• Journal of Chest Surgery
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• v.42 no.5
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• pp.624-629
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• 2009

Background: Making the histologic diagnosis of small pulmonary nodules and ground glass opacity (GGO) lesions is difficult. CT-guided percutaneous needle biopsies often fail to provide enough specimen for making the diagnosis. Video-assisted thoracoscopic surgery (VATS) can be inefficient for treating non-palpable lesions. Preoperative localization of small intrapulmonary lesions provides a more obvious target to facilitate performing intraoperative. resection. We evaluated the efficacy of CT-guided localization with using a hook wire and this was followed by VATS for making the histologic diagnosis of small intrapulmonary nodules and GGO lesions. Material and Method: Eighteen patients (13 males) were included in this study from August 2005 to March 2008. 18 intrapulmonary lesions underwent preoperative localization by using a CT-guided a hook wire system prior to performing VATS resection for intrapulmonary lesions and GGO lesions. The clinical data such as the accuracy of localization, the rate of conversion-to-thoracotomy, the operation time, the postoperative complications and the histology of the pulmonary lesion were retrospectively collected. Result: Eighteen VATS resections were performed in 18 patients. Preoperative CT-guided localization with a hook-wire was successful in all the patients. Dislodgement of a hook wire was observed in one case. There was no conversion to thoracotomy, The median diameter of lesions was 8 mm (range: $3{\sim}15\;mm$). The median depth of the lesions from the pleural surfaces was 5.5 mm (range: $1{\sim}30\;mm$). The median interval between preoperative CT-guided with a hook-wire and VATS was 34.5 min (range: ($10{\sim}226$ min). The median operative time was 43.5.min (range: $26{\sim}83$ min). In two patients, clinically insignificant pneumothorax developed after CT-guided localization with a hook-wire and there were no other complications. Histological examinations confirmed 8 primary lung cancers, 3 cases of metastases, 3 cases of inflammation, 2 intrapulmonary lymph nodes and 2 other benign lesions. Conclusion: CT-guided localization with a hook-wire followed by VATS for treating small intrapulmonary nodules and GGO lesions provided a low conversion thoracotomy rate, a short operation time and few localization-related or postoperative complications. This procedure was efficient to confirm intrapulmonary lesions and GGO lesions.

• Journal of Chest Surgery
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• v.35 no.8
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• pp.611-615
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• 2002

Pneumoconiosis is fibrogenic disease, caused by inhalation of mineral dust. It is defined as the accumulation of dust in the lung and tissue reaction to its presence and the dust is considered to be an aerosal of solid and inanimate particles. It is among the most common and the most important occupational lung disease, especially in developing countries. It is required three prerequisites for making a clinical diagnosis of pneumoconiosis: 1) a full clinical and occupational history together with the result of physical examination; 2) previous X-ray for comparison; and 3) a clear understanding of the time scale involved in the progression of the diseases. Most pneumoconiosises are slow to evolve and changes in the appearances take many months -usually years- to occur. Pneumoconiosis is represented on a plain X-ray of the chest as multiple small round opacities, usually smaller than 1cm diameter. In 58 years old female patient, pneumoconiosis is manifested as $5{\times}4{\times}3$cm sized solitary pulmonary nodule without any occupational history and past history of exposure of dust. so we treated this case with right upper lobectomy. Therefore we report this case with a brief review of literatures.

• Quality Improvement in Health Care
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• v.20 no.1
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• pp.28-40
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• 2014

Objectives: Prescriptions for Parkinson's can be dispensed at the outpatient pharmacy. In general, the treatment of Parkinson's disease requires a multitude of drugs, sometimes taken 4 to 6 times a day at specific times as prescribed by the medical practitioner. Said "time-specific therapy" is one of the major reasons of dispensing delay observed at the outpatient pharmacy. Because our establishment lacked a computerized system to support time-specific prescriptions, they were not recognized electronically. They had to be issued and dispensed manually, which required a greater amount of time than the automated process. To solve the problem, a new sig code was developed to handle time-specific prescriptions with a comprehensive automated dispensing system to support it. This study aims to create electronic programs and streamline the process to increase dispensing performance. And thus, ensure greater patient safety and dispensing accuracy within a shorter dispensing time and also increase employee satisfaction through a decreased workload. Methods: After identifying the problems caused by non-electronic prescriptions an automated system that allowed the issuance of time-specific prescriptions was developed. A new sig code was created that could be recognized by the Pharmacy electronic medical program, the label printer to group medications by administration times and the Automatic Tablet Counter(ATC) to count the grouped drugs accordingly. Result: With the new sig code, the practitioner became able to electronically select the times of drug administration while issuing the prescription. This 'time-specific prescription' can now be recognized by the pharmacy electronic medical program, the label printer and the ATC like any other prescription. Conclusion: The developed program started operating on September 2013. Although not all Parkinson's patients have been issued with the new electronic 'time-specific prescription', the overall dispensing process has become more streamlined and accurate. As the medical team continues to integrate the new system in their practice an additional decrease of the dispensing time is predicted. Future program upgrades and other new time-saving approaches are scheduled, which are expected to further increase the service quality of our outpatient pharmacy.

