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Standardization of the Method of Measuring Average Glandular Dose (AGD) and Evaluation of the Breast Composition and Thickness for AGD (평균 유선선량 측정방법의 표준화 및 유방 두께, 실질양상과의 상관관계 분석)

  • Park, Hye-Suk;Kim, Hee-Joung;Lee, Chang-Lae;Cho, Hyo-Min;Yu, A-Ram
    • Progress in Medical Physics
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    • v.20 no.1
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    • pp.21-29
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    • 2009
  • Breast cancer is the most common form of cancer among korean woman. Therefore, the early detection activities of breast cancer such as breast self-examinations, clinical breast examinations, mammography are important. A yearly mammography examination has been recommended for women aged 40 and older for the early detection of breast cancer in asymptomatic periods. However, the glandular tissue of breast is the most radiation-sensitive tissue, and the determination of average glandular dose (AGD) forms an important part of the quality control of the mammographic systems. Because of the difficulty of estimating AGD directly, it is often estimated from the measurements of the incident air kerma and by applying the appropriate conversion factors. The primary objective of this study was to standardize the method of measuring AGD. The secondary objective was to evaluate the relationships between AGD per various composition and thickness of the breast using Monte Carlo simulations. As a result, we standardized the method of measuring AGD according to International Atomic Energy Agency (IAEA) guidelines (CoP: an international code of practice). Overall, AGD for mammographic practice in Korea was less than 3.0 mGy recommended by the Korea Food and Drug Adminstration (KFDA) protocol, and Korean Institute for Accreditation of Medical Image (KIAMI). The measured and simulated AGD for a given condition were calculated as 1.7 and 1.6 mGy, respectively. For the AGDs obtained, there was no significant difference between them. The simulated AGD was dependent on the fraction of glandular tissue of the breast. The AGD increases with increasing of the breast glandularity due to increasing absorption of low energy photons. The AGD also increases as a function of breast thickness. In conclusion, the results of this study could be used as a baseline to establish a reference level of radiation dose in mammography.

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"Legal Study on Boundary between Airspace and Outer Space" (영공(領空)과 우주공간(宇宙空間)의 한계(限界)에 관한 법적(法的) 고찰(考察))

  • Choi, Wan-Sik
    • The Korean Journal of Air & Space Law and Policy
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    • v.2
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    • pp.31-67
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    • 1990
  • One of the first issues which arose in the evolution of air law was the determination of the vertical limits of airspace over private property. In 1959 the UN in its Ad Hoc Committee on the Peaceful Uses of Outer Space, started to give attention to the question of the meaning of the term "outer space". Discussions in the United Nations regarding the delimitation issue were often divided between those in favour of a functional approach ("functionalists"), and those seeking the delineation of a boundary ("spatialists"). The functionalists, backed initially by both major space powers, which viewed any boundary as possibly restricting their access to space(Whether for peaceful or military purposes), won the first rounds, starting with the 1959 Report of the Ad Hoc Committee on the Peaceful Uses of Outer Space which did not consider that the topic called for priority consideration. In 1966, however, the spatialists, were able to place the issue on the agenda of the Outer Sapce Committee pursuant to Resolution 2222 (xxx1). However, the spatialists were not able to present a common position since there existed a variety of propositions for delineation of a boundary. Over the years, the funtionalists have seemed to be losing ground. As the element of location is a decisive factor for the choice of the legal regime to be applied, a purely functional approach to the regulation of activities in the space above the Earth does not offer a solution. It is therefore to be welcomed that there is clear evidence of a growing recognition of the defect inherent to such an approach and that a spatial approach to the problem is gaining support both by a growing number of States as well as by publicists. The search for a solution of the problem of demarcating the two different legal regimes governing the space above the Earth has undoubtedly been facilitated, and a number of countries, among them Argentina, Belgium, France, Italy and Mexico have already advocated the acceptance of the lower boundary of outer space at a height of 100km. The adoption of the principle of sovereignty at that height does not mean that States would not be allowed to take protective measures against space activities above that height which constitute a threat to their security. A parallel can be drawn with the defence of the State's security on the high seas. Measures taken by States in their own protection on the high seas outside the territorial waters-provided that they are proportionate to the danger-are not considered to infringe the principle of international law. The most important issue in this context relates to the problem of a right of passage for space craft through foreign air space in order to reach outer space. In the reports to former ILA Conferences an explanation was given of the reasons why no customary rule of freedom of passage for aircraft through foreign territorial air space could as yet be said to exist. It was suggested, however, that though the essential elements for the creation of a rule of customary international law allowing such passage were still lacking, developments apperaed to point to a steady growth of a feeling of necessity for such a rule. A definite treaty solution of the demarcation problem would require further study which should be carried out by the UN Outer Space Committee in close co-operation with other interested international organizations, including ICAO. If a limit between air space and outer space were established, air space would automatically come under the regime of the Chicago Convention alone. The use of the word "recognize" in Art. I of chicago convention is an acknowledgement of sovereignty over airspace existing as a general principle of law, the binding force of which exists independently of the Convention. Further it is important to note that the Aricle recognizes this sovereignty, as existing for every state, holding it immaterial whether the state is or is not a contracting state. The functional criteria having been created by reference to either the nature of activity or the nature of the space object, the next hurdle would be to provide methods of verification. With regard to the question of international verification the establishment of an International Satelite Monitoring Agency is required. The path towards the successful delimitation of outer space from territorial space is doubtless narrow and stony but the establishment of a precise legal framework, consonant with the basic principles of international law, for the future activities of states in outer space will, it is still believed, remove a source of potentially dangerous conflicts between states, and furthermore afford some safeguard of the rights and interests of non-space powers which otherwise are likely to be eroded by incipient customs based on at present almost complete freedom of action of the space powers.

