• Korean Journal of Psychosomatic Medicine
• /
• v.24 no.1
• /
• pp.66-73
• /
• 2016

Objectives : The purpose of this study was to investigate the characteristics of psychosocial factors related to functional dyspepsia(FD) and their effects on quality of life(QOL) in firefighters. Methods : This study examined data collected from 1,217 firefighters. We measured psychological symptoms by Patient Health Questionnaire-9(PHQ-9), Generalized Anxiety Disorder questionnaire(GAD-7), Korean Occupational Stress Scale(KOSS), Ways of Coping checklist(WCCL), Rosenberg's Self-Esteem Scale(RSES) and World Health Organization Quality of Life Scale abbreviated version(WHOQOL-BREF). Chi-square test, independent t-test, Pearson's correlation test, logistic regression analysis, and hierarchical regression analysis were used as statistical analysis methods. Results : For the group with FD, the male participants showed significantly higher frequency(p=0.006) compared to the female participants. The group with FD had higher scores for depressive symptoms(p<.001), anxiety (p<.001), and occupational stress(p<.001), and did lower scores for self-esteem(p=.008), quality of life(p<.001) than those without FD. The FD risk was higher in the following KOSS subcategories: job demand(OR 1.94, 95% CI : 1.29-2.93), lack of reward(OR 2.47, 95% CI : 1.61-3.81), and occupational climate(OR 1.51, 95% CI : 1.01-2.24). In the hierarchical regression analysis, QOL was best predicted by depressive symptoms, self-esteem, and occupational stress. Three predictive variables above accounts for 42.0% variance explained of total variance. Conclusions : The psychosocial factors showed significant effects on FD, and predictive variables for QOL were identified based on regression analysis. The results suggest that the psychiatric approach should be accompanied with medical approach in future FD assessment.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.16 no.2
• /
• pp.199-210
• /
• 2005

Objective : Attention deficit hyperactivity disorder(ADHD) affects $5-10\%$ of children in Korea, with more boys and girls being diagnosed. Despite seriousness of ADHD, little is known about its causes. From the current genetic epidemiologic studies, ADHD is known as a heritable disorder. Till now, however, there have been very few genetic studies about ADHD in Korea. The aim of the this study is to examine the association between dopamine transporter gone type 1 and ADHD using case-control design in Korean ADHD probands and normal controls. Materials and Method : Child Psychiatric Genetic research team in Seoul National University Hospital, Clinical Research Institute recruited the ADHD probands using clinical interview/observation, diverse rating scales, and neuropsychological tests. For eliminating phenocopy or ADHD, diagnosis of ADHD was based upon clinical data, psychometric data, and parent/teacher reports. Total 85 ADHD-probands were recruited as final study subjects and independent 100 normal adults participated in this study as control group. For all the ADHD probands, and controls, the 3'-UTR-VNTR polymorphism of DAT1 was analyzed. Based on the DAT1 allele and genotype informations, Chi-square test based on case-control design was performed. Results : As for genetic study, total of 85 probands and 100 controls were included for the genetic analysis. Four different alleles, 350bp (7repeat), 440bp (9repeat), 480bp (10repeat) and 520bp (11repeat) were found in DAT1 gene of study subjects. In case-control analysis, ADHD probands and parents have significantly more 9 repeat allele and 9/10 genotype. Also, The probands with 9repeat allele have more commission errors in ADS. Conclusion : The positive association between ADHD and DAT1 gene was replicated in this report like other previous results for caucasian children and Korean children with ADHD. There are ongoing studies on other candidate genes such as DRD4 and DRD5 and it would be required to explore the association of these candidate genes in Korean children with ADHD. These ongoing genetic research will contribute to the understanding of heterogenous genetic and environmental etiologies of ADHD phenotype, which will lead to the development of more comprehensive treatment and preventive interventions for ADHD.

• Korean Journal of Psychosomatic Medicine
• /
• v.26 no.1
• /
• pp.68-75
• /
• 2018

