• Title/Summary/Keyword: quality evaluation index

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Analysis on the Dosimetric Characteristics of Tangential Breast Intensity Modulated Radiotherapy (유방암의 접선 세기조절 방사선치료 선량 특성 분석)

  • Yoon, Mee Sun;Kim, Yong-Hyeob;Jeong, Jae-Uk;Nam, Taek-Keun;Ahn, Sung-Ja;Chung, Wong-Ki;Song, Ju-Young
    • Progress in Medical Physics
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    • v.23 no.4
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    • pp.219-228
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    • 2012
  • The tangential breast intensity modulated radiotherapy (T-B IMRT) technique, which uses the same tangential fields as conventional 3-dimensional conformal radiotherapy (3D-CRT) plans with physical wedges, was analyzed in terms of the calculated dose distribution feature and dosimetric accuracy of beam delivery during treatment. T-B IMRT plans were prepared for 15 patients with breast cancer who were already treated with conventional 3D-CRT. The homogeneity of the dose distribution to the target volume was improved, and the dose delivered to the normal tissues and critical organs was reduced compared with that in 3D-CRT plans. Quality assurance (QA) plans with the appropriate phantoms were used to analyze the dosimetric accuracy of T-B IMRT. An ionization chamber placed at the hole of an acrylic cylindrical phantom was used for the point dose measurement, and the mean error from the calculated dose was $0.7{\pm}1.4%$. The accuracy of the dose distribution was verified with a 2D diode detector array, and the mean pass rate calculated from the gamma evaluation was $97.3{\pm}2.9%$. We confirmed the advantages of a T-B IMRT in the dose distribution and verified the dosimetric accuracy from the QA performance which should still be regarded as an important process even in the simple technique as T-B IMRT in order to maintain a good quality.

A study of the plan dosimetic evaluation on the rectal cancer treatment (직장암 치료 시 치료계획에 따른 선량평가 연구)

  • Jeong, Hyun Hak;An, Beom Seok;Kim, Dae Il;Lee, Yang Hoon;Lee, Je hee
    • The Journal of Korean Society for Radiation Therapy
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    • v.28 no.2
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    • pp.171-178
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    • 2016
  • Purpose : In order to minimize the dose of femoral head as an appropriate treatment plan for rectal cancer radiation therapy, we compare and evaluate the usefulness of 3-field 3D conformal radiation therapy(below 3fCRT), which is a universal treatment method, and 5-field 3D conformal radiation therapy(below 5fCRT), and Volumetric Modulated Arc Therapy (VMAT). Materials and Methods : The 10 cases of rectal cancer that treated with 21EX were enrolled. Those cases were planned by Eclipse(Ver. 10.0.42, Varian, USA), PRO3(Progressive Resolution Optimizer 10.0.28) and AAA(Anisotropic Analytic Algorithm Ver. 10.0.28). 3fCRT and 5fCRT plan has $0^{\circ}$, $270^{\circ}$, $90^{\circ}$ and $0^{\circ}$, $95^{\circ}$, $45^{\circ}$, $315^{\circ}$, $265^{\circ}$ gantry angle, respectively. VMAT plan parameters consisted of 15MV coplanar $360^{\circ}$ 1 arac. Treatment prescription was employed delivering 54Gy to recum in 30 fractions. To minimize the dose difference that shows up randomly on optimizing, VMAT plans were optimized and calculated twice, and normalized to the target V100%=95%. The indexes of evaluation are D of Both femoral head and aceta fossa, total MU, H.I.(Homogeneity index) and C.I.(Conformity index) of the PTV. All VMAT plans were verified by gamma test with portal dosimetry using EPID. Results : D of Rt. femoral head was 53.08 Gy, 50.27 Gy, and 30.92 Gy, respectively, in the order of 3fCRT, 5fCRT, and VMAT treatment plan. Likewise, Lt. Femoral head showed average 53.68 Gy, 51.01 Gy and 29.23 Gy in the same order. D of Rt. aceta fossa was 54.86 Gy, 52.40 Gy, 30.37 Gy, respectively, in the order of 3fCRT, 5fCRT, and VMAT treatment plan. Likewise, Lt. Femoral head showed average 53.68 Gy, 51.01 Gy and 29.23 Gy in the same order. The maximum dose of both femoral head and aceta fossa was higher in the order of 3fCRT, 5fCRT, and VMAT treatment plan. C.I. showed the lowest VMAT treatment plan with an average of 1.64, 1.48, and 0.99 in the order of 3fCRT, 5fCRT, and VMAT treatment plan. There was no significant difference on H.I. of the PTV among three plans. Total MU showed that the VMAT treatment plan used 124.4MU and 299MU more than the 3fCRT and 5fCRT treatment plan, respectively. IMRT verification gamma test results for the VMAT plan passed over 90.0% at 2mm/2%. Conclusion : In rectal cancer treatment, the VMAT plan was shown to be advantageous in most of the evaluation indexes compared to the 3D plan, and the dose of the femoral head was greatly reduced. However, because of practical limitations there may be a case where it is difficult to select a VMAT treatment plan. 5fCRT has the advantage of reducing the dose of the femoral head as compared to the existing 3fCRT, without regard to additional problems. Therefore, not only would it extend survival time but the quality of life in general, if hospitals improved radiation therapy efficiency by selecting the treatment plan in accordance with the hospital's situation.

