• The Journal of the Korean bone and joint tumor society
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• v.20 no.1
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• pp.14-21
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• 2014

Purpose: To analyze the clinical features and treatment outcome of Langerhans' cell histocytosis. Materials and Methods: From August 1996 to June 2013, 28 patients who histologically proven with LCH were analyzed of medical records, radiography, pathologic character retrospectively. Results: A total of 28 cases of LCH including 22 child has been reported. Onset age was 0.6 to 51 years old, occurred in the average age was 14.8 years. Follow-up period was 6 months to 134 months average was 44.6 months. The M:F ratio was 2.5:1. The initial symptoms was pain in 18 cases, 5 cases of pathologic fracture, 3 case of palpable mass, 1 case of discovered by accident in radiography, 1 case of torticollis. In radiological examination osteolysis was seen all cases, 7 cases showed a periosteal reaction, 1 case showed soft tissue extension. Clinical type of all cases were eosinophilic granuloma. 25 cases were classified as unifocal disease and 3 cases were multifocal single systemic diseases. In all cases, incisional biopsy was performed. After histologic confirmed, 14 cases was treated with curettage or surgical excision of the lesion and the other 14 cases were followed up without treatment. There is no death during follow up period. 11 cases has no radiological improvement after 3-6 months observation, intralesional steroid injection was performed. Conclusion: Patients with LCH who has rapid systemic onset is very rare, so if you meet the young children who suspected LCH, you shoulder avoid the examination which cause excessive radiation exposure to the young patient. In order to confirm the diagnosis of disease, biopsy is needed. Close observation after confirmed by histological method will bring the satisfactory results. But the patients who had pathologic fracture or wide bone destruction already may need curettage and bone grafting to lesion or internal fixation. The lesion which has no radiological improvement after 3-6 months observation or appear with pain interferes daily life may need local steroid injection as a good treatment.

• Journal of the Korean Society of Radiology
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• v.9 no.4
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• pp.205-211
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• 2015

At a recent medical imaging technology, the major issue of X-ray diagnosis in breast cancer is the early detection of breast cancer and low patient's exposure dose. As one of studies to acquire a monochromatic X-ray, Technologies using multilayer mirror had been preceded. However, a uniform multilayer mirror that consists of uniform thin-film thickness can acquire a monochromatic X-ray only in the partial area corresponds to angle of incidence of white X-ray, so there are limits for X-ray imaging technology applications. In this study, we designed laterally graded multilayer mirror(below GML) that reflects same monochromatic X-ray over the entire area of thin-film mirror, which have the the thickness of the linear gradient that correspond to angle of incidence of white X-ray. By using ion-beam sputtering system added the mask control system we fabricated a GML which has size of $100{\times}100mm^2$. The GML is designed to achieve the monochromatic X-ray of 17.5kev energy and has thin-film thickness change from 4.62nm to 6.57nm(3.87nm at center). It reflects the monochromatic X-ray with reflectivity of more than 60 percent, FWHM of below 2.6keV and X-ray beam width of about 3mm. The monochromatic X-ray corresponded to 17.5keV using GML would have wide application in development of mammography system with high contrast and low dose.

• The Journal of the Korean bone and joint tumor society
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• v.9 no.1
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• pp.69-76
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• 2003

Purpose: This study was designed to provide the data base for the diagnosis and treatment of the foot tumor by investigation of the clinical and pathological characteristics and distribution of the foot tumor. Materials and Methods: 142 foot tumors of 141 patients were studied. All patients were diagnosed with surgical biopsy. We investigated clinical and pathological characteristics and epidemiologic distribution of the foot tumor by reviewing the medical records and imaging materials. The location of the tumors were classified with zone of Kirby et al. Results: 75 patients were female and 66 were male. The average age of the patients was 33.2 years old. Benign soft tissue tumors were the most as 68 cases, and followed by 57 benign bone tumors, 12 malignant soft tissue tumors and 5 malignant bone tumors. Ganglia were the most in benign soft tissue tumors as 36 cases, subungual exostoses in benign bone tumors as 18, squamous cell carcinomas in malignant soft tissue tumors as 7, and metastatic lung cancers in malignant bone tumors as 2. The rate of pain complaints was the highest in malignant bone tumors, the duration of symptom was longest in benign soft tissue tumors, and the size of the tumor was the biggest in malignant bone tumors. Neurological symptoms were found in only 3 benign soft tissue tumors. For the zonal distribution, zone 5 was the most in 59 cases and zone 4 was the least as 10. The most numbers of the benign bone tumors located in zone 5, of benign soft tissue tumors in zone 1, of malignant bone tumors in zone 1 and 2, and of malignant soft tissue tumors in zone 5. The methods of surgical treatment included intralesional or marginal resection, curettage with or without bone graft, toe amputation, below knee amputation and limb salvage. Conclusion: The tumors of the foot were rare and various, and mostly benign (88%), but we can do proper treatment of those tumors without excluding malignant tumors by considering the age of patients, pain, duration of symptom, size of the tumors, and zonal distribution.

