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A Study on the Utilization of Diagnostic Equipments and Patient Dose for Diagnostic Radiological Procedures in Korea (진단방사선영역에서 방사선장치의 이용실태 및 환자피폭선량에 관한 조사연구)

  • Kim Youhyun;Choi Jonghak;Kim Sungsoo;Lee Chanhyeup;Cho Pyongkon;Lee Youngbae;Kim Chelmin
    • Progress in Medical Physics
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    • v.16 no.1
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    • pp.10-15
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    • 2005
  • IAEA's guidance levels have been provided for western people to the end. Guidance levels lower than the IAEA'S will be necessary in view of Korean people's proportions. Therefore, we need to develope the standard doses for Korean people. And we conducted a nationwide survey of patient dose from x-ray examinations in Korea. In this study, the 278 institutions were selected from Members Book of Korean Hospital Association. The valid response rate was approximately 57.9%. Doses were calculated from the questionnaires by NDD method. We obtained the results were as follows; 1) General radiographic equipments were distributed for 42.0%, fluoroscopic equipments 29.4%, dental equipments 13.2%, CT units 8.1 % and mamographic units 7.2%. 2) According to classification by rectification, three-phase equipments were 29.9%, inverter-type generators 29.5%, single-phase equipments 25.5%, constant voltage units 9.0% and unknown units 6.0%. 3) According to classification by receptor system, film-screen types were 46.8%, CR types 26.8%, DR types 17.7% and unknown types 8.9%. 4) The number of examinations were chest 49.2%, spine 16.8% and abdomen 12.7%. 5) Patient doses were head AP 3.44 mGy, abdomen AP 4.25 mGy and chest PA 0.39 mGy.

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Analysis of Traffic Accidents Injury Severity in Seoul using Decision Trees and Spatiotemporal Data Visualization (의사결정나무와 시공간 시각화를 통한 서울시 교통사고 심각도 요인 분석)

  • Kang, Youngok;Son, Serin;Cho, Nahye
    • Journal of Cadastre & Land InformatiX
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    • v.47 no.2
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    • pp.233-254
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    • 2017
  • The purpose of this study is to analyze the main factors influencing the severity of traffic accidents and to visualize spatiotemporal characteristics of traffic accidents in Seoul. To do this, we collected the traffic accident data that occurred in Seoul for four years from 2012 to 2015, and classified as slight, serious, and death traffic accidents according to the severity of traffic accidents. The analysis of spatiotemporal characteristics of traffic accidents was performed by kernel density analysis, hotspot analysis, space time cube analysis, and Emerging HotSpot Analysis. The factors affecting the severity of traffic accidents were analyzed using decision tree model. The results show that traffic accidents in Seoul are more frequent in suburbs than in central areas. Especially, traffic accidents concentrated in some commercial and entertainment areas in Seocho and Gangnam, and the traffic accidents were more and more intense over time. In the case of death traffic accidents, there were statistically significant hotspot areas in Yeongdeungpo-gu, Guro-gu, Jongno-gu, Jung-gu and Seongbuk. However, hotspots of death traffic accidents by time zone resulted in different patterns. In terms of traffic accident severity, the type of accident is the most important factor. The type of the road, the type of the vehicle, the time of the traffic accident, and the type of the violation of the regulations were ranked in order of importance. Regarding decision rules that cause serious traffic accidents, in case of van or truck, there is a high probability that a serious traffic accident will occur at a place where the width of the road is wide and the vehicle speed is high. In case of bicycle, car, motorcycle or the others there is a high probability that a serious traffic accident will occur under the same circumstances in the dawn time.