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Microbial Analysis and Safety Evaluation in the Process of Packaged Tofus (포장두부의 가공공정에서 미생물 분석 및 안전성 평가)

  • Wang, Soun-Nam;Choi, Sung-Won;Hur, Nam-Yoon;Baik, Moo-Yeol;Lee, Han-Seung;Kim, Chang-Nam
    • Journal of Life Science
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    • v.19 no.4
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    • pp.486-491
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    • 2009
  • This study was conducted to investigate microbial distribution in the processing steps and to estimate quality index and shelf life of packaged Tofu (soybean curd). Sanitation and safety of Tofu were analysed in aspects of total viable counts (TVCs) and coliforms. Organoleptic deterioration was observed from some packaged Tofu when their TVCs were over $10^6\;CFU/g$. The controlled simply packaged Tofu and sterilized Tofu with TVCs of under $10^5\;CFU/g$ were 32.0% and 86.9% of the total samples, respectively. Also, the controlled simply packaged Tofu and sterilized Tofu with negative coliforms were 12.0% and 83.7% of the total samples, respectively. TVCs and coliforms increased in some processing steps, which include washing and soaking of raw soybeans, and formation and 1st cooling of packaged Tofu. Increases of TVCs and coliforms in the washing and soaking step were due to contamination from the soaking tank and airborne bacteria, whereas increases of TVCs and coliforms in the grinding step were due to contaminations from the grinder, line and reserving tank. TVCs and coliforms increased in the formation and 1st cooling step of packaged Tofu due to contaminations from filter wools, trays, employee's hands, cooling water, formed products and filter wools.

Water Chemistry Characteristics and Fish Fauna of Sodo Stream Watershed in Taebaeksan Provincial Park (태백산 도립공원 내 소도천 수계의 이·화학적 수질 특성 및 어류상)

  • Han, Jeong-Ho;Paek, Woon Kee
    • Korean Journal of Environment and Ecology
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    • v.30 no.1
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    • pp.71-80
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    • 2016
  • The fauna of freshwater fish and water chemistry characteristics were investigated from June, 2014 to October, 2014 at 10 sites in Taebaeksan Provincial Park. A total of 7 species under three families were collected from the survey sites and among them one endangered species - Koreocobitis naktongensis - was identified. The endemic species of Korea were 2 species: Koreocobitis naktongensis, Iksookimia koreensis. Dominant species was Rhynchocypris oxycephalus(89%) and subdominant species was Orthrias nudus(8.9%). Water quality including conductivity, turbidity, pH and total dissolved solids(TDS) varied largely depending on the sampling locations. Values of ambient conductivity and TDS were greater in the upstream than in the downstream, and seasonal variabilities were also higher in the upstream. The pH decreased towards the downstream, and especially showed a sharp decrease in S5. This phenomenon was evident due to a dilution by the influx in the acid mine drainage(AMD) of S4. Physical habit conditions, based on qualitative habitat evaluation index(QHEI) model, indicated a "Sub-optimal" condition(mean: 157.3; range: 78 ~ 194) in the Sodo stream watersheds.

