• Title/Summary/Keyword: stability period

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Development of Error Analysis Program for Phase-based Respiratory Gating Radiation Therapy (위상기반 호흡연동 방사선치료 시 오차 분석 프로그램 개발)

  • Song, Ju-Young;Nah, Byung-Sik;Chung, Woong-Ki;Ahn, Sung-Ja;Nam, Taek-Keun;Yoon, Mi-Sun
    • Progress in Medical Physics
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    • v.17 no.3
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    • pp.136-143
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    • 2006
  • The respiratory gating radiation therapy which Irradiates only in the stable respiratory period with analyzing the periodic motion of a reflective marker on the patient's abdomen has been applied to the precise radiation treatment in order to minimize the effect of organ motion induced by the respiration. This respiratory gating system establishes irradiation region using the amplitude-based or phase-based method. Although phase-based method Is preferred because of the stability in the real treatment conditions, it has some limits to explain the exact correlation between the marker motion and organ motion. Even when the variation of amplitude which can introduce target motion considered as an error is produced, the phase-based method has the possibility to irradiate including the error positions. In this study, the error analysis program was developed for the verification of the tumor position's variation correlated with the variation of marker's amplitude which can be occurred during a phase-based respiratory sating treatment. The analysis program was tested with a virtual treatment record file and with a record file using moving phantom which were modified considering the irregular amplitude's variation simulating the real clinical situations. In both cases, accurate discrimination of error points and error calculation were produced. When the treatment record files of a real patient were analyzed with the program, the accurate recognition and calculation of the error points were also verified. The analysis program developed in this study will be applied as a useful tool for the analysis of errors due to the irregular variation of patients' respiration during the phase-base respiratory gating radiation treatment.

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Menstrual Experience of Adolescent Girls (사춘기 여성들의 월경경험)

  • 정현숙
    • Journal of Korean Academy of Nursing
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    • v.26 no.2
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    • pp.257-270
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    • 1996
  • Studies on menstruation have focused only on menstruation itself and menstrual disorders. The menstruating girls or women have been neglected. So, the purpose of this study was to understand menstrual experience of adolescent girls in their perspective and build a theory on it, The specific purpose of this study were to find initial reaction of the girls, their strategies to adapt to menstruation. consequences of their efforts, influencing factor, and patterns of experience. The subjects of this study were eleven adolescent girls who experienced menarche three months to twenty-six months before the interview time. They were selected purposively. Their ages were in range of twelve and sixteen. One of them was a elementary school girl, three high school girls, and seven middle school girls. Two girls were handicapped because of cerebral palsy. All of them had some knowledge about menstrual physiology and hygiene during menstruation. Data were collected from September, 1994 to July, 1995. Data collection & analysis were done according to the grounded theory methodology by Strauss & Corbin(1990). Data collecting method was the long interviews and observation. Each interview took from 1 hour to 2 hours. Interview were tape-recorded and transcribed later by author. Data were analyzed immediately after interviews. Based on the results of previous interview, next interview were planned until gathered data reached the saturation point. Results were as follows. One hundred and six concepts were found. Those concepts were grouped into twenty eight categories and then fourteen higher categories. Twenty eight categories were as follows. “want to hide”, “bewildered”, “sense of burden”, “sense of heterogeneity”. “gladness”. “sense of superiority”, “negative empathy”, “positive empathy”, “limited hygenic control”, “sense of timing”, “lack of knowledge”, “lack of support”, “advance knowledge”, “informational support”, “emotional support”, “endurance”, “prayer”, “disclosing”, “avoidance”, “diversion”, “sense of powerlessness”, “discovery of sex identity”, “sense of maturation”, “sense of stability”, “acceptance of menstruation ”. fourteen higher categories were as follows. “negative feeling”, “posive feeling”, “exchange of feeling”, “limited hygenic control”, “sense of timing”, “accumulated experience”, “dysmenorrhea”, “level of knowledge”, “need for support”, “perceived support”, “sharing of feeling”, “self-control”, “passive acceptance”, “active acceptance”. The core category was “emotional shaking”, which consisted of “positive feeling” and “negative feeling”. “Emotional shaking”comes up to every adolescent girls experiencing menarche, independently of any contextual conditions, and its dimension has two directions : positive one and negative one. Its influencing factors were time of menarche, advance knowledge, support from the significant persons, expression and self-regulation. Even if they showed different process of adaptation to menstruation, general process of adaptation were as follows : 1. stage of emotional shaking 2. stage of acceptance 3. stage of internalization of the menstrual experience. Seven patterns existed on the process of adaptation to menstruation after menarche. Those are as follows. 1. If girls thought their menarche came too early and they had not much knowledge on menstruation, they had a kind of negative feeling. If they did not get enough support and dysmenorrhea superimposed, they came to accept menstruation passively. 2. If girls had menarche too early. they had negative feeling, even though they had enough advance knowledge. But support helped them accept menstruation easily. 3. If girls had menarche too early, they had negative feeling, even though they had enough advance knowledge on menstruation. But by experiencing subsequent menstruations and disclosing feeling, they began to accept menstruation. 4. If girls had menarche too lately and they had enough advance knowledge on menstruation. they had positive feeling. If dysmenorrhea superimposed later, their feeling turned in to negative one. But they came to accept menstruation positively by disclosing feeling and getting support. 5. If girls had menarche too early, they had negative feeling, even though they had enough advance knowledge on menstruation. In addition to this. if dysmenorrhes superimposed while they did not get enough support, they felt powerless and came to accept menstruation passively. 6. If girls had menarche too early and did not get enough advance knowledge, they had negative feeling. But disclosing feeling and support made them get sense of homogeneity and began to accept menstruation. 7. If girls had handicap, they had negative feeling, even though they had enough advance knowledge and menarche was late. But Menarche made them get feel sexual identity. Their limited hygenic control and negative empathy from their mothers made them accept menstruation passively. To let adolescent girls take their menstrual experience as a part of their lives forming a positive sense of feminine identity, it needs qualified teaching and, support and deep concern of the significant others. Nurses including school nurses should try to develop an educational program, which include menstrual physiology. hygiene during menstrual period, meaning of menstruation and impact of menstruation on the development of female sexual identity.