Objectives : Since pain in cancer patients is an important factor that greatly affects the quality of life and prognosis, many attempts have been actively made to reduce the pain. Despite continuous effort on reducing pain after Endoscopic submucosal dissection (ESD), research has not been done on psychological factors as much as on biological factors affecting pain. The objective of this study is to investigate the psychological factors affecting postoperative pain in gastric tumor patients who underwent gastric ESD. Methods : 91 gastric tumor patients who visited National Health Service Ilsan Hospital in Korean between May 2015 and June 2016, and received ESD were evaluated. Baseline characteristics including sociodemographic factors, anxiety, depression, and resilience were evaluated before the procedure. Multivariate logistic regression was done to analyze factors affecting postoperative pain. Results : The group with high postoperative pain showed lower alcohol consumption and higher depressive symptom scores than the group with low postoperative pain. Also, the group with high postoperative pain showed lower total resilience score with lower subtotal scores in self-control and positive item. Multivariate logistic regression analysis of the postoperative pain showed that patients with lower score in self-control of resilience [odd ratio (OR), 0.911 ; 95% CI, 0.854-0.971, p=0.004) reported more pain after ESD. Conclusions : This study showed that patients with lower self-control ability of resilience felt more pain after ESD. Among the psychological factors evaluated in this study, resilience of an individual seems to have effect on pain.

• The Korean Journal of Nuclear Medicine
• /
• v.28 no.3
• /
• pp.317-325
• /
• 1994

The accuracy of dipyridamole stress/rest $^{99m}Tc$-MIBI myocardial imaging for detection of ischemia depends on reproducible image interpretation. To evaluate the reproducibility of visual assessment, agreement in interpretation among two independent observers, blind-ed to clinical data, was evaluated in SPECT images of 131 patients (94 males, 38 females; mean age $58{\pm}7yr$) with suspected coronary artery disease who underwent both dipyridamole stress/rest $^{99m}Tc$-MIBI myocardial SPECT and coronary angiography. The left ventricle was divided into twenty-nine segments in stress and rest SPECT images and each segment was visually graded according to a five-point scale (segmental score : 0=normal, 1=equivocal, 2=mild decrease, 3=severe decrease and 4=absent uptake). Overall concordance of segmental scoring between the two observers was 80%. The Pear-son's correlation coefficient (r) of the segmental scores for stress and rest images were 0.67 and 0.65, respectively, while the difference in score between the two images showed a correlation of 0.45 (all p<0.001). Agreement between two observers in final SPECT diagnosis as absence or presence of disease was 93%. The degree of agreement in segmental scoring showed no difference between patients with or without agreement as to the presence of disease. Therefore it appeared that cases with inconcordant diagnosis between the 2 observers were mainly due to a difference in individual threshold for interpretating the significance of a particular decreased uptake area rather than to a difference in perceiving the degree of the hypoactivity Thus, establishment of individual optimum thresholds in visual interpretation of myocardial SPECT may be helpful to improve reproducibility and accuracy of scan diagnosis.

• Journal of Hospice and Palliative Care
• /
• v.11 no.4
• /
• pp.196-205
• /
• 2008

Purpose: The purpose of this study was to evaluate the current status of hospice palliative care facilities, and to identify problems and improve hospice palliative care in Korea. Methods: The questionnaire survey was implemented from October to December, 2007. It was consisted of general characteristics of organization, health manpower, facilities & equipments, service programs, and so on. Sixty two (79.5%) out of 78 hospice palliative care facilities returned the questionnaires. Results: They were 42 hospital-based hospice palliative care hospitals and 9 clinics, and most of them are located at central metropolitan areas (Seoul and Gyeonggi Province). more than 80% of hospitals met with the requirements (one doctor per 10 patients and one nurse per 1.5 patients), whereas 42.9% of clinics met the requirements. Approximately 22% of them met the requirement of sick room (4 patients for 1 room). Most of them provided various hospice palliative care programs. The proportion of giving regular education programs to hospice palliative care personnels were about half (41.9%). Thirty two (51.6%) facilities provided home visiting hospice palliative care service. Conclusion: There were lack of enough health manpower, rooms, and programmes and they varied among facilities. It is necessary to increase the number of hospice palliative care facilities with consideration of regional fair distribution and standardization of programmes.

• The Journal of Korean Academic Society of Nursing Education
• /
• v.5 no.2
• /
• pp.376-387
• /
• 1999

Purpose : To provide fundamental data to present further direction of education on Nursing Ethics by investigating the status of Nursing Ethics education performed at 4-year-Colleges of Nursing. Korea. Methods : A descriptive survey study The data collected from 28 universities through a questionnaire to examine the status of Nursing Ethics education in Korea. Results : I. Teaching Nursing Ethics class as a independent subject-6(21.4%) universities. 1) The average of 23.67 hours(2 credits) in the total educational hours. 2) Teaching method-theoretical class, discussion of case study, discussion of related issues, presentation of video tapes and discussion, team education, role play, and submission of reports. 3) Education contents-Nursing profession and ethics, the dignity of human life, necessity of bioethics, ethical theory and refutation, code for nurses, ethical issues between nurses and patients, nurses and co-workers, and nurses and nurses 6 universities 4) 5 universities-Included ethical decision making, artificial insemination, external insemination, artificial abortion, organ transplantation, brain death, human subject of study suicide, and euthanasia. II. Teaching Nursing Ethics as an inclusive theme in other subjects-22 (78.57%) universities. 1) Educated in Introduction of Nursing (14 universities), Nursing Management, Nursing Ethics and Philosophy, Special Nursing, Nursing and Law, and Professional Nursing. 2) Educational course-Taught in freshman level at 14 universities, average 9.32 education hours. Conclusion: Showed not only that universities, not operating Nursing Ethics as a independent class, unreasonably operate and assign too many contents in comparing with its education hours and are likely to become only a cramming education but also professors whose major is not Nursing Ethics presently in charge need to take a chance to supplement their knowledge and teaching method.

