• Journal of Yeungnam Medical Science
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• v.8 no.2
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• pp.185-201
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• 1991

A household survey was conducted to compare the patterns of morbidity and medical care utilization between medical aid beneficiaries and medical insurance beneficiaries. The study population included 285 medical aid beneficiaries that were completely surveyed and 386 medical insurance benficiaries selected by simple random sampling from a Dong(Township) in Taegu. Well-trained surveyers mainly interviewed housewives with a structured questionnaire. The morbidity rates of acute illness during the 15-day period, were 63 per 1,000 medical aid beneficiaries and 62 per 1,000 medical insurance beneficiaries. The rates for chronic illness were 123 per 1,000 medical aid beneficiaries and 73 per 1,000 medical insurance beneficiaries. The most common type of acute illness in medical aid and medical insurance beneficiaries was respiratory disease. In medical aid beneficiaries, musculoskeletal disease was most common, but in medical insurance beneficiaries, gastrointestinal disease was most common. The mean duration of acute illness of medical aid beneficiaries was 3.8 days and that of medical insurance beneficiaries was 6.8 days. During the one year period, mean duration of medical aid beneficiaries chronic illnesses was 11.5 months which was almost twice as long compared to medical insurance beneficiaries. Pharmacy was most preferrable facility among the acute illness patient in medical aid beneficiaries, but acute cases of medical insurance beneficiaries visited the clinic most commonly. Chronic cases of both groups visited the clinic most frequently. There were some findings suggesting that much unmet need existed among the medical aid beneficiaries. In acute cases, the average number of days of medical aid users utilized medical facilities was less than medical insurance users. On the other hand, the length of medical care utilization of chronic cases was reversed. Geographical accessibility was the most important factors in utilization of medical facilities. Almost half of the study population answered the questions about source of funds on medical security correctly. Most respondents considered that the objective of medical security was afford ability. The chief complaint on hospital utilization was the complicated administrative procedures. These findings suggest that there were some problems in the medical aid system, especially in the referral system.

• Journal of Chest Surgery
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• v.39 no.2 s.259
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• pp.106-110
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• 2006

Background: Bronchioloalveolar carcinoma (BAC) is an uncommon primary malignancy of the lung, and it accounts for $2{\~}14\%$ of all pulmonary malignancies. According to World Health Organization (WHO) categorisation, BAC is a subtype of adenocarcinoma. The current definition of BAC includes the following: malignant neoplasms of the lung that have no evidence of extrathoracic primary adenocarcinoma, an absence of a central bronchogenic source, a peripheral parenchymal location, and neoplastic cells growing along the alveolar septa. Previous reports had demonstrated a better prognosis following surgery for patients affected by BAC than those affected by other type of non-small cell lung cancer (NSCLC). We aim to analyse Asan Medical Center experiences of BAC. Material and Method: Between 1990 and 2002, 31 patients were received operations for BAC. We analyse retrosepectively sex, age, disease location, preoperative clinical stage, postoperative pathologic stage & complications, survival according to medical record. Result: There were 12 men and 19 women, the average age was 61.09$\pm$10.63 ($31{\~}79$) years. Tumor locations were 7 in RUL, 1 in RML, 4 in RLL, 8 in LUL, 11 in LLL. Operations were 28 lobectomies, 2 pneumonectomies. Postoperative pathologic stage were 12 T1N0M0, 15 T2N0M0, 1 T1N1M0, 1 T1N2M0, 1 T2N2M0, 1 T1N0M1. Mortality were 4 cases ($12.9\%$) and there were no early mortality. Cancer free death was 1 cases, other 3 were cancer related deaths. All of them were affected by distal metastasis and received chemotherapy and each metastatic locations were right rib, brain, and both lung field. The average follow up periods were 50.87$\pm$24.77 months. The overall 3, 5-year survival rate among all patients was $97.1\%,\;83.7\%$, stage I patients overall 2, 5year survival rate was $96.3\%$. The overall disease free 1, 2, 5-year survival rate among all patients was $100\%,\;90\%,\;76\%$ and 2, 5-year survival rate in cases of stage I was $96.4\%,\;90.6\%$. 7 cases ($22.58\%$) were chemotherapies, 1 case ($3.22\%$) was radiation therapy, and 2 cases ($6.45\%$) were chemoradiation therapies. Metastatic locations were 3 cases in lung, 1 case in bone, 1 cases in brain. Conclusion: BAC has a favourable survival and low recurrence rate compare with reported other NSCLC after operative resections.