Clinical Analysis of the Belsey Mark IV Operation in Hiatal Hernia with Gastroesophageal Reflux and Achalasia (위 식도 역류를 가진 열공 헤르니아 환자와 식도 무이완증 환자에서 시행한 Belsey Mark IV 수술의 임상적 고찰)

  • 최영호;조원민;류세민;황재준;손영상;김학제;김광택
    • Journal of Chest Surgery
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    • v.35 no.3
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    • pp.217-222
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    • 2002
  • Background: The incidence of gastroesophageal reflux disease(GERD) is increasing recently, but medical management for GERD has many limitations. Therefore, variable surgical treatments have been introduced. Material and Method: A retrospective study was done in 10 patients who underwent the Belsey Mark IV operation at Korea university Guro hospital between 1996 and 2001. Preoperative diagnoses were hiatal hernia with gasroesophageal reflux in 8 patients and achalasia in 2 patients. Result: Mean age of the patients was 54.3$\pm$19.0 years. Belsey Mark IV operation was performed on patients where preoperative medical failed and mean hospital days were 13.1$\pm$2.6 days. We routinely practiced follow-up endoscopy on postoperative 3rd, 6th, 9th, and 12th months. After remission for reflux and esophagitis, they were transferred to internal medicine department. Six patients of hiatal hernia with reflux (one patient who lost follow-up and the other patient who didn't practice the follow-up endoscopy due to short postoperative follow-up period were excluded) had lowered endoscopic gradings and two patients of achalasia did not complained of reflux symptoms, postoperatively. We experienced 10% operation failure rate. Conclusion: We experienced satisfactory operation results with Belsey Mark IV in hiatal hernia with GERD and achalasia patients.

Small Aortic Annulus in Aortic Valve Replacement; Comparison between Aortic Annular Enlargement Group and Patient-prosthesis Mismatch Group (협소한 대동맥판륜 환자에서의 대동맥판막 치환술; 대동맥판륜 확장술군과 환자-인공판막 부조화군의 비교)

  • Kim, Jae-Hyun;Oh, Sam-Sae;Yie, Kil-Soo;Shin, Sung-Ho;Baek, Man-Jong;Na, Chan-Young
    • Journal of Chest Surgery
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    • v.40 no.3 s.272
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    • pp.200-208
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    • 2007
  • Background: The effect of patient-prosthesis mismatch (PPM) on the clinical outcome following aortic valve replacement (AVR) remains controversial. This study compared the surgical outcomes of AVR between patients with a patient-prosthesis mismatch and those having undergone an aortic annular enlargement. Material and Method: Six hundred and twenty seven adult patients, who underwent AVR with stented bioprosthetic or mechanical valves, between January 1996 and February 2006, were evaluated. PPM was defined as an indexed effective orifice area (iEOA) ${\leq}0.85cm^2/m^2$, and Severe if the iEOA${\leq}0.65cm^2/m^2$ PPM was present in 103 (16.4%, PPM group) patients, and severe in 11 (1.8%, SPPM group). During the period of the study, 21 patients underwent an AVR with annular enlargement (AE group). Result: The mean iEOA of the AE group was larger than that of the PPM group ($0.95\;vs.\;0.76cm^2/m^2,\;p=0.00$). The AE group had longer CPB, ACC and operation times than the PPM group, and showed a tendency toward higher operative mortality (14.3% vs. 2.9%, p=0.06). The SPPM group had higher AV pressure gradients (peak/mean) than the AE group (72/45 mmHg vs. 38/25 mmHg, p=0.02/0.06) and suffered more AV related events (AV reoperation or severe aortic stenosis)(45.5% vs. 9.5%, p=0.03). LV masses were not regressed in the patients who experienced an AV related event. Conclusion: During AVR in patients with a small aortic annulus, annular enlargement should be carefully applied taking into account the high risk of operative mortality due to annular enlargement and co-morbidities of patients. Aortic annular enlargement; however, should be considered as an alternative method in patients expected to have a severe PPM after an AVR.