• Investigative Magnetic Resonance Imaging
• /
• v.18 no.1
• /
• pp.7-16
• /
• 2014

Purpose : To evaluate the prevalence and pattern of perfusion defect (PD) on first-pass stress perfusion MR imaging in relation with the degree of left ventricular hypertrophy (LVH) and late gadolinium-enhancement (LGE) in patients with apical hypertrophic cardiomyopathy (APH). Materials and Methods: Cardiac MR imaging with first-pass stress perfusion, cine, and LGE sequence was performed in 26 patients with APH from January 2008 to December 2012. We analyzed a total of 416 segments for LV wall thickness on end-diastolic phase of cine images, and evaluated the number of hypertrophied segment and number of consecutive hypertrophied segment (NCH). We assessed the presence or absence of PD and LGE from all patients. If there was PD, we subdivided the pattern into sporadic (sporadic-PD) or ring (ring-PD). Using univariate logistic method, we obtained the independent predictor for presence of overall PD and ring-PD. Results: PD on stress perfusion MRI was observed in 20 patients (76.9%), 12 of them (60%) showed ring-PD. Maximal LV wall thickness and number of hypertrophied segment were independent predictors for overall PD (all, p < 0.05). NCH with more than 3 segments was an additional independent factor for ring-PD. However, LGE was not statistically related with PD in patients with APH. Conclusion: About three quarters of the patients with APH showed PD, most of them represented as ring-PD. LVH degree or distribution was related with pattern of PD, however, LGE was not related with PD. Therefore, the clinical significance of PD in the patients with APH seems to be different from those with non-APH, and further comparison study between the two groups should be carried out.

• Journal of the Korean Society of Radiology
• /
• v.18 no.4
• /
• pp.345-353
• /
• 2024

The purpose of this study was to suggest an appropriate collimation size and central X-ray incidence point by analyzing the correlation between the collimation size used in lumbar lateral examination and factors affecting the collimation size. the lumbar lateral examination results of 148 patients suitable for the purpose of this study were analyzed. The measurement method was to set the total horizontal width shown in the image to the size of the irradiation field(collimation) used during the examination. The distance connected vertically from the end of the dorsal field to the apophyseal joint of the third lumbar vertebra(AJD), the distance from the dorsal end of the image field to the center of the body of the third lumbar vertebra(BD), and the distance from the end of the dorsal field of the image to the center of the pedicle of the third lumbar vertebra(PD). The distance was measured. For comparative analysis of the mean values of dependent variables according to gender, age, height, weight, and body mass index, the mean values were compared using the independent samples t test and one-way ANOVA. For post hoc analysis, duncan was used. The correlation between independent and dependent variables was analyzed using Pearson correlation analysis. In this study, statistical significance was set at a p value of 0.05 or lower. The average value of the collimation size during the lumbar spine lateral examination was 252.45 mm, AJD was 102.11 mm, BD was 141.17 mm, and PD was 119.73 mm. The mean values of collimation size, AJD, BD, and PD were larger in men than in women, but statistical significance for the difference in mean values by gender was found only in BD (p<0.05). There was a slight difference in the mean value of each group according to age, but there was no statistical significance (p>0.05). The collimation size and mean values of AJD, BD, and PD according to height, weight, and body mass index differed depending on the independent variables, and the differences were all statistically significant (p<0.05). As a result of the correlation analysis, field size and AJD, BD, and PD showed no correlation with gender and age, a weak positive correlation with height, and a medium positive correlation with weight and body mass index. The results of this study showed that CS was correlated with height, weight, and BMI during lumbar lateral examination. If the entrance point of the central X-ray is moved to the appophyseal joint by considering weight and BMI when adjusting the collimation size in clinical practice, it is expected that the collimation size can be reduced bu about 5%.

