• Journal of Hospice and Palliative Care
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• v.2 no.2
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• pp.125-137
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• 1999

Purpose : Surveying the rates, severity, and variables influencing depression and their correlation between pain and depression in Korean cancer patients, we attempted to provide a basic database for the effective depression management program. Methods : The results of survey were colleted from 10 patients who were hospitalized at Seoul National University Hospital for cancer treatment from February to June of 1999. Factors of depression and the level of pain were examined by self-reported survey employing Korean version of Beck Depression Inventory(BDI) and an abridged version of Brief pain Inventory respectively. The purpose of this study and guidelines for the questionnaires were clearly explained to participating patients by Resgitered Nurses before answering the survey. Demographic and clinical characteristics of patients were compiled by reviewing their medical records in corporation with a family physician. The difference in the level of depression among patient groups was analyzed with the t-test and ANOVA, and the correlation between variables with Pearson correlation coefficient. Results : 1) 142 subjects comprised 79 male and 63 female, and their mean age was 51.86. 2) The mean scores of the worst pain for last 24-hours was 6.08(SD 2.23), the average pain for last 24-hours 4.44(SD 1.85), and the mean scores of pain at the time of survey 3.48(SD 2.25), while the mean scores of the least pain for last 24-hours 2.25(SD 1.83). 3) The mean BDI scores were 23.73(SD 0.99), and 55.6% of patients were evaluated to be in depression(cutting point 21). Scores of depression for cancer patients were higher than normal population. 4) The correlation between worst pain for last 24-hours and depression(r=0.252, P=0.002), average pain for last 24-hours and depression(r=0.225, P=0.007), present pain and depression(r=0.291, P=0.000) were significant. 5) Significant differences were found among groups of cancer patients with pain with respect to gender(t=3.59, p=0.000), level of education(F=4.063, P=0.009), ECOG(F=3.352, P=0.021). There was significant positive correlation between depression and pain(r=0.171, P=0.042). Conclusions : More than 50% of cancer patients with pain are suffering from depression. We have shown that the variables like the degree of pain, gender, level of education, ECOG, and age are significantly related to the depression in cancer patients. The findings of this study may be used for assessing high-risk patients in need of intervention and for planning effective therapeutic strategies for them after the routine assessment. Further study is necessary to investigate the cultural differences and the variables influencing on depression in Korean cancer patients.

• Journal of Hospice and Palliative Care
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• v.11 no.3
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• pp.147-155
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• 2008

Purpose: This study aimed to assess the educational needs for nurses who care for terminal cancer patients and their families. To identify top needs along with key issues in consideration to develope hospice training program and provide specific recommendations. Methods: A cross-sectional design with nurses from nine universities' hospice specialist courses and seven cancer centers was used. Data were collected via e-mail or mail service from March to April in 2008. One hundred seventy three questionnaires were returned (return rate: 73.6%), and 156 questionnaires were eventually analyzed. The questionnaire consisted of Mason and Ellershaw's The Self-efficacy in Palliative Care (SEPC) and self-reporting confidence and educational needs in hospice care. Results: The mean age of the participants was 37.94 years, 82.1% were staff nurses, and 44.9% completed over six months hospice education. Mean$\pm$standard deviation score for total SEPC was $2.67{\pm}.62$, which was lower than average (score 3), with communication score being the lowest ($2.49{\pm}.69$). The lowest self-reporting confidence score was $2.03{\pm}.77$ in hospice administration and management, followed by providing complement therapy ($2.34{\pm}.77$), bereavement care ($2.34{\pm}.71$), lymph edema management ($2.35{\pm}.79$), and care planning ($2.36{\pm}.81$). The participants reported that additional education is needed in all topics, with pain management score being the highest ($3.71{\pm}.50$), followed by pain and symptom evaluation ($3.67{\pm}.52$), care for dying ($3.67{\pm}.52$), and communication and counseling ($3.63{\pm}.53$). There were significant subgroup differences in SEPC and self-reporting confidence between groups who completed 6 months hospice education or not, however, no significant difference in educational need between the groups. Conclusion: This study showed the need for developing hospice training program to improve compentency of nurses in hospice palliative care.

