• Title/Summary/Keyword: with-without analysis

Search Result 11,856, Processing Time 0.049 seconds

Effect of the Configuration of Contact Type Textile Electrode on the Performance of Heart Activity Signal Acquisition for Smart Healthcare (스마트 헬스케어를 위한 심장활동 신호 검출용 접촉식 직물전극의 구조가 센싱 성능에 미치는 영향)

  • Cho, Hyun-Seung;Koo, Hye-Ran;Yang, Jin-Hee;Lee, Kang-Hwi;Kim, Sang-Min;Lee, Jeong-Hwan;Kwak, Hwy-Kuen;Ko, Yun-Su;Oh, Yun-Jung;Park, Su-Youn;Kim, Sin-Hye;Lee, Joo-Hyeon
    • Science of Emotion and Sensibility
    • /
    • v.21 no.4
    • /
    • pp.63-76
    • /
    • 2018
  • The purpose of this study was to investigate the effect of contact type textile electrode structure on heart activity signal acquisition for smart healthcare. In this study, we devised six contact type textile electrodes whose electrode size and configuration were manipulated for measuring heart activity signals using computerized embroidery. We detected heart activity signals using a modified lead II and by attaching each textile electrode to the chest band in four healthy male subjects in a standing static posture. We measured the signals four times repeatedly for all types of electrodes. The heart activity signals were sampled at 1 kHz using a BIOPAC ECG100, and the detected original signals were filtered through a band-pass filter. To compare the performance of heart activity signal acquisition among the different structures of the textile electrodes, we conducted a qualitative analysis using signal waveform and size as parameters. In addition, we performed a quantitative analysis by calculating signal power ratio (SPR) of the heart activity signals obtained through each electrode. We analyzed differences in the performance of heart activity signal acquisition of the six electrodes by performing difference and post-hoc tests using nonparametric statistic methods on the calculated SPR. The results showed a significant difference both in terms of qualitative and quantitative aspects of heart activity signals among the tested contact type textile electrodes. Regarding the configurations of the contact type textile electrodes, the three-dimensionally inflated electrode (3DIE) was found to obtain better quality signals than the flat electrode. However, regarding the electrode size, no significant difference was found in performance of heart signal acquisition for the three electrode sizes. These results suggest that the configuration method (flat/3DIE), which is one of the two requirements of a contact type textile electrode structure for heart activity signal acquisition, has a critical effect on the performance of heart activity signal acquisition for wearable healthcare. Based on the results of this study, we plan to develop a smart clothing technology that can monitor high-quality heart activity without time and space constraints by implementing a clothing platform integrated with the textile electrode and developing a performance improvement plan.

Performance of Investment Strategy using Investor-specific Transaction Information and Machine Learning (투자자별 거래정보와 머신러닝을 활용한 투자전략의 성과)