Prevalence of Extended Spectrum $\beta-Lactamase-Producing$ Clinical Isolates of Escher­ichia coli in a University Hospital, Korea (국내 대학병원에서 분리된 Eschepichia coli의 Extended-spectrum $\beta-Lactamase$ (ESBL) 현황)

  • Lee Kyenam;Kim Woo-Joo;Lee Yeonhee
    • Korean Journal of Microbiology
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    • v.40 no.4
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    • pp.295-301
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    • 2004
  • Recently, the rapid increase and global spread of extended-spectrum $\beta-lactamase$ producing clinical isolates has become a serious problem. The incidence of extended-spectrum $\beta-lactamase$ producing clinical isolates of Escherichia coli in Korea and susceptibility to antimicrobial agents were investigated. Total 233 isolates of E. coli were obtained from urine from hospitalized patients in Guro hospital, Korea University in 2001. One hun­dred and eighty four isolates $(78.9\%)$ were resistant to ampicillin, 80 isolates $(34.3\%)$ were resistant to ceph­alothin, 93 isolates $(39.9\%)$ were resistant to gentamicin, and 64 isolates $(27.5\%)$ were resistant to norfloxacin. Among 233 isolates, 17 isolates $(7.3\%)$ were positive as determined by the double disk synergy test. When min­imal inhibitory concentrations were assayed with additional 6 antimicrobial agents, 13 isolates $(76.5\%)$ were multi-drug resistant to at least four different class antimicrobial agents. Extended-spectrum $\beta-lactamase$ were characterized with isoelectric focusing gel electrophoresis and DNA sequencing. They were TEM-1 in 5 iso­lates, TEM-15 in 1 isolate, TEM-20 in 1 isolate, TEM-52 in 4 isolates, TEM-1 and AmpC in 2 isolates, TEM-1 and OXA-30 in 1 isolate, TEM-1 and OXA-33 in 1 isolate, TEM-1, CTX-M-3, and AmpC in 1 isolate, but SHV was not detected. Antimicrobial resistance genes were transferred to animal isolate of E. coli (CCARM No. 1203) by the filter mating method. Extended spectrum $\beta-lactamase$ producers studied in the current study have low correlation to each other as determined by random amplified polymorphic DNA and pulsed field gel elec­trophoresis. This is a contradictory result from the general hypothesis that extended-spectrum $\beta-lactamase$ pro­ducers in one hospital is a result from a clonal spread.

Factors Influencing Pain Medication Preference for Breakthrough Cancer Patients and Their Application to Treatments: Survey on Physicians (돌발성 암성 통증 약물 선택 요인과 사용 경험: 의사 대상 설문조사)

  • Shin, Jinyoung;Shim, Jae Yong;Seo, Min Seok;Kim, Do Yeun;Lee, Juneyoung;Hwang, In Gyu;Baek, Sun Kyung;Choi, Youn Seon
    • Journal of Hospice and Palliative Care
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    • v.21 no.1
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    • pp.9-13
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    • 2018
  • Purpose: The purpose of this study was to assess the factors influencing the rescue medication decisions for breakthrough cancer patients and evaluate treatments using the factors. Methods: Based on the results of an online survey conducted by the Korean Society of Hospice and Palliative Care from September 2014 through December 2014, we assessed the level of agreement on nine factors influencing rescue medication preference. The same factors were used to evaluate oral transmucosal fentanyl lozenge, oral oxycodone and intravenous morphine. Results: Agreed by 77 physicians, a rapid onset of action was the most important factor for their decision of rescue medication. Other important factors were easy administration, strong efficacy, predictable efficacy and less adverse effects. Participants agreed that intravenous morphine produced a rapid onset of action and strong and predictable efficacy and cited difficulty of administration and adverse effects as negative factors. Oral oxycodone was desirable in terms of easy administration and less adverse effects. However, its onset of action was slower than intravenous morphine. While many agreed to easy administration of oral transmucosal fentanyl lozenge, the level of agreement was low for strength and predictability of its efficacy, long-term durability and sleep improvement. Conclusion: Rapid onset of action is one of the important factors that influence physicians' selection of rescue medication. Physicians' assessment of rescue medication differed by medication.