• Korean Journal of Psychosomatic Medicine
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• v.13 no.2
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• pp.75-84
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• 2005

Objectives : This study was conducted to look over the current status of psychiatric consultation in a general hospital. Methods : We analyzed 664 medical records : 317 in 2002 and 347 in 1997, and compared the records of 1997 and 2002. Results 1) The average age of the patients increased from 45.9 years(1997) to 53.2 years of age (2002). Dividing the referred patients into 3 age-brackets as below 40, between 40 and 60, and above 60, the number of patients in the age group above 60 was significantly increased, more prominently in women. 2) Overall consultation rate was 2.29% in 2002 and 2.2% in 1997 .44.2% and 57.1% of the whole referrals were from the department of internal medicine in each year, and the department of rehabilitation medicine was leading in consultation rate in both years. 3) 'Mood disorders' and 'Substance related disorders' were the most frequent diagnoses in 2002 and 1997 respectively. 4) Use of psychotropic drugs was the most frequent recommendations of psychiatric consultation, in both years, and the most frequently prescribed drugs were anti-anxiety drugs in both years. The use of SSRI and atypical anti-psychotics were increased, while the use of typical anti-psychotics was decreased significantly in 2002. Conclusion : In 2002, compared with 1997, the average age of the patients was increased, and the consultation of the patients with the diagnosis of 'mood disorders' and 'cognitive disorders' was done more frequently than in 1997. The recommendation to use psychotropic drugs was well accepted, but the concern to diagnostic procedure was relatively low.

• Korean Journal of Psychosomatic Medicine
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• v.25 no.2
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• pp.200-209
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• 2017

Objectives : The aim of this study was to analyze the relationship between depressive symptoms and sociodemographic factors associated with geriatric depression and insomnia and to examine the effects of these factors on depression. Methods : The severities of insomnia and depression in elderly aged 60 and older lived in Gwangmyeong city were evaluated and the related sociodemographic factors were investigated. From April 20, 2016 to December 1, 2016, Gwangmyeong city Mental Health Sevices consignment by department of psychiatry of a university-affiliated general hospital conducted surveys and interviews for total 837 elderly peoples lived in Gwangmyeong city by visiting welfare center and wards located in the city. Structured interviews were conducted using Insomnia Severity Index(ISI) and Short form-Geriatric Depression Scale(S-GDS) to examine the relationship between sociodemographic factors and the severities of insomnia and depression. Results : There were significant differences in S-GDS mean scores and age(below 70 years old, 70s, 80s, above 90 years old), type of health care(health insurance, medical aid), type of residency(own, not own) and marital status(single, married, divorced or widowed).There was a significant difference in education level, especially between not educated(and/or) elementary graduates and college graduate(F=3.227, p=0.012). Also, there were significant differences in age, type of health care, type of residency, number of household on divided S-GDS score above and below 10 scores(p<0.05). Insomnia measured by ISI was not significantly associated with sociodemographic factors(p>0.05), but was significantly associated with depressive symptoms(p<0.05). These findings suggest more severe insomnia symptom indicated the higher probability of depression and elderly with depressive symptoms had more severe insomnia. Conclusions : Geriatric depression has significant relationships with age, type of health care, type of residency, marital status, education and number of households. In addition, insomnia which is main symptom of depression in elderly, has important role in predicting the severity and diagnosis of depression.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.4 no.1
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• pp.147-162
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• 1997