  • Kim, Kyung Mock;Kim, Sun Woong;Choi, Heung Sik
    • Journal of Intelligence and Information Systems
    • /
    • v.27 no.1
    • /
    • pp.65-82
    • /
    • 2021
  • Stock market investors are generally split into foreign investors, institutional investors, and individual investors. Compared to individual investor groups, professional investor groups such as foreign investors have an advantage in information and financial power and, as a result, foreign investors are known to show good investment performance among market participants. The purpose of this study is to propose an investment strategy that combines investor-specific transaction information and machine learning, and to analyze the portfolio investment performance of the proposed model using actual stock price and investor-specific transaction data. The Korea Exchange offers daily information on the volume of purchase and sale of each investor to securities firms. We developed a data collection program in C# programming language using an API provided by Daishin Securities Cybosplus, and collected 151 out of 200 KOSPI stocks with daily opening price, closing price and investor-specific net purchase data from January 2, 2007 to July 31, 2017. The self-organizing map model is an artificial neural network that performs clustering by unsupervised learning and has been introduced by Teuvo Kohonen since 1984. We implement competition among intra-surface artificial neurons, and all connections are non-recursive artificial neural networks that go from bottom to top. It can also be expanded to multiple layers, although many fault layers are commonly used. Linear functions are used by active functions of artificial nerve cells, and learning rules use Instar rules as well as general competitive learning. The core of the backpropagation model is the model that performs classification by supervised learning as an artificial neural network. We grouped and transformed investor-specific transaction volume data to learn backpropagation models through the self-organizing map model of artificial neural networks. As a result of the estimation of verification data through training, the portfolios were rebalanced monthly. For performance analysis, a passive portfolio was designated and the KOSPI 200 and KOSPI index returns for proxies on market returns were also obtained. Performance analysis was conducted using the equally-weighted portfolio return, compound interest rate, annual return, Maximum Draw Down, standard deviation, and Sharpe Ratio. Buy and hold returns of the top 10 market capitalization stocks are designated as a benchmark. Buy and hold strategy is the best strategy under the efficient market hypothesis. The prediction rate of learning data using backpropagation model was significantly high at 96.61%, while the prediction rate of verification data was also relatively high in the results of the 57.1% verification data. The performance evaluation of self-organizing map grouping can be determined as a result of a backpropagation model. This is because if the grouping results of the self-organizing map model had been poor, the learning results of the backpropagation model would have been poor. In this way, the performance assessment of machine learning is judged to be better learned than previous studies. Our portfolio doubled the return on the benchmark and performed better than the market returns on the KOSPI and KOSPI 200 indexes. In contrast to the benchmark, the MDD and standard deviation for portfolio risk indicators also showed better results. The Sharpe Ratio performed higher than benchmarks and stock market indexes. Through this, we presented the direction of portfolio composition program using machine learning and investor-specific transaction information and showed that it can be used to develop programs for real stock investment. The return is the result of monthly portfolio composition and asset rebalancing to the same proportion. Better outcomes are predicted when forming a monthly portfolio if the system is enforced by rebalancing the suggested stocks continuously without selling and re-buying it. Therefore, real transactions appear to be relevant.

Analysis of Intervention in Activities of Daily Living for Stroke Patients in Korea: Focusing on Single-Subject Research Design (국내 뇌졸중 환자를 대상으로 한 일상생활활동 중재 연구 분석: 단일대상연구 설계를 중심으로)

  • Sung, Ji-Young;Choi, Yoo-Im
    • Therapeutic Science for Rehabilitation
    • /
    • v.13 no.1
    • /
    • pp.9-21
    • /
    • 2024
  • Objective : The purpose of this study was to confirm the characteristics and quality of a single-subject research that conducted interventions to improve activities of daily living (ADL) in stroke patients. Methods : 'Stroke,' 'activities of daily living,' and 'single-subject studies' were searched as keywords among papers published in the last 15 years between 2009 and 2023 among Research Information Sharing Service, DBpia, and e-articles. A total of nine papers were examined for the characteristics and quality before analysis. Results : The independent variables applied to improve ADL included constraint-induced therapy, mental practice for performing functional activities, virtual reality-based task training, subjective postural vertical training without visual feedback, bilateral upper limb movement, core stability training program, traditional occupational therapy and neurocognitive rehabilitation, smooth pursuit eye movement, neck muscle vibration, and occupation-based community rehabilitation. Assessment of Motor and Process Skills was the most common evaluation tool for measuring dependent variables, with four articles, and Modified Barthel Index and Canadian Occupational Performance Measure were two articles each. As a result of confirming the qualitative level of the analyzed papers, out of a total of nine studies, seven studies were at a high level, two at a moderate level, and none were at a low level. Conclusion : Various types of rehabilitation treatments have been actively applied as intervention methods to improve the daily life activities of stroke patients; the quality level of single-subject studies applying ADL interventions was reliable.

Interpreting Bounded Rationality in Business and Industrial Marketing Contexts: Executive Training Case Studies (집행관배훈안례연구(阐述工商业背景下的有限合理性):집행관배훈안례연구(执行官培训案例研究))