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Spectrophotometric Analysis of Crown Discoloration Induced by Various MTA Based Materials (분광분석법을 이용한 수종 MTA의 치관변색 평가)

  • Lim, Yuran;Choi, Namki;Kim, Jaehwan;Kim, Seonmi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.44 no.1
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    • pp.28-37
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    • 2017
  • Mineral trioxide aggregate have been used for many years as a pulp therapy material. The most widely used product, Proroot white $MTA^{(R)}$ has a major drawback that it causes tooth discoloration. This study assessed discoloration of crown when various MTA-based materials were placed in the coronal aspect of the root canal. Seventy-five single-rooted, unrestored premolar teeth were selected. The teeth were randomly assigned to four experimental groups, each of $Biodentine^{(R)}$, Proroot $wMTA^{(R)}$, $Endocem^{(R)}$, $RetroMTA^{(R)}$ and one negative control groups. Color measurements were utilized by the Commission International de I'Eclairage's L*a*b* system with spectrophotometer. The color was assessed eight times : initial, 1 day, 1 week, 2 weeks, 4 weeks, 8 weeks, 12 weeks, and 16 weeks after the placement. Statistical analysis was performed using the 2-way repeated analysis of variance and Bonferroni's method with p < 0.05. Proroot $wMTA^{(R)}$ induced significant decreases in $L^*$ values during experiment period. Tooth samples from the $Endocem^{(R)}$ group presented indistinct grayish color changes. The $Biodentine^{(R)}$ and $RetroMTA^{(R)}$ showed color stability. Consequently, while Proroot $wMTA^{(R)}$ and $Endocem^{(R)}$ that contain bismuth oxide as a radiopacifier showed tooth discoloration, displayed no sign of discoloration $Biodentine^{(R)}$ and $RetroMTA^{(R)}$ that contain zirconium oxide as a radiopacifier.

Effects of Addition of Gelatinized Wheat Flour Dough on Pan Bread (호화밀가루반죽의 첨가가 식빵 특성에 미치는 영향)

  • Kim, Won-Mo;Kim, Kee-Hyuk;Lee, Gyu-Hee
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.45 no.10
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    • pp.1467-1475
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    • 2016
  • To make soft and less stale bread, various amounts of gelatinized wheat flour dough were added for making pan bread. In the dough process, higher gelatinized wheat flour dough showed higher consistency and dough development time but a lower dough stability time. Expansion during fermentation represented the highest value upon addition of 10% gelatinized wheat flour dough (GWFD), and this value decreased with increasing amount of gelatinized wheat flour dough. Volume of bread was the highest in the control and lowest in 30% GWFD, and there was no difference between 10% GWFD and 20% GWFD. Moisture contents of bread made with various amounts of gelatinized wheat flour dough increased with increasing gelatinized wheat flour dough amount. Color values of bread made with various gelatinized wheat flour dough were not significantly different. Chewiness, brittleness, and hardness of bread made with control and 10% GWFD showed low values, whereas bread made with 20% GWFD and 30% GWFD showed high values. During storage, chewiness, brittleness, and hardness increased with increasing storage period in whole breads, whereas breads made with 10% GWFD showed the lowest increasing rate. In the sensory strength test, chewy texture increased upon addition of gelatinized wheat flour dough. In the consumer acceptance test, 10% GWFD showed the most overall acceptance. In conclusion, bread made with 10% gelatinized wheat flour dough is desirable for increasing softness and decreasing bread staling.

