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A study on oral discomfort in gynecological cancer patients undergoing chemotherapy (화학요법을 받는 부인암환자의 구강불편감에 관한 연구)

  • 정재원
    • Journal of Korean Academy of Nursing
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    • v.25 no.2
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    • pp.372-389
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    • 1995
  • The frequency with which administration of chemotherapy for gynecological cancer treatment is used has increased along with the use of surgery and radiotherapy Among the various side effects of chemotherapy, stomatitis causes a problem of function and sensation in the oral cavity. This oral discomfort can be categorized into two components ; perceived oral symptoms and observed oral symptoms. If the oral problem continues, it may cause infection, bleeding and nutritional deficiencies. As a result of this condition, compliance with the treatment process can be affected as well as the prognosis for the cancer patients. But as the oral discorrfort usually appears after chemotherapy, it is often not reported to the health care personnel as a patient problem. Without problem identification of the oral discomfort and ability to assess the problem, effective intervention cannot be planned. Therefore, this study was conducted to identify the pattern and the degree of oral discomfort due to cancer chemotherapy and thus to provide data for identification of the patient problem and for nursing assessment. The design of this study was a longitudinal de-scriptive study The subjects were in - patients who received chemotherapy under the diagnosis of gynecological cancer between Mar. 15, 1994 and May 15, 1994 at a general hospital in Seoul, Korea. The number of subjects was 64 and they were divided into two groups, one of 41 (A : 5FU & Neoplatin), the other of 23(B : Neoplatin, Cytoxan, Adriamycin), according to the treatment regimen. The data were collected for 24 days using self-re-port instruments. The instruments were the 「Perceived Oral Symptom Assessment Tool」 and 「Observed Oral Symptom Assessment Tool」 developed by this researcher. Data were analyzed using the SPSS-PC program, ANOVA, t-test, paired t-test and the Pearson Correlation Coefficient were applied. The results of this study are as follows : 1. In A regimen the peak time for perceived oral symptom scores was the fifth day after chemotherapy, and the tenth day for observed oral symptom scores. Both of the problems started on first day of chemotherapy and were not resolved completely until the 24th day after treatment. 2. In B regimen, the peak time for perceived oral symptom scores was on the seventh day after chemotherapy, and the eighth day for observed oral symptom scores. It was noted that perceived oral symptom scores were higher than observed oral symptom scores consistently for 24 days. Both also started on first day of chemotherapy, and were not resolved completely until the 24th day after chemotherapy. 3. There were no differences statistically in perceived oral symptom scores between A and B regimen. The loss of appetite and xerostomia caused the most severe discomfort in both of these two groups. 4. The were no differences statistically in observed oral symptom scores between the A and B regi moil. In the A regimen, the highest observed symptom scores were the lips, gingiva, tongue and buccal membrane in that order. But in the B regimen, the highest observed symptom scores were tongue, lips, buccal membrane and gingiva in that order. 5. In A regimen, the patients who had gingival edema and dentures had significantly higher perceived oral symptom scores. And those who had gingival edema and bleeding, foul odor and aphthous stomatitis had significantly higher observed oral symptom scores. 6. In B regimen, the patients who had the experience of stomatitis in the last course of chemotherapy had significantly higher perceived oral symptom scores. Those who had gingival edema had significantly higher observed oral symptom scores. 7. In the A regimen there was no correlation between lab values for lymphocytes and albumin with perceived oral symptom scores and observed oral symptom scores. In the B regimen, there was a significant negative correlation between lymphocytes and albumin with the observed oral symptom scores, but not between perceived oral symptom scores and lymphocytes and albumin values. In conclusion, the nurse should expect that the patient undergoing chemotherapy will complain severely about subjective discomfort and before objective physical change is observed. Also the patients who have chronic oral problems such as dentures, gingival edema and bleeding, foul odor, aphthous stomatitis will complain of severe oral discomfort due to chemotherapy.