• The Korean Journal of Nuclear Medicine
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• v.38 no.4
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• pp.318-324
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• 2004

Purpose: Philips GEMINI is a newly introduced whole-body GSO PET/CT scanner. In this study, performance of the scanner including spatial resolution, sensitivity, scatter fraction, noise equivalent count ratio (NECR) was measured utilizing NEMA NU2-2001 standard protocol and compared with performance of LSO, BGO crystal scanner. Methods: GEMINI is composed of the Philips ALLEGRO PET and MX8000 D multi-slice CT scanners. The PET scanner has 28 detector segments which have an array of 29 by 22 GSO crystals ($4{\times}6{\times}20$ mm), covering axial FOV of 18 cm. PET data to measure spatial resolution, sensitivity, scatter fraction, and NECR were acquired in 3D mode according to the NEMA NU2 protocols (coincidence window: 8 ns, energy window: $409[\sim}664$ keV). For the measurement of spatial resolution, images were reconstructed with FBP using ramp filter and an iterative reconstruction algorithm, 3D RAMLA. Data for sensitivity measurement were acquired using NEMA sensitivity phantom filled with F-18 solution and surrounded by $1{\sim}5$ aluminum sleeves after we confirmed that dead time loss did not exceed 1%. To measure NECR and scatter fraction, 1110 MBq of F-18 solution was injected into a NEMA scatter phantom with a length of 70 cm and dynamic scan with 20-min frame duration was acquired for 7 half-lives. Oblique sinograms were collapsed into transaxial slices using single slice rebinning method, and true to background (scatter+random) ratio for each slice and frame was estimated. Scatter fraction was determined by averaging the true to background ratio of last 3 frames in which the dead time loss was below 1%. Results: Transverse and axial resolutions at 1cm radius were (1) 5.3 and 6.5 mm (FBP), (2) 5.1 and 5.9 mm (3D RAMLA). Transverse radial, transverse tangential, and axial resolution at 10 cm were (1) 5.7, 5.7, and 7.0 mm (FBP), (2) 5.4, 5.4, and 6.4 mm (3D RAMLA). Attenuation free values of sensitivity were 3,620 counts/sec/MBq at the center of transaxial FOV and 4,324 counts/sec/MBq at 10 cm offset from the center. Scatter fraction was 40.6%, and peak true count rate and NECR were 88.9 kcps @ 12.9 kBq/mL and 34.3 kcps @ 8.84 kBq/mL. These characteristics are better than that of ECAT EXACT PET scanner with BGO crystal. Conclusion: The results of this field test demonstrate high resolution, sensitivity and count rate performance of the 3D PET/CT scanner with GSO crystal. The data provided here will be useful for the comparative study with other 3D PET/CT scanners using BGO or LSO crystals.

• The Korean Journal of Nuclear Medicine Technology
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• v.12 no.3
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• pp.208-213
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• 2008

