• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.2
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• pp.33-37
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• 2010

Purpose: In the early stage of using PET/CT, it was used to damper revision but recently shows that CT with MDCT is commonly used and works well for an anatomical diagnosis. This hospital makes the accuracy and convenience more higher in the diagnosis and evaluate of coronary heart disease through concurrently running myocardial perfusion SPECT examination, myocardial PET examination with FDG, and CT coronary artery CT angiography(coronary CTA) used PET/CT with 64-slice. This report shows protocol and image based on results from about 400 coronary heart disease examinations since having 64 channels PET/CT in July 2007. Materials and Methods: An Equipment for this examination is 64-slice CT and Discovery VCT (DVCT) that is consisted of PET with BGO ($Bi_4Ge_3O_{12}$) scintillation crystal by GE health care. First myocardial perfusion SPECT with pharmacologic stress test to reduce waiting time of a patient and get a quick diagnosis and evaluation, and right after it, myocardial FDG PET examination and coronary CTA run without a break. One-stop evaluation protocol of ischemic heart disease is as follows. 1)Myocardial perfusion SPECT with pharmacologic stress: A patient is injected with $^{99m}Tc$-MIBI 10 mCi and does not have any fatty food for myocardial PET examination and drink natural water with ursodeoxcholic acid 100 mg and we get SPECT image in an hour. 2)Myocardial FDG PET: To reduce blood fatty content and to increase uptake of FDG, we used creative oral glucose load using insulin and Acipimox to according to blood acid content. A patient is injected with $^{18}F$-FDG 5 mCi for reduction of his radiation exposure and we get a gated image an hour later and get delay image when we need. 3) Coronary CTA: The most important point is to control heart rate and to get cooperation of patient's breath. In order to reduce a heart rate of him or her below 65 beats, let him or her take beta blocker 50 mg ~ 200 mg after a consultation with a doctor about it and have breath-practices then have the examination. Right before the examination, we spray isosorbide dinitrate 3 to 5 times to lower tension of bessel wall and to extension a blood wall of a patient. It makes to get better the shape of an anatomy. At filming, a patient is injected CT contrast with high pressure and have enough practices before the examination in order to have no problem. For reduction of his radiation exposure, we have to do ECG-triggered X-ray tube modulation exposure. Results: We evaluate coronary artery stenosis through coronary CTA and study correlation (culprit vessel check) of a decline between stenosis and perfusion from the myocardial perfusion SPECT with pharmacologic stress, coronary CTA, and can check viability of infarction or hibernating myocardium by FDG PET. Conclusion: The examination makes us to set up a direction of remedy (drug treatment, PCI, CABG) because we can estimate of effect from remedy, lesion site and severity. In addition, we have an advantage that it takes just 3 hours and one-stop in that all of process of examinations run in succession and at the same time. Therefore it shows that the method is useful in one stop evaluation of ischemic heart disease.

• Korean Journal of Psychosomatic Medicine
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• v.19 no.2
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• pp.66-73
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• 2011

Objectives:The present study investigates the status of inpatient psychiatric consultations at a general hospital in order to find factors that contribute to treatment compliance related to psychiatric consultations. Methods:The subjects were 333 patients who were hospitalized at Korea University Medical Center Ansan Hospital from 1 September 2009 to 31 July 2010.The patients were referred for psychiatric consultation during hospitalization. This study investigates demographic data, request department, referral causes, requestor, psychiatric history and diagnosis, andpsychiatric treatment compliance. Treatment compliance was defined as whether or not the patient had accepted psychiatric treatment during hospitalization or outpatient department(OPD) follow-up. This study ascertains the factors that have impact on compliance, by taking binary logistic regression with compliance and other variables. Results:Among the patients that were offered psychiatric treatment during hospitalization(N=310), treatment compliance was 82.9%. Among the patients that were offered OPD treatment(N=111), compliance was 55.8%. Elderly group(>65 years) showed better compliance to treatment during hospitalization than the younger patient group(OR=4.838, p=0.004). Patients with secondary psychiatric disorders showed better OPD follow-up compliance than patients with secondary psychiatric disorders(OR=8.520, p=.008). Conclusion:Elderly patients showed better compliance for psychiatric treatment during hospitalization. However they commonly have disorders such as delirium and mood disorders that have impact on the patient's physical state, hence further active measures should be carried out. Patients referred due to primary psychiatric disorders showed poor OPD compliance. Therefore clinicians have to suggest multidisciplinary interventions that will improve treatment compliance of such patients.

