• Korean Journal of Radiology
• /
• 제25권10호
• /
• pp.902-912
• /
• 2024

Objective: The increasing utilization of various molecular tests for diagnosing and selecting treatments for patients with malignancies has led to a rising trend in both the frequency of biopsies and the required tissue volume. We aimed to compare the safety of outpatient ultrasound (US)-guided percutaneous liver biopsy (PLB) between the coaxial method with needle track plugging (NTP) and the conventional method. Materials and Methods: This single-center, prospective, randomized controlled study was conducted from October 2022 to May 2023. Patients referred for US-guided PLB with target liver lesions measuring ≥1 cm and requiring ≥3 tissue cores were enrolled. Patients with severe coagulopathy or a substantial volume of ascites were excluded. Patients were randomly assigned to undergo PLB using either the coaxial method with NTP or the conventional method, in a 1:1 ratio, and were subsequently discharged after 2 hours. The primary endpoint was the presence of a patent track sign, defined as a linear color flow along the biopsy track on Doppler US, as an indication of bleeding. The secondary endpoints included clinically significant bleeding, delayed bleeding after discharge, and diagnostic yield. The incidences of these endpoints were compared between the two methods. Results: A total of 107 patients completed the study protocol. Patent track signs were observed significantly less frequently in the coaxial method with NTP group than in the conventional method group: 16.7% (9/54) vs. 35.8% (19/53; P = 0.042). Clinically significant bleeding and delayed bleeding did not occur in either group, and both methods achieved a high diagnostic yield: 94.4% (51/54) vs. 98.1% (52/53; P = 0.624). Conclusion: Compared with the conventional method, the coaxial method with NTP may potentially be safer, with a reduced risk of overall bleeding complications after PLB when retrieving ≥3 tissue cores. The coaxial method with NTP could be considered a viable option for acquiring multiple liver tissues on an outpatient basis.

• Journal of Preventive Medicine and Public Health
• /
• 제18권1호
• /
• pp.25-39
• /
• 1985

도시 영세지역 주민의 이환 및 의료이용 양상을 파악하기 위하여 1984년 7월 한 달 동안에 대구시 중구 남산 4동 영세지역 468가구의 가구원 2,002명과 대조지역 374가구의 가구원 1,709명을 대상으로 가구원의 일반적 특성, 질병이환 및 의료이용 양상 등을 면담조사 하였다. 영세지역과 대조지역의 성별, 연령별 분포는 비슷하였으나, 경제수준, 교육수준, 주거밀집도, 의료보장 종류별 분포는 유의한 차이를 보였다. 15일간의 상병 이환율은 영세지역이 1,000명당 131로 대조지역의 71보다 유의하게 높았고, 연령이 증가함에 따라 이환율도 증가하는 경향을 보였으나 65세이상의 노인층에서는 오히려 감소하였다. 년간 만성병 이환율도 영세지역이 1,000명당 134로 대조지역의 89보다 유의하게 높았고 나이가 증가함에 따라 이환율이 증가하였다. 15일간의 상병은 영세지역과 대조지역 모두 호흡기계 질환이 각각 24.0%, 29.8%로 가장 많았고 그 다음은 소화기계 질환으로 21.0%, 20.6%였으며 손상 및 중독은 영세지역이 10.3%인데 비해 대조지역은 3.3%였다. 만성병은 영세지역과 대조지역 모두 소화기계질환이 22.1%, 21.7%로 가장 많았고 그 다음으로 영세지역은 근골격계 질환으로 12.3%, 대조지역은 신경통으로 14.5%였으며, 순환기계 질환은 대조지역이 11.8%로 영세지역의 5.6% 보다 더 많은데 비해 손상 및 중독은 영세지역이 10.8%로 대조지역의 4.6%보다 더 많았다. 15일간의 상병으로 활동제한을 받은 일수는 영세지역이 평균 4.0일로 대조지역의 평균 2.2일보다 유의하게 높았다. 15일간의 상병이나 만성병을 치료받기 위해 영세지역은 약국을 더 많이 이용하고 대조지역은 병의원 외래를 더 많이 이용하였으며, 특히 의료보장 종류별로는 의료보험 가입자는 병의원 외래를, 그리고 일반환자는 약국을 더 많이 이용하였으며, 미치료율은 의료보장 종류에 관계없이 15일 이환의 경우 영세지역이 17.9%, 대조지역은 11.6%, 그리고 만성병은 영세지역이 15.2%, 대조지역은 9.2%로 영세지역의 미치료율이 대조지역보다 더 높았다. 15일간의 상병이나 만성병 모두 경제적인 이유로 치료받지 않은 경우가 가장 많았다. 영세지역의 이환율이 대조지역보다 높은 것은 경제수준, 교육정도, 주거밀집도 등 여러가지 사회 경제적인 요소가 관련된 것으로 나타났으므로, 영세민을 위한 보건사업 계획에는 이러한 사회 경제적인 요소들을 개선하는 노력을 병행해야 효과적인 보건사업이 추진될 것으로 생각된다.