• Childhood Kidney Diseases
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• v.8 no.2
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• pp.205-213
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• 2004

Purpose: To evaluate the clinical manifestations of various glomerular diseases in children, a clinicopathological study was performed in 52 children who had renal biopsy. The type and relative incidence of the glomerular pathologies were analyzed, and the clinical predictability and usefulness of renal biopsy in glomerular diseases were assessed. Methods: Medical records of fifty two children with renal disease who had undergone percutaneous renal biopsy under ultrasonic guidance at Chungnam University Hospital from October 1995 to August 2003 were reviewed. In addition, we compared the clinical findings before renal biopsy with the pathological diagnosis. Results: The male to female ratio was 1.6:1 and they were $9.8\pm2.6$ years old on average. The chief complaints for biopsy were hematuria in 22 cases which was the most common (42.3%), proteinuria in 16 cases(30.8%), and hematuria & proteinuria(26.9%). Among the 22 cases of hematuria, there were 15 cases of gross hematuria(68.2%) and 7 cases of microscopic hematuria(31.8%). In terms of histopathologic diagnosis, most of them were primary glomerular diseases(84.6%), which included IgA nephropathy(28.8%), thin glomerular basement membrane disease(25.0%), focal segmental glomerulosclerosis(FSGS)(11.5%), membranous proliferative glomerulonephritis(7.7%), minimal change lesion(3.8%), acute poststreptococcal glomerulonephritis(3.8%) and membranous glomerulonephritis(3.8%). The clinical manifestations and pathologic diagnosis were not correlated. Conclusion: The clinical manifestations could not predict the pathological diagnosis. Therefore, renal biopsy would be inevitable in diagnosis of glomerular diseases for effective management and assessment of prognosis.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.12 no.1
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• pp.30-38
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• 2009

Purpose: To investigate the physical and biochemical parameters related with elevated serum alanine aminotransferase (ALT) levels in obese children. Methods: One hundred forty-two obese or overweight children who visited the out-patient clinics of Chungnam National University Hospital between January 2006 and August 2008 were enrolled. Physical measures and biochemical tests were performed in all patients. Liver sonography was performed in 43 patients. They were divided into the following 2 groups based on ALT levels: group I, normal ALT levels (n=65); and group II, elevated ALT levels (n=77). We compared the physical measures, biochemical results, and ultrasonographic findings of the livers in both groups. Other causes of elevated serum ALT levels were ruled out. Results: The male-to-female ratios were 1.6:1 in group I and 7.6:1 in group II. Among physical parameters, the waist circumference-to-height ratio and hip circumference-to-height ratio were significantly higher in group II (p=0.001 and 0.046, respectively). Among biochemical parameters, aspartate aminotransferase (AST), ${\gamma}$-glutamyltransferase (${\gamma}$-GT), and total cholesterol levels were significantly higher in group II (p<0.001, 0.001, and 0.001, respectively). The AST/ALT ratio was <1 (mean, 0.55) and statistically lower in group II. There was a positive correlation between the serum ALT level and ${\gamma}$-GT (p<0.001, r=0.750), and a positive correlation between the serum ALT level and the waist circumference-to-height ratio in group II (p<0.001, r=0.401). Conclusion: The results suggest that the waist circumference-to-height ratio and ${\gamma}$-GT may be associated with elevated alanine aminotransferase activity in obese children.

• Korean Journal of Soil Science and Fertilizer
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• v.8 no.3
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• pp.135-152
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• 1975

The following informations are known from physical and chemical characteristics of orchard soils and nutritional diagnosis of orange leaves in Jeju. 1. Most orange orchards are located on terrace and cindercone thus soil moisture and microclimate of an orchard will greatly be affected by its topography. 2. Excessive well drainage, shallow soil depth, high content of gravels, low solid phase ratio and strong wind will give severe problem of soil moisture and wind errosion, thus the exte- nsion of soil depth is necessary for maintain nutrients, water and sufficient root volume. 3. Available soil water was significantly and positively correlated with organic matter content and clay content also contributes to available soil water. Vinyl mulching was greatly helpful for soil water conservation, wind errosion prevention, soil temperature increases during winter. 4. Abundant amphoteric amorphous allophane take a key role to fix phosphorus and also rations and thus it is the major factor to determine fertilizer efficiency. Lime and phosphorus must be applied in deeper soil layer. Release of filed phosphorus must be reevluated for availability. 5. Organic matter such as see weeds will greatly increase fertilizer efficiency and low fertilizer efficiency during spring may be related to available soil water. 6. Nitrogen was in superoptimum and Mg was enough but P and Ca were somewhat deficient according to leaf analysies while K was deficient according to fruit analysis. Phosphorus application increased sugar/acid ratio and potassium decreases rind percentage. 7. Manganese deficiency and toxicity appeared in a few places. Iron and boron were enough. Most places showed tendency of copper excess but some places showed copper deficiency. 8. Soiling after elimination of rock base, application of slow release fertilizer and abundant organic matter, vinyl mulching and drip irrigation will increase fertilizer efficiency greatly and fruit yield drastically.

