• The Journal of Korean Society for Radiation Therapy
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• v.26 no.2
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• pp.281-287
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• 2014

Purpose : The purpose of this study is to compare the plan quality of volumetric-modulated arc therapy (VMAT) and intensity-modulated radiation therapy (IMRT) for the treatment of orbital lymphoma. IMRT, partial single arc(SA) and partial-double arc(DA) VMAT plans for four patients with orbital lymphoma treated at our institution were used for this study. Conformity Index(CI), Paddick's Conformity Index(PCI) and Homogeneity Index(HI) of planning target volume(PTV) were used to evaluate dosimetric quality of each plan. The Monitor Unit (MU), treatment time and dose of ipsilateral lens from each type of plan were measured for comparison. Materials and Methods : The CI of PTV for IMRT, SA and DA were measured as 0.88, 0.86, 0.92. The PCI of DA was the lowest as 1.33. Also HI of DA was the lowest in measured plans as 1.15. Mean dose of lens, lacrimal gland, optic chiasm, the opposite optic nerve and both orbit was analyzed with V30, V20, V10, V5. The result showed that the lowest dose in IMRT highest in SA in opposite lens, lacrimal gland, optic nerve, orbit. Results : Treatment time and average MU of IMRT was about three times higher than SA. Conclusion : Considering the superior plan quality as well as the delivery efficiency of VMAT compared with that of IMRT, VMAT may be the preferred modality for treating orbital lymphoma.

• Quality Improvement in Health Care
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• v.10 no.2
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• pp.176-189
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• 2003

Background : Gastric cancer is the most common malignant tumor in Korea. Surgical operation is one of the major treatment modalities for gastric cancer patients. Therefore, gastrectomy is one of the most common procedures in General Surgery. There were variation in length of hospital stay and medical treatment for gastrectomy between three surgeons at Asan Medical Center. Clinical pathways have received considerable attention as a tool for reducing the medical practice variation, increasing the efficiency of care process, and improving the quality of care. The aim of this study was to evaluate the effect of a clinical pathway for gastrectomy in gastric cancer patients. Methods : The clinical pathway for gastrectomy was developed and implemented by a multidisciplinary group in Asan Medical Center. A computerized clinical pathway program was developed and revised after a pilot test. A total of 145 patients underwent gastrectomy by three surgeons at Asan Medical Center. We compared the length of hospital stay, patient satisfaction, and the unplanned readmission rate between the pre-pathway group (n=67) and the post-pathway group (n=78). We also investigated the degree of satisfaction among the physicians and nurses who were main end-users of the clinical pathway. Results : The clinical pathway was applied to all target patients. The average length of hospital stay was shortened from 12.7days to 10.6days (p<0.01). The degree of patient satisfaction with the care process changed from 90.3% to 89.2% after the implementation of the clinical pathway, but the difference was not statistically significant (p=0.761). Unplanned readmission rate was 2.9% in the pre-pathway group and 0% in the post-pathway group. More than 90% of physicians and nurses answered that the clinical pathway had been a useful tool in their medical practice. Conclusions : The findings of the study demonstrated that implementation of the clinical pathway for gastrectomy produced substantial reduction in the length of hospital stay while improving the quality of patient outcomes. The computerized clinical pathway program can be used as one of the powerful patient management tools for reducing the practice variations and increasing the efficiency of care process in Korean hospital settings.

• Journal of Fashion Business
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• v.6 no.1
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• pp.137-154
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• 2002

