• 대한의용생체공학회:의공학회지
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• 제39권2호
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• pp.80-86
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• 2018

The aim of this study were to establish the clinical references and guidelines for the maximum standardized uptake ($SUV_{max}$) value of pancreatic cancer, pancreatitis, and normal pancreas in $^{18}F-FDG$ PET-CT examinations for pancreatic disease. For this purpose, we performed the statistical analysis on the descriptive statistics, percentiles and inter quartiles range (IQR), normal distribution, and using the probability density function for pancreatic cancer, pancreatitis, and normal pancreas. As a result, the clinical reference of $SUV_{max}$ for the pancreatic cancer, pancreatitis, and normal pancreas was more than 3.45, 1.91 to 2.62, and less than 1.91, respectively. Also, optimal cut-off value for applying the dual time point PET-CT examination was determined to be 2.62. The results of this study are summarized as follows: first, we suggests the clinical reference and guideline for the pancreatic cancer, pancreatitis, and normal pancreas, and second, suggests a scientific approach to improve diagnostic accuracy of pancreatic disease by deviating from an approximate experience approach.

• 의학교육논단
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• 제16권3호
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• pp.119-125
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• 2014

Much of the behavior of doctors reflects the influences from the social, cultural, historical, and economic environment of the time. Therefore, it is very important for future doctors to understand the practice environment in an ever changing world. Traditionally, doctors' competence has been based on the doctor-patient relationship. However, the social practice of medicine in the contemporary era asks future doctors to have social competencies, which often are defined as non-clinical competencies. As a global project, the World Federation for Medical Education has urged every country to define the future role of doctors to encompass global roles based on the duty toward and value of clinical as well as non-clinical competencies. In the past four years, Korean medical professional societies have coordinated to set forth the global role of Korean doctors. Five domains of clinical competence, professionalism, social accountability, communication and collaboration, and education and research have been chosen. The current version of the "global role of Korean doctors" can be used not only for the common objectives of medical education, but also for translating into the competencies of doctors that can be achieved through life-long learning. If we all want to improve medical education in order to produce more qualified and competent doctors as the public desires, then it may be the most urgent task to produce doctors who are equipped with social competencies to persuade, negotiate, and engage in constructive dialogues with society for better health care for a better society.

• 대한간호학회지
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• 제50권6호
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• pp.778-786
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• 2020

Purpose: This study aimed to explore the motives of clinical nurses for experiencing empathy with patients and their families based on a self-determination theory framework. Methods: Semi-structured face-to-face interviews with twenty-one nurses at four tertiary hospitals in Anhui, China, were conducted, recorded and transcribed. A content analysis with a directed approach was performed. Results: An analysis of the interview transcripts revealed three categories of empathy motivation: autonomous motivation, controlled motivation and a lack of empathy motivation. Autonomous motivation included personal interests, enjoyment and a sense of value, pure altruism, assimilation, and recognition of the importance of empathy. Controlled motivation highlighted pressures from oneself and others, the possibility of tangible or intangible rewards, and avoidance of adverse effects. Finally, a lack of empathy motivation referred to a lack of intention for empathy and denial of the value of empathy. Conclusion: This study provides a deep understanding of the motives underlying empathy in nurses. The results reveal the reasons for empathy and may support the development of effective strategies to foster and promote empathy in nurses.

• 생물정신의학
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• 제27권2호
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• pp.94-100
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• 2020

Objectives Amyloid β positron emission tomography (Aβ PET) is widely used as a diagnostic tool in patients who have symptoms of cognitive impairment, however, this diagnostic examination is too expensive. Thus, predicting the positivity of Aβ PET before patients undergo the examination is essential. We aimed to analyze clinical predictors of patients who underwent Aβ PET retrospectively, and to develop a predicting model of Aβ PET positivity. Methods 468 patients who underwent Aβ PET with cognitive impairment were recruited and their clinical indicators were analyzed retrospectively. We specified the primary outcome as Aβ PET positivity, and included variables such as age, sex, body mass index, diastolic blood pressure, systolic blood pressure, education, dementia family history, Mini Mental Status Examination (MMSE), Clinical Dementia Rating (CDR), Clinical Dementia Rating-Sum of Box (CDR-SB), hypertension (HTN), diabetes mellitus (DM) and presence of apolipoprotein E (ApoE) E4 as potential predictors. We developed three final models of amyloid positivity prediction for total subjects, mild cognitive impairment (MCI) and Alzheimer's disease (AD) dementia using a multivariate stepwise logistic regression analysis. Receiver operating characteristic (ROC) curve analysis was performed and the area under curve (AUC) value was calculated for the ROC curve. Results Aβ PET negative patients were 49.6% (n = 232), and Aβ PET positive patients were 50.4% (n = 236). In the final model of all subjects, older age, female sex, presence of ApoE E4 and lower MMSE are associated with Aβ PET positivity. The AUC value was 0.296. In the final model of MCI subjects (n = 244), older age and presence of ApoE E4 are associated with Aβ PET positivity. The AUC value was 0.725. In the final model of AD subjects (n = 173), lower MMSE scores, the presence of ApoE E4 and history of HTN are associated with Aβ PET positivity. The AUC value was 0.681. Conclusions The cerebral amyloid positivity model, which was based on commonly available clinical indicators, can be useful for prediction of amyloid PET positivity in MCI or AD patients.