Middle and Long Term Results of 34 Cases of Emergency Coronary Artery Bypass Graft Surgery (응급 관상동맥 우회술 34예의 중장기 성적)

  • 손정환;김응중;지현근;신윤철;김건일;최광민;이원진;이원용
    • Journal of Chest Surgery
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    • v.36 no.10
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    • pp.741-747
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    • 2003
  • Background: Coronary artery bypass graf t (CABG) has been settled as most safe surgery among the open heart surgeries. However, in patients with cardiogenic shock, the emergency CABG has higher mortality than elective CABG. We analyzed thirty four patients who underwent emergency CABG and report the middle and long-term results. Material and Method: From June 1994 to December 2001, 34 patients who underwent emergency CABG at Kang-dong Sacred Heart Hospital were include in this study. On the basis of hospital databases and Out Patient Department (OPD) follow up data, preoperative diagnosis, risk factor, coronary artery anatomy, operation technique, postoperative mortality, complication, recurrence of symptom, and mid and long term mortality were analyzed retrospectively. Result: Indications for emergency CABG were 29 cardiogenic shocks (85.3%), 4 intractable chest pains (11.8%), and 1 polymorphic ventricular tachycardia (2.9%). Preoperative angiographic diagnoses were triple vessel disease in 16 (47.1%) and left main disease in 8 (23.5%) patients. We used saphenous vein grafts in 81 and left internal thoracic artery grafts in 14 anastomosis. The mean number of grafts per patients was 2.8$\pm$0.8. The mean aortic cross clamp time was 91.9$\pm$34.6 minutes and the mean cardiopulmonary bypass time was 262.7$\pm$198.3 minutes. Early mortality was 50% and the most common cause of early mortality was low cardiac output in 7 (20.6%) patients. The mean follow-up period was 30.9$\pm$35.7 months. There were no recurrences of symptom and late mortality. Conclusion: In the case of emergency operation, aggressive and proper management with drugs and IABP should be done for preoperative hemodynamic stability and early surgical intervention is the most important factor for patient salvage.

Development and Evaluation of the Supplementary Foods for Korean Infants and Children (지역 식품을 이용한 이유 보충식의 개발과 이의 영양학적 검토 및 저장성에 관한 연구)

  • Ahn, Kyung-Mi;Moon, Soo-Jae;Choi, Hong-Sik;Kwak, Tong-Kyung
    • Journal of Nutrition and Health
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    • v.18 no.4
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    • pp.259-271
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    • 1985
  • The purpose of this study was to develop supplementary foods for infants and young children in order to improve their nutritional status. Three formulas composed of rice, soybeans, fish, dry skim milk and sesame in varying proportions were studied. The three formulas, $RS_{1}S_{2}$, $RFS_{1}S_{2}$, and $RMS_{1}S_{2}$, were consisted of Rice(R), Soybean$(S_{1})$, Sesame$(S_{2})$ (60 : 35 : 5) , Rice, Fish(F), Soybean, Sesame (60 : 10 : 25 : 5) , and Rice, Dry Skin Milk (M), Soybean, Sesame (60 : 10 : 25 : 5), respectively. A proximate analysis and amino acid determination were made on the developed formulas. In the animal assay, growth rate, PER and FER were evaluated and biochemical analyses were also carried out. A storage test and the cost evaluation were also conducted. The summarized results are as follows : 1) The proximate composition of the three formulas were 7.3-7.4% of moisture, 15.9-21.5% of crude protein, 7.8-9.6% of crude fat and 2.5-2.8% ash. 2) The result of amino acid analysis showed that the 1st limiting amino acids of $RS_{1}S_{2}$ and $RFS_{1}S_{2}$ were lysine (amino acid score, 76.6) and threonine (amino acid score, 93.3), and that of $RMS_{1}S_{2}$ and the commercially prepared formula were sulfur containing amino acids (amino acid score, 82.0 and 54.4). When the contents of the amino acids of the three formulas were compared with mother's milk and cow's milk, the balance of the amino acid of each formula was superior to mother's milk but inferior to cow's milk. 3) In the animal assay, the growth rate of all groups increased gradually during the experimental period. 4) The C- PER, which was corrected on the basis of the casein PER of 2.5 was 2.99, 3.38 and 3.10 in the $RS_{1}S_{2}$, $RFS_{1}S_{2}$ and $RMS_{1}S_{2}$ respectively. The C- PER of $RFS_{1}S_{2}$ and $RMS_{1}S_{2}$ were Significantly (P<.05) higher than that of the casein. 5) The FER of the casein, $RS_{1}S_{2}$, $RFS_{1}S_{2}$, and $RMS_{1}S_{2}$ were 0.37, 0.39, 0.43 and 0.39, respectively. The FER of $RFS_{1}S_{2}$ and $RMS_{1}S_{2}$ were also significantly (P<.05) higher than that of the casein. 6) The concentrations of hematocrit, hemoglobin, total protein and albumin in the serum of the rats of all groups were not significantly different among groups. 7) The storage stability test showed that the total plate count (TPC), the coliforms count and the bacterial spore count in the ingredients were quiet low. However, after 30 and 60 days storage, the count in $RFS_{1}S_{2}$ increased and were higher at room temperature than refrigerated temperature. 8) In the cost evaluation, the cost of the developed formulas was \1,826-2,626 / kg. This was less than that of the commercially prepared formula (\3,300-4,073 / kg) and that of the imported formula (\4,250-8,720 / kg).