This study was attempted to provide the basic data for nursing intervention to improve the psychosociological adaptation of patients receiving chemotherapy for breast cancer by examining relationship between anxiety and hopelessness that they are experiencing and family support, in order to help them successfully cope with various psychological problems. This study was carried out with 93 breast cancer patients who are receiving chemotherapy in the injection treatment room of K University Hospital located in the downtown of Taegu after having underwent mastectomy in the hospital between December 1995 and August 1996. This study used the systematized questionnaires which contain 7 questions about general characteristics, Spielberger's trait anxiety & state anxiety scale, the tool that WON(1987) modified the hopelessness scale which was developed by Beck et al.(1967) and the family support tool made by TAE(1985). By using the SPSS/PC program, this study obtained the real number and percentage for the general characteristics of the subjects, and mean and standard variation for the degrees of trait anxiety, state anxiety, hopelessness and family support. The correlation between each variables was identified on the basis of the Pearson Correlation, and the degrees of trait anxiety, state anxiety, hopelessness and family support in the general characteristics of the subjects were analyzed by using the t-test, ANOVA, and Duncan test. The results of this study were summarized as follows. In the general characteristics of the subjects, most of each group were 51 years old or more and the middle class in income, had educational background under elementary school, no job, Buddhism in religion and spouse, and were receiving chemotherapy using MTX and 5FU. It was shown that the degree of the subjects' trait anxiety is, on an average, 50. 29, state anxiety 49. 68, hopelessness 51. 46 and family support 34. 28. Both trait anxiety and hopelessness showed normal correlation ; the higher the degree of trait anxiety is, the higher the degree of hopelessness is, while trait anxiety and family support showed reverse correlation ; the higher the degree of trait anxiety, the lower the degree of family support that the subjects perceive is. State anxiety and hopelessness also showed normal correlation ; the higher the degree of state anxiety is, the higher the degree of hopelessness is. Family support and hopelessness showed reverse correlation ; the higher the degree of family support is, the lower the degree of hopelessness that the subjects perceive is. And family support and state anxiety showed reverse correlation but there was a statistically significant difference. The degree of trait anxiety in the general characteristics of the subjects showed a significant difference by age, job and religion, the degree of state anxiety a signigicant difference by job and religion, the degree of hopelessness a signigicant difference by age, educational background and existence or not of spouse. In conclusion, the breast cancer patients receiving chemotherapy perceive anxiety and hopelessness due to several causes such as diagnosis itself or side effects of chemotherapy, so that it is required not only to develop specific nursing interventions including family support to alleviate anxiety and hopelessness but also to apply such interventions to clinical practice.

• Journal of Korean Academy of Nursing
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• v.23 no.4
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• pp.569-584
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• 1993