• Quality Improvement in Health Care
• /
• v.7 no.2
• /
• pp.138-155
• /
• 2000

Background: Factors related to waiting and staying time for patient care in emergency care center (ECC) were examined during 1 month from Apr. 1 to Apr. 30, 1997 at an ECC of Yeungnam university hospital in Taegu metropolitan city, to obtain the baseline data on the strategy of effective management of emergency patients. Method: The study subjects consisted of the 1,742 patients who visited at ECC and the data were obtained from the medical records of ECC and direct surveys. Results: The mean interval between ECC admission time and initial care time by each ECC duty residents was 83.1 minutes for male patients and 84.9 minutes for female patients, and mean ECC staying time (time interval between admission and final disposition from ECC) was 718.0 minutes in men and 670.5 minutes in women. As the results, the mean staying time in ECC was higher in older age, and especially the both of initial care time and staying time were highest in patients of medical aid, and shortest in patients of worker's accident compensation insurance. The on admission or not, previously endotracheal-intubation state of patient. The ECC staying ti initial care time was much more delayed in patients of not having previous medical records and the ECC staying time was higher in referred patients from out-patient department, in transferred patients from the other hospitals and patients having previous records, and in patients partly used the order-communicating system. The factors associated with the initial care time were the numbers of ECC patients and the existence of any true emergent patients, being cardiopulmonary resuscitation (CPR) statusme was much more longer in patients of drug intoxication, in CPR patients, in medical department patients, in transfused patients and in patients related to 3 or more departments. And according to the numbers of duty internships, the ECC staying time for four internships was more longer than for five internships and after admission ordering was done, also-more longer in status being of no available beds. As above mentioned results, the factors for the ECC staying time were thought to be statistically significant (P<0.01) according to the patient's age and the laboratory orders and the X-ray films checked. And also the factor for the ECC staying time were thought to be statistically significant (P<0.01) according to the status being of no available beds, the laboratory orders and/or the special laboratory orders, the X-ray films checked, final disposing department, transferred to other hospital or not, home medication or not, admission or not, the grades of beds, the year grades of residents, the causes of ECC visit, the being CPR status on admission or not, the surgical operation or not, being known personells in our hospital. Conclution: Authors concluded that the relieving method of long-staying time in ECC was being establishing the legally proved apparatus which could differentiate the true emergency or non-emergency patients, and that the methods of shortening ECC staying time were doing definitely necessary laboratory orders and managing beds more flexibly to admit for ECC patients and finally this methods were thought to be a method of unloading for ECC personnels and improving the quality of care in emergency patients.

• Investigative Magnetic Resonance Imaging
• /
• v.17 no.2
• /
• pp.133-143
• /
• 2013

Purpose : To evaluate and compare the accuracy of magnetic resonance imaging (MRI) and ultrasound (US) for detection and estimation of invasion depth of colorectal carcinoma (CRC) by correlation with histopathologic findings in vitro, and to find out the best MR pulse sequence for accurate delineation of tumor from surrounding normal tissue. Materials and Methods: Resected specimens of CRC from 45 patients were examined about tumor detectability and invasion depth of US using high frequency (5-17 MHz) linear transducer in a tube filled with normal saline and MRI in a 8-channel quadrate head coil. The institutional review board approved this study and informed consent was waived. MRI with seven pulse sequences of in- and out-of-phases gradient echo T1 weighted images, fast spin echo T2 weighted image and its fat suppression image, fast imaging employing steady-state acquisition (FIESTA) and its fat suppression image, and diffusion weighted image (DWI) were performed. In each case, both imaging findings of MRI and US were evaluated independently for detection and estimation of invasion depth of tumor by consensus of two radiologists and were compared about diagnostic accuracy according to the histopathologic findings as reference standard. Seven MR pulse sequences were evaluated on the point of accurate delineation of tumor from surrounding normal tissue in each specimen. Results: In specimens of CRC, both imaging modalities of MRI (91.1%) and US (86.7%) showed relatively high diagnostic accuracy to detect tumor and evaluate invasion depth of tumor. In early CRC, diagnostic accuracy of US was 87.5% and that of MRI was 75.0%. There was no statistically significant difference between two imaging modalities (p > 0.05). The best pulse sequence among seven MR sequences for accurate delineation of tumor from surrounding normal tissue in each specimen of CRC was fast spin echo T2 weighted image. Conclusion: MRI and US show relatively high diagnostic accuracy to detect tumor and evaluate invasion depth of resected specimen of CRC. The most excellent pulse sequence of MRI for accurate delineation of tumor from surrounding normal tissue in CRC is fast spin echo T2 weighted image.