• Journal of Chest Surgery
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• v.38 no.4 s.249
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• pp.271-276
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• 2005

We analysed differences in operative methods and postoperative outcome according to the severity of preoperative cyanosis in adult ToF (Tetralogy of Fallot) patients. Material and Method: From August 1989 to June 2001, thirty three adult patients, 18 females and 15 males, underwent total correction for ToF. Their age ranged from 15 years to 54 years (median: 34). Patients were divided into 2 groups by preoperative $SaO_2$ (arterial oxygen saturation): group I$(n=cyanotic,\;SaO_2\;\geq94\%)$ and group II $(acyanotic,\; SaO_2\geq95%)$. Preoperative median hemoglobin level was higher in group I compared to group II (17.5 g/dl vs 15 g/dl). Postoperative follow-up duration ranged from 1 to 94 months (670 patient-month, median: 14 months), and 63 two-dimensional echocardiographic examinations were done during this period. Result: There were no early or late mortality. With regard to RVOT (right ventricular outflow tract) reconstruction, trans-annular patch and RV-PA extracardiac conduit were used in 7 and 3 patients respectively, and all of them belonged to group I. In group I, cardiopulmonary bypass time, aortic cross-clamping time, ICU day, hospital day were significantly longer than in group II, and postoperative inotropic support was significantly greater than in group II. There was no ventricular arrhythmia in both groups, and one patient in group I suffered from atrial arrhythmia, which was resolved spontaneously after tricuspid and pulmonary valve replacement. During follow-up periods, functional class, residual RVOT stenosis and pulmonary regurgitation, tricuspid regurgitation, occurrence of ventricular and atrial arrhythmias were comparable between two groups. Conclusion: In adult ToF patients with severe preoperative cyanosis, more aggressive RVOT reconstruction and careful postoperative care are mandatory. However intermediate-term outcome of this group of patients is comparable to the patients with minimal or no preoperative cyanosis.

• Journal of Chest Surgery
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• v.38 no.9 s.254
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• pp.616-621
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• 2005

Background: In the resection of lung cancer, pneumonectomy occupied $20 {\~}35\%$ of all resections, and significantly high operative mortality is reported in right pneumonectomy ($10{\~}25\%$). The aim of this study is to identify the characteristics of morbidity, operative mortality and factors affecting operative mortality after pneumonectomy. Material and Method: This study recruited the database which performed pneumonectomy for lung cancer in Korea Cancer Center Hospital from Aug 1987 to Apr 2002. Result: Total of 386 pneumonectomies were peformed in that period. Sidedness were left in 238, right in 148; and the procedures were standard resection in 207, and extended resection in 179. Morbidity occurred in 115 cases ($29.8\%$, 115/386). Mortality occurred in 12 cases ($3.1\%$, 12 in 386). This mortality rate was similar to that of lobectomy ($2.1\%$, 13 in 613) during the same period. Morbidity consisted of 42 hoarseness, 17 (9) pneumonia and ARDS, 8 empyema, 5 (1) broncho-pleural fistula, 5 reoperation for bleeding, 5 (1) arrhythmia, 1 (1) pulmonary edema, and 25 others (The number in the parenthesis is the number of mortality case for that morbidity). Several factors affecting the operative mortality were evaluated. At first, extended procedure ($3.3\%$, 6 in 179) affected the operative mortality similar to the standard procedure ($2.9\%$, 6 in 207)(p=0.812). Second, the rate of operative mortality in an elderly group over 60 years ($5.5\%$, 10 in 182) was significantly higher than the younger group under 60 years ($1\%$, 2 in 204)(p=0.016). Third, sidedness of resection affects to operative mortality. Right pneumonectomy ($6.8\%$, 10 in 148) showed higher operative mortality than that of left pneumonectomy ($0.8\%$, 2 in 238)(p=0.002). The group over 60 years showed higher incidence of respiratory morbidity ($11.0\%$, 20 in 182) than that of the group under 60 years ($3.4\%$, 7 in 204)(p=0.005). Right pneumonectomy also showed significantly higher incidence ($11.5\%$, 17 in 148) than that of left pneumonectomy ($4.2\%$, 10 in 238)(p=0.008). Conclusion: Age and sidedness of pneumonectomy were the risk factors of operative mortality and respiratory complications, Therefore, careful selection of patients and more attention perioperatively were demanded in right pneumonectomy. However, because the operative mortality is acceptable, pneumonectomy could be done safely if the pneumonectomy is necessary for curative resection of lung cancer.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.9 no.1
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• pp.82-90
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• 1998