• The Korean Nurse
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• v.29 no.3
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• pp.36-48
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• 1990

This study was attempted to provide us with basic information on how to improve understanding with patients for operation, and to offer then better nursing and treatment. This kind of study will help scientific application to nursing practice and operating room. The data was collected by interviewing 29 patients who underwent the elective surgery under the general anesthesia at Y hospital in Seoul. The interview ran from October 15 to December 15, 1989. The research instrument was a anxiety measurement device (SAAI) originally developed by Spielberger, et al and modified by Jung-Tack Kim. 1. Hypothesis Testing Hypothesis one was that there would be a difference in state anxiety level according to a time difference in watiting for operation. This hypothesis was rejected(state.anxiety level one hour before operation P>.05, r-.747, State anxiety level half an hour before operation P>.05, r-.1550, state anxiety level just before operation, P>.05, r=.1099). However, state anxiety, evel appeared to be associated with a longer watiting period, like one day before operation (P<.05, r-.4628). Hypothesis two was that there would be a difference according to state anxiety level of patients for operation. This was rejected. (Change of blood perssure in systolie P>.05 r=.1082, Change of blood pressure in diastolic P>.05, r=.088, Change of pulse rate, P>.05, r-1.909) 2. Examining trait anxiety and state anxiety levels, the average level of trait anxiety was 42.034, and the average level of state anxiety one day before operation was 43,000. The average level of state anxiety was averaged 42.356 in a waiting room for operation. 3. Examining the state anxiety level by time period, the one hour before was 42.379 the level half an hour before 42.276, and the level just before operation 42.414. The low level of state anxiety was due to the fact that premedication was not eliminated. 4. Age and time period like one day before operation was related to state anxiety level (F=5.271, P<.0.01) and blood pressure in waiting room for operation. That is, state anxiety level and blood pressure of patients one day before operation appeared high. Sex was relation to changes of blood pressure ; the blood pressure of male patients appeard higer than of female patients. A marital status was also related anxiety level one hour before operation the married patient for operation showed a higher state anxiety level than that of the unmarried patient for operation. Education was similarily related to trait anxiety level in which highly educated patients show lower levels of trait anxiety than poorly educated ones. Motive for hospitalization was related to state anxiety level for patient one hour before operation (F=6.464, P<.05) likewise, patients who are supposed to undergo operation hastily showed higher levels of anxiety than patients who expect elective surgeries.

• The Korean Journal of Nuclear Medicine Technology
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• v.18 no.1
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• pp.110-114
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• 2014

Purpose: The advancement in PET/CT test devices has decreased the test time and popularized the test, and PET/CT tests have continuously increased. However, this increases the exposure dose of radiation workers, too. This study aims to measure the radiation shielding rate of $^{18}F-FDG$ with a strong energy and the shielding effect when worker wore an apron during the PET/CT test. Also, this study compared the shielding rate with $^{99m}TC$ to minimize the exposure dose of radiation workers. Materials and Methods: This study targeted 10 patients who visited in this hospital for the PET/CT test for 8 days from May 2nd to 10th 2013, and the $^{18}F-FDG$ distribution room, patient relaxing room (stand by room after $^{18}F-FDG$ injection) and PET/CT test room were chosen as measuring spots. Then, the changes in the dose rate were measured before and after the application of the APRON. For an accurate measurement, the distance from patients or sources was fixed at 1M. Also, the same method applied to $^{99m}TC's$ Source in order to compare the reduction in the dose by the Apron. Results: 1) When there was only L-block in the $^{18}F-FDG$ distribution room, the average dose rate was $0.32{\mu}Sv$, and in the case of L-blockK+ apron, it was $0.23{\mu}Sv$. The differences in the dose and dose rate between the two cases were respectively, $0.09{\mu}Sv$ and 26%. 2) When there was no apron in the relaxing room, the average dose rate was $33.1{\mu}Sv$, and when there was an apron, it was $22.3{\mu}Sv$. The differences in the dose and dose rate between them were respectively, $10.8{\mu}Sv$ and 33%. 3) When there was no APRON in the PET/CT room, the average dose rate was $6.9{\mu}Sv$, and there was an APRON, it was $5.5{\mu}Sv$. The differences in the dose and dose rate between them were respectively, $1.4{\mu}Sv$ and 25%. 4) When there was no apron, the average dose rate of $^{99m}TC$ was $23.7{\mu}Sv$, and when there was an apron, it was $5.5{\mu}Sv$. The differences in the dose and dose rate between them were respectively, $18.2{\mu}Sv$ and 77%. Conclusion: According to the result of the experiment, $^{99m}TC$ injected into patients showed an average shielding rate of 77%, and $^{18F}FDG$ showed a relatively low shielding rate of 27%. When comparing the sources only, $^{18F}FDG$ showed a shielding rate of 17%, and $^{99m}TC$'s was 77%. Though it had a lower shielding effect than $^{99m}TC$, $^{18}F-FDG$ also had a shielding effect on the apron. Therefore, it is considered that wearing an apron appropriate for high energy like $^{18}F-FDG$ would minimize the exposure dose of radiation workers.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.2
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• pp.3-8
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• 2010