This study was done to verify validity of nursing diagnoses related to difficulty in respiratory function. First, content validity was examined by an expert group considering the etiology and the signs / symptoms of three nursing diagnoses - ineffective airway clearance, ineffective breathing pattern, impaired gas exchange. Second, clinical validity was examined by comparing the frequencies of the etiologies and signs / symptoms of the three nursing diagnoses in clinical case studies with the results of the content validity. This study was a descriptive study. The sample consisted of 23 experts (professors, head nurses and clinical instructors) who had had a variety of experiences using nursing diagnoses in clinical practice, and 102 case reports done by senior student nurses of the college of nursing of Y-university. These reports were part of their clinical practice in the ICU. The instrument used for this study was a checklist for etiologies and signs and symptoms based on the literature, Doenges and Moorhouse (1988), Kim, McFarland, McLane (1991), Lee Won Hee et al. (1987), Kim Cho Ja et at. (1988). The data was collected over four month period from May 1992 to Aug. 1992. Data were analyzed using frequencies done with the SPSS / PC＋ package. The results of this study are summarized as follows : 1. General Characteristics of the Expert Group A bachelor degree was held by 43.5% and a master or doctoral degree by 56.5% of the expert group. The average age of the expert group was 35.3 years. Their average clinical experience was 9.3 years and their average experience in clinical practice was 5.9 years. The general characteristics of the patients showed that there were more women than men, that the age range was from 1 to over 80. Most of their medical diagnoses were diagnoses related to the respiratory. system, circulation or neurologic system, and 50% or more of them had a ventilator with intubation or a tracheostomy. The number of cases for each nursing diagnoses was : · Ineffective airway clearance, 92 cases. · Ineffective breathing pattern, 18 cases. · Impaired gas exchange, 22 cases. 2. The opinion of the expert group as to the classification of the etiology, and signs and symptoms of the three nursing diagnoses was as follows : · In 31.8% of the cases the classification of etiology was clear. · In 22.7%, the classification of signs and symptoms was clear. · In 17.4%, the classification of nursing interventions was clear. 3. In the expert group 80% or mere agreed to ‘dysp-nea’as a common sign and symptom of the three nursing diagnoses. The distinguishing signs and symptoms of (Ineffective airway clearance) were ‘sputum’, ‘cough’, ‘abnormal respiratory sounds : rales’. The distinguishing sings and symptoms of (Ineffective breathing pattern) were ‘tachypnea’, ‘use of accessory muscle of respiration’, ‘orthopnea’ and for (Impaired gas exchange) it was ‘abnormal arterial blood gas’, 4. The distribution of etiology, and signs and symptoms of the three nursing diagnoses was as follows : · There was a high frequency of ‘increased secretion from the bronchus and trachea’ in both the expert group and the case reports as the etiology of ineffective airway clearance. · For the etiologies for ineffective breathing pat-tern, ‘rain’, ‘anxiety’, ‘fear’, ‘obstructions of the tract, ca and bronchus’ had a high ratio in the ex-pert group and ‘decreased expansion of lung’ in the case reports. · For the etiologies for impaired gas exchanges, ‘altered oxygen -carrying capacity of the blood’ and ‘excess accumulation of interstitial fluid in lung’ had a high ratio in the expert group and ‘altered oxygen supply’ in the case reports. · For signs and symptoms for ineffective airway clearance, ‘dyspnea’, ‘altered amount and character of sputum’ were included by 100% of the expert group. ‘Abnormal respiratory. sound(rate, rhonchi)’ were included by a high ratio of the expert group. · For the signs and symptoms for ineffective breathing pattern. ‘dyspnea’, ‘shortness of breath’ were included by 100% of the expert group. In the case reports, ‘dyspnea’ and ‘tachypnea’ were reported as signs and symptoms. · For the sign and symptoms for impaired gas exchange, ‘hypoxia’ and ‘cyanosis’ had a high ratio in the expert group. In the case report, ‘hypercapnia’, ‘hypoxia’ and ‘inability to remove secretions’ were reported as signs and symptoms. In summary, the similarity of the etiologies and signs and symptoms of the three nursing diagnoses related to difficulty in respiratory function makes it difficult to distinguish among them But the clinical validity of three nursing diagnoses was established through this study, and at last one sign and symp-tom was defined for each diagnosis.

• Korean Journal of Health Education and Promotion
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• v.12 no.1
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• pp.83-110
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• 1995

The purpose of this study was to investigate the status of the problematic behavior for the demented elderly and the stress among family members, and the effects of the problematic behavior upon the stress in order to offer the basic data for the adult and the elderly health education about dementia. For this purpose, 70 families who were resident in Seoul and Inchon were surveyed by quetionnaires. This was carried out from 26 July, 1994 to 11 September, 1994. Datum was analysed by using SPSS\PC+ including percentage, mean, t - test, ANOVA, Pearson correlation. So, the results of this study were as follows: 1. In view of socia-demographic characteristics, female were 82.9%, and of the female daughters-in-law of the demented elderly were 44.9%. 40th years old were 32.9% and 88.6% wase married. The christian were 34.8%, those who graduated university 47.1%, and those who had a job 32.9%. 2. Of the demented elderly, female were 74.3%, 80 years old were 37.1%, and their average age was seventy-seven point one years old. 66.2% of the elderly has been lived alone and the christian were 27.5%. In addition, those who graduated elementary school were 66.5%. 3. Of the behavior problem for the demented elderly, Activities of the Daily Living(ADL) was the most severe problem. The 2nd was cognitive function problem, the 3th, change of personality, the 4th, emotional disturbance, and the last, misconduct behavior. 4. For the status of behavior problems, females were more severe than male, and 80th years elderly ware the most severe groups. The longer disease period was, the severe problematic behaviors were, and in 4-6 years of the disease period the status was the highest(p＜0.05). Those who diagnosed the disease had more severe problems(p＜0.001). 5. The orders of the stress among family members caring for the demented elderly in this study were as follows : 1. The deficiency of supporting network 2. Decrease of elderly's cognitive activities 3. Assistance of BADL(Basic Activities of Daily Living) 6. Elderly's abnormal behavior 5. Assistance of IADL(Instrumental Activities of Daily Living), 6. As for the status of the stress among family members, female respondants were higher than male. On the ages, 20th years' stress score were the highest. Daughters-in-law were stressed more than other family members. The longer the time of caring per day was, the highest the status of the stress(p＜0.05), 7. Those who caring for female elderly and more than 80 years had more stressed. When the elderly was received the diagnosis, the family members were more stressed. On the disease period, 1-2 years was the highest and after 2 years the status of the stress was decreased and more than 6 years was the lowest(p＜0.05). 8. Behavior problems of the demented elderly were closely associated to the stress for family members. Of the problems, change of personality was the most related factor(r = 0.6552). The factors of Basic Activities of the Daily Living(BADL) was most correlated on assistance of Basic Activities of Daily Living (BADL), emotional disturbance the assistance of IADL(Instrumental Activities of Daily Living). Change of personality was most related to the stress of the decrease of cognitive activities and elderly's abnormal behavior. The deficiency of supporting network was most related to misconduct behavior.