• 농촌의학ㆍ지역보건
• /
• 제31권1호
• /
• pp.9-20
• /
• 2006

본 연구는 전국 및 시도별로 결핵 사망률의 의료보장 유형에 따른 차이를 분석하고 관련 요인을 파악하기 위해 시행되었고 다음과 같은 결과를 얻었다. 의료급여 대상자는 건강보험 가입자에 비해 결핵 사망률이 5.6배가 높으며 남자에서는 6.3배, 여자에서는 3.8배 높아 의료보장 유형별 결핵 사망률비는 남자에서 더 높은 것으로 나타났다. 또한 각 연령군에서의 의료보장 유형별 결핵 사망률비는 30대, 40대, 50대의 장년층에서 가장 높은 것으로 나타났으며 이러한 경향은 남자와 여자 모두 비슷하였다. 시도별 의료보장 유형별 결핵 사망률 차이는 광역자치단체마다 다른 양상을 보였다. 이러한 차이에 영향을 미치는 변수로는 재정자립도, 인구밀도, 보건소당 관할 인구수, 백만명당 병원수, 의료급여 대상자 비율로 나타났다. 본 연구 결과를 종합하여 볼 때 의료급여 대상 결핵 환자들의 결핵관리에 문제가 있으며 특히 의료급여 대상자의 중장년 계층 결핵관리가 취약하고 이는 지역별로 차이가 있음을 알 수 있었다. 그리고 인구밀도가 높고 의료급여 대상자가 적은 비율로 있으며 재정자립도가 높은 대도시지역 일수록 건강보험 가입자에 비해 의료급여 대상자의 결핵 사망률의 격차가 높은 것으로 나타나 이들의 결핵관리 실태에 대한 보다 체계적이고 정밀한 연구가 추후 필요할 것으로 판단된다.

• Journal of Preventive Medicine and Public Health
• /
• 제1권1호
• /
• pp.25-36
• /
• 1968