It's not easy to renew old brand of over 50 years history to the tastes of new consumer of our time. Most of national brands that has a history of some 20 years in Korea have strove for continuation and growth of brand to no avails, which can be taken as a good example of current situation. For instance, C company, one of the National brand of US which has a history of 51 years, has made its position secure as a fashion group and based itself on a sound foundation by establishing new marketing strategy and completing successful brand renewal in the process of strategic M&A with Italian company. Those successful marketing strategies are as follows. 1) they regarded both market and consumer oriented marketing activity as company's highest priority strategy and put great emphasis upon concentration on target market and reestablishment of brand image of business casual wear. 2) Setting up and operating planning team composed of merchandizer alone in Milano, they set the direction of plan on the basis of concentrated research on potential item in market according to thorough market research done by buying office in Korea, branch office in Hong Kong and buyer in US prior to blueprint planning for season. 3) Great emphasis was placed on business which focused on intensive presentation of basic key item for apparel career women who are main consumer group in the midium-low prices market in US and on supplementation of size and color. they named this line 'collectibles' and helped their customer develop their own clothes plan without worrying about the change of color and fabric by supporting same fabric and color throughout the year and enabled them to add variation easily by supplementing new trend item. 4) Company set black as a main color that lots of apparel career women find easy to care and to express their own image and presented them with pebble which belongs to navy and beige and added fashion color such as wine and brown etc as season goes by. They constructed basic line in order for their customers to coordinate purchased item with new one or to add them to present collection, and to achieve efficient sale by setting up strategy which allows this cross coordination and changing pattern occasionally. 5) Though basic jacket for 99$, short slim skirt for 49$ are products within midium-low prices range, in the material planning stage aiming at production of item that has both resonable function appealing to consumer and is fashionable, synthetic material had to be used as a main source due to price competitiveness. Despite this situation, considering comfortable sense of fit and refined drape of silhouette that has no sign of cheap material, whole collectible line was divided into two items, which contributed to reduction of cost. In case of material that is composed of triacetate and polyester in 70 to 30 ratio, was used up to 4 million yard, which allowed drastic curtailment of cost accompanied by concentration. In case of 'collectibles' line, using Korean material mainly, C company chose to have their product sewed in Southeast Asian countries where transportation is well developed and both productivity and quality verified by operating global production system which aiming at cutdown of cost through outsourcing production from the country where labor cost is low and getting finished product. Polarization between present consumers telling us that consumers with the mind of middle classes in the past no longer exists between consumers who seek after only fine article of highest quality and wise consumers who are sensible enough to judge bubble on correlation between price and quality. To cope with this change in new consumer mind, apparel makes changing their policy so as to produce item that has reasonable quality and falls within affordable price range anywhere in the world. and they're striving to get out of difficult situation by operating global marketing strategy which stresses separation of planning, production and sale and sensibility of fashion shared worldwide. The marketing strategy of C company can be exemplified as a successful one.

• Journal of Fashion Business
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• v.9 no.6
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• pp.160-174
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• 2005

Despite the decrease in the number of children due to low birth rate, the domestic children's apparel market has been achieving steady growth as family income is rising thanks to more opportunities for working women, parents spend more on their children, and they prefer brand products that make their children look special. In addition, the market is suffering from hard competition as large enterprises have joined the race. The present study purposed to survey the children's apparel market in Korea, which is in a transitional period, and to contribute to the development of the market with Korean brands. For this purpose, we analyzed the characteristics of children's apparel brands in the 21st century based on the current state of the domestic children's apparel market and, based on the findings, forecasted the future trend of children's apparel brands, suggested improvements for expected problems, proposed standards for coping with changes such as diversification, high quality and differentiation in the children's apparel market, and provided consumers with information on how to purchase products. According to the result of analyzing the characteristics of children's apparel brands in the 21st century, brands are categorized largely into four types - life cultural brands, functional product brands, character brands and brands advancing to China. Life cultural brands equipped with all necessities for children are expanding, and with the deepening social problems of environmental pollution and the reduction of the child population, functional products made of environment-friendly materials are spreading widely, targeting infants and children. Furthermore, for extending age targets and diversifying products, children's apparel is using characters. The use of characters is expected to have a considerable effect on the growth of brands because children are more subjective as consumers than before and they are more easily persuaded with characters. Domestic children's apparel brands advancing to China have a high expectation of success in overcoming the limitation of the local market that has reached its peak and growing into global brands. Korean apparel makers are struggling to overcome the depressed domestic market, to recover consumers' consumption, to cope with market opening, to pursue high value of sensibility and to expand the seniors' market, etc. In this situation, future trends of children's apparel brands will be the expansion of family brands, brand totalization, quality price, niche market (pre-teen market), etc. In response to these trends, we made the following suggestions for improvement. 1. Children's apparel brands are evolving into family brands as well as into total brands through voluming. Today, however, apparel makers are advancing to the children's apparel market with the concept of adults' apparel and, as a result, children's apparel is merely adults' apparel of reduced size, having problems in design, color and materials. Thus, apparel makers must develop design considering the wide range of size and the characteristics of children's apparel, strengthen sourcing abilities to create revenues, and make thorough survey of customers to find common denominators between adults' apparel and children's apparel considering that characteristic that the target class is different from the buyer class. Furthermore, they must make active investments in human resources, develop outstanding products through advanced planning and design, and support marketing techniques and management systems to stores. 2. As the declining birth rate will continue to have a negative effect on the market, it may be difficult to expand the market size but there is still a margin for growth through high-sensibility and high-quality products. The competitiveness of brands is determined by their market shares. Accordingly, concepts should be specialized according to lifestyle, customers' diverse needs should be satisfied, and cross-coordination should be achieved within a brand. 3. Considering Korean parents who do not spare investment in their children despite shrinking consumption, functional products must be high value-added goods that can enhance efficiency. However, in the current situation of the infants' apparel industry where a textile manufacturer supply its products to multiple brands, it is difficult to develop unique products only based on materials. Thus, it is considered urgent to appeal to consumers not by relying on materials only but by finding methods of applying their own characters to children's dress.

