• Journal of the korean academy of Pediatric Dentistry
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• v.29 no.4
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• pp.539-554
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• 2002

To identify the trend of pediatric dentistry in USA and Japan, closely related to Korean pediatric dentistry. The Japanese Journal of Pediatric Dentistry(JJPD) and The Journal of the American Academy of Pediatric Dentistry(PD) were reviewed. We collected the bibliographical data of the articles published in the two journals from 1991 to 2000. We analyzed thematic distributions and chronological changes, and then compare those of two groups. The following results were obtained: 1. The 869 articles were published in JJPD and 672 in PD. This was about 30% more in JJPD. 2. In both JJPD and PD, the case reports were a quarter of scientific articles in quantity. 3. The studies on the systemic diseases had the highest proportion in both JJPD and PD. The studies on the dental caries and restorative materials also had high proportion in both journals. 4. The studies on the sedation and biochemical survey had high proportion in PD when had low proportion in JJPD. To the contrary, The studies on the behavior science in JJPD were about double of those in PD. 5. There was no statistically significant difference in quantity between JJPD and PD in the studies on the dental caries, prevention of dental caries, community dental survey, conservative treatment, restorative materials, pulp treatment, diagnosis and treatment of malocclusion, oral pathology and minor surgery, local anesthesia and nerve tissue, traumatic injuries. 6. There was statistically significant increase in the studies on the dental equipment in JJPD and in those on restorative materials in PD. 7. There was statistically significant decrease in the studies on the prevention of dental caries and local anesthesia and nerve tissue in JJPD, and those on conservative treatment in PD.

• Journal of Radiation Protection and Research
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• v.24 no.4
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• pp.195-203
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• 1999

It is difficult to determine dosimetric characteristics for small field photon beams since such small fields do not achieve complete lateral electronic equilibrium and have steep dose gradients. Dosimetric characteristics of small field 4, 6, and 10 MeV photon beams have been measured in water with a diamond detector and compared to measurements using small volume cylindrical and plane parallel ionization chambers. Percent depth dose (PDD) and beam profiles for 6 and 10 MeV photon beams were measured with diamond detector and cylindrical ion chamber for small fields ranging from $1{\times}1\;to\;4{\times}4cm^2$. Total scatter factors($S_{c,p}$) for 4, 6, and 10 MeV photon beams were measured with diamond detector, cylindrical and plane parallel ion chambers for small fields ranging from $1{\times}1\;to\;4{\times}4cm^2$. The $S_{c,p}$ factors obtained with three detectors for 4, 6, and 10 MeV photon beams agreed well ($\pm1.2%$) for field sizes greater than $2{\times}2,\;2.5{\times}2.5,\;and\;3{\times}3\;cm^2$, respectively. For smaller field sizes, the cylindrical and plane parallel ionization chambers measure a smaller $S_{c,p}$ factor, as a result of the steep dose gradients across their sensitive volumes. The PDD values obtained with diamond detector and cylindrical ionization chamber for 6 and 10MeV photon beams agreed well ($\pm1.5%$) for field sizes greater than $4{\times}4\;cm^2$. For smaller field sizes, diamond detector produced a depth-dose curve which had a significantly shallower falloff than that obtained from the measurements of relative depth-dose with a cylindrical ionization chamber. For the measurements of beam profiles, a distortion in terms of broadened penumbra was observed with a cylindrical ionization chamber since diamond detector exhibited higher spatial resolution. The diamond detector with small sensitive volume, near water equivalent, and high spatial resolution is suitable detector compared to ionization chambers for the measurements of small field photon beams.

• Progress in Medical Physics
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• v.16 no.2
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• pp.62-69
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• 2005

The purpose of this study has been performed to investigate the possibility of external audit program using thermoluminescence dosimetry for electron beam in korea. The TLD system consists of LiF powder, type TLD-700 read with a PCL 3 reader. In order to determine a calibration coefficient of the TLD system, the reference dosimeters are irradiated to 2 Gy in a $^{60}CO$ beam at the KFDA The irradiation is performed under reference conditions is water phantom using the IAEA standard holder for TLD of electron beam. The energy correction factor is determined for LiF powder irradiated of dose to water 2 Gy in electron beams of 6, 9, 12, 16 and 20 MeV (Varian CL 2100C). The dose is determined according to the IAEA TRS-398 and by measurement with a PTW Roos type plane-parallel chamber. The TLD for each electron energy are positioned in water at reference depth. In this study, to verify of the accuracy of dose determination by the TLD system are performed through a 'blind' TLD irradiation. The results of blind test are $2.98\%,\;3.39\%\;and\;0.01\%(1\sigma)$ at 9, 16, 20 MeV, respectively. The value generally agrees within the acceptance level of $5\%$ for electron beam. The results of this study prove the possibility of the TLD quality assurance program for electron beams. It has contributed to the improvement of clinical electron dosimetry in radiotherapy centers.