Introduction In order to improve medical education through the introduction of a concept of comprehensive health care of a community, an area surrounding the University Campus was chosen for the Community Health Service Project. It has been on operation for last 4 years with its major emphasis on family planning services, and maternal and child health care. The major objectives of this survey at the area are to obtain: 1) The demographic data, 2) The health need and trend of medical care, 3) The attitude and practice in maternity care to be used for further improvement of the planning and the services of the project. Population and Survey Method Out of three Dongs of the Community Health Service Area, only two Dongs namely Changchun and Yonhee were selected for the survey. Total number of households and population in the area studied was 3,683 and 21,857 respectively. An interview was performed with questionnaire schedule which was recorded by interviewers. This includes the degree of utilization of health services provided by the Community Health Service Program such as family planning, prenatal care during their last pregnancy, delivery history and complications of the delivery as well as the incidence of illnesses in general. Prior to the interview, all interviewers were trained for interviewing technique for two days. The survey was carried out during the period from October December 1967. Results 1) Demographic Data : 41.3% of the population studied were children under age 15 and only 3.5% were over 60 years of age. Crude birth rate and crude death rate of this area studied during the period of November 1966-October 1967 were 20.5 and 7.7 respectively. Infant mortality rate during the same period was 35.9. 50.4% of the 2,832 households fell into the category of middle class, 39.8% to the lower class and 9.5% to the upper class in economic condition. 19.8% of 2,832 householders had no formal education, 22.7% primary school, and 57.5% middle or higher school education. 2) Health Status and Utilization of the Community Health Service: Those who suffered from many illnesses during the month of October, 1967 were 690(4.6% of 14,891 persons). Classification of these patients into the type of disease shown respiratory diseases 27.4%, gastrointestinal diseases 18.1%, tuberculosis 10.9%, skin and genitourethral diseases 4.5% and gynecologic patients 4.5%. Only 55.9% of the patients received medical care at hospital or doctor's clinic. But among TB and gynecologic patients, 70.7% and 72.4% were treated at medical facilities. 10.6% of 2,832 householders interviewed has ever utilized the Community Health Service Program provided by the Yonsei Medical School, Classifying these clients into the type of service, 35.9% utilized the wellbaby clinic, 31.0% the family planning clinic, 14.7% the home delivery care, and the rest utilized other services such as the premarital guidance cinlic and the sanitary inspection service. 