• Journal of IKEEE
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• v.25 no.3
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• pp.493-500
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• 2021

In this paper, we propose the development of deep learning structure to improve quality of polygonal containers. The deep learning structure consists of a convolution layer, a bottleneck layer, a fully connect layer, and a softmax layer. The convolution layer is a layer that obtains a feature image by performing a convolution 3x3 operation on the input image or the feature image of the previous layer with several feature filters. The bottleneck layer selects only the optimal features among the features on the feature image extracted through the convolution layer, reduces the channel to a convolution 1x1 ReLU, and performs a convolution 3x3 ReLU. The global average pooling operation performed after going through the bottleneck layer reduces the size of the feature image by selecting only the optimal features among the features of the feature image extracted through the convolution layer. The fully connect layer outputs the output data through 6 fully connect layers. The softmax layer multiplies and multiplies the value between the value of the input layer node and the target node to be calculated, and converts it into a value between 0 and 1 through an activation function. After the learning is completed, the recognition process classifies non-circular glass bottles by performing image acquisition using a camera, measuring position detection, and non-circular glass bottle classification using deep learning as in the learning process. In order to evaluate the performance of the deep learning structure to improve quality of polygonal containers, as a result of an experiment at an authorized testing institute, it was calculated to be at the same level as the world's highest level with 99% good/defective discrimination accuracy. Inspection time averaged 1.7 seconds, which was calculated within the operating time standards of production processes using non-circular machine vision systems. Therefore, the effectiveness of the performance of the deep learning structure to improve quality of polygonal containers proposed in this paper was proven.

• Journal of the Korean Society of Radiology
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• v.15 no.4
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• pp.463-472
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• 2021

Demand for examinations using transvaginal transducer with high frequencies is increasing to observe pelvic organs in gynecological ultrasound tests. However, the quality control of the replacement probe in clinical trials is not properly implemented and the evaluation criteria have not been established. Therefore, 58 transvaginal transducers and 20 convex transducers were applied to the ATS-539 ultrasound phantom for 20 ultrasound devices currently in clinical use to obtain their respective images and measure them quantitatively and qualitatively. For quantitative measurements, vertical measurement, horizontal measurement, and focal zone and qualitative measurements, dead zone, axial·lateral resolution, sensitivity, functional resolution, gray scale·dynamic range were performed. Quantitative statistical analysis showed significant differences between the two transducers in the lateral measurement and local area (p<0.05). qualitative comparative analysis showed differences in sensitivity and functional resolution. This occurs due to the difference in frequency between transducers and the transducer's injection geometry. Based on the above experiments, the tolerance for horizontal measurement is raised to 10% (±8 mm), the tolerance for sensitivity is observed up to 6 cm deep, which is 12 cm deep,which is the level of the third quartile (75%). The permissible range of functional resolution is up to 6 (12 cm), 6 (12 cm), 11 (11 cm), 9 (9 cm), 6 (6 cm) target, which is the level of the third quartile (75%). It is considered reasonable to adjust the depth of targets in gray scale·dynamic range to measure at a depth of 2 cm, which is 50% of the depth of 4 cm. As above, the criteria for evaluating the quality of transvaginal transducer for use in the past have been proposed and it is expected that this study will be used as a basic data for the production of phantom exclusively for transvaginal transducer in the future.