• Clinical and Experimental Pediatrics
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• v.52 no.3
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• pp.310-314
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• 2009

Purpose : Pneumothorax is an important factor responsible for increased mortality and morbidity in neonates. Here, we compared the clinical findings and prognosis for neonatal pneumothorax induced by respiratory distress syndrome (RDS) and pneumonia. Methods : Between January 2001 and December 2005, 80 patients with neonatal pneumothorax induced by RDS and pneumonia and admitted to the NICU of Dongsan Medical Center, Keimyung University, were enrolled. They were assigned to the RDS group (30 cases) or the pneumonia group (50 cases). Admission records for gestational age, onset day of life, rate of ventilatory care and thoracostomy, and prognosis were retrospectively reviewed and statistically analyzed for both groups. Results : The mean gestation age was significantly shorter in the RDS group (32.3 weeks) than in the pneumonia group (38.1 weeks) (P<0.001), and the mean onset day of life were later in the RDS group (4.6 days) than in the pneumonia group (1.8 days) (P<0.05). Rates of ventilatory care and thoracostomy were higher for the RDS group than for the pneumonia group (100% vs. 44%, and 66.7% vs. 48%, respectively). Total mortality rates and pneumothorax specific mortality rates were higher for the RDS group than for the pneumonia group (46.7% vs. 18%, P<0.01 and 33.3% vs. 16%, P<0.05, respectively). After logistic regression analysis, preterm significantly increased the mortality rate (OR 7.44, 95% CI: 1.99-27.86, P<0.005), but bilateral involvement (OR 1.17, 95% CI: 0.82-1.67, P>0.5) and the RDS group itself (OR 1.70, 95% CI: 0.52-5.54, P>0.3) did not increase mortality rates significantly. Conclusion : Our study suggests that neonatal pneumothorax in the RDS group tends to have a later onset, higher mortality rate, and needs a higher rate of thoracostomy than the pneumonia group. However, after logistic analysis, only preterm significantly and independently increased the mortality rate.

• Clinical and Experimental Pediatrics
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• v.53 no.2
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• pp.184-189
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• 2010

Purpose : Pseudomembranous colitis (PMC) occurs rarely in children, but its incidences are increasing due to frequent antibiotic use. We investigated the incidence and clinical characteristics of PMC accompanied by bacterial enteritis-like symptoms in children. Methods : Between November 2003 and July 2007 at the Department of Pediatrics, Dongsan Medical Center, we analyzed the medical records of consecutive patients who received antibiotics in the past 1 month, developed bacterial enteritis-like symptoms, and were diagnosed with PMC based on sigmoidoscopy examination and histological findings. Results : Among 22 patients who underwent sigmoidoscopy and biopsy examinations, 11 (50%) were diagnosed with PMC. These 11 patients were aged 2 months-12 years, among whom 5 patients (45.5%) were less than 1 year old. The clinical symptoms were bloody diarrhea (28.6%), abdominal pain or colic (28.6%), watery or mucoid diarrhea (23.8%), vomiting (9.5%), and fever (9.5%). The antibiotics used were penicillins (55.6%), macrolides (27.8%), cephalosporins (11.1%), and aminoglycosides (5.6%). The period of antibiotic use was 3-14 days. The interval between the initial antibiotic exposure and the onset of symptoms was 5-21 days. The results of stool examination of all patients were negative for Clostridium difficile toxin A. Patient distribution according to the degree of PMC was as follows: grade I, 18.2% (2 cases); grade II, 27.3% (3); grade III, 36.4% (4); and grade IV, 18.2% (2). PMC did not recur in any case.Conclusion : PMC is not a rare disease in children. If pediatric patients receiving antibiotics manifest symptoms like bacterial enteritis, PMC should be suspected. Endoscopy and biopsy should be applied as aggressive diagnostic approaches to detect this condition.