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Periodontal Response According to the Timing of Orthodontic Force Application alter Bone Graft into Angular Bony Defect in the Dog (성견에서 수직적 골결손부에 골이식후 교정력 적용시기에 따른 치주조직의 반응)

  • Lee, Sang-Yeol;Lee, Ki-Heon;Hwang, Hyeon-Shik
    • The korean journal of orthodontics
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    • v.31 no.3 s.86
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    • pp.369-379
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    • 2001
  • The aim of this study was to investigate the periodontal response according to the timing of orthodontic force application after bone graft into the angular bony defect. Nine dogs were divided into three groups, 2, 4, and 6 weeks, according to the timing of orthodontic force application after bone graft. Periodontal angular bony defects were created surgically at the distal aspect of both maxillary third incisors. Two weeks later, flap operation was performed to eliminate inflammation and reference notch was made on the root surface at the level of the bottom of each defect. Demineralized freeze-dried bone was implanted on the left side whereas only debridement was done on the other side. Experimental tooth movement was executed during 8 weeks on both graft and non-graft sides. After 2 weeks of retention period, animals were sacrificed for histologic specimens. The results were obtained as follows 1 New bone formation was more pronounced in the graft side than in the non-grad side in all experimental animals. 2. In the 6-week group, new bone and cementum formation was observed in more than half from the notch to the cemento-enamel junction, and the zone of connective tissue attachment was found without apical migration of junctional epithelium. 3. In the 4-week group, the amount of new bone formation was smaller than in the 6-week group whereas the overall remodeling pattern was similar. 4. New bone formation was confined to around the notch and the junctional epithelium migrated apically to the level of the notch with no connective tissue attachment and cementum formation in the 2-week group. The results of the present study suggest that periodontal response may be influenced by the timing of orthodontic force application after bone graft into angular bony defect.

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Clinical Application of in Vivo Dosimetry System in Radiotherapy of Pelvis (골반부 방사선 치료 환자에서 in vivo 선량측정시스템의 임상적용)