  • Woodside, Arch G.;Lai, Wen-Hsiang;Kim, Kyung-Hoon;Jung, Deuk-Keyo
    • Journal of Global Scholars of Marketing Science
    • /
    • v.19 no.3
    • /
    • pp.49-61
    • /
    • 2009
  • This article provides training exercises for executives into interpreting subroutine maps of executives' thinking in processing business and industrial marketing problems and opportunities. This study builds on premises that Schank proposes about learning and teaching including (1) learning occurs by experiencing and the best instruction offers learners opportunities to distill their knowledge and skills from interactive stories in the form of goal.based scenarios, team projects, and understanding stories from experts. Also, (2) telling does not lead to learning because learning requires action-training environments should emphasize active engagement with stories, cases, and projects. Each training case study includes executive exposure to decision system analysis (DSA). The training case requires the executive to write a "Briefing Report" of a DSA map. Instructions to the executive trainee in writing the briefing report include coverage in the briefing report of (1) details of the essence of the DSA map and (2) a statement of warnings and opportunities that the executive map reader interprets within the DSA map. The length maximum for a briefing report is 500 words-an arbitrary rule that works well in executive training programs. Following this introduction, section two of the article briefly summarizes relevant literature on how humans think within contexts in response to problems and opportunities. Section three illustrates the creation and interpreting of DSA maps using a training exercise in pricing a chemical product to different OEM (original equipment manufacturer) customers. Section four presents a training exercise in pricing decisions by a petroleum manufacturing firm. Section five presents a training exercise in marketing strategies by an office furniture distributer along with buying strategies by business customers. Each of the three training exercises is based on research into information processing and decision making of executives operating in marketing contexts. Section six concludes the article with suggestions for use of this training case and for developing additional training cases for honing executives' decision-making skills. Todd and Gigerenzer propose that humans use simple heuristics because they enable adaptive behavior by exploiting the structure of information in natural decision environments. "Simplicity is a virtue, rather than a curse". Bounded rationality theorists emphasize the centrality of Simon's proposition, "Human rational behavior is shaped by a scissors whose blades are the structure of the task environments and the computational capabilities of the actor". Gigerenzer's view is relevant to Simon's environmental blade and to the environmental structures in the three cases in this article, "The term environment, here, does not refer to a description of the total physical and biological environment, but only to that part important to an organism, given its needs and goals." The present article directs attention to research that combines reports on the structure of task environments with the use of adaptive toolbox heuristics of actors. The DSA mapping approach here concerns the match between strategy and an environment-the development and understanding of ecological rationality theory. Aspiration adaptation theory is central to this approach. Aspiration adaptation theory models decision making as a multi-goal problem without aggregation of the goals into a complete preference order over all decision alternatives. The three case studies in this article permit the learner to apply propositions in aspiration level rules in reaching a decision. Aspiration adaptation takes the form of a sequence of adjustment steps. An adjustment step shifts the current aspiration level to a neighboring point on an aspiration grid by a change in only one goal variable. An upward adjustment step is an increase and a downward adjustment step is a decrease of a goal variable. Creating and using aspiration adaptation levels is integral to bounded rationality theory. The present article increases understanding and expertise of both aspiration adaptation and bounded rationality theories by providing learner experiences and practice in using propositions in both theories. Practice in ranking CTSs and writing TOP gists from DSA maps serves to clarify and deepen Selten's view, "Clearly, aspiration adaptation must enter the picture as an integrated part of the search for a solution." The body of "direct research" by Mintzberg, Gladwin's ethnographic decision tree modeling, and Huff's work on mapping strategic thought are suggestions on where to look for research that considers both the structure of the environment and the computational capabilities of the actors making decisions in these environments. Such research on bounded rationality permits both further development of theory in how and why decisions are made in real life and the development of learning exercises in the use of heuristics occurring in natural environments. The exercises in the present article encourage learning skills and principles of using fast and frugal heuristics in contexts of their intended use. The exercises respond to Schank's wisdom, "In a deep sense, education isn't about knowledge or getting students to know what has happened. It is about getting them to feel what has happened. This is not easy to do. Education, as it is in schools today, is emotionless. This is a huge problem." The three cases and accompanying set of exercise questions adhere to Schank's view, "Processes are best taught by actually engaging in them, which can often mean, for mental processing, active discussion."

  • PDF

Dynamic Limit and Predatory Pricing Under Uncertainty (불확실성하(不確實性下)의 동태적(動態的) 진입제한(進入制限) 및 약탈가격(掠奪價格) 책정(策定))