3) Maternity Care: 23.6% of 2,151 deliveries were done at medical facilities such as hospital, private clinic, while 76.4% were done at home. Acceptance rate of prenatal care was 32.6% as whole, but 49.6 of 774 women who had the prenatal care service had their deliveries at medical facility. 45.1% of total deliveries were attended by medical and or paramedical personnel. 75.8% of the deliveries of those received prenatal care were attended by medical and or paramedical personnel while only 27.8% of the deliveries of those who did not have prenatal care attended by medical and or paramedical personnel. 49.8% of deliveries of the upper class, 29.8% of the middle class and 9.9% of the lower class were attended by medical and or paramedical personnel. 6.2, 3.3% and 24.8% of mothers reported about their xeperience of edema, coma and fever during the period of trimester of pregnancy and puerperium. 4) Family Planning: The rate of practice of family planning was 27.9%. 31.7% of them were by IUD, 2.9% by oral pill, 15.2% by sterilization and the rest by traditional methods. Those women who had 3 to 4 children had highest(30.2%). Practice rate among the various methods of family planning, oral pill was the most popular method to whom had 2 or less children. In relation between the practicing rate of family planning and living standard, the upper, middle and lower class practiced 37.5, 29.4 and 19.9% respectively.

• Journal of Yeungnam Medical Science
• /
• 제10권1호
• /
• pp.91-102
• /
• 1993

도시영세지역의 가계의료비 지출 정도를 파악하고자 1992년 3월 1일부터 5월 31일까지 3개월간 대구직할시 남구 대명8동의 영세지역의 85가구(대상군)와 임의로 선정한 96가구(대조군)를 대상으로 자기기업방법에 의한 의료비지출 조사를 실시하였다. 조사대상 가구원의 전체 가구원은 819명으로 대상군 377명, 대조군이 442명 이었으며, 평균연령은 대상군 31.1세, 대조군 37.1세였다. 가구당 평균 가구원수는 대상군과 대조군 모두 4.5명이었다. 가구당 평균 월수입은 대상군이 848,600원, 대조군이 1,752,300원이었다. 월평균가계지출은 대상군 635,300원, 대조군 1,414,600원이었으며, 월평균소비지출은 각각 568,800원, 1,238,400원이었다. 월평균 의료비지출은 대상군이 34,500원, 대조군이 58,400원이었다. 월평균 의료보험료는 대상군이 12,900원, 대조군 26,800원으로써 두 군 모두 소득의 1.5% 수준이었다. 월수입에서 보건의료비가 차지하는 비율은 대상군이 4.1%, 대조군이 3.3%였고, 가계지출에서 차지하는 비율은 대상군이 5.4%, 대조군이 4.1%였으며, 가계소비지출에서 보건의료가 차지하는 비율은 대상군이 6.1%, 대조군이 4.7%였다. 월평균 의료보험료를 포함 시켰을 때 가계소비지출에서 보건의료비가 차지하는 비율은 대상군과 대조군이 각각 8.3%와 6.9%를 차지하였다. 보건의료비지출을 의약품, 보건의료용품기구, 보건의료서비스 항목으로 나누어 보았을 때, 대상군은 의약품이 차지하는 비율이 57.4%, 보건의료서비스 41.4%였으며, 대조군에서는 의약품이 52.4%, 보건의료서비스가 45.7%를 차지하였다. 대상군에서는 한방의료비 지출이 전체 의료비 지출의 36.9%, 그리고 대조군에서는 병 의원 의료비 지출이 37.8%로 가장 많았다. 방문당, 이용일당 의료비지출은 대상군에서는 한방의료가 58,100원으로 가장 많았고, 다음이 민속의료로 19,900원이었으며, 대조군은 민속의료가 112,800원으로 가장 많았고, 다음이 한방의료로 66,000원이었다. 이상의 결과로 보아 대상군의 월수입, 가계지출, 소비지출에 대한 의료비의 지출이 대조군에 비하여 그 절대액수는 적으나, 상대적 비율은 높은 것으로 나타나 대상군이 대조군에 비해 의료비 부담이 과중한 것으로 생각된다. 향후 조사표본이 크고, 조사기간을 1년으로 한 의료비지출에 대한 연구가 필요할 것으로 생각된다.