Purpose: Generally a whole body bone scan has been known as one of the most frequently executed exams in the nuclear medicine fields. Asan medical center, usually use various gamma camera systems - manufactured by PHILIPS (PRECEDENCE, BRIGHTVIEW), SIEMENS (ECAM, ECAM signature, ECAM plus, SYMBIA T2), GE (INFINIA) - to execute whole body scan. But, as we know, each camera's sensitivity is not same so it is hard to consistent diagnosis of patients. So our purpose is when we execute whole body bone scans, we exclude uncontrollable factors and try to correct controllable factors such as inherent sensitivity of gamma camera. In this study, we're going to measure each gamma camera's sensitivity and study about reasonable correction factors of whole body bone scan to follow up patient's condition using different gamma cameras. Materials and Methods: We used the $^{99m}Tc$ flood phantom, it recommend by IAEA recommendation based on general counts rate of a whole body scan and measured counts rates by the use of various gamma cameras - PRECEDENCE, BRIGHTVIEW, ECAM, ECAM signature, ECAM plus, IFINIA - in Asan medical center nuclear medicine department. For measuring sensitivity, all gamma camera equipped LEHR collimator (Low Energy High Resolution multi parallel Collimator) and the $^{99m}Tc$ gamma spectrum was adjusted around 15% window level, the photo peak was set to 140-kev and acquirded for 60 sec and 120 sec in all gamma cameras. In order to verify whether can apply calculated correction factors to whole body bone scan or not, we actually conducted the whole body bone scan to 27 patients and we compared it analyzed that results. Results: After experimenting using $^{99m}Tc$ flood phantom, sensitivity of ECAM plus was highest and other sensitivity order of all gamma camera is ECAM signature, SYMBIA T2, ECAM, BRIGHTVIEW, IFINIA, PRECEDENCE. And yield sensitivity correction factor show each gamma camera's relative sensitivity ratio by yielded based on ECAM's sensitivity. (ECAM plus 1.07, ECAM signature 1.05, SYMBIA T2 1.03, ECAM 1.00, BRIGHTVIEW 0.90, INFINIA 0.83, PRECEDENCE 0.72) When analyzing the correction factor yielded by $^{99m}Tc$ experiment and another correction factor yielded by whole body bone scan, it shows statistically insignificant value (p<0.05) in whole body bone scan diagnosis. Conclusion: In diagnosing the bone metastasis of patients undergoing cancer, whole body bone scan has been conducted as follow up tests due to its good points (high sensitivity, non invasive, easily conducted). But as a follow up study, it's hard to perform whole body bone scan continuously using same gamma camera. If we use same gamma camera to patients, we have to consider effectiveness of equipment's change by time elapsed. So we expect that applying sensitivity correction factor to patients who tested whole body bone scan regularly will add consistence in diagnosis of patients.

• Journal of dental hygiene science
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• v.17 no.6
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• pp.523-532
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• 2017

The purpose of this study was to provide basic data to standardize the clinical dental hygiene curriculum, based on analysis of current clinical dental hygiene curricula in Korea. We emailed questionnaires to 12 schools to investigate clinical dental hygiene curricula, from February to March, 2017. We analyzed the clinical dental hygiene curricula in 5 schools with a 3-year program and in 7 schools with a 4-year program. The questionnaire comprised nine items on topics relating to clinical dental hygiene, and four items relating to the dental hygiene process and oral prophylaxis. The questionnaire included details regarding the subject name, the grade/semester/credit system, course content and class hours, the number of senior professors, and the number of patients available for dental hygiene clinical training purposes. In total, there were 96 topics listed in the curricula relating to clinical dental hygiene training, and topics varied between the schools. There was an average of 20.4 topic credits, and more credits and hours were allocated to the 4-year program than to the 3-year program. On average, the ratio of students to professors was 21.4:1. Course content included infection control, concepts for dental hygiene processes, dental hygiene assessment, intervention and evaluation, case studies, and periodontal instrumentation. An average of 2 hours per patient was spent on dental hygiene practice, with an average of 1.9 visits. On average, student clinical training involved 19 patients and 26.6 patients in the 3-year and 4-year programs, respectively. The average participation time per student per topic was 38.0 hours and 53.1 hours, in the 3-year and 4-year programs, respectively. Standardizing the clinical dental hygiene curricula in Korea will require consensus guidelines on topics, the number of classes required to achieve core competencies as a dental hygienist, and theory and practice time.