  • Yoo, Yoon-ha
    • KDI Journal of Economic Policy
    • /
    • v.13 no.1
    • /
    • pp.151-166
    • /
    • 1991
  • In this paper, a simple game-theoretic entry deterrence model is developed that integrates both limit pricing and predatory pricing. While there have been extensive studies which have dealt with predation and limit pricing separately, no study so far has analyzed these closely related practices in a unified framework. Treating each practice as if it were an independent phenomenon is, of course, an analytical necessity to abstract from complex realities. However, welfare analysis based on such a model may give misleading policy implications. By analyzing limit and predatory pricing within a single framework, this paper attempts to shed some light on the effects of interactions between these two frequently cited tactics of entry deterrence. Another distinctive feature of the paper is that limit and predatory pricing emerge, in equilibrium, as rational, profit maximizing strategies in the model. Until recently, the only conclusion from formal analyses of predatory pricing was that predation is unlikely to take place if every economic agent is assumed to be rational. This conclusion rests upon the argument that predation is costly; that is, it inflicts more losses upon the predator than upon the rival producer, and, therefore, is unlikely to succeed in driving out the rival, who understands that the price cutting, if it ever takes place, must be temporary. Recently several attempts have been made to overcome this modelling difficulty by Kreps and Wilson, Milgram and Roberts, Benoit, Fudenberg and Tirole, and Roberts. With the exception of Roberts, however, these studies, though successful in preserving the rationality of players, still share one serious weakness in that they resort to ad hoc, external constraints in order to generate profit maximizing predation. The present paper uses a highly stylized model of Cournot duopoly and derives the equilibrium predatory strategy without invoking external constraints except the assumption of asymmetrically distributed information. The underlying intuition behind the model can be summarized as follows. Imagine a firm that is considering entry into a monopolist's market but is uncertain about the incumbent firm's cost structure. If the monopolist has low cost, the rival would rather not enter because it would be difficult to compete with an efficient, low-cost firm. If the monopolist has high costs, however, the rival will definitely enter the market because it can make positive profits. In this situation, if the incumbent firm unwittingly produces its monopoly output, the entrant can infer the nature of the monopolist's cost by observing the monopolist's price. Knowing this, the high cost monopolist increases its output level up to what would have been produced by a low cost firm in an effort to conceal its cost condition. This constitutes limit pricing. The same logic applies when there is a rival competitor in the market. Producing a high cost duopoly output is self-revealing and thus to be avoided. Therefore, the firm chooses to produce the low cost duopoly output, consequently inflicting losses to the entrant or rival producer, thus acting in a predatory manner. The policy implications of the analysis are rather mixed. Contrary to the widely accepted hypothesis that predation is, at best, a negative sum game, and thus, a strategy that is unlikely to be played from the outset, this paper concludes that predation can be real occurence by showing that it can arise as an effective profit maximizing strategy. This conclusion alone may imply that the government can play a role in increasing the consumer welfare, say, by banning predation or limit pricing. However, the problem is that it is rather difficult to ascribe any welfare losses to these kinds of entry deterring practices. This difficulty arises from the fact that if the same practices have been adopted by a low cost firm, they could not be called entry-deterring. Moreover, the high cost incumbent in the model is doing exactly what the low cost firm would have done to keep the market to itself. All in all, this paper suggests that a government injunction of limit and predatory pricing should be applied with great care, evaluating each case on its own basis. Hasty generalization may work to the detriment, rather than the enhancement of consumer welfare.

  • PDF

A study on evaluation of the image with washed-out artifact after applying scatter limitation correction algorithm in PET/CT exam (PET/CT 검사에서 냉소 인공물 발생 시 산란 제한 보정 알고리즘 적용에 따른 영상 평가)