• Journal of Korean Academy of Nursing Administration
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• v.1 no.1
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• pp.132-146
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• 1995

Even though Korean medical law stipulates that number of patients attended by a nurse is 2.5 for hospitalization and 30 for ambulatory care, the number of patients cared by a nurse per day is much greater than the standard prescribed by the medical law. Current productivity of nurses is not desirable unless the quality of care is considered. And nursing manpower staffing based on neither current nurses' productivity nor standard of medical law cannot respond properly to dynamic situation of the medical services. Under this background, the necessity of more efficient management of nursing manpower occupying 1/3 of total hospital workers has been recognized by many nursing administrators. Many nursing researchers have studied to foretell the nursing manpower objectively on the basis of measured nursing workload according to patient classification as well. Most of These researches, however, have been conducted in the tertiary hospitals, so it is imperative to conduct other researches to predict necessary nursing manpower in the secondary and the primary hospitals. The study was performed to measure nursing workload and predict pertinent nursing manpower to a secondary hospital with 400beds. Nursing workload was surveyed using measuring tool for direct and indirect care hours in a surgical unit and a medical unit. Survey was conducted from Sep.10 to Sep.16 and from Oct.5 to Oct.11, 1994 respectively by two skilled nurses, Subjects were patients, patients' family members and nursing personnels. Results are follows : 1. Patient classification distributed as 22% of class I (mildly ill patient), 57% of class II (moderately ill patient), and 21% of class III (acutely ill patient) in the medical nursing unit, while 23% of class I, 29% of class II, 12% of class III, and 36% of classIV (critically ill patient) in the surgical nursing unit. There was no difference of inpatient number between weekday and weekend. Bed circulation rate was 89% in both units and average patients number per day was 37.4 (total 42beds) in the medical nursing unit, 32.9 (total 37beds) in the medical nursing unit. 2. Direct care hours per day measured as 2.8hrs for class I, 3.3hrs for class II, and 3.5hrs for class III in the medical nursing unit, while 3.1hrs for class I, 3hrs for class II, 2.7hrs for class III, and 2.2hrs for classIV in the surgical nursing unit. Meanwhile, hours for nursing assistant activities per patient by patients' family members were 11mins and 200mins respectively. Direct care hour rate by shift was day 36%, evening 25%, and night 39% in the medical nursing unit, while 40%, 29%, and and 31% respectively in the surgical nursing unit. 3. Measurement and observation activity held 44.2% of direct care activities of nurses and medication 36.7%, communication 11.7%, exercise 1.8%, treatment 1.3%, hygiene 1.3%, elimination and irrigation 1.1%, suction 1%, nutrition 0.5%, thermotherapy 0.3%, oxygen therapy 0.1% in order. 4. Indirect care hours per day were 294.2mins in the medical nursing unit, and 273.9mins in the surgical nursing unit. By shift, evening was the highest in both units. Indirect care hours for each patient were 44.5mins in the medical nursing unit and 46mins in the surgical nursing unit. 5. checking activities including doctor's order, medication, and delivering patients to the next shift occupied 39.7% of indirect care activities, and preparation 26%, recording 23.8%, communication and conference 6.7%, managing equipments 2.1%, messenger activity 1.7% in order. 6. On the ground of these results, nursing manpower needed in a secondary hospital was estimated ; 27 nursing personnels for the medical nursing unit of 37beds, and 20 nursing personnels for the surgical nursing unit of 33beds.

• Journal of Nutrition and Health
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• v.48 no.6
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• pp.542-557
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• 2015

Purpose: The aim of this study is to develop an evaluation tool for operation of food safety and nutrition education projects for middle class elderly using the concept of the balanced score card. Methods: After the draft of the evaluation tool for the elderly training projects was completed, it was revised into the questionnaire and the validity of the indicators was tested by the Delphi group. The validity of the indicators was rated using a 5-point scale. The Delphi group consisted of 26 experts in the education sector, 16 government officials, and 24 professionals of the related area in communities. The first round test was conducted from July 9 to July 17, 2012, and 45 persons responded. The second round test was conducted from July 18 to July 25 and 32 persons responded. Results: The indicators, which were answered by more than 75 percent of the experts as 'agree' (4 points), 'strongly agree' (5 point) were included as the final indicators for the evaluation tool: 28 items out of 36 in outcome perspectives, 9 items out of 12 in process perspectives, and 17 out of 20 items in structure perspectives. The score was allocated as 50 points for outcome indicators, 20 points for process indicators, and 30 points for structure indicators. Conclusion: Completion of the evaluation tool is a prerequisite to determine whether the program is effectively implemented. The monitoring tool developed in the study could be applied for identification of the most optimal delivery path for the food safety and nutrition education program, for the spread of the food safety and nutrition education program for middle class elderly.