• Korea Science and Art Forum
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• v.34
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• pp.327-337
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• 2018

Korea is rapidly becoming an aging society as much as it takes the first place among OECD countries, and as the life expectancy of Korea gradually increases, the proportion of the elders in society increases. Accordingly, the happiness of the elders is contributed to the overall social atmosphere and happiness, however, the lower quality of life of the elders due to physical, psychological and social changes can be developed into social problems such as depression and rising suicide rate. As a result, there is a social interest in improving the quality of life and satisfaction of the elders, and the senior citizen center is receiving renewed attention as a form of welfare facility that can play a pivotal role in the social activities of the elders. In recent years, efforts to improve the environment of the senior citizen center have been made due to the growing role of it, however, there is a controversy over whether the quality of the indoor environment is user-friendly or not due to the limitations of material resources and human resources. It is considered that the quality of the color environment should be improved in the senior citizen center in the way that the color environment is not only an indoor environmental factor which gives high psychological and mental effects to users but also a way to improve the environmental satisfaction at the lowest cost. Previous studies on the facilities related to the elders have been actively carried out, but they were very sporadic and there was very little information about the color environment in the related laws or in the guideline presented by cities. It is necessary to integrate guidelines that are scattered within a comprehensive range without any specific target in order to grasp the current status of the color environment and to properly evaluate it. In addition, considering that the senior citizen center is an important leisure facility for the elders that functions in a residential area with a nationwide network, the results of this study are expected to contribute to the environmental improvement of existing senior citizen center which will be activated in the future by enabling the improvement of psychological satisfaction of the elders.

• The Journal of Korean Society for Radiation Therapy
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• v.35
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• pp.41-51
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• 2023

Purpose: This study compares and analyzes the image quality of 3D-CBCT(Cone Beam Computed-Tomography) and Gated CBCT according to baseline changes during SBRT(Stereotactic Body RadioTherapy) in lung cancer patients to find a useful CBCT method for correcting movement due to breathing Materials and methods : Insert a solid tumor material with a diameter of 3 cm into the QUASAR^TM phantom. 4-Dimentional Computed-Tomography(4DCT) images were taken with a speed of the phantom at period 3 sec and a maximum amplitude of 20 mm. Using the contouring menu of the computerized treatment planning system Eclipse^TM Gross Tumor Volume was outlined on solid tumor material. Set-up the same as when acquiring a 4DCT image using Truebeam STx^TM, breathing patterns with baseline changes of 1 mm, 3 mm, and 5 mm were input into the phantom to obtain 3D-CBCT (Spotlight, Full) and Gated-CBCT (Spotlight, Full) images five times repeatedly. The acquired images were compared with the Signal-to-Noise Ratio(SNR), Contrast-to-Noise Ratio(CNR), Tumor Volume Length, and Motion Blurring Ratio(MBR) based on the 4DCT image. Results: The average Signal-to-Noise Ratio, Contrast-to-Noise Ratio, Tumor Volume Length and Motion Blurring Ratio of Spotlight Gated CBCT images were 13.30±0.10%, 7.78±0.16%, 3.55±0.17%, 1.18±0.06%. As a result, Spotlight Gated-CBCT images according to baseline change showed better values than Spotligtht 3D-CBCT images. Also, the average Signal-to-Noise Ratio, Contrast-to-Noise Ratio, Tumor Volume Length and Motion Blurring Ratio of Full Gated CBCT images were 12.80±0.11%, 7.60±0.11%, 3.54±0.16%, 1.18±0.05%. As a result Full GatedCBCT images according to baseline change showed better values than Full 3D-CBCT images. Conclusion : Compared to 3D-CBCT images, Gated-CBCT images had better image quality according to the baseline change, and the effect of Motion Blurring Artifacts caused by breathing was small. Therefore, it is considered useful to image guided using Gated-CBCT when a baseline change occurs due to difficulty in regular breathing during SBRT that exposes high doses in a short period of time

• Progress in Medical Physics
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• v.23 no.1
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• pp.15-25
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• 2012