  • Ko, Hyun-Soo;Ryu, Jae-kwang
    • The Korean Journal of Nuclear Medicine Technology
    • /
    • v.22 no.1
    • /
    • pp.55-66
    • /
    • 2018
  • Purpose In PET/CT exam, washed-out artifact could occur due to severe motion of the patient and high specific activity, it results in lowering not only qualitative reading but also quantitative analysis. Scatter limitation correction by GE is an algorism to correct washed-out artifact and recover the images in PET scan. The purpose of this study is to measure the threshold of specific activity which can recovers to original uptake values on the image shown with washed-out artifact from phantom experiment and to compare the quantitative analysis of the clinical patient's data before and after correction. Materials and Methods PET and CT images were acquired in having no misalignment(D0) and in 1, 2, 3, 4 cm distance of misalignment(D1, D2, D3, D4) respectively, with 20 steps of each specific activity from 20 to 20,000 kBq/ml on $^{68}Ge$ cylinder phantom. Also, we measured the distance of misalignment of foley catheter line between CT and PET images, the specific activity which makes washed-out artifact, $SUV_{mean}$ of muscle in artifact slice and $SUV_{max}$ of lesion in artifact slice and $SUV_{max}$ of the other lesion out of artifact slice before and after correction respectively from 34 patients who underwent $^{18}F-FDG$ Fusion Whole Body PET/CT exam. SPSS 21 was used to analyze the difference in the SUV between before and after scatter limitation correction by paired t-test. Results In phantom experiment, $SUV_{mean}$ of $^{68}Ge$ cylinder decreased as specific activity of $^{18}F$ increased. $SUV_{mean}$ more and more decreased as the distance of misalignment between CT and PET more increased. On the other hand, the effect of correction increased as the distance more increased. From phantom experiments, there was no washed-out artifact below 50 kBq/ml and $SUV_{mean}$ was same from origin. On D0 and D1, $SUV_{mean}$ recovered to origin(0.95) below 120 kBq/ml when applying scatter limitation correction. On D2 and D3, $SUV_{mean}$ recovered to origin below 100 kBq/ml. On D4, $SUV_{mean}$ recovered to origin below 80 kBq/ml. From 34 clinical patient's data, the average distance of misalignment was 2.02 cm and the average specific activity which makes washed-out artifact was 490.15 kBq/ml. The average $SUV_{mean}$ of muscles and the average $SUV_{max}$ of lesions in artifact slice before and after the correction show a significant difference according to a paired t-test respectively(t=-13.805, p=0.000)(t=-2.851, p=0.012), but the average $SUV_{max}$ of lesions out of artifact slice show a no significant difference (t=-1.173, p=0.250). Conclusion Scatter limitation correction algorism by GE PET/CT scanner helps to correct washed-out artifact from motion of a patient or high specific activity and to recover the PET images. When we read the image occurred with washed-out artifact by measuring the distance of misalignment between CT and PET image, specific activity after applying scatter limitation algorism, we can analyze the images more accurately without repeating scan.

Increased Peripheral NK Cell Fraction and Their Cytolytic activity in Patients with History of Recurrent Spontaneous Abortion (말초혈액 자연살해세포 분획 및 세포용해 활성도 분석을 통한 습관성 유산 위험군의 진단적 유용성에 관한 연구)

  • Choi, Ji-Young;Hwang, Su-Jin;Han, Ae-Ra;Yoo, Ji-Hee;Park, Dong-Wook;Park, Chan-Woo;Kim, Hye-Ok;Cha, Sun-Hwa;Kim, Jin-Young;Song, In-Ok;Koong, Mi-Kyoung;Kang, In-Soo;Yang, Kwang-Moon
    • Clinical and Experimental Reproductive Medicine
    • /
    • v.37 no.2
    • /
    • pp.115-124
    • /
    • 2010
  • Objective: To testify whether the increased peripheral blood natural killer (pbNK) cells fraction and their cytolytic activity could coincide with patient's history of recurrent spontaneous abortion (RSA) and to evaluate these factors are can be valuable diagnostic markers in RSA. Methods: Women with a history of RSA comprised the patient group (n=35). Normal fertile women, who were experienced at least one healthy term birth without history of infertility or recurrent miscarriage, were included as the healthy control group (n=15). The pbNK cells of $CD3^-/CD56^+/CD16^+$ and their cytolytic activities against K562 cells were measured by flow cytometry and the values were compared between study and control groups. Results: Proportions of pbNK cells among peripheral blood monocytes (PBMC) ($14.2{\pm}5.2$ vs. $9.4{\pm}3.7%$, p=0.002, 95% confidence interval [CI], 1.8 to 7.8) was significantly higher in the patient group. The odds ratio of having RSA history was increased as 8.4 folds (59% of sensitivity, 80% of specificity, and 95% CI: 2.0 to 35.8) in patients who showed pbNK cells fraction above 12.1% which was determined as cut-off value by using ROC curve analysis. The cytolytic activities of pbNK cells which measured by three different ratio of effecter pbNK cells to target K562 cells and calculated by the percent of cytolytic K562 cells, were significantly higher in study group than that of control group (in 50:1 ratio, $48.3{\pm}19.0$ vs. $31.3{\pm}11.9%$, p=0.002; in 25:1 ratio, $37.0{\pm}18.1$ vs. $20.2{\pm}9.2%$, p<0.001; in 12.5:1 ratio, $23.5{\pm}12.7$ vs. $12.4{\pm}7.3%$, p=0.001). With the cut-off values of cytolytic activity of pbNK cells as 43.1% (50:1), 26.9% (25:1), and 17.4% (12.5:1) each, the risk of having RSA history was increased by 10.0, 11.4, and 15.0 folds in patients who had increased in each effector of pbNK to target of K562 cells ratio. Conclusion: The analysis of pbNK cells fraction and their cytolytic activity can be valuable diagnostic markers for RSA. We are going to planning the large scaled studies which include the data of obstetric outcomes in subsequent pregnancies to clarify our results of this study.