• Journal of agricultural medicine and community health
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• v.25 no.1
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• pp.29-49
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• 2000

Objectives: To estimate the prevalence rate of hypertension, the changes of health behavior, and compliance for the drug treatment after diagnosed as hypertension. Methods: 7,030 persons who live in Cheonan City of Chungnam Province were selected by the cluster sampling method, and 5,372 persons were surveyed by questionnaire and health examination. This data is analyzed by Chi-square test on each variable. Results: 49.8%- of men and 38.8%- of women had been diagnosed as hypertension, and the prevalence rate of hypertension was significantly increased with aging in both gender. The prevalence rate tended to decrease in highly educated women group. Unemployed persons or obese persons showed relatively higher prevalence rate. The prevalence rate of hypertension increased in groups with higher total cholesterol levels over 240 mg/dl, and groups with glucose level over 200 mg/dl. 53.1%- of male patients and 66.6%- of female patients showed compliance for antihypertensive treatment. Compliance for treatment was higher in aged group or lower educated group in both gender. Among men, proportion of compliant subjects was higher in unemployed group(49.3%-), and lower in labor or primary industry than the others but among women, there was not any significant difference. And men with compliance for treatment had higher monthly income than the others, but women did not show any. Conclusion : This population had a high prevalence rate of hypertension which may lead to cardiovascular disease. Therefore health education programs and distribution of information must be emphasized in order to increase compliance to treatment and encourage the change of health behavior to promote health.

• Tuberculosis and Respiratory Diseases
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• v.42 no.4
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• pp.481-491
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• 1995

Background: Recently there has been a trend of an increasing incidence of mediastinal tuberculous lymphadenitis(MTL) in adults. MTL often cause bronchial stenosis or esophago-mediastinal fistula. In spite of effective treatment, it is difficult to cure. Moreover, relapse frequently occurs. Authors analyzed chest CT findings and clinical features of 29 cases with MTL Methods: 29 cases with MTL were retrospectively studied with the clinical and radiologic features from April 1990 to March 1995 Results: 1) A total of 29 cases were studied. 12 cases were male and 17 cases were female. The male to female ratio was 1:1.4 Mean age was 29 years old. The 3rd decade(45%) was the most prevalent age group 2) The most common presenting symptoms and signs were palpable neck masses(62%) followed by cough(59%) and sputum(38%) 3) Except in one case of MTL, all patients had coexisting pulmonary tuberculosis, cervical tuberculous lymphadenitis, endobronchial tuberculosis and tuberculous pleurisy. Among the coexisting tuberculous diseases, Pulmonary tuberculosis was the most common(76%) 4) On simple chest X-ray, mediastinal enlargement was noted in 21 cases(72%), but it was not noted in 8 cases(28%). The most frequently involving site was the paratracheal node in 16 cases(72%). Rt side predominence(73%) was noted 5) Patterns of node appearance on a postcontrast CT scan were classified into 3 types. There were 19 cases(30%) of the Homogenous type, 30 cases(47%) of the Central low density type and 15 cases(23%) of the Peripheral fat obliteration type. The most common type was the central low density type. The most common lymph node size was 1~2 cm(88%) 6) The most frequently involved site was the paratracheal node in 26 cases(89%) by chest CT. Rt side(63%) was predominant 7) 9 cases(43%) had complete therapy and most common treatment duration was 13 - 18 months. 12 cases(57%) had incomplete continuing antituberculous medication and half of the cases had been treated above 19 months. Conclusion: Chest CT findings of MTL showed central low density area and peripheral rim enhancement, so this characteristic findings could differentiate it from other mediastinal diseases and help a diagnosis of tuberculosis. In spite of effective antituberculous medication, it is difficult to cure. Moreover, relapse frequently occurs. Further studies will be needed of the clinical features and the treatment of MTL.

• The Journal of Korean Society for Radiation Therapy
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• v.32
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• pp.93-109
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• 2020