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Rear Vehicle Detection Method in Harsh Environment Using Improved Image Information (개선된 영상 정보를 이용한 가혹한 환경에서의 후방 차량 감지 방법)

  • Jeong, Jin-Seong;Kim, Hyun-Tae;Jang, Young-Min;Cho, Sang-Bok
    • Journal of the Institute of Electronics and Information Engineers
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    • v.54 no.1
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    • pp.96-110
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    • 2017
  • Most of vehicle detection studies using the existing general lens or wide-angle lens have a blind spot in the rear detection situation, the image is vulnerable to noise and a variety of external environments. In this paper, we propose a method that is detection in harsh external environment with noise, blind spots, etc. First, using a fish-eye lens will help minimize blind spots compared to the wide-angle lens. When angle of the lens is growing because nonlinear radial distortion also increase, calibration was used after initializing and optimizing the distortion constant in order to ensure accuracy. In addition, the original image was analyzed along with calibration to remove fog and calibrate brightness and thereby enable detection even when visibility is obstructed due to light and dark adaptations from foggy situations or sudden changes in illumination. Fog removal generally takes a considerably significant amount of time to calculate. Thus in order to reduce the calculation time, remove the fog used the major fog removal algorithm Dark Channel Prior. While Gamma Correction was used to calibrate brightness, a brightness and contrast evaluation was conducted on the image in order to determine the Gamma Value needed for correction. The evaluation used only a part instead of the entirety of the image in order to reduce the time allotted to calculation. When the brightness and contrast values were calculated, those values were used to decided Gamma value and to correct the entire image. The brightness correction and fog removal were processed in parallel, and the images were registered as a single image to minimize the calculation time needed for all the processes. Then the feature extraction method HOG was used to detect the vehicle in the corrected image. As a result, it took 0.064 seconds per frame to detect the vehicle using image correction as proposed herein, which showed a 7.5% improvement in detection rate compared to the existing vehicle detection method.

Association of Serum Vitamin D with Insulin Resistance and Beta Cell Function in Korean Health Checkup Examinees (건강검진 수검자에서 혈청 Vitamin D 수준과 인슐린저항성 및 β-세포 기능과의 관련성)

  • Kim, Han-soo;Ryu, So Yeon;Park, Jong;Han, Mi-Ah;Choi, Seong-Woo;Shin, Min-Ho
    • Journal of agricultural medicine and community health
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    • v.43 no.1
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    • pp.18-30
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    • 2018
  • Objectives: This study was conducted to examine the association of serum Vitamin D with insulin resistance and ${\beta}-cell$ function in Korean health checkup examinees. Methods: This study subjects were 374 healthy adults (199 males, 175 females) over the age of 20, who visited a general hospital medical center located in Haenam-gun, Jeollanam-do. To find the association of Vitamin D with HOMA-IR and $HOMA-{\beta}$, the used statistical analysis were ANOVA and ANCOVA. Results: Of the study subjects, the level of serum Vitamin D defined by deficient group, insufficient group and sufficient group was 38.5%, 48.1% and 13.4%, respectively. According to the level of serum Vitamin D, the mean values of HOMA-IR were $1.92{\pm}1.08$ in sufficient group, $1.99{\pm}1.04$ in the insufficient group and $2.91{\pm}1.05$ in deficient group and there were statistically significant different(p<0.001). The mean values of $HOMA-{\beta}$ were $84.69{\pm}1.07$ in sufficient group, $78.41{\pm}1.04$ in the insufficient group and $80.48{\pm}1.04$ in deficient group, and there were not significant. As a result of ANCOVA, adjusted mean of HOMA-IR were statistically significant different (p<0.001), but those of $HOMA-{\beta}$ were not statistically significant according to the level of serum Vitamin D. Conclusion: The insufficient level of serum Vitamin D was relatively high in healthy adults who live in rural area, and it was found that HOMA-IR significantly increased when Vitamin D was deficient. To prevent insulin resistance or diabetes, it is necessary to provide sufficient information related to sufficient production of Vitamin D such as Vitamin D supplement, sun exposure, food intake and etc.