Purpose: $^{11}C$-Acetate PET/CT is useful in detecting lesions that are related to livers in the human body and leads to a sensitivity of 87.3%. On the other hand, $^{18}F$-FDG PET/CT has a sensitivity of 47.3% and it has been reported that if both $^{18}F$-FDG and $^{11}C$-Acetate PET/CT are carried out together, their cumulative sensitivity is around 100%. However, the normal intake of the pancreas and the spleen in $^{11}C$-Acetate PET/CT can influence the $^{18}F$-FDG PET/CT leading to an inaccurate diagnosis. This research was aimed at the verification of the usefulness of how much influence these two radioactive medical supplies can cause on the medical images through comparative analysis between the one-day and two-day protocol. Materials and Methods: This research was carried out based on 46 patients who were diagnosed with liver cancer and have gone through the PET/CT (35 male, 11 female participants, average age: $54{\pm}10.6$ years, age range: 29-69 years). The equipment used for this test was the Biograph TruePoint40 PET/CT (Siemens Medical Systems, USA) and 21 participants who went through the one-day protocol test were first given the $^{11}C$-Acetate PET/CT and the $^{18}F$-FDG PET/CT, the latter exactly after one hour. The other 25 participants who went through the two-day protocol test were given the $^{11}C$-Acetate PET/CT on the first day and the $^{18}F$-FDG PET/CT on the next day. These two groups were then graded comparatively by assigning identical areas of interest of the pancreas and the spleen in the $^{18}F$-FDG images and by measuring the Standard Uptake Value (SUV). SPSS Ver.17 (SPSS Inc., USA) was used for statistical analysis, where statistical significance was found through the unpaired t-test. Results: After analyzing the participants' medical images from each of the two different protocol types, the average${\pm}$standard deviation of the SUV of the pancreas carried out under the two-day protocol were as follows: head $1.62{\pm}0.32$ g/mL, body $1.57{\pm}0.37$ g/mL, tail $1.49{\pm}0.33$ g/mL and the spleen $1.53{\pm}0.28$ g/mL. Whereas, the results for participants carried out under the one-day protocol were as follows: head $1.65{\pm}0.35$ g/mL, body $1.58{\pm}0.27$ g/mL, tail $1.49{\pm}0.28$ g/mL and the spleen $1.66{\pm}0.29$ g/mL. Conclusion: It was found that no statistical significant difference existed between the one-day and two-day protocol SUV in the pancreas and the spleen (p<0.05), and nothing which could be misconceived as false positive were found from the PET/CT medical image analysis. From this research, it was also found that no overestimation of the SUV occurred from the influence of $^{11}C$-Acetate on the $^{18}F$-FDG medical images where those two tests were carried out for one day. This result was supported by the statistical significance of the SUV of measurement. If $^{11}C$-Acetate becomes commercialized in the future, the diagnostic ability of liver diseases can be improved by $^{18}F$-FDG and one-day protocol. It is from this result where tests can be accomplished in one day without the interference phenomenon of the two radioactive medical supplies and furthermore, could reduce the waiting time improving customer satisfaction.

• The Korean Journal of Nuclear Medicine
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• v.33 no.3
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• pp.327-336
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• 1999

Purpose: To assess the quantitative accuracy and the clinical utility of 3D volumetric PET imaging with FDG in brain studies, 24 patients with various neurological disorders were studied. Materials and Methods: Each patient was injected with 370 MBq of 2-[$^{18}F$]fluoro-2-deoxy-D-glucose. After a 30 min uptake period, the patients were imaged for 30 min in 2 dimensional acquisition (2D) and subsequently for 10 min in 3 dimensional acquisition imaging (3D) using a GE $Advance^{TM}$ PET system, The scatter corrected 3D (3D SC) and non scatter-corrected 3D images were compared with 2D images by applying ROIs on gray and white matter, lesion and contralateral normal areas. Measured and calculated attenuation correction methods for emission images were compared to get the maximum advantage of high sensitivity of 3D acquisition. Results: When normalized to the contrast of 2D images, the contrasts of gray to white matter were $0.75{\pm}0.13$ (3D) and $0.95{\pm}0.12$ (3D SC). The contrasts of normal area to lesion were $0.83{\pm}0.05$ (3D) and $0.96{\pm}0.05$ (3D SC). Three nuclear medicine physicians judged 3D SC images to be superior to the 2D with regards to resolution and noise. Regional counts of calculated attenuation correction was not significantly different to that of measured attenuation correction. Conclusion: 3D PET images with the scatter correction in FDG brain studies provide quantitatively and qualitatively similar images to 2D and can be utilized in a routine clinical setting to reduce scanning time and patient motion artifacts.