  • Kim, Bo-Kyung;Chie, Eui-Kyu;Huh, Soon-Nyung;Lee, Hyoung-Koo;Ha, Sung-Whan
    • Journal of Radiation Protection and Research
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    • v.27 no.1
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    • pp.37-49
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    • 2002
  • The accuracy of radiation dose delivery to target volume is one of the most important factors for good local control and less treatment complication. In vivo dosimetry is an essential QA procedure to confirm the radiation dose delivered to the patients. Transmission dose measurement is a useful method of in vivo dosimetry and it's advantages are non-invasiveness, simplicity and no additional efforts needed for dosimetry. In our department, in vivo dosimetry system using measurement of transmission dose was manufactured and algorithms for estimation of transmission dose were developed and tested with phantom in various conditions successfully. This system was applied in clinic to test stability, reproducibility and applicability to daily treatment and the accuracy of the algorithm. Transmission dose measurement was performed over three weeks. To test the reproducibility of this system, X-tay output was measured before daily treatment and then every hour during treatment time in reference condition(field size; $10 cm{\times} 10 cm$, 100 MU). Data of 11 patients whose pelvis were treated more than three times were analyzed. The reproducibility of the dosimetry system was acceptable with variations of measurement during each day and over 3 week period within ${\pm}2.0%$. On anterior- posterior and posterior fields, mean errors were between -5.20% and +2.20% without bone correction and between -0.62% and +3.32% with bone correction. On right and left lateral fields, mean errors were between -10.80% and +3.46% without bone correction and between -0.55% and +3.50% with bone correction. As the results, we could confirm the reproducibility and stability of our dosimetry system and its applicability in daily radiation treatment. We could also find that inhomogeneity correction for bone is essential and the estimated transmission doses are relatively accurate.

The Etiologic Agents and Clinical Outcomes of Adult Community-acquired Pneumonia in Jeju (제주지역 성인 지역사회획득 폐렴의 원인균 및 임상양상)

  • Jeon, Bong-Hee;Kim, Miok;Kim, Jeong Hong;Shin, Sang Yop;Lee, Jaechun
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.5
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    • pp.358-364
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    • 2009
  • Background: The appropriate empirical antimicrobial choice in the treatment of community-acquired pneumonia (CAP) should be advocated by community-based information on the etiologic pathogens, their susceptibility to antimicrobials, clinical characteristics and outcomes. Jeju is a geographically isolated and identical region in Korea. However, there is no regional reference on adult CAP available. This study investigated the etiologic agents and clinical outcomes of adult patients diagnosed with CAP in Jeju, Korea, to help guide the empirical antimicrobial choice. Methods: A prospective observational study for one year in a referral hospital in Jeju, Korea. Patients diagnosed with CAP were enrolled with their clinical characteristics. Microbiological evaluations to identify the etiologic agents in the adult patients with CAP were performed with blood culture, expectorated sputum smear and culture, antibody tests for mycoplasma, chlamydophila, and antigen tests for legionella and pneumococcus. The clinical outcomes of the initial empirical treatment were analyzed. Results: Two hundred and three patients with mean age of 64 and 79 females were enrolled. Ten microbials from 90 cases (44.3%) were isolated and multiple isolates were confirmed in 30. Among the microbial isolates, S. pneumoniae (36.3%) was the most common, followed by M. pneumoniae (23.0%), C. pneumoniae (17.0%), S. aureus (9.6%) and P. aeruginosa (5.9%). The initial treatment failure (23.8%) was related to the isolation of polymicrobial pathogens, elevated inflammatory markers, and the presence of pleural effusion. Among the 30 isolates of S. pneumoniae, 16 (53.3%) were not susceptible to penicillin, and 19 isolates (63.3%) to erythromycin and clarithromycin. However, 29 isolates (96.7%) were susceptible to levofloxacin and ceftriaxone. Conclusion: S. pneumoniae, M. pneumoniae, S. aureus, and P. aeruginosa are frequent etiologic agents of adult CAP in Jeju, Korea. The clinical characteristics and antibiotic resistance should be considered when determining the initial empirical antimicrobial choice. Respiratory quinolone or ceftriaxone is recommended as an empirical antimicrobiotic in the treatment of adult CAP in Jeju, Korea.