Comparison on accuracy of porcelain color reproducibility using two colorimeters (2종의 측색기에 의한 도재 색조 재현의 정확성 비교)

  • Lee, Tai-Il;Ahn, Jin-Soo;Kim, Young-Soo;Shin, Sang-Wan
    • The Journal of Korean Academy of Prosthodontics
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    • v.47 no.3
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    • pp.348-355
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    • 2009
  • Statement of problem: Although the use of colorimeter to improve the accuracy of tooth color measurement has increased, it is real situation that there is almost no comparative study about the accuracy among various colorimeters. Purpose: The purpose of this study is to compare the accuracy of porcelain color reproducibility using ShadeEye-Ncc dental chroma meter (Shofu Inc., Kyoto, Japan) and Shadepilot$^{TM}$ system (Degudent Inc., Hanau, Germany). Material and methods: Color of 2M2 and 3M2 shade tap of Vitapan 3D Master shade guide were measured using the above two colorimeters. Porcelain specimens were fabricated through this data. The porcelain systems used were Vintage Halo Porcelain system with ShadeEye-Ncc dental chroma meter, and VitaOmega900 Porcelain system with Shadepilot$^{TM}$ system. Colors of shade tap models and porcelain specimen were measured with spectrophotometer, and calculated delta E based on the results. Results: The following results were obtained. 1. Shadepilot$^{TM}$ system showed more suitable porcelain color reproducibility compared to ShadeEye-Ncc dental chroma meter (P <.05). 2. The result showed the difference of porcelain color reproducibility according to shade of Shade tap which is model. More suitable porcelain color reproducibility was shown at 3M2 shade tap than at 2M2 shade tap (P <.05). 3. The average of ${\Delta}E*$ of porcelain specimens which was made by the two colorimeters was 4.44-6.14, so the difference of shade was shown through the naked eye. Conclusion: Shadepilot$^{TM}$ system showed more suitable porcelain color reproducibility. When using ShadeEye-Ncc dental chromameter, it will be necessary to improve accuracy through coloring various parts of the whole tooth.

Development of Prediction Equation of Diffusing Capacity of Lung for Koreans

  • Hwang, Yong Il;Park, Yong Bum;Yoon, Hyoung Kyu;Lim, Seong Yong;Kim, Tae-Hyung;Park, Joo Hun;Lee, Won-Yeon;Park, Seong Ju;Lee, Sei Won;Kim, Woo Jin;Kim, Ki Uk;Shin, Kyeong Cheol;Kim, Do Jin;Kim, Hui Jung;Kim, Tae-Eun;Yoo, Kwang Ha;Shim, Jae Jeong
    • Tuberculosis and Respiratory Diseases
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    • v.81 no.1
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    • pp.42-48
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    • 2018
  • Background: The diffusing capacity of the lung is influenced by multiple factors such as age, sex, height, weight, ethnicity and smoking status. Although a prediction equation for the diffusing capacity of Korea was proposed in the mid-1980s, this equation is not used currently. The aim of this study was to develop a new prediction equation for the diffusing capacity for Koreans. Methods: Using the data of the Korean National Health and Nutrition Examination Survey, a total of 140 nonsmokers with normal chest X-rays were enrolled in this study. Results: Using linear regression analysis, a new predicting equation for diffusing capacity was developed. For men, the following new equations were developed: carbon monoxide diffusing capacity (DLco)=-10.4433-0.1434${\times}$age (year)+0.2482${\times}$heights (cm); DLco/alveolar volume (VA)=6.01507-0.02374${\times}$age (year)-0.00233${\times}$heights (cm). For women the prediction equations were described as followed: DLco=-12.8895-0.0532${\times}$age (year)+0.2145${\times}$heights (cm) and DLco/VA=7.69516-0.02219${\times}$age (year)-0.01377${\times}$heights (cm). All equations were internally validated by k-fold cross validation method. Conclusion: In this study, we developed new prediction equations for the diffusing capacity of the lungs of Koreans. A further study is needed to validate the new predicting equation for diffusing capacity.

