topics, with pain management score being the highest ($3.71{\pm}.50$), followed by pain and symptom evaluation ($3.67{\pm}.52$), care for dying ($3.67{\pm}.52$), and communication and counseling ($3.63{\pm}.53$). There were significant subgroup differences in SEPC and self-reporting confidence between groups who completed 6 months hospice education or not, however, no significant difference in educational need between the groups. Conclusion: This study showed the need for developing hospice training program to improve compentency of nurses in hospice palliative care.

• Radiation Oncology Journal
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• v.27 no.2
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• pp.64-70
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• 2009

Purpose: Concurrent chemoradiotherapy (CCRT) is the standard treatment for locally advanced unresectable pancreatic cancer. However, the introduction of gemcitabine and the recognition of a benefit in patients with advanced disease stimulated the design of trials that compare chemotherapy alone to concurrent chemoradiation. Therefore, we evaluated role of CCRT for locally advanced unresectable pancreatic cancer. Materials and Methods: We carried out a retrospective analysis of treatment results for patients with locally advanced unresectable pancreatic cancer between January 2000 and January 2008. The radiation was delivered to the primary tumor and regional lymph nodes with a 1~2 cm margin at a total dose of 36.0~59.4 Gy (median: 54 Gy). The chemotherapeutic agent delivered with the radiation was 5-FU (500 mg/$m^2$). The patients who underwent chemotherapy alone received gemcitabine (1,000 mg/$m^2$) alone or gemcitabine with 5-FU. The follow-up period ranged from 2 to 38 months. The survival and prognostic factors were analyzed using Kaplan-Meier method and log-rank test, respectively. Results: Thirty-four patients received concurrent chemoradiotherapy, whereas 21 patients received chemotherapy alone. The median survival time was 12 months for CCRT patients, compared to 11 months for chemotherapy alone patients (p=0.453). The median progression-free survival was 8 months for CCRT patients, compared to 5 months for chemotherapy alone patients (p=0.242). The overall response included 9 partial responses for CCRT and 1 partial response for chemotherapy alone. In total, 26% of patients from the CCRT group experienced grade 3~4 bowel toxicity. In contract, no grade 3~4 bowel toxicity was observed in the chemotherapy alone group. The significant prognostic factors of overall survival were lymph node status, high CA19-9, and tumor location. Conclusion: The response rate and progression-free survival were more favorable in the CCRT group, when compared with the chemotherapy alone group. Therefore, radiation therapy seems to be an effective tool for local tumor control.