Analysis and Improvement Strategies for Korea's Cyber Security Systems Regulations and Policies

  • Park, Dong-Kyun;Cho, Sung-Je;Soung, Jea-Hyen
    • Korean Security Journal
    • /
    • no.18
    • /
    • pp.169-190
    • /
    • 2009
  • Today, the rapid advance of scientific technologies has brought about fundamental changes to the types and levels of terrorism while the war against the world more than one thousand small and big terrorists and crime organizations has already begun. A method highly likely to be employed by terrorist groups that are using 21st Century state of the art technology is cyber terrorism. In many instances, things that you could only imagine in reality could be made possible in the cyber space. An easy example would be to randomly alter a letter in the blood type of a terrorism subject in the health care data system, which could inflict harm to subjects and impact the overturning of the opponent's system or regime. The CIH Virus Crisis which occurred on April 26, 1999 had significant implications in various aspects. A virus program made of just a few lines by Taiwanese college students without any specific objective ended up spreading widely throughout the Internet, causing damage to 30,000 PCs in Korea and over 2 billion won in monetary damages in repairs and data recovery. Despite of such risks of cyber terrorism, a great number of Korean sites are employing loose security measures. In fact, there are many cases where a company with millions of subscribers has very slackened security systems. A nationwide preparation for cyber terrorism is called for. In this context, this research will analyze the current status of Korea's cyber security systems and its laws from a policy perspective, and move on to propose improvement strategies. This research suggests the following solutions. First, the National Cyber Security Management Act should be passed to have its effectiveness as the national cyber security management regulation. With the Act's establishment, a more efficient and proactive response to cyber security management will be made possible within a nationwide cyber security framework, and define its relationship with other related laws. The newly passed National Cyber Security Management Act will eliminate inefficiencies that are caused by functional redundancies dispersed across individual sectors in current legislation. Second, to ensure efficient nationwide cyber security management, national cyber security standards and models should be proposed; while at the same time a national cyber security management organizational structure should be established to implement national cyber security policies at each government-agencies and social-components. The National Cyber Security Center must serve as the comprehensive collection, analysis and processing point for national cyber crisis related information, oversee each government agency, and build collaborative relations with the private sector. Also, national and comprehensive response system in which both the private and public sectors participate should be set up, for advance detection and prevention of cyber crisis risks and for a consolidated and timely response using national resources in times of crisis.

  • PDF

The Analysis of Dose in a Rectum by Multipurpose Brachytherapy Phantom (근접방사선치료용 다목적 팬톰을 이용한 직장 내 선량분석)

  • Huh, Hyun-Do;Kim, Seong-Hoon;Cho, Sam-Ju;Lee, Suk;Shin, Dong-Oh;Kwon, Soo-Il;Kim, Hun-Jung;Kim, Woo-Chul;K. Loh John-J.
    • Radiation Oncology Journal
    • /
    • v.23 no.4
    • /
    • pp.223-229
    • /
    • 2005
  • Purpose: In this work we designed and made MPBP(Multi Purpose Brachytherapy Phantom). The MPBP enables one to reproduce the same patient set-up in MPBP as the treatment of the patient and we tried to get an exact analysis of rectal doses in the phantom without need of in-vivo dosimetry. Materials and Methods: Dose measurements were tried at a point of rectum 1, the reference point of rectum, with a diode detector for 4 patients treated with tandem and ovoid for a brachytherapy of a cervix cancer. Total 20 times of rectal dose measurements were made with 5 times a patient. The set-up variation of the diode detector was analyzed. The same patient set-ups were reproduced in self-made MPBP and then rectal doses were measured with TLD. Results: The measurement results of the diode detector showed that the set-up variation of the diode detector was the maximum $11.25{\pm}0.95mm$ in the y-direction for Patient 1 and the maximum $9.90{\pm}4.50mm,\;20.85{\pm}4.50mm,\;and\;19.15{\pm}3.33mm$ in the z-direction for Patient 2, 3, and 4, respectively. Un analyzing the degree of variation in 3 directions the more variation was showed in the z-direction than x- and y-direction except Patient 1. The results of TLD measurements in MPBP showed the relative maximum error of 8.6% and 7.7% at a point of rectum 1 for Patient 1 and 4, respectively and 1.7% and 1.2% for Patient 2 and 3, respectively. The doses measured at R1 and R2 were higher than those calculated except R point of Patient 2. this can be thought to related to the algorithm of dose calculation, whcih corrects for air and water but is guessed not to consider the correction for the scattered rays, but by considering the self-error (${\pm}5%$) TLD has the relative error of values measured and calculated was analyzed to be in a good agreement within 15%. Conclusion: The reproducibility of dose measurements under the same condition as the treatment could be achieved owing to the self-made MPMP and the dose at the point of interest could be analyzed accurately. If a treatment is peformed after achieving dose optimization using the data obtained in the phantom, dose will be able to be minimized to important organs.