• Journal of the Korean Society of Radiology
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• v.10 no.5
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• pp.327-335
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• 2016

The study is enforce to study image quality evaluation of condition provide the IEC and combination of clinical conditions each quality of radiation that image quality to assess the conditions provided to IEC in the clinical environment to conduct image quality assessment of the digital radiography system in the detector have environmental limits. First, image quality evaluation was evaluated by measuring the MTF, NPS using four quality of radiation and Using MCNPX simulation lastly DQE make a image quality evaluation after calculating the particle fluence to analyze spectrum quality of radiation. Second, Using MCNPX simulation of four quality of radiation was evaluated absorbed dose rate about electronic 1 per unit air, water, muscle, bone by using Radiation flux density and energy, mass-energy absorption coefficient of matter. Results of evaluation of image quality, MTF of four quality of radiation was satisfied diagnosis frequency domain 1.0 ~ 3.0 lp/mm of general X-ray that indicated 1.13 ~ 2.91 lp/mm spatial frequency. The NPS has added filter, spatial frequency 0.5 lp/mm at standard NPS showed a tendency to decrease after increase. Unused added filter, spatial frequency 0.5 lp/mm at standard NPS showed a certain NPS result value after decrease. DQE in 70 kVp / unuesd added filter(21 mm Al) / SID 150 cm that patial frequency 1.5 lp/mm at standard showed a tendency to decrease after certain value showed. Patial frequency in the rest quality of radiation was showed a tendency to decrease after increase. Results of evaluation of absorbed dose, air < water < muscle < bone in the order showed a tendency to increase. Based on the results of this study provide to basic data that present for the image quality evaluation method of a digital radiation imaging system in various the clinical condition.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.10 no.1
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• pp.64-75
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• 1999

Objective：The purpose of this study was to investigate the prevalence and characteristics of comorbid disorders and associated symptoms in pervasive developmental disorder(PDD) and to examine the correlation between associated symptoms and developmental characteristics in PDD children. Method：The sample consisted of 209 cases of PDD and 143 cases of developmental language disorder(DLD)(control group) who were treated at the Seoul National Mental Hospital from Jan. 1996 to Mar. 1999. The diagnostic work based on DSM-IV criteria was performed by one or two child psychiatrists, while the clinical feature was evaluated by doctors’s notes, occupational/speech therapy reports, and results of social maturity scale(SMS), childhood autism rating scale(CARS), and psycho-educational profile(PEP). Two groups were compared on a wide range of measures including comorbid disorders, associated symptoms, treatment drugs, and PEP. The relation between associated symptom & PEP was investigated in total(106 cases) and in each dignostic group. Sixty-four cases of PDD were divided into three groups by CARS and then compared on associated symptoms. Result：The prevalence of comorbid disorder was 19.6% in PDD, 41.2% in DLD. The rate of manifestation of 13 associated symptoms was 31.47% in PDD, 22.13% in DLD on the average. Associated symptoms significantly high in PDD were preoccupation, obsession, self-mutilation, stereotypy, sleep problems, and odd response. In total patient group, associated symptoms that significantly influenced PEP were preoccupation, self-stimulation, stereotypy, inappropriate affect, sleep problems, and odd response. But, in each diagnostic group, no associated symptom influenced PEP. Associated symptoms significantly different between the 3 groups of CARS were stereotypy, anxiety, and sleep problems. Conclusion：These preliminary results suggest that developmental characteristics may influence associated symptoms in PDD children and a realistic approach considering minute diagnosis by associated symptoms and comorbid disorders is required.