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Reconstruction of Anterior Cruciate Ligament in Adolescent (청소년기에 시행한 전방십자인대 재건술)

  • Song Eun Kyoo;Shim Sang Don;Kim Hyung Jong;Kim Hyung Won
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.2
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    • pp.101-108
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    • 2002
  • Purpose: To evaluate the clinical results of anterior cruciate ligament (ACL) reconstruction and to know the results of physeal injury by transphyseal tunnel in adolescents who had remaining growth potential. Materials and Methods : This study involved 12 patients under 19 years old out of 445 patients, who underwent ACL reconstruction between 1993 and 2001. The mean age at the time of operation was 15.9 $(13.1\~16.9)$ years and fellow-up period was 45.1 $(24\~120.6)$ months in avrarge. Autologous quadrupled hamstring tendon was used as graft in 11 cases and bone-patellar tendon-bone in 1 case. Clinical results were evaluated by Lysholm Knee Scoring Scale, range of motion and return to preinjury sports activities. Radiologic results were evaluated by $Telos^{\circledR}$ device. Bone maturity were analyzed by chronological age, standing height and the width of growth plate in AP and lateral view of knee joint at preoperatively. The growth disturbances were evaluated by measuring femorotibial angle, anatomical and mechanical lateral distal femoral angle, mechanical medial proximal tibial angle and leg length and by comparing those of uninjured site in last follow-up teleoroentgenogram. Results : The mean Lysholm Knee score was 51 $(25\~63)$points preoperatively and 98 $(94\~100)$ points at last follow up. The mean anterior displacement of the tibia by using $Telos^{\circledR}$ device was improved from 13.5 $(6\~27)$ mm to 2.9 $(1\~4)$ mm and there were no significant instabilities of the knee in all cases. There were no leg length discrepancies over 1 cm and no statistically significant abnormal alignment of the knee joint in all cases. Conclusion: ACL reconstruction using transphyseal tunnel for restoring stability and knee function is assumed as a good mettled of treatment without significant leg length discrepancy and abnormal alignment of the knee joint.

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Closed Interlocking Intrmedullary Nailing of Metastatic Diaphyseal Fractures of the Humerus (상완골 간부 악성 병적골절의 비관혈적 고합성 골수강내 금속정 고정술)