• Progress in Medical Physics
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• v.10 no.1
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• pp.17-22
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• 1999

INJ-I, INJ-E, PFN, BMI, and PRF were selected among the various factors which constitute a digital linear accelerator to find effects on the dose distribution by changing current and voltage within the permitted scale which Mevatron automatically maintained. We measured the absorbed dose using an ion chamber, analyzed the waveform of beam output using an oscilloscope, and measured symmetry and flatness using a dosimetry system. An RFA plus (Scanditronix, Sweden) device was used as a dosimetry system. Then an 0.6cc ion chamber (PR06C, USA), an electrometer (Capintec192, USA), and an oscilloscope (Tektronix, USA) were employed to measure the changes on the dose distribution characteristics by changing the beam-tuning parameters. When the currents and the voltages of INJ-I, INJ-E, PFN, BMI, and PRF were modified, we were able to see the notable change on the dose rate by examining the change of the output pulse using the oscilloscope and by measuring them using the ion chamber. However, the results of energy and flatness graph from RF A plus were almost identical. The factors had fine differences: INJ-I, INJ-E, PFN, BMI, and PRF had 0.01∼0.02% differences in D10/D20, 0.1∼0.2 % differences in symmetry, and 0.1∼0.4% differences in flatness. Since Mevatron controlled itself automatically to keep the reference value of the factor, it was not able to see large differences in the dose distribution. There were fine differences on the dose rate distribution when the voltage and the currents of the digitized factors were modified Nonetheless, a basic operational management information was achieved.

• Progress in Medical Physics
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• v.12 no.1
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• pp.51-58
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• 2001

Synchrotron radiation (SR) has several advantages over convetional x-rays, including its phase, collimation, and high flux. A synchrotron radiation beamline 5C1 at Pohang Light Source (PLS) was recently built for imaging applications. We have shown that a SR imaging system is useful in imaging microscopic structures. SR with broad-band energy spectrum were adjusted to an object by Si wafers and their energy were approximately ranging from 6 keV to 30 keV. SR were passed through an object and finally transformed into visible lights by CdWO$_4$ scintillator screen. The visible lights which were reflected at an angle of 90 degrees by gold plated mirror were detected by a CCD camera and the image data were acquired using image acquisition system. A high-resolution phantom, capacitor, adult tooth, child tooth, cancerous breast tissue, and mouse lumbar vertebra were imaged with SR imaging system. The Objects were rotated within the field of view of the CCD detector, and their projection image data were obtained at 250 steps over 180 degrees rotation. Image reconstructions were carried out in a PC by using IDLTM(Research systems, Inc., US) program. The spatial resolution of the images acquired by the SR imaging system was measured with a high-resolution chart manufactured for several micrometer resolution. The specimens were also imaged with conventional x-ray radiography system to compare the image quality of radiography obtained with the SR imaging system. The results showed more structural details and high contrast images with SR imaging system than conventional x-ray radiography system. The SR imaging system may have a potential for imaging in biological researches, material applications, and clinical radiography.

• Progress in Medical Physics
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• v.18 no.2
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• pp.98-106
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• 2007

In June 2005, Yonsei University Medical Center, Severance Hospital upgraded a full-PACS system by adding twenty (5 mega pixels) Totoku ME511L flat panel LCD display devices for diagnostic interpretation purposes. Here we report upon the quantitative (or visual) acceptance testing of the twenty Totoku ME511L display devices for reflection, luminance response, luminance spatial dependency, resolution, noise, veiling glare, and display chromaticity based on AAPM TG 18 report. The tools used in the tests included a telescopic photometer, which was used as a colorimeter, illuminance meter, light sources for reflection assessment, light-blocking devices, and digital TG18 test patterns. For selected 8 flat panel displays, mean diffuse reflection coefficient ($R_d$) was $0.019{\pm}0.02sr^{-1}$. In the luminance response test, luminance ratio (LR), maximum luminance difference ($L_{max}$), and deviation of contrast response were $550{\pm}100,\;2.0{\pm}1.9%\;and\;5.8{\pm}1.8%$, respectively. In the luminance uniformity test, maximum luminance deviation was $14.3{\pm}5.5%$ for the 10% luminance of the TG18-UNL10 test pattern. In the resolution test with luminance measurement method, percent luminance (${\Dalta}L$) at the center was $0.94{\pm}0.64%$. In all cases of noise testing, rectangular target In every square in the three quadrants was visible and all 15 targets except the smallest one in the every corner pattern and the center pattern. The glare ratio (GR) was $12,346{\pm}1,995$. The color uniformity, (u',v'), was $0.0025{\pm}0.0008$. Also, the research results of qualify control guideline of primary disply devices suitable for domestic circumstance are presented All test results are in-line with the criteria recommended by AAPM TG18 report and are thus fully acceptable for diagnostic image interpretation. As a result, the acceptance testing schedule described provides not only an acceptance standard but also guidelines for quality control, optimized viewing conditions, and a means for determining the upgrading time of LCD display devices for diagnostic interpretation.