• 대한한의학회지
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• 제42권1호
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• pp.1-11
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• 2021

Objectives: This pilot study aimed to evaluate the agreement between traditional face-to-face Korean medicine (KM) pattern identification and non-face-to-face KM pattern identification using the data from related questionnaires, tongue image, and pulse features in patients with cancer. Methods: From January to June 2020, 16 participants with a cancer diagnosis were recruited at the one Korean medicine hospital. Three experienced Korean medicine doctors independently diagnosed the participants whether they belong to the cold pattern or not, heat pattern or not, deficiency pattern or not, and excess pattern or not. Another researcher collected KM pattern related data using questionnaires including Cold-Heat Pattern Identification (CHPI), tongue image analysis system, and pulse analyzer. Collected KM pattern related data without participants' identifier was provided for the three Korean medicine doctors in random order, and non-face-to-face KM pattern identification was carried out. The kappa value between face-to-face and non-face-to-face pattern identification was calculated. Results: From the face-to-face pattern identification, there were 13/3 cold/non-cold pattern, 4/12 heat/non-heat pattern, 14/2 deficiency/non-deficiency pattern, and 0/16 excess/non-excess pattern participants. In cold/non-cold pattern, kappa value was 0.455 (sensitivity: 0.85, specificity: 0.67, accuracy: 0.81). In heat/non-heat pattern, the kappa value was 0.429 (sensitivity: 0.75, specificity: 0.72, accuracy: 0.75). The kappa value of deficiency/non-deficiency and excess/non-excess pattern was not calculated because of the few participants of non-deficiency, and excess pattern. Conclusions: The agreement between traditional face-to-face pattern identification and non-face-to-face pattern identification seems to be moderate. The non-face-to-face pattern identification using questionnaires, tongue, and pulse features may feasible for the large clinical study.

• 대한한의학원전학회지
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• 제23권1호
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• pp.317-319
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• 2010

The collateral diagnosis method is unique in Traditional Chinese Medicine diagnosis methods which has important clinical value. In my article, the contents of the "Hwangjenaegyeong(黃帝內經)" related to this method is discussed. According to the site of inspection in the diagnosis process, there are five types as following: inspection of the face and surface, the thenar, the orifices, abdominal collaterals and finally the index finger of children. This method can inspire clinical practitioners.

• 간호행정학회지
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• 제8권1호
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• pp.73-83
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• 2002

To identify the effects of preceptorship on teaching effectiveness at clinical nursing education, a group of nursing students who participate in program under the instruction of the preceptors was compared with the other group of nursing students trained by head nurses.The data were collected from 14 Mary. 2001 to 8 June 2001. The subjects of this study were 85 nursing students trained by the preceptors in the G. medical college hospital in Inchon, and 122 nursing students trained by head nurses at several hospitals in Inchon and Puchon, Korea. The scale for measuring the teaching effectiveness and satisfaction of student for clinical practice developed by Kim, Miae and Lee, Sookja were employed as the tool for the study. The data collected were analysed with SPSS on the teaching effectiveness items, then mean value and SD were evaluated. The t-test were also employed to compare the teaching effectiveness and satisfaction of student for clinical practice of the both groups. The relation of teaching effectives and satisfaction of student for clinical practice were analysed with Pearson's correlation coefficient. The following findings were carried out from this study. 1) The group trained by preceptors showed significant higher teaching effectiveness statistically than the group trained by head nurses, scored mean value of 3.46 and 3.04 respectively in the item of teaching effectiveness. 2) The respective item showing high score of teaching effectiveness in both groups was 'smooth and reasonable dealing on the issues occurred in the wards'. But the items of 'help nursing students to familiarize with other staffs quickly'and 'help always at near' showed low scores. 3) For 5 causal factors classified on the teaching effectiveness, the factor of 'professional knowledge and capability' got the highest score, but 'availability as a supporter' showed the lowest score in both groups. 4) The group trained by preceptors showed significant higher students' satisfaction of clinical practice than the group trained by head nurses, scored mean value of 3.54 and 3.17. 5) Total teaching effectives were posive correlation with students' satisfaction of clinical practice significantly (r=0.603)

• Journal of Nutrition and Health
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• 제11권4호
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• pp.11-23
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• 1978