• The Korean Journal of Nuclear Medicine Technology
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• v.17 no.1
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• pp.76-79
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• 2013

Purpose: It is very important to establish the appropriate reference range in the laboratory for preventing mistakes like false positive or false negative. Because the reference range in the laboratory is standard of patient test results interpretation. Proinsulin is precursor hormone of insulin, and the importance is increasing for diagnosing diabetes or insulinoma. Proinsulin reagent used in our laboratory is produced in the USA, and the reference range provided by manufacturer was adapted to our reference range after the validation test. But, it is generally recommend for the every laboratory to establish the their own reference range. So, we decided to re-evaluate the reference range with our patients' test results. Materials and Methods: Among 737 patients who had been to health promotion center in our hospital between Dec. $8^{th}$ 2011 and Dec. $21^{st}$ 2011, 563 patients are chosen with exception of diabetics patients and patients showing abnormal test results in Fasting Glucose, HbA1c, Insulin, and C-peptide. The 563 test results (275 males and 288 females) were classified with three groups(entire, male, female), and analysis of normal distribution was performed with aid of SPSS(version 19.0). Because Each group didn't show normal distribution, the reference range was set from the lowest limit of 2.5% to the highest limit of 97.5% with Percentile method used in non-normal distribution. Results: When evaluation values are sorted in ascending order, the entire range is 4.5~52.0 pM and 5.3~51.9 pM for male and 4.5~52.0 pM for female. The calculated reference range with percentile method shows 6.7~26.5 pM for entire group, 6.8~26.5 pM for male and 6.7~26.5 pM for female, respectively. Conclusion: The reference range provided by reagent manufacturer is 6.4~9.4 pM and the one established in this study is 6.7~26.5 pM. This difference might be caused by racial characteristics between Western people and Koreans. So an ideal reference range can be gotten with normal population visiting to every hospital. Our hospital has been using the newly re-establishing reference range under consultation with the department of endocrinology since Aug. $1^{st}$ 2012.

• Journal of Korean Academy of Nursing Administration
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• v.5 no.2
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• pp.355-368
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• 1999

This study was a quasi-experimental study to investigate the effect of a telephone follow-up on the self-care and the satisfaction on nursing care in G-I surgical patients. The subjects of the study were 38 patients, 19 in experimental group and 19 in control group, who discharged after gastrointestinal surgery at a university hospital in Taegu between August 11. 1998 and October 16, 1998. The telephone follow-up program for the experiment was developed by the researcher, which contained consultation, support and encouragement for self-care after discharge. Number of the instruments used for measurement of the outcome variables were 5, self-care after discharge, satisfaction(1)${\sim}$(2) on Nursing care. intention to visit the hospital again. intention to recommend the hospital to others. The results of this study were as follows ; 1. The first hypothesis, "The subjects of experimental group will show a higher level of self-care than the subjects of control group" was rejected (F=.48. p=.4937). 2. The Second hypothesis. "The subjects of experimental group will show a higher level of satisfaction than the subjects of control group" was accepted partly as follows. 1) The hypothesis 2-1, "The subjects of experimental group will show a higher level of satisfaction(1) than the subjects of control group" was accepted(F=4.04. p=.0496). 2) The hypothesis 2-2. "The subjects of experimental group will show a higher level of satisfaction(2) than the subjects of control group" was accepted(F=8.48. p=.0064). 3) The hypothesis 2-3, "The subjects of experimental group will show a higher level of intention to visit hospital again than the subjects of control group" was rejected(F=1.95. p=.1723). 4) The hypothesis 2-4. "The subjects of experimental group will show a higher level of intention to recommend the hospital to others than the subjects of control group" was rejected(F=1.43. p=.2411) . From the results of this study, the telephone follow-up can be regarded as an effective nursing intervention for the discharged patients.