Distribution of Hydrometeors and Surface Emissivity Derived from Microwave Satellite Observations and Model Reanalyses (위성관측(MSU)과 모델 재분석 자료에서 조사된 대기물현상과 표면 방출율의 분포)

  • Kim, Tae-Yean;Yoo, Jung-Moon
    • Journal of the Korean earth science society
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    • v.23 no.7
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    • pp.552-564
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    • 2002
  • The data of satellite-observed Microwave Sounding Unit (MSU) channel 1 (Ch1) brightness temperature and General Circulation Model (GCM) reanalyses over the globe have been used to investigate low tropospheric hydrometeors and microwave surface emissivity during the period from January 1981 to December 1993. The average of GCM Ch1 temperature has been reconstructed from three kinds of reanalyses, based on the MSU weighting function. Since the GCM temperature mainly corresponds to the thermal state of the lower troposphere without the difference in the emissivity between ocean and land, it is higher in summer than in other seasons over the regions. The MSU temperature over the ocean shows its maximum at the ITCZ and the SPCZ due to hydrometeors. Over high latitude ocean, the temperature is enhanced because of sea ice emissivity, while it is reduced over the land. The seasonal displacement of the ITCZ and the SPCZ systematically appeared in the difference of Ch1 temperature between the GCM and the MSU. The difference values decrease in the regions of the ITCZ, the SPCZ, and the sea ice because of the increase of the MSU temperature. According to the local minima of the values, the ITCZ moves norhward to 9 N in fall, and the SPCZ moves southward to 12 S in boreal fall and winter. The sea ice in the northern hemisphere is extended southward to 53 N in winter, while the ice in the southern hemisphere, northward to 58 S in boreal summer. We also have discussed the separated contribution from hydrometeors and surface emissivity to the MSU Ch1 temperature, utilizing radiative transfer theory. The increase of 4-6K in the temperature over the ITCZ is inferred to result from hydrometeors of 1-1.5mm/day, and furthermore the increase of 10-30K over the high latitude ocean, ice emissivity of 0.6-0.9.

A Study on the Stress Distribution of Condylar Region and Edentulous Mandible with Implant-Supported Cantilever Fixed Prostheses by using 3-Dimensional Finite Element Method (임플란트 지지 캔틸레버 고정성 보철물 장착시 과두와 하악골의 응력 분포에 관한 3차원 유한요소법적 연구)

  • Kim, Yeon-Soo;Lee, Sung-Bok
    • Journal of Dental Rehabilitation and Applied Science
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    • v.17 no.4
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    • pp.283-305
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    • 2001
  • The purpose of this study was to analyze the stress distribution of condylar regions and edentulous mandible with implant-supported cantilever prostheses on the certain conditions, such as amount of load, location of load, direction of load, fixation or non-fixation on the condylar regions. Three dimensional finite element analysis was used for this study. FEM model was created by using commercial software, ANSYS(Swanson, Inc., U.S.A.). Fixed model which was fixed on the condylar regions was modeled with 74323 elements and 15387 nodes and spring model which was sprung on the condylar regions was modeled with 75020 elements and 15887 nodes. Six Br${\aa}$nemark implants with 3.75 mm diameter and 13 mm length were incorporated in the models. The placement was 4.4 mm from the midline for the first implant; the other two in each quardrant were 6.5 mm apart. The stress distribution on each model through the designed mandible was evaluated under 500N vertical load, 250N horizontal load linguobuccally, buccal 20 degree 250N oblique load and buccal 45 degree 250N oblique load. The load points were at 0 mm, 10 mm, 20 mm along the cantilever prostheses from the center of the distal fixture. The results were as follows; 1. The stress distribution of condylar regions between two models showed conspicuous differences. Fixed model showed conspicuous stress concentration on the condylar regions than spring model under vertical load only. On the other hand, spring model showed conspicuous stress concentration on the condylar regions than fixed model under 250N horizontal load linguobuccally, buccal 20 degree 250N oblique load and buccal 45 degree 250N oblique load. 2. Fixed model showed stress concentration on the posterior and mesial side of working and balancing condylar necks but spring model showed stress concentration on the posterior and mesial side of working condylar neck and the posterior and lateral side of balancing condylar neck under vertical load. 3. Fixed model showed stress concentration on the posterior and lateral side of working condylar neck and the anterior and mesial side of balancing condylar neck but spring model showed stress concentration on the anterior sides of working and balancing condylar necks under horizontal load linguobuccally. 4. Fixed model showed stress concentration on the posterior side of working condylar neck and the posterior and lateral side of balancing condylar neck but spring model showed stress concentration on the anterior side of working condylar neck and the anterior and lateral side of balancing condylar neck under buccal 20 degree oblique load. 5. Fixed model showed stress concentration on the anterior and lateral side of working condylar neck and the posterior and mesial side of balancing condylar neck but spring model showed stress concentration on the anterior side of working condylar neck and the anterior and lateral side of balancing condylar neck under buccal 45 degree oblique load.. 6. The stress distribution of bone around implants between two models revealed difference slightly. In general, magnitude of Von Mises stress was the greatest at the bone around the most distal implant and the progressive decrease more and more mesially. Under vertical load, the stress values were similar between implant neck and superstructure vertically, besides the greatest on the distal side horizontally. 7. Under horizontal load linguobuccally, buccal 20 degree oblique load and buccal 45 degree oblique load, the stress values were the greatest on the implant neck vertically, and great on the labial and lingual sides horizontally. After all, it was considered that spring model was an indispensable condition for the comprehension of the stress distributions of condylar regions.