The Effects of Intra-Abdominal Hypertension on the Prognosis of Critically Ill Patients in the Intensive Care Unit (ICU) (복강 내압 항진증이 내과계 중환자의 예후에 미치는 영향)

  • Kim, Se Joong;Seo, Jeong-Su;Son, Myeung-Hee;Kim, Soo-Youn;Jung, Ki Hwan;Kang, Eun-Hae;Lee, Sung Yong;Lee, Sang Yeub;Kim, Je-Hyeong;Shin, Chol;Shim, Jae Jeong;In, Kwang Ho;Yoo, Se Hwa;Kang, Kyung Ho
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.1
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    • pp.46-53
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    • 2006
  • Background: Intra-abdominal hypertension (IAH) is defined as the presence of either an intra-abdominal pressure (IAP) ${\geq}12mmHg$ or an abdominal perfusion pressure (APP = mean arterial pressure - IAP) ${\leq}60mmHg$. Abdominal compartment syndrome (ACS) is defined as the presence of an IAP ${\geq}20mmHg$ together with organ failure. The purpose of this study was to investigate the prevalence of IAH and ACS on the day of admission and the effects of these maladies on the prognosis of critically ill patients in the ICU. Methods: At the day of admission to the ICU, the IAP was recorded by measuring the intravesicular pressure via a Foley catheter. The APACHE II and III scores were checked and SAPS II was also scored during the days the patients were in the ICU. The primary end point was the prevalence of IAH and ACS at the day of admission and the correlation between them with the 28-days mortality rate. The measurement of IAP continued until the 7th day or the day when the patient was transferred to the general ward before 7th day, unless the patient died or a Foley catheter was removed before 7th day. Patients were observed until death or the 28th day. Results: A total of 111 patients were enrolled. At the day of admission, the prevalence of IAH and ACS were 47.7% and 15.3%, respectively and the mean IAP was $15.1{\pm}8.5mmHg$. The rates of IAH for the survivor and the non-survivor groups were 56.5% and 71.4%, respectively, and these were not significantly different (p=0.593). Yet the rates of ACS between these two groups were significantly different (4/62, 6.5% vs. 13/49, 26.5%; Odds Ratio = 5.24, 95% CI = 1.58-17.30, p=0.004). Conclusion: In the present study, the prevalence of IAH was 47.7% and the prevalence of ACS was 15.3% on the day of admission. ACS was associated with a poor outcome for the critically ill patients in the ICU.

A Study on Comparison of Changes in Ecological Characteristics for Bulgwangcheon(stream) Close-to Nature Section (불광천 자연형 하천 정비구간의 생태적 특성 변화 비교 연구)

  • Park, Won-Zei;Lee, Kyong-Jae;Han, Bong-Ho;Jang, Jae-Hoon
    • Journal of the Korean Institute of Landscape Architecture
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    • v.40 no.2
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    • pp.112-129
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    • 2012
  • The aim of this study was to provide basic data in managing the project that was carried out on Bulgwangcheon in a nature-friendly way to improve the conditions around the areas, which was brought to completion in 2002, based on changes in ecological characteristics. For this propose, this study examined documents related to the project, compared physical and enviromnental changes before and after the project was conducted and analyzed changes in the stream ecosystem. The result showed that in areas that effluent water was often observed, especially when it rained, the river wall was washed away and vegetation was found damaged. As for actual vegetation, this study compared planting coverage of each section of the research area and actual vegetation charts. The results indicated that Lespedeza spp., Aster koraiensis among mixed seeds that were planted in the reservoir path were almost swept away while Festuca arundinacea dominated the areas. Phragmites communis, Miscanthus sacchariflorns and Salix gracilistyla which had been planted in a small number were also almost washed out though a small number of them were left to form a colony. After examining the topography and structure of the plant community, this study found that areas where mixed seed were planted had changed into two types of vegetation: First type of area is dominated by P and R which are usually raised in apron with abundant floating particles. The second type of area is dominated by dry gramineous plant such as F and A. Areas around low flow channel where Phragmites communis, Miscanthus sacchariflorus and Salix gracilistyla planting construction method is applied was washed away with the width of low flow channel reduced. Though P, M and S formed a small community in some areas around the low flow area, they were in small number and in composition of simple plant species. Two ways were suggested in this study to manage the stream in an ecological way. First, adequate revetment construction methods should be applied by monitoring the flow of the stream as well as considering the flood control of urban streams. Second, target vegetation communities that are suitable for the environment of the stream should be chosen and be plantedconstantly with high density. At the same time, ornamental native plants shouldn't be planted as they have been and disturbing vegetation should be removed.