The Usefulness of Noninvasive Positive Pressure Ventilation in Patients With Acute Respiratory Failure after Extubation (기관내 관 제거 후 발생한 급성 호흡부전에서 비침습적 양압 환기법의 유용성)

  • Na, Joo-Ock;Lim, Chae-Man;Shim, Tae-Sun;Park, Joo-Hun;Lee, Ki-Man;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Koh, Youn-Suck
    • Tuberculosis and Respiratory Diseases
    • /
    • v.46 no.3
    • /
    • pp.350-362
    • /
    • 1999
  • Background: Acute Respiratory failure which is developed after extubation in the weaning process from mechanical ventilation is an important cause of weaning failure. Once it was developed, endotracheal reintubation has been done for respiratory support. Noninvasive Positive Pressure Ventilation (NIPPV) has been used in the management of acute or chronic respiratory failure, as an alternative to endotracheal intubation, using via nasal or facial mask. In this study, we evaluated the usefulness of NIPPV as an alternative method of reintubation in patients who developed acute respiratory failure after extubation. Method: We retrospectively analyzed thirty one patients(eighteen males and thirteen females, mean ages $63\pm13.2$ years) who were developed acute respiratory failure within forty eight hours after extubation, or were extubated unintentionally at medical intensive care unit(MICU) of Asan Medical Center. NIPPV was applied to the patients. Ventilatory mode of NIPPV, level of ventilatory support and inspiratory oxygen concentration were adjusted according to the patient condition and results of blood gas analysis by the attending doctors at MICU. NIPPV was completely weaned when the patients maintained stable clinical condition under 8 $cmH_2O$ of pressure support level. Weaning success was defined as maintenance of stable spontaneous breathing more than forty eight hours after discontinuation of NIPPV. Respiratory rate, heart rate, arterial blood gas analysis, level of pressure support, and level of PEEP were monitored just before extubation, at thirty minutes, six hours, twenty four hours after initiation of NIPPV. They were also measured at just before weaning from NIPPV in success group, and just before reintubation in failure group. Results: NIPPV was successfully applied to thirty-one patients of thirty-two trials and one patient could not tolerated NIPPV longer than thirty minutes. Endotracheal reintubation was successfully obviated in fourteen patients (45%) among them. There was no difference in age, sex, APACHE III score on admission at MICU, duration of intubation, interval from extubation to initiation of NIPPV, baseline heart rate, respiratory rate, arterial blood gas, and $PaO_2/FiO_2$ between the success and the failure group. Heart rate and respiration rate were significantly decreased with increase $SaO_2$ after thirty minutes of NIPPV in both groups(p<0.05). However, in the patients of failure group, heart rate and respiratory rate were increased again with decrease in $SaO_2$ leading to endotracheal reintubation. The success rate of NIPPV treatment was significantly higher in the patients with COPD compared to other diseases(62% vs 39%) (p=0.007). The causes of failure were deterioration of arterial blood gas without aggravation of underlying disease(n=9), aggravation of undelying disease(n=5), mask intolerance(n=2), and retained airway secretion(n=l). Conclusion: NIPPV would be a useful therapeutic alternative which can avoid reintubation in patient who developed acute respiratory failure after extubation.

  • PDF