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Clinical Characteristics of Smoking Asthmatics

  • Ha, Eun Sil;Kim, Hye Ok;Lee, Kyoung Ju;Lee, Eun Joo;Hur, Gyu Young;Jung, Ki Hwan;Lee, Sung Yong;Kim, Je Hyeong;Lee, Sang Yeub;Shin, Chol;Shim, Jae Jeong;Kang, Kyung Ho;Yoo, Se Hwa;In, Kwang Ho
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.6
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    • pp.506-511
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    • 2009
  • Background: The smoking prevalence in asthma patients are similar to those in the general population. Asthma and active cigarette smoking can interact to create more severe symptoms, an accelerated decline in lung function and impaired therapeutic responses. Accordingly, asthmatics with a history of smoking were examined to define the clinical characteristics and lung function of smoking asthmatics. Methods: The medical records of 142 asthmatics with a known smoking history were reviewed. The patients were divided into three groups according to their smoking history - current smokers, former smokers and non-smokers. The clinical characteristics, lung function, and annual declines of the forced expiratory volume in one second ($FEV_1$) were compared. Results: Fifty-three of the 142 patients (37%) were current smokers, 24 were former smokers (17%) and 65 were non-smokers (45%). The patients with a hospital admission history during the previous year included 16 current smokers (30%), 4 former smokers (17%) and 7 non-smokers (11%) (p=0.02). The mean $FEV_1$ (% predicted) was 76.8${\pm}$19.8%, 71.6${\pm}$21.1% and 87.9${\pm}$18.7% for current smokers, former smokers and non-smokers, respectively (p< 0.001). The $FEV_1$/forced vital capacity (FVC) (ratio, %) values were 63.6${\pm}$12.6%, 59.3${\pm}$14.9% and 72.1${\pm}$11.8% in current smokers, former smokers and non-smokers, respectively (p<0.001). The corresponding mean values for the individual $FEV_1$ slopes were not significant (p=0.33). Conclusion: Asthmatic smokers demonstrated higher hospital admission rates and lower lung function. These findings suggest that the smoking history is an important predictor of a poor clinical outcome in asthma patients.

Study on Optimum Contrast Medium Quantity during Abdominal CT using Dual Energy Technique (복부 CT 검사 시 이중에너지 기법을 통한 적정한 조영제 양에 관한 연구)