• Journal of Preventive Medicine and Public Health
• /
• 제14권1호
• /
• pp.65-74
• /
• 1981

This survey was made to determine the overall health situation on (1) the status of sickness; (2) the medical care utilization; (3) the medical cost in Mi-Kum Myun, Nam Yang Ju Gun, Kyung-Gi Do. The survey with questionnaire was carried out with 2,840 peoples in 560 households from August 9th to 16th, 1979. The findings from the survey were as follows; 1. Annual morbidity rate of the prolonged ill cases was 97.2 per 1,000 population (male 94.7, female 99.6), The highest age specific morbidity rate was 274.5 of the 45-to 64-year group and the lowest was 21.9 of the 5-to 14-year group. 2. Annual morbidity rate of the new patients was 777.5 per 1,000 population(male 644.5, female 909.5). 3. The chief complaints distribution of the prolonged ill cases was: local pain 36.6%, indigestion 22.4%, and coughing 7.3%, respectively, In terms of age and sex distribution, a large number of female of the 45-to 64-year group complained of local pain or general pain and a large number of both sexes of the 25-to 44-year group complaned of indigestion. 4. The major diseases of the new patients which classified with International Classfication of Diseases (I.C.D.) were disease of the respiratory system, disease of the digestive system, and disease of the musculo-skeletal system and connective tissue for male, disease of the respiratory system, disease of the digestive system, and accident, poisoning, violence for female. 5. Total ill days of the 92 new patients were 536 days and average ill days per case were $6{\pm}38.3$ days. 6. The rate of receiving treatment in the prolonged ill cases was 82.2%(medical facilities 46.4%, drug stores 27.5%, herb medicine 8.3%). 7. The rate of receiving treatment by first choice of the new patients was 88.0% (drug stores 57.%, medical facilities 28.2%, and herb medicine 2.2%), and the rate of receiving treatment by second choice was 30.9% of first treatment cases (medical facilities 44.0%, drug store 44.0% and herb meicine 12.0%). 8. Annual hospitalization rate per 1,000 population was 12.0 (male 12.0, female 11.9). 9. The locations of medical facilities utilized by out-patients were: in the prolonged ill cases Seoul or other places 66.4%, Nam Yang Ju Gun 33.6%, in cases of the new patients Seoul or other places 35.1% and Nam Yang Ju Gun 64.9% respectively. 10. The satisfaction rate of the new patients by mode of receiving treatment was: in cases of primary utilization by first choice herb medicine 100.0%, medical facilities 88.5%, and drug stores 69.8%, in cases of secondary utilization medical facilities 100.0%, herb medicine 100.0%, and drug stores 72.7% respectively. 11. The medical cost per utilized facilities was as follows; in average medical fee per case out-patient 8.947 won, in-patient 266,000 won, drug stores 1,532 won, and herb medicine 15,607 won, in average medical fee per day out-patient 4,829 won, in patient 14,178 won, drug stores 891 won, and herb medicine 4,906 won respectively. 12. The sources of the hospital charges paid out were: there own expense 50.0%, debt 35.3%, and security of medical care 14.7% respectively.