Effects of Mindfulness Based Stress Reduction Program on Depression, Anxiety and Stress in Patients with Aneurysmal Subarachnoid Hemorrhage

  • Joo, Hye-Myung;Lee, Sung-Jae;Chung, Yong-Gu;Shin, Il-Young
    • Journal of Korean Neurosurgical Society
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    • v.47 no.5
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    • pp.345-351
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    • 2010
  • Objective : In this study, the Mindfulness Based Stress Reduction (MBSR) program was applied to patients presenting with depression and anxiety after surgery from spontaneous subarachnoid hemorrhage (SAH) and the effects were assessed. Methods : The subjects were patients admitted for cerebral aneurysm rupture and treated by means of surgery from March to December, 2007. More than 6 months had passed after surgery, without any special lesions showing up on computed tomography (CT), and the Glasgow outcome scale (GOS) was 5 points. Among patients with anxiety and depression symptoms, 11 patients completed the program. The MBSR program was conducted once a week, 2.5 hours each, for 8 weeks. The evaluation criteria were : 1) the Beck Depression Inventory (BDI): it measures the type and level of depression, 2) the State-Trait Anxiety Inventory : the anxiety state of normal adults without mental disorder, and 3) Heart Rate Variability (HRV) : the influence of the autonomous nervous system on the sinoarterial node varies continuously in response to the change of the internal/external environment. Results : The BDI value was decreased from 18.5 ${\pm}$ 10.9 to 9.5 ${\pm}$ 7.1 (p = 0.013) : it was statistically significant, and the depression level of patients was lowered. The state anxiety was decreased from 51.3 ${\pm}$ 13.9 to 42.3 ${\pm}$ 15.2; the trait anxiety was reduced from 50.9 ${\pm}$ 12.3 to 41.3 ${\pm}$ 12.8, and a borderline significant difference was shown (p = 0.091, p = 0.056). In other words, after the treatment, although it was not statistically significant, a decreased tendency in anxiety was shown. In the HRV measurement, standard deviation normal to normal (SDNN), square root of the square root of the mean sum of squared differences between adjacent normal to normal intervals (RMSSD), and total power (TP) showed significant increase, Physical Stress Index (PSI) showed a significant reduction, and thus an improvement in the homeostatic control mechanism of the autonomic nervous system was ween. Conclusion : The MBSR program was applied to the patients showing anxiety and depression reaction after SAH treatment, and a reduction in depression symptoms and physiological reactions were observed. The application of the MBSR program may be considered as a new tool in improving the quality of life for patients after surgery.

Assessment of Nutritional Status in Elderly Dialysis Patients (노인 투석환자의 영양상태 평가)

  • 노유자;하혜정;고혜영;박옥순
    • Journal of Korean Academy of Nursing
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    • v.26 no.2
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    • pp.304-319
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    • 1996
  • It is important to evaluate nutritional status of elderly patients receiving dialysis, since wasting and malnutrition are their common problems. This study aims at assessing their nutritional status by the type and duration of dialysis. The nutritional status such as somatic fat and protein storage was evaluated with anthropometric measure including weight/height ratio, triceps skinfold thickness and midarm muscle circumference. It was also measured with albumin, transferrin, C3 and IGF-1 and calorie and protein intakes. The general clinical condition of patients was evaluated with the severity of uremia and metabolic acidosis. which were measured through the levels of serum urea, creatinine and bicarbonateion. The data were analyzed by using t-test, ANOVA, Wilcoxon-rank sums test, Scheffe test, Kruskal-Wallis test and Pearson correlation coefficients. The results are following : 1. There was no significant difference in the calorie and protein intakes by the type and duration of dialysis received. 2. As for the anthropometric measures, no significant difference was found by the type of dialysis in body mass index triceps skinfold thickness and midarm muscle circumference. Yet these anthropometric measures differed significantly by the duration of dialysis in those elderly patients receiving hemodialysis(HD group), but this finding was not found in those receiving continuous ambulatory peritoneal dialysis(CAPD). 3. Regarding the indicators of uremia and metabolic acidosis, blood urea nitrogen(BUN) and creatinine were lower in the CAPD group than in the HD group, whereas bicarbonate ion was higher in the CAPD group than in the HD group, with no statistical significance. In the HD group, creatinine increased significantly with the increase of the duration of dialysis. 4. Serum trasferrin and C3 were significantly higher in the CAPD group than in the HD group. However. each of biochemical indices did not show statistical significance by the duration of dialysis in both HD and CAPD groups. 5. Anthropometric measures were significantly associated with dietary intake. Significant correlations were observed between biocarbonate ion, BUN and creatinine. In addition, the correlations between serum protein and albumin and between transferrin and C3 were statistically significant. Yet, IGF-1 revealed no significant correlation with other nutritional indices. The above findings indicate that there were no difference in nutritional status measured with protein and calorie intakes between the type and duration of dialysis, but CAPD seems to benefit correcting uremia and metabolic acidosis than HD. Studies of dietary management for dialysis patients need to be pursued in order to improved the quality of aged patients receiving dialysis.