• Industry Promotion Research
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• v.5 no.3
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• pp.89-96
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• 2020

This study is to study Adler's individual psychology and to study the counseling process and counseling techniques based on the counseling theory derived there. The progress of Adler's consultation process is first, and the relationship formation phase is the phase of seeking equal and mutually cooperative relations working as active partners toward agreed objectives between the counselor and the counsellor. Second, the lifestyle search phase is an important goal to understand lifestyle and how lifestyle affects life's task. Third, the insight phase is the one that has insight. Fourth, it is carried out in the financial direction (transformation of behavior). Adler's counseling techniques include general techniques and special techniques, and general techniques include promptness, advice, encouragement, paradoxical intentions, demonstration of poetry, and role play. Special techniques include pressing a doorbell, spitting on a physician's soup, Midas technique, entertaining others, avoiding low-quality children and self-restraint. In conclusion, individual psychological counseling is based on growth model, not medical model, and has more interest in re-education and re-lighting healthy individuals and societies than on the aspect of treatment. Therefore, it applies to various areas such as child guidance centers, parent-child counseling, marital counseling, family counseling, group counseling and treatment, personal counseling for children and adolescents, cultural conflicts and mental health campaigns.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.11
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• pp.106-114
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• 2019

This study aims to identify the effects of experiencing health promotion education on the present health status of elderly people. The subjects of this study were a total 10,532 elderly people (aged 65 years or older), and who were selected from the data of the '2017 Community Health Survey'. The health promotion education experience consisted of handwashing education/campaign, a non-smoking campaign and non-smoking education. The chronic disease control education experience consisted of education on hypertension, diabetes mellitus and arthritis. Psychiatric counseling consisted of consultations on stress, depression and suicide. The present health status consisted of the patients' ability to exercise, their self-care ability, their activities of daily living, their pain/discomfort and their anxiety/depression. The data was analyzed utilizing the chi-square test, the Mann-Whitney test and multivariate logistic regression analysis. The general characteristics of the subjects were 4,075 males (38.69%) and 6,457 females (61.31%). The average age was 73.71(±6.18) years old. The significant factors influencing the elderly peoples' present health status were age (OR=0.909, 95% CI=0.886-0.933), handwashing education/campaign (OR=2.463, 95% CI=1.703-3.563), a stop smoking campaign (OR=1.624, 95% CI=1.146-2.301) and consultation for mental problems (OR=0.533, 95% CI=0.359-0.791). In conclusion, to modify the personal habits that the elderly have had for a long time and to show the effects of education, long-term continuous education that focuses on the characteristics of the people will be effective.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.4 no.2
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• pp.73-76
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• 2008

Hemophilia A is an X-linked disorder resulting from a deficiency in factor VIII. Hemophilia A is classified into severe, moderate, and mild forms. A 12-month old boy visited for uncontrolled bleeding on the upper labial frenum area. Spontaneous bleeding occurred about 13 days ago. We sutured the wound. However, the patient returned after 6 days with large hematoma formation. Consultation to the hematologist and laboratory examination were carried out. Activated PTT was elongated and factor VIII was only 6%. He was diagnosed as mild hemophilia A. Fresh frozen plasma (FFP) was provided and hemostasis was achieved. At 5-day check-up, no more bleeding was observed. For the management of prolonged bleeding in hemophilia A patient, not only local hemostatic measures, but factor VIII replacement therapy, antifibrinolytics, and Desmopressin are also available. Mild hemophilia A often occurs without either familial or medical history. It is often first detected by dental trauma.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.7
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• pp.490-499
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• 2017

In recent years, the introduction of complex systems analysis based on various variables has become more active in order to identify and analyze complex problems of Modern Society. Prediction of patients' spatial perception and usability according to the spatial arrangement of the outpatient department is a very important factor for providing high quality hospital service. For objective analysis, the standard program procedure and analysis index for the diseases of the elderly were prepared and the uniformity of the atmospheric space was evaluated through heat map analysis and quantitative analysis. In this study, 73 cells were installed and simulated to analyze the uniformity of the four alternatives according to the change of the arrangement of the medical care space, receiving space, and consultation space using the complex system analysis method for the nursing hospitals. The resulting density was derived. The results are as follows. 1)The layout of the reception space has the greatest influence on the total spatial density of the waiting space. 2) The uniformity of the waiting space can be increased by separating the examination space and the examination space. 3)The closer the location of the receiving space is from the entrance, the greater the density of the waiting space. Finally, this study applied discrete event simulation to the evaluation of uniformity of atmosphere space, and proved that the actor - based model can be utilized for utilization and evaluation as spatial analysis methodology.

