Park, Su Yeon;Chae, Moon Ki;Lim, Jun Teak;Kwon, Dong Yeol;Kim, Hak Joon;Chung, Eun Ah;Kim, Jong Sik
The Journal of Korean Society for Radiation Therapy
/
v.32
/
pp.93-109
/
2020
Purpose: The radiochromic film (Gafchromic EBT3, Ashland Advanced Materials, USA) and 3-dimensional analysis system dosimetry checkTM (DC, MathResolutions, USA) were evaluated for patient-specific quality assurance (QA) of helical tomotherapy. Materials and Methods: Depending on the tumors' positions, three types of targets, which are the abdominal tumor (130.6㎤), retroperitoneal tumor (849.0㎤), and the whole abdominal metastasis tumor (3131.0㎤) applied to the humanoid phantom (Anderson Rando Phantom, USA). We established a total of 12 comparative treatment plans by the four geometric conditions of the beam irradiation, which are the different field widths (FW) of 2.5-cm, 5.0-cm, and pitches of 0.287, 0.43. Ionization measurements (1D) with EBT3 by inserting the cheese phantom (2D) were compared to DC measurements of the 3D dose reconstruction on CT images from beam fluence log information. For the clinical feasibility evaluation of the DC, dose reconstruction has been performed using the same cheese phantom with the EBT3 method. Recalculated dose distributions revealed the dose error information during the actual irradiation on the same CT images quantitatively compared to the treatment plan. The Thread effect, which might appear in the Helical Tomotherapy, was analyzed by ripple amplitude (%). We also performed gamma index analysis (DD: 3mm/ DTA: 3%, pass threshold limit: 95%) for pattern check of the dose distribution. Results: Ripple amplitude measurement resulted in the highest average of 23.1% in the peritoneum tumor. In the radiochromic film analysis, the absolute dose was on average 0.9±0.4%, and gamma index analysis was on average 96.4±2.2% (Passing rate: >95%), which could be limited to the large target sizes such as the whole abdominal metastasis tumor. In the DC analysis with the humanoid phantom for FW of 5.0-cm, the three regions' average was 91.8±6.4% in the 2D and 3D plan. The three planes (axial, coronal, and sagittal) and dose profile could be analyzed with the entire peritoneum tumor and the whole abdominal metastasis target, with planned dose distributions. The dose errors based on the dose-volume histogram in the DC evaluations increased depending on FW and pitch. Conclusion: The DC method could implement a dose error analysis on the 3D patient image data by the measured beam fluence log information only without any dosimetry tools for patient-specific quality assurance. Also, there may be no limit to apply for the tumor location and size; therefore, the DC could be useful in patient-specific QAl during the treatment of Helical Tomotherapy of large and irregular tumors.
Objectives : This study aimed to clarify the relationship between the Oriental medical diagnosis and arteriosclerosis by measuring carotid-ankle vascular index(CAVI) in acute cerebral infarction patients. Method : One hundred thirty-one subjects were recruited from the patients admitted to the Internal Medical Department at Kyunghee University Oriental Medical Center from April 2007 to August 2008. We sorted cerebral infarction patients and assessed one hundred fourteen patients' CAVI data. We diagnosed dampness-phlegm by Oriental medical diagnosis and evaluated stroke type by single or multiple infarctions. then, we analyzed their characteristics with type of stroke, risk factor, lifestyle, metabolic syndrome and dampness-phlegm diagnosis. Result : 1. On the demographic variables of the patients, age, hypertension, hyperlipidemia, multiple infarction group and metabolic syndrome and dampness-phlegm group were significantly higher in the high CAVI score group than in the control. 2. According to the significant difference in the dampness-phlegm group, we analyzed dampness-phlegm related index for pattern identifications by CAVI score. As a result, dark circles, insomnia, headache, white coating tongue. slippery pulse, and rough pulse were significantly higher in the high CAVI score group then in the control. 3. In multivariate analysis, age, hypertension, multiple infarction and dampness-phlegm groups showed a close relationship with the high CAVI score group. Conclusions : According to the analysis, significance between dampness-phlegm diagnosed patients group and high CAVI score were clarified. Moreover, multiple location infarctions also have a relationship with high CAVI score in cerebral infarction patients. These results can be utilized in the future as a basis material.