The Cut-off Values and Related Factors for Serum Total Cholesterol in Normal Korean Adults (정상 성인에서 총콜레스테롤의 분별치와 관련 요인)

  • 홍인선;김지식;여영규
    • Biomedical Science Letters
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    • v.2 no.2
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    • pp.187-198
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    • 1996
  • The cut-off values and related factors for total cholesterol of serum in normal Korean adults were studied from March to October, 1995, based on the data of 1,818 healthy adults of human involved the male and female. The comparisons of the serum total cholesterol levels were analyzed by sex, age, systolic blood pressure, diastolic blood pressure, body weight, height, PIBW, BMI and other biochemical tests. 1. The serum total cholesterol level were 194.4 mg/dl in total group, 186.9 mg/dl for male, and 197.6 mg/dl for female. 2. There was no significant differences by sex among the 21 to 50 ages group, but significantly higher in women than in men over 51 years old. 3. In general, the levels of serum total cholesterol were increased with age, the highest level in men was 192.7 mg/ dl in 51 to 60 years old, and 210.5 mg/dl in more than 60 years old in women. 4. The cut-off values of serum total cholesterol for moderate risk were 191 mg/dl in 21 to 30 years group, 195 mg/dl in 31 to 40 years,214 mg/dl in 41 to 50 years, 227 mg/dl in 51 to 60 years, and 222 mg/dl in more than 61 years. The cut-off values of serum total cholesterol for high risk were 214 mg/dl dl in 21 to 30 years group, 214 mg/dll in 31 to 40 years, 239 mg/dl in 41 to 50 years, 213 mg/dl in 51 to 60 years, and 248 mg/dl in more than 61 years. 5. The mean values of serum total cholesterol were showed positive correlation with age, PIBW, BMI, systolic blood pressure and diastolic blood pressure. 6. Serum total cholesterol level of drinking group(188.9$\pm$34.85mg/dl) was showed love. than those of non-drinking group(196.0$\pm$36.0 mg/dl). 7. Serum total cholesterol levels of regular excercise group(192.1$\pm$33.3 mg/dl) was significantly lower than those of non regular excercise group(195.8$\pm$37.0 mg/dl).

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Suggestion for Comprehensive Quality Assurance of Medical Linear Accelerator in Korea (국내 선형가속기의 포괄적인 품질관리체계에 대한 제언)

  • Choi, Sang Hyoun;Park, Dong-wook;Kim, Kum Bae;Kim, Dong Wook;Lee, Jaiki;Shin, Dong Oh
    • Progress in Medical Physics
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    • v.26 no.4
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    • pp.294-303
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    • 2015
  • American Association of Physicists in Medicine (AAPM) Published Task Group 40 report which includes recommendations for comprehensive quality assurance (QA) for medical linear accelerator in 1994 and TG-142 report for recommendation for QA which includes procedures such as intensity-modulated radiotherapy (IMRT), stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT) in 2010. Recently, Nuclear Safety and Security Commission (NSSC) published NSSC notification no. 2015-005 which is "Technological standards for radiation safety of medical field". This notification regulate to establish guidelines for quality assurance which includes organization and job, devices, methods/frequency/tolerances and action levels for QA, and to implement quality assurance in each medical institution. For this reason, all of these facilities using medical machine for patient treatment should establish items, frequencies and tolerances for proper QA for medical treatment machine that use the techniques such as non-IMRT, IMRT and SRS/SBRT, and perform quality assurance. For domestic, however, there are lack of guidelines and reports of Korean Society of Medical Physicists (KSMP) for reference to establish systematic QA report in medical institutes. This report, therefore, suggested comprehensive quality assurance system such as the scheme of quality assurance system, which is considered for domestic conditions, based the notification of NSSC and AAPM TG-142 reports. We think that the quality assurance system suggested for medical linear accelerator also help establishing QA system for another high-precision radiation treatment machines.

Normative data of penile length in Korean newborns (한국인 신생아 음경 길이에 대한 연구)