• Journal of Korean Academy of Nursing
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• v.28 no.3
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• pp.705-717
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• 1998

Ostomates have suffered from many difficulties due to their physical, psychosocial handicaps and changes of life style to include ostoma management that influences their daily and quality of life. An appropriate nursing education for ostoma management is very important. Practical educational materials needs revision because those were developed by pharmaceutical companies and hospital institutions. The purpose of this study is to provide more practical and reasonable education materials for ostomates by doing analysis and survey of educational materials now being used. We surveyed 8 types of educational materials used in 23 university hospitals and medical centers in Seoul ; four of them were developed by department of nursing and the remainder by an Ostomy Company Data, collected from July 14, 1997 through July 31, 1997 were analyzed. The results are as follows ; 1. The analysis of education guide, on ostomate included 14 subcategories : introduction, structure and function of gastrointestinal tracts, definition of stoma, types of ostomy, definition of peristalsis, methods of defecation management, selection of instrument, resolution of problems and general situations following surgery, daily life, where to ask for help, explanations for terms, information about where to buy instrument, explanations for enterostomal therapist, a matter of consultation with doctor, etc. 2. Introduction contained specific contents on practical ostomate management that ostomates would experience through their lives. Ostomate education guides were developed 3 hospitals except one which missed this point. 3. Most ostomate education guides, except one hospital, helped ostomates to understand their physical structure changes with specific explanations on gastrointestinal tracts with figures. 4. Six institutions did not talk about the definition of peristalsis. 5. All institutions, except two, helped ostomates to understand types of ostomy with figures. 6. More detailed explanations on natural defecation are needed. The benefits and pitfalls of natural defecation should be more specified. 7 No psychosocial difficulties of ostomy management were addressed. 8. The efficiency of enema can be better understood through all explanations with figures. Some institutions did not mention items about definition, benefits, pitfalls of enema, sequency of enema, how to wash, cautions performing and enema, skin management, cleaning instrument after enema proper time to spend. 9. There were no detailed contents and what to do in case of not being able to do enema. 10. Only one educational material mentioned emotional aspects after the surgrey. 11. Most institutions explained subcategory of daily life but did not provide specific contents on the difficulties of physical, psychological, and sociocultural controls. 12. The subcategory of ureterostomy education guides included explanations on normal structure and function of urinary tracts, types of ureterostomy, how to manage skin, usage and types of instrument, commercial urostomy, how to manage instrument, daily life, introduced the general contents. However, more specific explanations were needed.

• Journal of Korean Academy of Nursing
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• v.26 no.1
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• pp.194-222
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• 1996

Various accidents and injuries are currently occurring in Korea at increasingly high rates. Good quality emergency care service is urgently needed to cope with these various forms of accidents and injuries. In order to develop a sound emergency care system, there need to be a plan to educate and train professionals specifically in emergency care. One solution for the on going problem would be to educate and train emergency clinical nurse specialists. This study on a strategy for curriculum development for emergency clinical nurse specialist was based on the following five content areas, developed from literature related to the curriculum of emergency nursing and emergency care situation : 1. Nurses working in the emergency rooms of three university hospitals were analyzed for six days to identify categories of nursing activities. 2. Two hundreds and eleven nurses working in the emergency rooms of 12 university hospitals were surveyed to identify needs for educational content that should be included in a curriculum for the clinical nurse specialist. 3. Examination of the environment in which emergency management was provided. 4. Identification of characteristics of patients in the emergency room. 5. The role of emergency clinical nurse specialist was identified through literature, recent data, and research materials. The following curriculum was formulated using the above mentioned process. 1. The philosophy of education for emergency clinical nurse specialist was established through a realistic philosophical framework. In this frame, client, environment, health, nursing, and learning have been defined. 2. The purpose of education is framed on individual development, social structure, nursing process and responsibility along with the role and function of the emergency clinical nurse specialist. 3. The central theme was based on human, environment, health and nursing. 4. The elements of structure in the curriculum content were divided to include two major threads, I, e., vertical and horizontal : The vertical thread to consist of the client, life cycle, education, research, leadership and consultation, and the horizontal thread to consist of level of nursing (prevention to rehabilitation), and health to illness based on the health care system developed by Betty Neuman system model. 5. Behavioral objectives for education were structured according to the emergency clinical nurse specialist role and function as a master degree prepared in various emergency settings. 6. The content of the curriculum consisted of three core courses(9 credits), five major courses(15 credits), six elective courses(12 credits) and six prerequisite courses (12 credits). Thus 48 credits are required. Recommendations : 1. To promote tile quality of the emergency care system, the number of emergency professionals, has to be expanded. Further the role and function of the emergency clinical nurse specialist needs to be specified in both the medical law and the Nursing Practice Act. 2. In order to upgrade the qualification of emergency clinical nurse specialists, the course should be given as part of the graduate Program. 3. Certification should be issued through the Korean Nurses Association.