This study is based on data from the nutritional and clinical survey in Chung Nam area, namely Myl-Yang-Ri, Yoon-Gok-Myon, Chyung Yang Koon. Under the direction of two Nutrition professors and two clinical pathology professors it was carried by 35 Dae Jeun medical Junior College students majoring in nutrition and clinical pathology from 18 July to 25 July 1978. The nutrition surveys were carried out with subjects in village from a total 67 households, 36 of them were randomly selected. The clinical surveys were carried out with subjects in village from a total 382 inhabitant, 154 inhabitant were randomly selected and 109 peoples were subjected to stool examination. The results obtained in this study are summarized as follows. 1) Nutritional survey a) Food Intake The average food intake per person per day in survey area was 929.9 grams (95.5% in vegetables and 4.5% in animal foods). The average consumption of the basicfood groups per person per day was 965g for meats and legumes (10.4% of the total food in take). 268.9g for fruits and vegetables (29% of the total food intake), 559.1g for cereals and potatoes(60.1% of the total food intake), 5.2g for milk and small fishes and 0.2g for fats and oils. b) Nutrient Intake The average daily consumption of calories and nutrients was 2054.1 kcal and 61.2g for total proteins, 223.2mg for calcium, 9.5mg for iron, 4914.4 IU for vitamin A, 1.5mg for thiamin, 1.2mg for riboflavin, 19.9mg for niacin and 54.7mg for ascorbic acid. When these figures are compared with the recommended allowances for Korean, the calories and nutrients intakes were insufficient. Especially the intakes of the calcium were lower than the recommended allowance which are 500 milligrams per day. c) Kinds of food stuffs consumed The kinds of food stuffs consumed by the subjects were 47 figures total. Generally these kinds of food were vegetables food. 2) Clinical Survey a) The mean value of hemoglobin from 72 males was 13.2g/dl, that of 82 females was 12.3g/dl. b) The proportion of low hemoglobin (<12.2g/dl for male and <11.3g/dl fo female) for male was 20.8%, females was 11.0% and from 24 male & female (both sexes) were 15.6% c) The mean value of Hematocrit of males was 39.6%, that of females was 37.4%. d) The mean value of MCHC of males was 33.9%, that of females was 33.6%. e) The ABO blood group was distributed as following; 30.5%, for group O, 29.2% for group A, 24.0% for group B, and 16.3% for AB group. Biochemical race index was 1.13. f) The over all prevalence rate of heminthic infectious by rate of each helminth was as following; Ascaris lumbricoides 33.9%, Thrichocephalus trichiurus 11.9%, Hookworm 0.9%, Hymenolepis diminuta 0.9%, Trichostromgylus orientalis 0.9% and the prevalence rate of two more helminthic infection was 7.2%.

• 셀메드
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• 제14권2호
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• pp.4.1-4.4
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• 2024

The development of clinical reasoning, which is the basis of medical education, is of great importance in medical universities. One of the founders of modern structural clinical reasoning, based on the knowledge of pathological physiology, is the inventor of the stethoscope Rene Laennec (1781-1826). He described the pioneering experience of clinical reasoning in the pages of his treatise A Treatise on the Diseases of the Chest and on Mediate Auscultation, which is of lasting value, since every rookie physicians in his professional development goes through the path of Laennec. Laennec's practice is of great importance for novice physicians since Laennec's treatise contains a diagnostic analysis of the most common clinical cases. Each such analysis demonstrates the algorithm of clinical reasoning. The purpose of this study was to analyze the approaches of clinical reasoning by René Laennec, which made it possible to identify two basic principles. Laennec's diagnostic reasoning involved two principles: pathogenetic analysis of clinical manifestations and a syndrome-based approach to differential diagnosis. These principles help distinguish between diseases with similar symptoms and physical findings are used to demonstrate the practical application of syndrome-based differential diagnosis. These principles can be easily mastered by understanding the pathogenesis of clinical manifestations. Thanks to the pathogenetic basis, the principles of clinical reasoning of Rene Laennec are universal and applicable to the analysis of any signs of the disease: not only physical but also laboratory and instrumental.

• 대한치과교정학회지
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• 제43권6호
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• pp.279-287
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• 2013

Objective: To investigate the dentoskeletal factors which may predict soft-tissue chin strain during lip closure. Methods: The pretreatment frontal and lateral facial photographs and lateral cephalograms of 209 women (aged 18-30 years) with Angle's Class I or II malocclusion were examined. The subjects were categorized by three examiners into the no-strain and strain groups according to the soft-tissue chin tension or deformation during lip closure. Relationships of the cephalometric measurements with the group classification were analyzed by logistic regression analysis, and a classification and regression tree (CART) model was used to define the predictive variables for the group classification. Results: The lower the value of the overbite depth indicator (ODI) and the higher the values of upper incisor to Nasion-Pogonion (U1-NPog, mm), overjet, and upper incisor to upper lip (U1-upper lip, mm), the more likely was the subject to be classified into the strain group. The CART showed that U1-NPog was the most prominent predictor of soft-tissue chin strain (cut-off value of 14.2 mm), followed by overjet. Conclusions: To minimize strain of the soft-tissue chin, orthodontic treatment should be oriented toward increasing the ODI value while decreasing the U1-NPog, overjet, and U1 upper lip values.