  • Kang, Min;Choi, Namgil;Han, Jaebok;Kim, Wook;Jang, Yeongill;Song, Jongnam
    • Journal of the Korean Society of Radiology
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    • v.9 no.1
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    • pp.9-16
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    • 2015
  • The purpose of this study is finding optimum contrast medium quantity during abdominal CT using dual energy technique. The study subjects are 30 patients who had received general single energy abdominal CT and received double energy technique follow-up abdominal CT. dual energy technique abdominal CT images were obtained after setting contrast medium quantities at 30%, 40%, 50%, 60% and 70% of contrast medium quantity at the time of single energy technique. Then the contrast enhancement (Hounsfield Unit; HU) was estimated by setting-up the regions of interest at aorta, inferior vena cava, hepatic portal vein and hepatic parenchymal. The obtained values were compared to the values of the same parts measured during single energy technique abdominal CT. The results of the study were as following. The 60% set up group had HU in aorta : $210.80{\pm}13.609$, IVC : $190.40{\pm}25.215$, hepatic portal vein : $198.40{\pm}21.232$ and hepatic parenchymal : $119.20{\pm}7.98$, The single energy abdomianl CT images had HU in aorta : $205.40{\pm}16.426$, IVC : $188.20{\pm}21.476$, hepatic portal vein : $195.40{\pm}22.744$ and hepatic parenchymal : $121.00{\pm}6.595$. Therefore, it is possible to obtain contrast enhancement by dual energy technique abdominal CT similar to the same by single energy technique abdominal CT by setting-up the quantity of contrast medium at 60% of contrast medium at the time of single energy technique abdominal CT. Based on the result of this study, it is possible to decrease existing quantity of contrast medium by _% and the injection velocity can be also decreased. Accordingly, it is believed that the result of study would be quite useful for patients who have renal function disorder, weak vein or side effect of contrast medium in the past.

IMRT and IMRS Checking the Dose Distribution in the Small Field Evaluation of Measurement by Changes in SAD (IMRT 및 IMRS에서 Small Field의 선량분포 확인시 SAD 변화에 따른 측정의 유용성 평가)

  • Ko, Seung-Young;Kim, Sung-Joon;Park, Gir-Yong;Son, Mi-Suk;Lee, Nam-Ki;Kim, Jin-Soo
    • The Journal of Korean Society for Radiation Therapy
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    • v.22 no.1
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    • pp.33-39
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    • 2010
  • Purpose: It is very important to confirm conformance of dose distribution that is formed with treatment planning from IMRS or IMRT. It has been a problem dropped accuracy and conformance when the field size is getting smaller because of character of the 2D ion chamber. Verification of MatriXX Phantom dose distribution with a change in the SAD. Dose distribution measurement and analysis to improve the accuracy and should be useful to evaluate the award. Materials and Methods: A use of Novalis linear accelerator 6 MV photon beams. In general, IMRS were 25 patients with small field size. The selected patients were divided into three groups on the basis of the field size. SAD was changed from 80 to 130 cm and field size to determine the dose distribution to the change, each dose was measured using MatriXX Phantom. Analysis of measured values obtained from the program for each patient through the treatment planning system comparison and analysis of the dose distribution and gamma values were expressed. Result: SAD 80, 100, and 120 cm in size in the gamma value to the investigation of patients less than $3\;cm^2$ average 0.939, 0.969, and 0.979, respectively. Patients with more than $5\;cm^2$ 0.962, 0.983, and 0.988, respectively. $5\;cm^2$ or more patients 0.982, 0.990, and 0.992, respectively. Conclusion: The error rate of less than $3\;cm^2$ field size is increased rapidly. If the field size is increased, resolution is increased by 2D ion chambers. It has been approved that it can be credible if it is around $3\;cm^2$ when measuring dose distribution using MatriXX. Adjusting geometric field size by changing SAD is likely to be very useful when you measure dose distribution using MatriXX.

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A Study on Quality Changes of Domestic Frying Oils by Thermal Oxidation (시판식용유의 가열시간에 따른 품질 변화에 관한 연구)