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Analysis of Productivity in Rice Plant II Evaluation of Canopy Structure and Canopy Score (벼의 생산력(生産力) 분석(分析) II 생산구조(生産構造) 평가(評價)와 군낙평점(群落評點))

  • Park, Hoon;Kim, Yung Sup;Yoon, Jong Hyuk
    • Korean Journal of Soil Science and Fertilizer
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    • v.5 no.1
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    • pp.9-15
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    • 1972
  • Comparative analyses of canopy structure were conducted using newly bred high yield rice cultivars (IR 667-Suwon 213 and 214) and commercial varieties (Jinhung and Paldal) under the field condition. "Canopy score" as criteria of canopy structure was proposed. The results were summerized as follows: 1. IR667 line (IR8${\times}$Taichung Native 1${\times}$Yukara) showed lower canopy height, greater tiller openness, smaller leaf openness and leaf length ratio (flag leaf/3rd), shorter 4th and 5th internode length, greater diameter of 5th internode, consequently greater leaf area index, panicle weight and leaf weight ratio (leaf/leaf sheathculm) as merits, and greater leaf width, smaller leaf number(number of leaf/$m^2$)and specific leaf area($cm^2/g$) and faster destruction of canopy by senescence as demerits comparing with commercial varieties. 2. IR 667 line showed much higher "Canopy score", subsequently higher yield. 3. The quality of individual leaf was better in the commercial varieties indicating that the best combination for the better yield would be the leaf of commercial varieties with the structure of IR667 line.

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Nutritional Status of the Oldest-elderly Population in Sunchang County (순창군 장수인의 영양섭취 실태)

  • Lee, Mee-Sook
    • Korean Journal of Community Nutrition
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    • v.14 no.3
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    • pp.255-265
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    • 2009
  • This study was investigated nutrient intakes and dietary evaluation index of the healthy subjects over 85 of Sunchang County to explore the improved dietary pattern for healthy aging of the elderly. The survey was conducted by personal interview to 161 elderly subjects (59 males and 102 females over 85) in 2006, and their daily dietary intake was assessed by 24-hr recalls and weighing one meal. The daily energy intakes of males were 1,335 ${\pm}$ 67 kcal, and those of females were 1,095 ${\pm}$ 38 kcal comprised of 66.8% and 68.4% of the EER for the age group of 75. The proportions of energy from carbohydrate : protein : lipid were 70.7 : 14.6 : 14.6 for males and 68.6 : 14.0 : 17.4 for females. The average protein intakes were 95.4% for males and 85.0% for females of RI, and the average calcium intakes were 54.3% for males and 43.6% for females of RI. The daily vitamin intakes were below 70% except vitamin A, vitamin $B_6$, and vitamin E. The proportion of the relative risk groups of protein, phosphate, iron and vitamin A ranged 40-49% of RI over 75 year groups. The other nutrient intakes showed that there were over 50% risk groups. Especially for nutrients such as calcium, vitamin $B_1$, vitamin $B_2$, vitamin C, folate and niacin over 70% of the subjects were under risk. The median value of all nutrient intakes did not reach AI. The INQ of nutrients were over 0.8 except for folate and vitamin C. Calcium intakes were relatively low and needed attention. However, the ratio of calcium and phosphate showed 1 : 1.6, which appeared to be superior to the other districts. The DVS were higher as the dietary balance scores, KDDS were higher, and the groups with high KDDS had high intakes of nutrients compared to the groups with low KDDS. The high risk groups as judged by simple nutrition screening test had lower nutrient intakes than the groups of middle risk or low risk groups. The subjects in Sunchang area had relatively low intakes of several nutrients. However, judging from the desirable patterns of the energy proportion from three major nutrients, ratio of calcium and phosphate and INQ of nutrients there is a possibility that extended healthy aging might be related to the quality of nutrients and relative ratio between nutrients. To improve nutrient status of the elderly of the surveyed area further application involving KDDS and DVS appeared to be required.