• Journal of Chest Surgery
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• v.40 no.7 s.276
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• pp.467-472
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• 2007

Background: Lung transplantation is the definitive therapy for end stage lung disorders. The success of allogenic lung transplantation has led to an increasing shortage of donor lungs from humans, including cadavers, and attention has now turned to transplantation of lungs from other species. However, there are many biological hurdles when using organs from other species because of hyperacute rejection after discordant xenotransplantation. Material and Method: Pigs (n=6, weighing $20{\sim}30kg$ each) for the donors and mongrel dogs (n=6, weighing $20{\sim}28kg$ each) for the recipients were used in this experiment. The left kidney of a pig was perfused to a mongrel dog for 30 minutes through the femoral artery and vein of the dog, and the right kidney was perfused for 30 minutes sequentially. Then, both lungs of the pig were perfused to the dog through the pulmonary artery and left atrium with using the same time intervals. The levels of IgM and IgG were measured from the blood and specimens of the kidney and lung. Result: The average levels of serum IgM gradually decreased after the perfusion, but the average levels of serum IgG did not charge from before to after perfusion. The immunohistochemical findings revealed decreased deposition of IgG and IgM after the perfusion. Conclusion: We conclude that the levels of the serum natural antibodies would be decreased with pre-transplantation xenograft perfusion in the recipient and the occurrence rate of hyperacute rejection after transplantation would be decreased.

• Journal of Preventive Medicine and Public Health
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• v.27 no.1 s.45
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• pp.117-134
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• 1994

The effects of regional medical insurance on utilization of medical care in urban population was examined in this study. The data was collected in a 2-year follow-up household survey conducted at Taegu city before and after implementation of the regional medical insurance. The study population was divided into 2 groups. Cohort I was the uninsured in 1989 and cohort II was the insured in 1989. After the coverage of medical insurance, physician visit rate per 1,000 population, use-disability ratio and use-restricted activity ratio in cohort I were increased compared to cohort II in both of acute and chronically ill people. The use-disability ratio and use-restricted activity ratio of the insured poor were lower than those of the insured nonpoor in both of cohort I and cohort II. The major reasons for pharmacy use were accessibility and affordability before the coverage of medical insurance in cohort I, however, after the coverage of medical insurance, the important reason was accessibility rather than affordability. In logistic regression analysis of physician visit, the significant independent variables were acute illness episode (+), chronic illness episode (+) and income (+) in both of cohort I and cohort II. In cohort I, after the coverage of medical insurance, more people replied that the medical cost of hospital and clinic was reasonable. The people who covered by the regional medical insurance were more dissatisfied with the imposed premium than those who covered by other types of medical insurance in both of cohort I and cohort II. More people in cohort II than cohort I were dissatisfied with the services from hospitals and clinics after implementation of the regional medical insurance. In conclusion. after the coverage of medical insurance, the gap between the poor and the nonpoor still exists in terms of medical care utilization.

• Journal of Preventive Medicine and Public Health
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• v.26 no.2 s.42
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• pp.222-230
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• 1993

Industrial glues, known as 'Bonds' in Korea, contain many kinds of organic solvents, and glue sniffing of youths became one of the social problems in Korea. Mixed exposures to solvents by glue sniffing may induce chronic toxicities different from those by exposures to solvents of single component. To test effects of the glue sniffing on weight gain or central nervous system, two groups of 20 male Sprague-Dawley rats were exposed to air(control group) or vapors of the glues to narcotic status(exposed group), and weight check, tail flick test, hot plate test, rotarod treadmill test were done on the 14th,24th, 36th, 45th, 53rd, 86th, 102nd, 117th, 134th and 151st days after the first exposure. On the 188th day, their brains were excised and examined by a pathologist. Weight gain, controlled against time change, showed significant difference between the groups, but response times in tail flick test, hot plate tests, and rotarod treadmill test didn't. In pathological examination with blind method, no macroscopic or microscopic differences were found between the two groups. These results suggests that organic lesion in central nervous system may not ensue glue sniffing, but, before firm conclusion, more studies in various exposure conditions should be followed.