  • Chang, You-Kyung;Lee, Joung-Won;Kim, Teak-Je
    • Korean Journal of Food Science and Technology
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    • v.10 no.2
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    • pp.112-118
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    • 1978
  • Four domestic frying oils (soybean, corn, rapeseed and rice bran oil) were studied on their changing properties according to thermal oxidation by means of chemical analysis of their compositions and measurements of various physical and chemical properties. The content of linoleic acid which is an essential unsaturated fatty acid and the total amount of unsaturated fatty acids were highest in soybean oil (53.2% and 80.3% respectively) among the unheated frying oils and the degree of its thermal degradation was lowest during the continuous heating period for 48 hours at $180^{\circ}C$. However in general, the contents of unsaturated fatty acids were sharply decreased by thermal oxidation whereas the saturated fatty acid contents ranging 10-17% were not changed considerably, which largely agreed with the results of iodine value measurements. The free acid and peroxide values were also lowest in soybean oil (0.09 and 5.6 respectively) among the unheated oils whereas an anomalously high free acid value was observed in rapeseed oil (54.8) which was packed in unleveled glass bottles. Such a high value is probably ascribed to the photo-catalyzed oxidation during storage. The viscosity measurements have shown similar values before heating, but after thermal oxidation for 32 hours the rapeseed and rice bran oils became too thick to measure viscosity by capillary flow method with heavy darkening in color.

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Study on the Heat Transfer Phenomenon around Underground Concrete Digesters for Bigas Production Systems (생물개스 발생시스템을 위한 지하매설콘크리트 다이제스터의 열전달에 관한 연구)

  • 김윤기;고재균
    • Magazine of the Korean Society of Agricultural Engineers
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    • v.22 no.1
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    • pp.53-66
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    • 1980
  • The research work is concerned with the analytical and experimental studies on the heat transfer phenomenon around the underground concrete digester used for biogas production Systems. A mathematical and computational method was developed to estimate heat losses from underground cylindrical concrete digester used for biogas production systems. To test its feasibility and to evaluate thermal parameters of materials related, the method was applied to six physical model digesters. The cylindrical concrete digester was taken as a physical model, to which the model,atical model of heat balance can be applied. The mathematical model was transformed by means of finite element method and used to analyze temperature distribution with respect to several boundary conditions and design parameters. The design parameters of experimental digesters were selected as; three different sizes 40cm by 80cm, 80cm by 160cm and l00cm by 200cm in diameter and height; two different levels of insulation materials-plain concrete and vermiculite mixing in concrete; and two different types of installation-underground and half-exposed. In order to carry out a particular aim of this study, the liquid within the digester was substituted by water, and its temperature was controlled in five levels-35。 C, 30。 C, 25。 C, 20。C and 15。C; and the ambient air temperature and ground temperature were checked out of the system under natural winter climate conditions. The following results were drawn from the study. 1.The analytical method, by which the estimated values of temperature distribution around a cylindrical digester were obtained, was able to be generally accepted from the comparison of the estimated values with the measured. However, the difference between the estimated and measured temperature had a trend to be considerably increased when the ambient temperature was relatively low. This was mainly related variations of input parameters including the thermal conductivity of soil, applied to the numerical analysis. Consequently, the improvement of these input data for the simulated operation of the numerical analysis is expected as an approach to obtain better refined estimation. 2.The difference between estimated and measured heat losses was shown to have the similar trend to that of temperature distribution discussed above. 3.It was found that a map of isothermal lines drawn from the estimated temperature distribution was very useful for a general observation of the direction and rate of heat transfer within the boundary. From this analysis, it was interpreted that most of heat losses is passed through the triangular section bounded within 45 degrees toward the wall at the bottom edge of the digesten Therefore, any effective insulation should be considered within this region. 4.It was verified by experiment that heat loss per unit volume of liquid was reduced as the size of the digester became larger For instance, at the liquid temperature of 35˚ C, the heat loss per unit volume from the 0. 1m$^3$ digester was 1, 050 Kcal/hr m$^3$, while at for 1. 57m$^3$ digester was 150 Kcal/hr m$^3$. 5.In the light of insulation, the vermiculite concrete was consistently shown to be superior to the plain concrete. At the liquid temperature ranging from 15。 C to 350 C, the reduction of heat loss was ranged from 5% to 25% for the half-exposed digester, while from 10% to 28% for the fully underground digester. 6.In the comparison of heat loss between the half-exposed and underground digesters, the heat loss from the former was fr6m 1,6 to 2, 6 times as much as that from the latter. This leads to the evidence that the underground digester takes advantage of heat conservation during winter.

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