• 한국방사선학회논문지
• /
• 제13권4호
• /
• pp.495-502
• /
• 2019

혈관 질환을 검사하기 위한 방법으로 방사선 장비를 이용한 검사들이 주를 이루기 때문에 본 연구를 통해 뇌혈관 질환 검사에 있어 혈관 질환 검사에 사용되는 뇌혈관 조영술과 뇌혈관 전산화단층촬영검사의 입사표면선량(ESD; Entrance Surface Dose)을 비교 분석하여 뇌혈관 질환 검사 시 사용된 선량 결과에 따른 최적의 검사 방법 선택 유도 및 선량 저감화 방안에 대해 알아보고자 하였으며, 조영제 사용량을 측정 및 평가하여 조영제로 인한 부작용 발생 우려 시 권장 할 수 있는 검사선택 방법에 대해 알아보고자 연구를 진행하게 되었다. 대상으로는 2018년 6월부터 2018년 12월까지 여수지역 병원에서 뇌혈관 전산화 단층 촬영 검사를 시행한 70명 (남43, 여27)과 2018년 6월부터 2018년 11월까지 평택지역 병원에서 뇌혈관 조영술을 시행한 61 (남34, 여27)명을 대상으로 하였고, 분석 방법으로는 입사표면선량 데이터 값을 M-view와 PACS PLUS를 통해 후향적으로 획득하였으며 조영제 측정은 실제 사용된 량을 측정하는 방법으로 진행하였다. SPSS를 이용한 T-검정 분석결과 뇌혈관 조영술의 선량이 $245.74{\pm}71.91mGy$로 전산화 단층 촬영검사의 선량 $277.79{\pm}79.65mGy$보다 $32.05{\pm}7.74mGy$만큼 낮았으며 t=3.249, p=0.017로 통계적으로 유의했고(p<0.05) 조영제 총 사용량 비교 분석 결과에선 뇌혈관 조영술 시 사용된 평균 조영제 사용량이 $55.05{\pm}17.68ml$로 전산화 단층 촬영 검사에서 사용된 70 ml의 조영제 양보다 약 14.95 ml만큼 적었으며 t=-4.548, p<0.001로 통계적으로 유의했다. 결론적으로 뇌혈관 조영술의 선량이 전산화 단층 촬영검사보다 통계적으로 유의하게 낮았고, 조영제 사용량 또한 전산화 단층 촬영검사보다 유의할 만큼 적었으므로 뇌혈관 질환 검사에 있어 뇌혈관 조영술의 활용을 늘리는 방안이 피폭선량 저감화를 위한 방법임과 동시에 조영제 사용량을 감소시킬 수 있는 방안이라 생각된다.

• The Korean Journal of Medicine
• /
• 제99권3호
• /
• pp.149-157
• /
• 2024

목적: 장내세균에서 3세대 cephalosporin 계열 항생제에 내성을 나타내는 주된 내성 기전은 extended spectrum β-lactamase(ESBL)를 생성하는 것이다. ESBL 생성 장내세균은 ESBL 생성균이라고 하더라도 piperacillin/tazobactam 감수성 균인 경우 piperacillin/tazobactam을 사용해 볼 수 있으며 후향적 연구에서 carbapenem 계열 항생제를 투여한 경우에 비해 열등하지 않은 치료 효과가 보고된 바 있다. 하지만 미국감염학회 2023년 지침에서는 ESBL 생성 그람음성균 감염에서 carbapenem 계열 항생제를 권고하고 piperacillin/tazobactam 감수성인 그람음성균이더라도 carbapenem 계열 항생제를 투여하도록 하고 있다. 하지만 carbapenem 내성 장내세균의 증가 등으로 비 carbapenem 계열의 항생제들의 사용 필요성에 대한 평가는 아직도 필요한 상황이다. 이에 제주대학교병원의 ESBL 생성 장내세균속 균혈증 환자들의 carbapenem과 비 carbapenem 계열 항생제의 치료 효과를 보고한다. 방법: 2021년 1월부터 12월까지 527명의 성인 장내세균속 균혈증 환자들 중에서 ESBL 생성 장내세균속 환자 152명을 대상으로 후향적 자료를 수집하고 3개월 이내 장내세균 감염이 있었던 환자들과 30일 후 추적 관찰을 하지 못한 환자들을 제외하고 분석하였다. 결과: 총 118명의 ESBL 생성 장내세균속 균혈증 환자들중에서 54명의 환자가 확정적 항생제로 비 carbapenem 계열 항생제로 치료하였고 64명의 환자가 carbapenem 계열 항생제로 치료하였다. Kaplan-Meier 생존 분석 방법으로 30일 치료 실패율과 사망률을 분석한 결과 30일 치료 실패율은 비 carbapenem군이 16.7%, carbapenem군이 18.8%로 양 군 간의 유의한 차이는 없었다(p = 0.65). 30일 사망률은 비 carbapenem 계열군이 14.8%, carbapenem 계열군이 17.2%로 양 군 간의 유의한 차이는 없었다(p = 0.63). 전체 환자들 중에서 치료 실패한 환자들을 다변량 로지스틱 회귀 분석한 결과에서 요로 감염 외 감염과 이전 30일 이내 항생제 사용력이 있는 경우 치료 실패의 위험인자로 확인되었다. 결론: ESBL 생성 장내세균속 균혈증 환자들은 국내에서 확정적 항생제로 비 carbapenem 계열의 항생제를 사용해 볼수 있으나 중증 환자들을 포함한 다기관, 전향적 후속 연구들이 필요하다.