  • Kim, Sang Yeob;Jun, Jae Sung;Lee, Sang Geel
    • Clinical and Experimental Pediatrics
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    • v.51 no.9
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    • pp.944-949
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    • 2008
  • Purpose : As modern society has became more open, interest in healthy internal and external growth has increased, including that pertaining to penile length in children. A micropenis is defined as one where penile length is more than 2 SD (standard deviation) below the mean, and it can be traced back to chromosome and endocrine disorders. The authors executed this study to suggest guidelines for the study of the micropenis and standard information for penile length in Korean newborns. Methods : The subjects of this study were 168 male infants between 37 and 42 weeks of gestational age, none of whom had any complications during pregnancy or birth; each had been born in Daegu Fatima Hospital between February and June 2007. Penile length was measured using conventional stretched penile length measurement (CPLM) and syringe methods. Results : Penile length was $3.02{\pm}0.25cm$ (F=36.467, $R^2=0.180$, P<0.001) when measured with CPLM, and $3.29{\pm}0.26cm$ (F=9.149, $R^2=0.052$, P<0.001) with the syringe method. There was no statistically significant difference in the penile length of newborn infants as a result of taking measurements with the two methods, and both methods showed significance at 0.631 in terms of Pearson's correlation coefficient, at the level of P=0.01. Conclusion : In this study, penile length tended to be longer when gestational age was longer, and a micropenis can be assumed to be one less than 2.5 cm using CPLM and less than 2.8 cm using the syringe method. In the case of a concealed penis, the syringe method is helpful. When a micropenis is assumed, close observation by outpatient department personnel, and additional endocrine and chromosome studies should be undertaken after sufficiently consulting the parents.

Family History of Cancer and Head and Neck Cancer Risk in a Chinese Population

  • Huang, Yu-Hui Jenny;Lee, Yuan-Chin Amy;Li, Qian;Chen, Chien-Jen;Hsu, Wan-Lun;Lou, Pen-Jen;Zhu, Cairong;Pan, Jian;Shen, Hongbing;Ma, Hongxia;Cai, Lin;He, Baochang;Wang, Yu;Zhou, Xiaoyan;Ji, Qinghai;Zhou, Baosen;Wu, Wei;Ma, Jie;Boffetta, Paolo;Zhang, Zuo-Feng;Dai, Min;Hashibe, Mia
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.17
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    • pp.8003-8008
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    • 2015
  • Background: The aim of this study was to investigate whether family history of cancer is associated with head and neck cancer risk in a Chinese population. Materials and Methods: This case-control study included 921 cases and 806 controls. Recruitment was from December 2010 to January 2015 in eight centers in East Asia. Controls were matched to cases with reference to sex, 5-year age group, ethnicity, and residence area at each of the centers. Results: We observed an increased risk of head and neck cancer due to first degree family history of head and neck cancer, but after adjustment for tobacco smoking, alcohol drinking and betel quid chewing the association was no longer apparent. The adjusted OR were 1.10 (95% CI=0.80-1.50) for family history of tobacco-related cancer and 0.96 (95%CI=0.75-1.24) for family history of any cancer with adjustment for tobacco, betel quid and alcohol habits. The ORs for having a first-degree relative with HNC were higher in all tobacco/alcohol subgroups. Conclusions: We did not observe a strong association between family history of head and neck cancer and head and neck cancer risk after taking into account lifestyle factors. Our study suggests that an increased risk due to family history of head and neck cancer may be due to shared risk factors. Further studies may be needed to assess the lifestyle factors of the relatives.

Analysis of Tasks and Education Needs for Dental Hygienist for Development of Dental Hygiene Curriculum (치위생 교육과정 개발을 위한 치과위생사의 직무현황 및 교육요구도 분석)

  • Kim, Eung-Gwon;Lim, Soon-Hwan;Kwon, Mi-Young;Choi, Young-Yuhn;Han, Ji-Hyoung
    • Journal of dental hygiene science
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    • v.14 no.1
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    • pp.35-42
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    • 2014
  • In this study we analysed frequency and importance of tasks, and education needs of 114 people working in dental clinics to be a reference of dental hygiene curriculum development. The results are as follow: The order of performance frequency is management support, preventive dental treatment, dental treatment assistance and oral health education, and the order of importance level of tasks and education needs is management support, dental treatment assistance, preventive dental treatment and oral health education. There is no statistically significant difference of performance frequency by general characteristics. The tasks considered most important level depending on general characteristics are oral health education in age of 40s (p<0.05), dental treatment assistance in dental hygienists (p<0.05), management support in women (p<0.05), dental hygienists (p<0.05), and more experienced workers (p<0.05). The most need for Educations depending on general characteristics are oral health education in women (p<0.05), dental treatment assistance in women (p<0.001) and dental hygienists (p<0.001), and management support in Seoul region (p<0.05). The importance of tasks and education needs have correlations. The results showed management support and dental treatment assistance are considered important in dental clinics and most needed job competency for dental hygienists.