Purpose: The radiochromic film (Gafchromic EBT3, Ashland Advanced Materials, USA) and 3-dimensional analysis system dosimetry checkTM (DC, MathResolutions, USA) were evaluated for patient-specific quality assurance (QA) of helical tomotherapy. Materials and Methods: Depending on the tumors' positions, three types of targets, which are the abdominal tumor (130.6㎤), retroperitoneal tumor (849.0㎤), and the whole abdominal metastasis tumor (3131.0㎤) applied to the humanoid phantom (Anderson Rando Phantom, USA). We established a total of 12 comparative treatment plans by the four geometric conditions of the beam irradiation, which are the different field widths (FW) of 2.5-cm, 5.0-cm, and pitches of 0.287, 0.43. Ionization measurements (1D) with EBT3 by inserting the cheese phantom (2D) were compared to DC measurements of the 3D dose reconstruction on CT images from beam fluence log information. For the clinical feasibility evaluation of the DC, dose reconstruction has been performed using the same cheese phantom with the EBT3 method. Recalculated dose distributions revealed the dose error information during the actual irradiation on the same CT images quantitatively compared to the treatment plan. The Thread effect, which might appear in the Helical Tomotherapy, was analyzed by ripple amplitude (%). We also performed gamma index analysis (DD: 3mm/ DTA: 3%, pass threshold limit: 95%) for pattern check of the dose distribution. Results: Ripple amplitude measurement resulted in the highest average of 23.1% in the peritoneum tumor. In the radiochromic film analysis, the absolute dose was on average 0.9±0.4%, and gamma index analysis was on average 96.4±2.2% (Passing rate: >95%), which could be limited to the large target sizes such as the whole abdominal metastasis tumor. In the DC analysis with the humanoid phantom for FW of 5.0-cm, the three regions' average was 91.8±6.4% in the 2D and 3D plan. The three planes (axial, coronal, and sagittal) and dose profile could be analyzed with the entire peritoneum tumor and the whole abdominal metastasis target, with planned dose distributions. The dose errors based on the dose-volume histogram in the DC evaluations increased depending on FW and pitch. Conclusion: The DC method could implement a dose error analysis on the 3D patient image data by the measured beam fluence log information only without any dosimetry tools for patient-specific quality assurance. Also, there may be no limit to apply for the tumor location and size; therefore, the DC could be useful in patient-specific QAl during the treatment of Helical Tomotherapy of large and irregular tumors.

• Child Health Nursing Research
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• v.2 no.1
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• pp.93-111
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• 1996

The purpose of the study is to identify the lived experience of mothers who have children with cerebral palsy in order to understand their agony. Moreover, the result of study was to find some nursing intervention for disabled children and their mothers. For this purpose, ten mothers who are willing to cooperate with this research were selected at random from those who have children with the cerebral palsy, currently using the municipal facilities for the handicapped with cerebral malfunction. Data collection was done from October 4, 1994 th December 31, 1994. The data were collected by asking the mothers mentioned above with some unstructured open-ended questions, recorded on the tapes with permission by the interviewee in order to prevent missing of the interviewed contents. These collected data have been substantiated and properly analyzed on the basis of phenomenological approach initiated by Colaizzi's method. The results and validity are proved to be credible by means of the individual checking of the interviewed mothers. The results of this study are as follows : 1. When the mother is first informed of the diagnosis of cerebral palsy on her child, she usually misses the crucial timing needed for proper treatment of the child's disorder because she is notified through the doctor's indifference and his apparently inactive, matter-of-fact attitude. At first she suspects the doctor's diagnosis and tries to attribute it to the unknown cause from a certain genetic problem and then she quickly wants to deny the whole situation that her child is really suffering from the cerebral palsy. The reality is too much for her to accept as it is and she would not believe her child is abnormal. Therefore, she even attempts depend on the power of God for its solution. 2. The mother, who goes thorough this kind of uncommon experiences, is totally devoted to the treatment and care of the child and completely ignores her own life and happiness. At the same time, she feels sorry for her other normal children she believes having not enough care and concern. Also, she feels sorry for the sick child when the child's brothers or sisters show special concern for the patient out of sympathy. It is sorry and not satisfied for her that the child is growing with abnormality and neighbor other around have inappropriate attitudes. Likewise, she is discontent with her husband's lack of concern about the child's treatment. She believes that the health care system in this society isn't fulfilling its due purpose. In the state of her utmost distress and anxiety, she always feels the need of competent consultants, and is angry about that her child is treated as an abnormal being, she is trying to hide the child from other people and to make him or her disappear, if possible. Although she doesn't have harmonious relation with her husband, she id happy when he shows his affection for the child and she feels relieved and thankful when the relatives don't mention about the child's condition Since the child's overall status of health is continuously in unstable conditions, requiring her all-time readiness for an emergency, she feels guilty of her child's illness toward the fEmily members as if it was her own fault to have borne such an abnormal child and she feels responsible for the child morally and financially if necessary Because her life is centered on taking care of the child, she cannot afford to enjoy her own life and happiness. She is a lonely mother, fatigued, with no proper relationship with other people around her. With this sense of guilt and responsibility as a mother of an unusual disease, she has no choice but to grieve her destiny from which she is not allowed to escape. 3. Nevertheless, the mother with the child suffering from the cerebral palsy does not easily give up the hope of getting her child cured and she believes that in the long run, though slower than hoped, her abnormal son or daughter will be eventually cured to become a normal sibling someday. This kind of hope is sustained by the mother's strong faith coming from observing the progress of other similar children getting better. Sometimes she is encouraged to have this faith by other mothers who share the same painful experiences, believing that her child will improve even more rapidly than others with the same palsy. Full of hope, she painstakingly waits for the child's healing. Moreover, she plans to have another child. she thinks that the patient child's brothers and sisters only can truly understand and look after the patients. However, when she notices that the progress of other children under the treatment does not look so hopeful, she is distressed by the thoughts that her child may never get well. Too, she is worried that the patient's brother or sister will be born as the same invalid with the cerebral disease. She is discouraged to have another baby as much as she is encouraged to. She is also troubled by the thought that in case she has another baby, she will have to be forced. to neglect the patient child, especially when she does have an extra hand or some reliable person to help her with taking care of the patient.