This study is attempted to examine Korean teachers’ perceptions of mental health problems in students and their attitudes towards psychiatric consultations through a questionnaire survey. The results of this study are as follows. 1) Teachers thought that 5.3% of their students had mental health problems, 1.9% of students required psychiatric evaluation, and 1.2% of students were referred or recommended psychiatric evaluation by their teachers. 2) The most frequent mental health problems in students discovered by teachers were distractibility and inattention, lack of academic skills, and language difficulties in elementary schools；distractibility and inattention, conduct problems, and lack of academic skills in middle schools；and conduct problems, distractibility and inattention, physical symptoms, and substance abuse in high schools. 3) Teachers thought the mental health problems in students were caused by the family environment, psychological factors, the educational system, and a lack of mental health services. 4) Teachers desired smaller classes, improvement of the school environment, more time, regular mental health education, a special program for students with mental health problems, and the counseling staffs or consultants for the school mental health. 5) Teachers consulted with other teachers, the parents of the students, the counseling teachers, the health care teachers, the counseling institutes, the psychiatric clinics, and the principals in descending order to handle the hard case problems. The frequent reasons for failing in psychiatric consultations were the prejudice of parents against psychiatric services, the teachers’ sense of superiority in dealing with the problems of students, the prejudice of teachers themselves against psychiatric practice, and inaccessible professional consultation. 6) About 20.4% of teachers reported they had proposed psychiatric consultations or had recommended their students to receive psychiatric evaluations.

• Progress in Medical Physics
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• v.20 no.1
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• pp.21-29
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• 2009

Breast cancer is the most common form of cancer among korean woman. Therefore, the early detection activities of breast cancer such as breast self-examinations, clinical breast examinations, mammography are important. A yearly mammography examination has been recommended for women aged 40 and older for the early detection of breast cancer in asymptomatic periods. However, the glandular tissue of breast is the most radiation-sensitive tissue, and the determination of average glandular dose (AGD) forms an important part of the quality control of the mammographic systems. Because of the difficulty of estimating AGD directly, it is often estimated from the measurements of the incident air kerma and by applying the appropriate conversion factors. The primary objective of this study was to standardize the method of measuring AGD. The secondary objective was to evaluate the relationships between AGD per various composition and thickness of the breast using Monte Carlo simulations. As a result, we standardized the method of measuring AGD according to International Atomic Energy Agency (IAEA) guidelines (CoP: an international code of practice). Overall, AGD for mammographic practice in Korea was less than 3.0 mGy recommended by the Korea Food and Drug Adminstration (KFDA) protocol, and Korean Institute for Accreditation of Medical Image (KIAMI). The measured and simulated AGD for a given condition were calculated as 1.7 and 1.6 mGy, respectively. For the AGDs obtained, there was no significant difference between them. The simulated AGD was dependent on the fraction of glandular tissue of the breast. The AGD increases with increasing of the breast glandularity due to increasing absorption of low energy photons. The AGD also increases as a function of breast thickness. In conclusion, the results of this study could be used as a baseline to establish a reference level of radiation dose in mammography.

• Journal of Gastric Cancer
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• v.4 no.4
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• pp.219-224
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• 2004

Purpose: Through a survey on an Internet homepage, we conducted research concerning the need of patients and their families for information on gastric cancer. We also assessed their interest in gastric cancer. Materials and Methods: We analyzed 619 inquiries presented from June 2002 to September 2003 and 524 replies submitted to a questionnaire survey delivered by the Internet homepage (www.gastriccancer.co.kr) from August to October 2003 to gastric cancer patients and their families. Results: Analysis of Inquiries: The classified inquiries listed in order of frequency are as follows: treatment, prognosis, stages, symptoms, pathophysiology, diagnostic modalities, favorable food, etiology, follow-up, etc. Among the inquiries about treatment, the most frequent subgroup was about the scope of surgery or perioperative implications. Next came questions concerning chemotherapy. Among the questions from patients yet to be operated, on those about operability and the prognosis were most frequent. Among the patients who had undergone a resection, questions on complications and the corresponding prognosis were most frequent. The concern from patients with inoperable or recurrent cancers was related to terminal care and/or chemotherapy. Analysis of Questionnaires: The respondents acquired information on gastric cancer from the Internet ($40\%$), doctors ($32\%$), the mass media ($15\%$) and acquaintances ($13\%$). Only $6\%$ of the respondents were sufficiently satisfied with the information provided by doctors. Among the respondents, $89.9\%$ were interested in complementing treatment with folk remedies while only $5\%$ were not. Conclusion: Patients and their families were eager to get information about gastric cancer. However, many of them found the doctors' information to be insufficient. Our suggestion is that the public health, academic societies, medical institutions, and public organizations should endeavor to provide through an activated Internet network correct information on gastric cancer. (J Korean Gastric Cancer Assoc 2004;4:219-224)