Park, Kwang-Lai;Suga, Yuko;Hong, Seung-Gil;Lee, Chorong;Ahn, Minsil;Kim, Seok-Cheol;Hashimoto, Tomoyoshi
Journal of the Korea Organic Resources Recycling Association
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v.24
no.4
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pp.77-83
/
2016
The objectives of this study was to investigate the difference between organic-farming and conventional-farming soils relatives to soil chemical properties and microbial flora. Fifteen soil sampling sites were chosen from the certified organic upland farm, considered with its location, crop and application of organic compost types. Soil chemical properties were analyzed by standard methods established by National Institute of Agricultural Sciences, Rural Development Administration. For the soil chemical properties, the values of pH were ranged from 4.5 to 7.3. The values of electrical conductivity (EC) in the sampling sites were below 2 dS/m of convention cultivation soil. For analyzing the microbial flora, the bacillus(16S rDNA) and cladothricosis(18S rDNA) were analyzed by using PCR-DGGE (Denaturing Gradient Gel Electrophoresis) in the soil of 15 sampling sites. Cluster analysis of biodiversity index was performed by using pattern of DGGE. DGGE patterns and clustering analysis of bacterial DNA from soil extracts revealed that the bacterial community was differentiated between less than 5 years and more than 5 years depending on the cultivation history. But there was no consistent tendency between cultivation history and regional trend in the case of molds. Therefore, it would be very effective to analyze bacterial clusters of organically cultivated soils in long - term cultivated soil for more than 5 years.
Park, Myung-Hwan;Seo, Jeong-Min;Choi, Byeong-Gi;Shin, Eun-Hyeok;Song, Gi-Won
The Journal of Korean Society for Radiation Therapy
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v.23
no.2
/
pp.83-90
/
2011
Purpose: This study statistically analyzed the difference of the stability of maintaining a respiratory period shown according to position and use of a device to search the tendency and usefulness of a device. Materials and Methods: The study obtained respiratory signals which maintained a respiratory period for 20 minutes each supine and prone position for 11 subjects. The study obtained respiratory signals in a state of using a belly board for 7 patients in a bad condition of a respiratory period in a prone position to analyze a change in respiration and the stability before and after the use of a device. Results: The supine part showed 54.5%, better than the prone part of 36.4% in a case that the stability for maintaining a respiratory period was in a good condition as a fixed respiratory period was well maintained according to the position. 6 patients (85%) showed a maintenance pattern of a respiratory period significantly different before the use and 4 patients showed a significantly good change in the stability for maintaining a respiratory period as a result that belly boards were used for 7 patients that the maintenance of a respiratory period was not in a good condition on a prone position. Conclusion: It seemed that this study could contribute to the maintenance of respiratory period and of respiratory stability as the optimal position for maintenance of respiration and the use of a device such as a belly board were decided through statistic analysis of respiratory signals and its application even if patient position and use of device were decided by the beam arrangement a treatment part of a patient, location of a target, and an expected plan.
Purpose: The incidence of upper gastric cancer and especially the diffuse type have increased in western countries. The aim this study was to investigate the chronologic changes of the clinicopathological features and survival rates of Korean upper gastric cancer patients. Materials and Methods: 1,638 gastric cancer patients who underwent gastrectomy were included in this study and they were divided into two groups; the 1990's (1991~1999, n=987) and the early 2000's (2000~2003, n=651). We evaluated the differences of the clinicopathologic features and the factors that affected the survival rates by univariative and multivariative analysis. Results: The older age (>60) patients increased from 42.7% to 50.7% respectively. Being overweight (body mass index$\geq$23) also increased from 31.5% to 43.2%. For the pathology, the incidence of stage Ia gastric cancer increased (29.8% to 44.5%) and the incidence of stage IV gastric cancer decreased (23.5% to 11.8%). Yet there was no difference according to the WHO classification, Lauren's classification and the location of tumor between the groups. The 5 year survival rates increased 67.7% to 83.7%, according to the group. Multivariative analysis showed that the odd ratios of the early 2000s was 0.715 (95% CI; 0.555~0.921) as compared to that of the 1990s. Conclusion: There were no changes of the clinicopathologic features, like the pattern in western countries, although the incidence early gastric cancer, old age patients and overweight patients increased. The survival rate of early 2000s was better that that of the 1990s.