• Journal of Korean Society of Forest Science
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• v.75 no.1
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• pp.1-18
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• 1986

This study was initiated to estimate productivity of Quercus variabilis stand. However the practical objective of this study was to provide some information to establish the basis of selecting the suitable site for Quercus variabilis. The productivity measured in terms of DBH, height, basal area and stem volume was hypothesized, respectively, to be a function of a group of factors. This study considered 32 factors, 20 of which were related to the forest environmental factors such as tree age, latitude, percent slope, etc. and the rest of which were related to soil factors such as soil moisture, total nitrogen, available $P_2O_5$, etc. The data on 4 productivity measurements of Quercus variabilis growth and related factors cited were collected from 99 sample plots in Kyeongbook and chungbook provinces. Some factors considered were, in nature, discrete variables and the others continuous variables. Each kind of factor was classified into 3 or 4 categories and total numbers of such categories were eventually amounted to 110. Then each category was treated as an independent variable. This is amounted to saying that individual variable was treated a dummy variable and assigned a value 1 or 0. However the first category of each factor was deleted from the normal equation for statistical consideration. First of all, each of 4 productivity measurements of Quercus variabilis growth was regressed and, at the same time, those 110 categories. Secondly, the partial correlation coefficients were measured between each pair of 4 productivity measurements and 32 individual foctors. Finally, the relative scores were estimated in order to derive the category ranges. The result of these statistical analyses could be summarized as follows: 1) Growth measurement in terms of height seems to be a more significant criterion for estimation of productivity of Quercus variabilis. 2) Productivity of forest on stocked land may better be estimated in terms of forest environmental factors, on the other hand, that of unstocked land may be estimated in terms of physio-chemical factors of soil. 3) The factors that a strongly positive relation to all growth factors of tree are age group, effective soil, soil moisture, etc. This implies that these factors might effectively be used for criteria for selecting the suitable site for Quercus variabilis. 4) Parent rock, latitude, total nitrogen, age group, effective soil depth, soil moisture, organic matter, etc., had more significant category range for tree growth. Therefore, the suitable site for Quercus variabilis may be selected, based on this information. In conclusion, the above results obtained by the multivariable analysis can be not only the important criteria for estimating the growth of Quercus variabilis but also the useful guidance for selecting the suitable sites and performing the rational of Quercus variabilis forest.