• 핵의학기술
• /
• 제22권1호
• /
• pp.90-97
• /
• 2018

폐 관류 스캔은 방사성 물질의 폐동맥 내 미세색전증을 이용하여 폐색전증의 진단에 이용되고 있으며, 만성 폐쇄성 질환이나 국소 폐 관류평가 및 조기 폐암발견 등에 이용된다. 또한 폐암환자에서의 수술 및 방사선 치료 전, 후 국소 폐 기능 예측을 위하여 이용된다. 이를 위하여 관류의 정확한 정량화가 필요하다. 이에 본 연구에서는 모든 병변 및 장기에 추적자의 흡수율 정량화가 가능한 SPECT/CT의 Q-Metrix (GE Healthcare, USA)프로그램을 활용하여 실제로 많이 이용되고 있는 평면영상의 두 가지 결과 산출 방법에 대한 상관관계 및 각 엽의 차이를 비교 평가하고자 한다. Discovery NM/CT 670 scanner (GE Healthcare, USA)장비에서 2015년 5월 1일부터 2016년 9월 13일까지 수술 전 폐암환자 50명을 대상으로 시행하였다. 환자에 대하여 $^{99m}Tc-MAA$(macro aggregated albumin) 185 MBq (5 mCi)를 정맥 주사하였고 후면 영상(Posterior view)을 기준으로 전면, 우측면, 좌측면, 우후사면, 좌후사면 영상을 획득하였다. 평면 폐 관류검사 직후 SPECT/CT를 시행하였고 영상의 Processing은 GE사 Xeleris 3.1 Workstation에서 시행하였다. 후방사면 방법은 오른 엽과 왼 엽에 사각형의 관심영역을 설정하였고 RPO영상은 3엽, LPO영상은 2엽으로 나누어 각 엽에 대한 흡수율을 얻었다. 전후 방법은 오른 엽, 왼 엽에 각각 3개의 사각형의 ROI를 설정하여 흡수율을 구하였고 왼 엽은 2엽으로 구분되어 Left middle lobe은 Left upper lobe로 포함시켜 결과를 산출하였다. Q-Metrix Method는 CT영상에 직접 관심 영역(Region of interests, ROI)을 설정하였다. 시상면(Sagittal)영상에서 2개의 Slice마다 ROI를 설정하였고 관심부피(Volume of interest, VOI)를 이용하여 체적에 대한 흡수율을 분석하였다. 통계 분석은 SPSS version 23.(SPSS Inc. USA)를 이용하여 분석하였다. Q-Metrix 방법과 후방사면 방법의 흡수율에 대한 일치 상관관계는 Right upper lobe(RUL)는 0.663, Right middle lobe(RML)는 0.623, Right lower lobe(RLL)는 0.702이고 Left upper lobe(LUL)는 0.754, Left lower lobe(LLL)는 0.823로 가장 높은 상관관계를 보였다. 전후 방법은 RML는 0.035로 흡수율이 증가되어 가장 낮은 상관관계를 보였고, RUL는 0.224, RLL는 0.447로 흡수율이 감소되었다. 왼 엽에서 LUL는 0.643, LLL는 0.456로 나타났다. 전체적인 상관관계는 후방사면 방법은 0.795로 높은 상관관계를 보였고, 전후 방법은 0.161로 나타났다. 각 엽의 차이는 Q-Metrix방법 평균${\pm}$표준편차는 RUL, RML, RLL순서대로 각각 $20.12{\pm}6.21$, $10.86{\pm}3.83$, $24.57{\pm}7.80$이고 LUL, LLL는 각각 $24.34{\pm}6.47$, $20.12{\pm}7.11$로 나타났다. 동일한 순서대로 후방사면 방법의 오른 엽은 $17.4{\pm}5.0$, $10.5{\pm}3.6$, $27.3{\pm}6.0$이었고, 왼 엽은 $21.6{\pm}4.8$, $23.1{\pm}6.6$으로 나타났다. 전후 방법에 대한 오른 엽의 평균${\pm}$표준편차는 $11.6{\pm}4.5$, $26.9{\pm}6.2$, $17.8{\pm}4.2$이고, 왼엽은 $28.4{\pm}4.8$, $15.4{\pm}5.6$로 나타났다. 본 논문에서 Q-Metrix방법에 대한 평면영상의 두 가지 방법 간에는 차이가 있는 것으로 보였다. 전후 방법의 RML는 과대평가 되었으며 RML, RLL는 상대적으로 과소평가 되었고, 모든 엽에서는 통계적으로 유의한 차이가 있었다(P<0.05). 후방사면 방법은 전후 방법보다 4배정도의 높은 상관관계를 보였고, oblique영상을 활용하여 흡수율이 과대, 과소평가가 되는 것을 줄일 수 있었다. SPECT/CT검사를 시행하지 않거나 planar image 획득 시 후방사면 방법을 이용하면 보다 실용적인 결과 값을 기대할 수 있을 것으로 생각된다. 또한 많은 환자에 대한 데이터 분석과 호흡에 대한 보정, 객관적인 방법으로 관심영역을 설정한다면 보다 정확한 결과를 산출할 수 있을 것이라 사료된다.