Purpose: This study evaluated the pretreatment expression patterns of MDM2, p53, and pRb proteins to determine if the expression patterns could predict the outcome of concurrent chemoradiotherapy (CCRT) for esophageal squamous cell carcinoma and aid in the decisions for the selection of treatment modalities. Materials and Methods: Fifty-one patients that were treated with definitive chemoradiotherapy for stage $I{\sim}IVa$ esophageal squamous cell carcinoma were selected for this study. Radiotherapy was administered with daily $1.8{\sim}2\;Gy$ fractions up to a median dose of 54 Gy for primary tumors, and with four cycles of cisplatin/5-fluorouracil chemotherapy that was administered every 4 weeks, the first two cycles of which were administered concurrently with radiotherapy. Expression of MDM2, p53, and pRb was investigated by immunohistochemical analysis using pretreatment biopsy specimens. Results: MDM2, p53, and pRb were detected with high immunoreactivity in 19.6%, 27.5%, and 66.7% of the patients, respectively. However, there was no significant correlation between expression of these factors and clinical outcome. By the use of multivariate analysis with nine covariates-age, tumor location, tumor length, stage, pathological response, clinical response, MDM2 expression, p53 expression, and pRb expression, only pathological response and stage were significant factors for cause-specific survival. Conclusion: Expression of MDM2, p53, and pRb was not found to be clinically significant for predicting outcomes after CCRT in this study. Further studies with a larger patient population and longer follow-up periods are needed to re-evaluate the expression pattern and to identify new predictors for CCRT response.
The purpose of this study to empirically examine a smart work investment and job performance by change resistance. Firstly, There investigates mediating role of the communication between the smart work investment and the job performance. Secondly, It will identify the job productivity differences through a level of organizational change resistance that reduced smart work investment. The smart work is to provide the flexibility of time and location and is a working method to improve a work productivity of organization members. The introduction of smart work means the adoption of new organizational culture, institution and technology and requires a novel change of a custom and pattern on existing organization culture and institution because of transformation form of communication and collaboration. The method of this study adopts a structural equation model to test a mediating effect of communication and a moderating effect of change resistance level. This model confirms whether smart work investments provide a positive impact on communication and organizational productivity. In addition, I will classify a change resistance level of smart work by cluster analysis and then check a critical path difference of job productivity between each group. As a result, The organizational IT, institution and culture on the smart work investment appeared to important influencers in communication and also had a direct influence of individual performance. Also, The three independent variables of smart work investment have an indirect influence of individual and organizational performance through communication mediating variables. However, the organizational IT and institution as independent variables do not provide direct influence of organization performance. Nevertheless, two independent variables of organizational IT and institution have an indirect influence the organization performance through communication mediating variables. As a result of confirming a productivity of three groups on organization resistance, there was a difference the individual and organizational performance among groups. The low-level group of organizational resistance showed high coefficient value of performance compared to other groups. The group analysis implications, The smart work investment appeared significantly to revise the institution first, build culture secondly and advanced technology lastly. The theoretical implication from this study contributes an extension of social science theory through socio-technical systems, institution, culture, change resistance and job performance based on smart work. The practical implications explain the smart work success in step-by-step investment rather than radical investment as level management of change resistance. In future research, the smart work performance between private and public firms will analyze a difference of the organizational culture, institution, technology and performance.
In the preoperative evaluation before coronary artery bypass surgery, review of the coronary arteriogram is the most important step. Expected "normal" lumen diameter at a given coronary anatomic location is a basis for quantative estimation of coronary disease severity that could be more useful than the traditional "percent stenosis". The distribution and number of major coronary artery branches are determinants of number of bypass grafts needed. We reviewed the coronary artery anatomy in 174 adult patients who revealed no coronary pathology in angiographic studies done from September 1994 to June 1996. Quantative analysis was done in all cases by a single person using a Computerized System (Arripro 35ⓡ). The results were follows; 1) The mean diametre of left main coronary artery was 4.45 mm(range 2.74~6.72). The pattern of branching was bifurcation in 67.24%, trifurcation in 28.74% and quadrifurcation in 4.02% of the patients. 2) The mean diametre of left anterior descending artery was 3.17 mm(range 2.10~5.85), 2.79 (range 1.55~5.59) and 2.17 mm(range 1.37~3.81) in the proximal, mid, and the distal portions, respectively. The number of diagonal branches of left anterior artery was from one to four(mode=2). 3) The mean diametre of proximal and distal left circumflex artery were 3.17mm(range 1.74~4.89) and 2.19 mm(range 1.21~4.46). The number of obtuse marginal branches of left circumflex artery is from one to six(mode 2). 4) The mean diametre of proximal and distal right coronary artery, the posterior descending artery and the largest posterolateral branch were mean 3.51 mm(range 2.07~5.67), 2.09 mm (range 1.42~3.60), 2.09 mm(range 1.02~3.60) and 2.30 mm(range 1.39~4.39). 5) The right coronary artery dominant was 163 cases(93.68%) of the total 174 cases. 6) The large significant acute marginal artery was visualized in more than half of the people. half of the people.