The aim of this study is to evaluate plan quality and dose accuracy for Volumetric Modulated Arc Therapy (VMAT) on the TG-119 and is to investigate the effects on variation of the selectable optimization parameters of VMAT. VMAT treatment planning was implemented on a Varian iX linear accelerator with ARIA record and verify system (Varian Mecical System Palo Alto, CA) and Oncentra MasterPlan treatment planning system (Nucletron BV, Veenendaal, Netherlands). Plan quality and dosimetric accuracy were evaluated by effect of varying a number of arc, gantry spacing and delivery time for the test geometries provided in TG-119. Plan quality for the target and OAR was evaluated by the mean value and the standard deviation of the Dose Volume Histograms (DVHs). The ionization chamber and $Delta^{4PT}$ bi-planar diode array were used for the dose evaluation. For treatment planning evaluation, all structure sets closed to the goals in the case of single arc, except for the C-shape (hard), and all structure sets achieved the goals in the case of dual arc, except for C-shape (hard). For the variation of a number of arc, the simple structure such as a prostate did not have the difference between single arc and dual arc, whereas the complex structure such as a head and neck showed a superior result in the case of dual arc. The dose distribution with gantry spacing of $4^{\circ}$ was shown better plan quality than the gantry spacing of $6^{\circ}$, but was similar results compared with gantry spacing of $2^{\circ}$. For the verification of dose accuracy with single arc and dual arc, the mean value of a relative error between measured and calculated value were within 3% and 4% for point dose and confidence limit values, respectively. For the verification on dose accuracy with the gantry intervals of $2^{\circ}$, $4^{\circ}$ and $6^{\circ}$, the mean values of relative error were within 3% and 5% for point dose and confidence limit values, respectively. In the verification of dose distribution with $Delta^{4PT}$ bi-planar diode array, gamma passing rate was $98.72{\pm}1.52%$ and $98.3{\pm}1.5%$ for single arc and dual arc, respectively. The confidence limit values were within 4%. The smaller the gantry spacing, the more accuracy results were shown. In this study, we performed the VMAT QA based on TG-119 procedure, and demonstrated that all structure sets were satisfied with acceptance criteria. And also, the results for the selective optimization variables informed the importance of selection for the suitable variables according to the clinical cases.

• Radiation Oncology Journal
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• v.19 no.3
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• pp.275-286
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• 2001

Purpose : To setup procedures of quality assurance (OA) for implementing intensity modulated radiation therapy (IMRT) clinically, report OA procedures peformed for one patient with prostate cancer. Materials and methods : $P^3IMRT$ (ADAC) and linear accelerator (Siemens) with multileaf collimator are used to implement IMRT. At first, the positional accuracy, reproducibility of MLC, and leaf transmission factor were evaluated. RTP commissioning was peformed again to consider small field effect. After RTP recommissioning, a test plan of a C-shaped PTV was made using 9 intensity modulated beams, and the calculated isocenter dose was compared with the measured one in solid water phantom. As a patient-specific IMRT QA, one patient with prostate cancer was planned using 6 beams of total 74 segmented fields. The same beams were used to recalculate dose in a solid water phantom. Dose of these beams were measured with a 0.015 cc micro-ionization chamber, a diode detector, films, and an array detector and compared with calculated one. Results : The positioning accuracy of MLC was about 1 mm, and the reproducibility was around 0.5 mm. For leaf transmission factor for 10 MV photon beams, interleaf leakage was measured $1.9\%$ and midleaf leakage $0.9\%$ relative to $10\times\;cm^2$ open filed. Penumbra measured with film, diode detector, microionization chamber, and conventional 0.125 cc chamber showed that $80\~20\%$ penumbra width measured with a 0.125 cc chamber was 2 mm larger than that of film, which means a 0.125 cc ionization chamber was unacceptable for measuring small field such like 0.5 cm beamlet. After RTP recommissioning, the discrepancy between the measured and calculated dose profile for a small field of $1\times1\;cm^2$ size was less than $2\%$. The isocenter dose of the test plan of C-shaped PTV was measured two times with micro-ionization chamber in solid phantom showed that the errors upto $12\%$ for individual beam, but total dose delivered were agreed with the calculated within $2\%$. The transverse dose distribution measured with EC-L film was agreed with the calculated one in general. The isocenter dose for the patient measured in solid phantom was agreed within $1.5\%$. On-axis dose profiles of each individual beam at the position of the central leaf measured with film and array detector were found that at out-of-the-field region, the calculated dose underestimates about $2\%$, at inside-the-field the measured one was agreed within $3\%$, except some position. Conclusion : It is necessary more tight quality control of MLC for IMRT relative to conventional large field treatment and to develop QA procedures to check intensity pattern more efficiently. At the conclusion, we did setup an appropriate QA procedures for IMRT by a series of verifications including the measurement of absolute dose at the isocenter with a micro-ionization chamber, film dosimetry for verifying intensity pattern, and another measurement with an array detector for comparing off-axis dose profile.