Quality Characteristics and Reduced Sugar Conditions of Yanggaeng Prepared with Steamed Liriopis Tuber Extract Using Response Surface Methodology (반응표면분석법을 이용한 증숙 맥문동 첨가 양갱의 품질 특성 및 당류 저감화 조건 연구)

  • Park, Chanyoung;Park, So Hae;Kim, Won Baek;Hwang, Ji Hoe;Lee, Heeseob
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.46 no.2
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    • pp.229-236
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    • 2017
  • This study was performed to optimize yanggaeng processing conditions prepared with different amounts of steamed Liriopis tuber (SLT) extract, sugar, and agar powder using response surface methodology. The experimental conditions were designed according to the central composite design with 16 experimental points, including two replicates for three independent variables. The experimental data on physicochemical properties, textural properties, and sensory evaluation were fitted to various models, and the accuracy of the equations was analyzed by ANOVA. Among the responses, pH, water content, sugar content, L-value, browning index, chewiness, gumminess, and sensory properties of appearance, color, sweetness, hardness, texture, and overall acceptability showed significant correlation with contents of SLT, sugar, and agar powder. From these results, optimum formulation of yanggaeng was calculated as follows: SLT 35 mL, sugar 55.23 g, and agar powder 3.39 g.

Determinant factors of Exercise behaviors in Patients with Arthritis (관절염 환자의 운동행위 결정요인)

  • Suh, Gil-Hee;Lim, Nan-Young
    • Journal of muscle and joint health
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    • v.7 no.1
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    • pp.102-130
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    • 2000
  • The aims of this study were to understand and to predict the determinant factors affecting the exercise behaviors and physical fitness by testing the Ponder's health promotion model, and to help the patients with rheumatoid arthritis and osteoarthritis perform the continuous exercise program, and to help them maximize the physical effect such as muscle strength. endurance, and fuctional status and mental effects including self efficacy and quality of life, and improve the physical and mental wellbeing, and to provide a basis for the nursing intervention strategies. We analyzed the clinical records of 208 patients with rheumatoid arthritis and degenerative arthritis who visited the outpatient clinics at H university hospital in Seoul between October 5, 1999 and October 24, 1999. Data were composed of self reported questionnaire and good of fitness score which were obtained by pedalling the ergometer of bicycle for 9 minutes. SPSS Win 8.0 and Window LISREL 8.12a were used for statistical analysis. 24 Of 54 hypothetical paths were supported in modified model, which was considered as a proper model with improved fit index. The physical fitness was directly influenced by exercise participation behavior and education level, and indirectly by physical fitness, while fatigue, physical disability, pastexercise behavior, life-style, self-efficacy, which explained 20% of physical fitness. The exercise participation were directly influenced by perceived benefits and self-efficacy, and indirectly influenced by life-style, fatigue and physical disability, and directly and indirectly by past exercise behavior, which explained 53% of exercise participation. Exercise score were directly affected by perceived health status, perceived benefits, self efficacy, and past exercise behavior, and were indirectly affected by fatigue, physical disability, and life-style, which explained 50%. Perceived health status were directly influeced by level of education, depression, sleep disorder, and physical disability, which explained 34% of perceived health status. Perceived benefit was directly influenced by fatigue, sleep disorder, physical disability, and life-style, which explained 45%. Perceived barriers was directly influenced by fatigue, sleep disorder, and lifestyle, which explained 9%. Self- efficacy was directly influenced by fatigue, physical disability, past exercise behavior, and level of education, which explained 61%. In conclusion, important variables for physical fitness were exercise participation and level of education, and variables affecting exercise participation were perceived self-efficacy, benefits, and past exercise behavior. Perceived self-efficacy of exercise was a significant predictor of exercise participation. Life-style, fatigue, and physical disability showed direct effects on perceived benefit, perceived barriers, and self-efficacy, and indirect effects on exercise behavior. Therefore, disease related factor should be minimized for physical performance and well being in nursing intervention for patients with rheumatoid arthritis, and plans to promote and continue exercise should be soaked to reduce disability. In addition, Exercise program should be planned and performed by the exact evaluation of exercise according to the ability of the patients and the contents to improve the importance of exercise and self efficacy in self control program, dedicated educational program should be involved.

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