Purpose: This study was designed to evaluate the results of local control, survival rate, prognostic factors, and failure pattern in locally advanced esophageal cancer. Materials and Methods: We retrospectively studied 50 patients with locally advanced esophageal cancer treated with concurrent chemoradiotherapy at Keimyung University Dongsan Medical Center from June of 1999 to August of 2008. Seven patients with inappropriate data were excluded, and 43 patients were analyzed. There were 39 males and four female patients ranging in age from 43 to 78 years (median, 63 years). There were seven patients with stage IIA and 36 with stage III. Irradiation from 46 Gy to 63 Gy (median, 54 Gy) was carried out 5 days per week, 1.8 Gy once a day. There were eight patients with neo-adjuvant chemotherapy, and we mostly used 5-fluorouracil, cisplatin with 3 cycles for concurrent chemotherapy. The range of follow up periods was from 2 to 82 months (median, 15.5). Results: There were nine patients that exhibited a cornplete response, 23 that exhibited a partial response, 9 that exhibited no response, and 2 that exhibited disease progression. The median survival time was 15 months. Two-year and 5-year survival rates were 36.5% and 17.3%, respectively. Two-year and 5-year disease-free survival rates were 32.4% and 16%, respectively. Treatment failure occurred in 22 patients (51.2%). Patterns of failure were categorized as local failure in 18 patients and distant metastasis in four patients. In a univariate analysis for prognostic factors related to overall survival and disease-free survival, the hemoglobin levels during chemoradiotherapy (${\geq}$ 12 vs. <12, p=0.02(p=0.1) and the response to the treatments (CR/PR vs. NR/PD, p=0.002/p< 0.0001) were statistically significant. In a multivariate analysis, only response to the treatments was revealed to be statistically significant. There was no statistical significance associated with patient age, gender, disease stage, T-stage, smoking history, tumor location, or neo-adjuvant chemotherapy. Conclusion: Our survival rate was similar to those of other institutions. Local recurrence was the main reason for failure. It is suggested that further prospective studies should be performed to improve local control.
In this paper classifies the types of 228 anchor stones discharged from the west and south coasts, assumes a combined method by type, routes through discharge locations, and It attempted to estimate the burial site. Prior to classification of types, the weight, thickness, width, and length of the anchor stone were measured, and the largest Young in the tomb The scent weight was classified into I~V groups, and the shape of the anchor stone was classified into 1-6 types. All of these weight and shape correlations It was classified into 17 types. The combined method by type is 180kg or less depending on the morphological characteristics of the reference value of the extracted anchor stone, and the type An anchor of type 1 or 2 is used in combination with an anchor, and a anchor of type 3 or 6 weighs more than 180kg and is combined with an anchor The dragon was assumed to be an anchor. Along with this, the route and burial site are identified through past records and testimony of local residents It was checked against the data. The route was largely consistent with past records, but the new route was apparent in waters near the island or inland It was also drawn. In the case of burial sites, small and large in Taean Mado Sea and Jindo Byeokpajin Sea, where anchor stones are concentrated, Considering the pattern of the type anchor stones being discharged, it was consistent with the testimony that ships of various sizes were mysterious in the two seas. Based on this type classification, a study on the spatiality of the anchors was conducted. First, a comparison and analysis was done on whether actual real data, such as anchor stones, old ships, and relics, were identified on the Joun-ro route and international trade routes as recorded in the past literature. Where there was no record, the route was estimated based on real data. To this end, routes estimated based on the testimony of local residents and modern ship workers were analyzed as to whether ships traveled there in the past and whether they could actually sail. Next, the location of each seedling was estimated by ship size according to the weight of the anchor stone. In the case of the Taean Mado Sea and Jindo Byeokpajin Sea, both small and large anchor stones were discharged from the coastline and were far away.
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