  • Bahk, Won-Jong;Rhee, Seung-Koo;Kang, Yong-Koo
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.1-11
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    • 2003
  • Purpose: To analysis of the result of the treatment of metastatic diaphyseal fracture of the humerus with closed interlocking intrameduallry nailing. Materials and Methods: Among surgically treated 29 patients with pathologic or impending fracture of diaphysis of the humeurs, 13 patients (16 cases) treated with closed intramedullary interlocking nail were selected for the study. The final result of pain relief and functional recovery was evaluated by modified rating system of Perez et al. Results: Primary cancer was diagnosed after fracture was developed in 2 patients and pathologic or impending fracture was occurred average period of 28.9 months after primary cancer was diagnosed. The main primary malignancies were multiple myeloma, lung cancer and breast cancer. Mean survival after humeral metastasis was 11.7 months. The final result was superior to fair in 13 of 16 cases, and poor in 3 cases with progression of tumor spread or distant dissemination to the ipsilateral fingers. Except the latter 3 patients and other 3 patients, who died before 3 months postoperatively, bony union was achieved in 10 cases. There were no complications related to surgery. Conclusion: Closed interlocking intrameduallry nailing is accomplished with brief operative time, small amount of bleeding and provides immediate stability with resultant early return of function to the arm. Additionally it allows early postoperative irradiation. However, some of our cases shows that intramedullary nailing can accelerate tumor spread and metastases elsewhere, so that serious consideration must be given in planning this treatment. In conclusion, the functional status before fracture, life expectancy, type of tumor and extent of involvement should be carefully considered to decide operative treatment of metastatic disease.

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Allogeneic Inlay Cortical Strut Grafts for Large Cysts or Post-curettage Cavitary Bony Defects (거대 낭종성 골병소 또는 소파 후 잔유 골 결손부에 시행한 내재형 동종 피질 지주골 이식술)

  • Chung, Yang-Guk;Kang, Yong-Koo;Kim, Chol-Jin;Lee, An-Hi;Park, Jeong-Mi;Bahk, Won-Jong;Yoo, Hyun-Ho
    • The Journal of the Korean bone and joint tumor society
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    • v.17 no.2
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    • pp.73-78
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    • 2011
  • Purpose: This study was aimed to evaluate the result of inlay cortical strut bone grafts for large cysts or cavitary bone lesions in long bones. Materials and Methods: Seven patients with large cyst or cavitary bony lesions were managed with curettage, allogeneic inlay cortical strut and cancellous bone grafts. Additional plate and screw fixations were performed in 6 patients. There were three SBCs, two FDs with secondary ABC changes, one FD and one post-cement spacer removal state. Three of them had pathologic fractures. Progression of bone healing and mechanical support and functional result were evaluated. The mean follow-up period was 25.4 months. Results: Incorporations into host bones were progressed in all, average 4.2 months in six metaphyseal regions and 5.8 months in five diaphyseal regions respectively. Full structural supports were achieved in all except one patient without any additional procedures. No allograft-related complication was developed. Mean functional score according to the MSTS criteria was 29.6 at last follow up. Conclusion: Inlay cortical strut graft provided additional mechanical stability and bone stock for screw purchase in large cyst or cavitary defects of long bones, which allow early mobilization and excellent functional outcome.

Numerical Simulation on Seabed-Structure Dynamic Responses due to the Interaction between Waves, Seabed and Coastal Structure (파랑-지반-해안구조물의 상호작용에 기인하는 해저지반과 구조물의 동적응답에 관한 수치시뮬레이션)

  • Lee, Kwang-Ho;Baek, Dong-Jin;Kim, Do-Sam;Kim, Tae-Hyung;Bae, Ki-Seong
    • Journal of Korean Society of Coastal and Ocean Engineers
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    • v.26 no.1
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    • pp.49-64
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    • 2014
  • Seabed beneath and near the coastal structures may undergo large excess pore water pressure composed of oscillatory and residual components in the case of long durations of high wave loading. This excess pore water pressure may reduce effective stress and, consequently, the seabed may liquefy. If the liquefaction occurs in the seabed, the structure may sink, overturn, and eventually fail. Especially, the seabed liquefaction behavior beneath a gravity-based structure under wave loading should be evaluated and considered for design purpose. In this study, to evaluate the liquefaction potential on the seabed, numerical analysis was conducted using 2-dimensional numerical wave tank. The 2-dimensional numerical wave tank was expanded to account for irregular wave fields, and to calculate the dynamic wave pressure and water particle velocity acting on the seabed and the surface boundary of the structure. The simulation results of the wave pressure and the shear stress induced by water particle velocity were used as inputs to a FLIP(Finite element analysis LIquefaction Program). Then, the FLIP evaluated the time and spatial variations in excess pore water pressure, effective stress and liquefaction potential in the seabed. Additionally, the deformation of the seabed and the displacement of the structure as a function of time were quantitatively evaluated. From the analysis, when the shear stress was considered, the liquefaction at the seabed in front of the structure was identified. Since the liquefied seabed particles have no resistance force, scour can possibly occur on the seabed. Therefore, the strength decrease of the seabed at the front of the structure due to high wave loading for the longer period of time such as a storm can increase the structural motion and consequently influence the stability of the structure.