• 대한간호학회지
• /
• 제8권1호
• /
• pp.16-42
• /
• 1978

This survey was made for a month starting from November 15 to December 15, 1977 covering 711 students taking the junior. (3rd-yea.) and the senior. (4th-year) at nine college of nursing in Seoul concerning their perception and Attitude toward the profession of nursing, motive for the necessity of learning, environment of study, attitude of study and particulars relevant with study performance, particulars of library, references and reading, assignments and particulars of the degree of confidence for the learning achievement. Through the survey of the above Particulars, the following results were obtained by classifying all subject matters and by analysing motive of the selection of their course, awarding or not awarding of scholarships. 1. General characteristics: it was revealed that 406 students (57.1%) were attending at the junior. while 305 students (42.9%) were taking the senior. Thus, the total number was 711 and their average age was 21.4 years. Their dwelling category was; 73.9 percent of them resided at their parent's home, 214 students (30.1%) were awarded with scholarships. The reason to be attracted by nursing science was the possibility of continuing social life after graduation (43.5%). 2. Their perception and attitude toward the profession of nursing: According to the perception of profession by the students of each grade, students of the 4th grade showed comparatively strong conception. Also, students of the 4th grade showed more positive attitude in the purchase and reading of magazines relative with the science of nursing, in the reading of Code for Nurses and in their interest in the activity of nursing field. For the necessity of mission of nurse, 97.7 percent of the entire number of students covered responded to necessity. For the necessity of the particular humanity and particularity in the character of nurses, 95.8 percent of those students responded to necessity. By the each grade, students of the 4th grade showed more response. 3. As to professional field desired after completing the professional course: 57 percent of those students desired for clinician nurse while 55 percents desired for community health-nurse. 4. As to the environment of study: they were mostly satisfied with their present residential environment. However, they complained of inconvenience at their lecture-halls. Students of the 3rd grade showed more complain. As to their attitude toward the adjustment of environment of study, they showed a affirmative response. As to the opinion of factors which interfere with their study, comparatively strong response was showed in their scepticism in the science of nursing, insufficient comprehension in general learning, relation with professors n4 discrepancy in the method of study. According to opinions of students at each grade, students of the 4th grade showed more scepticism. 5. Particulars relative with their attitude and performance of study : As to their knowledge of the objectives of their study of subject, the majority was to study with a partial knowledge of the objectives of their study. As to the plan of study, a low percentage indicated management of routine life under regular scheduling. Students of the 4th grade responded to rather planned life. As to time spent in independent study, response to concentrated study when necessary was stronger than that to regular daily study. Students of the 4th grade showed stronger response to regular study than that of the 3rd grade. As to the contents of their note-taking, 67.4 percents of those students responded to such regulatory procedure performing in the lecture-hall as they listen to lectures. 17.3 percents of those students showed response to adding supplementary informations from references to what was entered in choir note-taking at their lecture-halls. 6. Particulars of library, references and reading books: As to receiving of instruction for the utilization of library and time of receiving such instruction 64.7 percents of those students had received such instruction. 66.7 percents of the those responded received such instruction at orientation conducted for freshmen. As to the convenience of the utilization of library, 49.9 percents of those students responded to convenience. However, students of the 3rd grade showed a much stronger response to inconvenience. As to the time of the utilization of library,92.5 percents of those students showed a response to occasional utilization for particular purpose than regular utilization. 53.2 percents of those students responded to ordinary in quantity that library have references. 34.2 percents of those students responded to insufficient. As to the particular relative with the method and field of reading: 53.5 percents of those students responded to intensive reading and was the majority. As to the reading field, fiction u as the majority. When read any books for their major, they usually rend Korean text-b, oks. 7. Particular relative with giving assignment: All respondents were well aware of the objectives of giving home tasks. As to the attitude toward assignments and performing home tasks, 54.8 percents of those students to making ostentatious study because of an excessive quantity of assignments imposed. For performing assignment, they showed comparatively positive response. Also, 52.2 percents of those students responded that they usually submitted complected assignment with references. 8. As to motive to realize the necessity of study : 55.6 percents of those students responded that they realized such necessity in communication with patients when they were engaged in clinical practice. Also, 8.6, the lowest percents of those students responded that they realized such necessity in the course of conversation with nurses when they were engaged in clinical practice. 9. As to the determination of their confidence in the performance of study relative with clinical experience: They showed a general inclination of having in nursing. The major response was that they came to well comprehend the patients families. the lowest response was that they could apply what was learned at lecture-hall to practice. This response incidentally showed the distance the lecture-hall and practical study. In general items, students of the 4th grade showed more favorable response than students of the 3rd grade and there was a significant difference. 10. As to the perception and attitude toward profession according to the motive of selecting the nursing science : Those who selected the nursing voluntarily showed stronger conception than those who selected the nursing through indirect influence. However, there was no significant difference on this point. Only there was a remarkable difference in the reading of Code for Nurses. 11. Those who showed a stronger conception in the profession of nursing according to the motives of attractive nursing science indicated a strong will and ability to manage stable life and comparatively strong response was shown in the management of good home life because of the good adaptability of the science to their character. This group showed a strong conception of the profession than those who responded that they prefer this profession out of a longing for the work of a hospital and for the easy obtaining of opportunity to immigrate to over seas and for economic cause and for high school grade. There was significant difference between these two groups, 12. As to the conception and attitude toward the profession of nursing according to benefits by scholarships, those who were benefitted by scholarship showed stronger conception of profession than those who did not receive scholarship and there was a remarkable difference between these two categories. However, there was no remarkable difference between these two categories in the extent of interest of the activities of nursing fields and in the reading of Code for Nurses. 13. As activation for study according to the benefits of scholarships, those who were benefitted by scholarships showed stronger response to the motive for study comparing with those who receive. 14. As to tile field of reading according to the benefits by scholarships, those who received scholarships tended to read autobiographies and essayers to a considerable extent. Those who did not receive scholarships tended to read novels. Those who received scholarships more read nursing boots than those who did not receive scholarships. 15. As to the attitude of study and doing of assignment according to benefits of scholarships, those who received scholarships managed a favorable life with schedules for study, More students of receiving scholarship showed a regular study for more than one hour per day. Also, in the method of doing home tasks, more students of receiving scholarship showed reference to relative books frequently for the submission of completed assignments.