• Journal of radiological science and technology
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• v.44 no.2
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• pp.85-90
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• 2021

The purpose of this study is to consider usefulness of using AEC mode and importance of patient center location in L-spine lateral radiography by comparing dose and image quality according to the change of patient center location with using AEC mode or not. In this study, guide wire is attached to the human body phantom's lumbar spine and the lead ruler is attached to the bottom of the wall detector to find out center location in detector. ESD, mAs, and EI were selected as dose factors, and image quality was compared through SNR. With the lumbar spine located center of the detector, dose factors and image quality were compared according to using AEC mode or not. Afterwards, phantom moved 4 cm and 8 cm back and forth and compared dose factors and image quality. The exposure parameters were 85 kVp, 320 mA, x-ray field size 10×17 inch, and the distance between the center X-ray and the detector was fixed at 100 cm. The center X-ray was perpendicular to the fourth lumbar spine and the only bottom AEC chamber was used. All data were analyzed by independent t-test and ANOVA. As a result of this study, with AEC when the center is matched, ESD was 1.31±0.01 mGy, without AEC was 2.12±0.01 mGy. SNR was shown to be 22.81±1.83, and 23.44±1.87 respectively. When the phantom's center moves 4 cm, 8 cm forward, and 4 cm, 8 cm backward, ESD were 1.09±0.004 mGy, 0.32±0.003 mGy, 1.19±0.017 mGy, 1.11±0.006 mGy respectively, SNR were 18.29±0.60 dB, 11.11±0.22 dB, 18.98±0.80 dB, 17.71±0.82 dB. Using AEC in L-spine lateral radiography reduced ESD by 38%, EI by 35%, and mAs by 38%, without any difference in SNR(p<0.05). When the phantom's center moves 4 cm, 8 cm forward, and 4 cm, 8 cm backward, ESD was decreasing each 16%, 75%, 9%, 15%, EI was decreasing each 14%, 77%, 15%, 20%, mAs was decreasing each 15% 75% 9%, 15%. SNR was decreasing each 19%, 51%, 17%, 22%.

• Clinical Endoscopy
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• v.55 no.2
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• pp.167-182
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• 2022

Sedation can resolve anxiety and fear in patients undergoing endoscopy. The use of sedatives has increased in Korea. Appropriate sedation is a state in which the patient feels subjectively comfortable while maintaining the airway reflex for stable spontaneous breathing. The patient should maintain a state of consciousness to the extent that he or she can cooperate with the needs of the medical staff. Despite its benefits, endoscopic sedation has been associated with cardiopulmonary complications. Cardiopulmonary complications are usually temporary. Most patients recover without sequelae. However, they may progress to serious complications, such as cardiovascular collapse. Therefore, it is essential to screen high-risk patients before sedation and reduce complications by meticulous monitoring. Additionally, physicians should be familiar with the management of emergencies. The first Korean clinical practice guideline for endoscopic sedation was developed based on previous worldwide guidelines for endoscopic sedation using an adaptation process. The guideline consists of nine recommendations based on a critical review of currently available data and expert consensus when the guideline was drafted. These guidelines should provide clinicians, nurses, medical school students, and policy makers with information on how to perform endoscopic sedation with minimal risk.

• Korean Journal of Hospice Care
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• v.7 no.2
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• pp.15-25
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• 2007

The purpose of this study was to survey the hospital staff's perception of hospice and death and thereby, suggest the ways to help them have a mature attitude towards and a better understanding of death through an effective education on hospice. For this purpose, this study was designed to provide some data useful for the hospital staff not experienced in facing the dying patients to handle the desperate situation skillfully and engage themselves more effectively in their hospice services. For this study, the researcher conducted a questionnaire survey for the staff of 'C' hospital in Seoul about their hospice philosophy, attitudes towards hospice and perception of death for the period from February, 2006 to March, 2006. A total of 751 subjects responded effectively to the survey. The data collected were analyzed using the SF55 11.0 for ANOVA and T-test in order to test the relationships among subjects' perception of death, their demographic variables, their health condition, their hospice philosophy formed from their experiences of patients' death and hospice services and their attitudes towards hospice. Besides, the correlations among their hospice philosophy, perception of death and attitudes towards hospice were tested. The results of this study can be summarized as follows; First, as a result of testing the relationships among subjects' experiences of health consulting. their experiences of patients' death and hospice and their hospice philosophy, it was confirmed that their experiences of health and death consulting and their experiences of having been educated were relevant. Second, it was found that such variables as health condition, death, experience of hospice and attitude towards hospice were not significantly correlated with each other. Third, as a consequence of testing the relationships among health condition, death, experience of hospice and perception of death, it was disclosed that only the physical health condition was significant. Fourth, it was confirmed that subjects' hospice philosophy, perception of death and attitudes towards hospice were at the usual level on average. Fifth, hospice philosophy, perception of death and attitudes towards hospice were found correlated significantly with each other. Sixth, as a result of the stepwise variable adjustment for such variables as hospice philosophy, perception of death, attitudes towards hospice, it was found that the adjusted r-square value was 0.347 when departments, experience of having been requested by dying patient for consulting, experience of having been educated on hospice, religion and marital status were set as independent variables. And the estimated value of each variable was found significant. Seventh, as a consequence of conducting the multiple regression analysis by setting 'religion' as significant independent variable, it was found that the estimated value of physical health condition was not significant statistically. This, as a result of the simple regression analysis for 'religion' only, its explanatory power was found .197, while its adjusted r-square value was 0.20. Eight, it was found that subjects' attitude towards hospice was significantly correlated with such variables of experience of patient's or relative's death, experience of having been requested for consulting about death, gender, marital status and departments. As a result of the multiple regression analysis and the subsequent stepwise adjustment for this variable, it was found that only 'experience of having been requested for consulting' had some explanatory power: its adjusted r-square value was 0.089. As discussed above, this study tested the correlations among various variables including hospital staff's attitude towards hospice and perception of death and thereby, provided for the data useful for their education on hospice. This study may be significant in that it proved that it would be essential to educate hospital staff on hospice for more effective care of hospice patients and their family members at hospital.

• Quality Improvement in Health Care
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• v.7 no.1
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• pp.60-70
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• 2000

Background : The aim of this study was to examine the effectiveness of the critical pathway to diabetic patients who were admitted in the hospital. Methods : For establishment of critical pathway for diabetic patients, we organized the multidisciplinary care team. During 5 months, 31 diabetic inpatients were applied the critical pathway and the results were compared with 11 diabetic inpatients who were treated with conventional way. We assessed the patients satisfaction, knowledge on the disease, compliance of medical regimen, length of stay(LOS) and hospital cost. We used the computer program SAS for statistical analysis. Data were summarized with mean, and analyzed using t-test repeated measures ANOVA and Wilcoxon rank sum test. Results : Length of stay(LOS) was remarkably shortened in critical pathway group compared with the conventional treatment group($7.6{\pm}1.23$ vs $12.0{\pm}4.73$, p<0.000). Although LOS was significantly shortened in critical pathway group, patients satisfaction was much higher than conventional treatment group. There were no significant difference of knowledge on the disease, compliance of medical regimen and blood glucose level between two groups at discharge. Hospital cost of each patients also significantly decreased in critical pathway group(890,000 won vs 1,280,000 won, p<0.05). Conclusion : These results showed that establishment of critical pathway for diabetic inpatients with team approach is the one of the way to improve the quality of diabetic patients management and to enhance the efficiency of hospital management.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.21 no.4
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• pp.297-305
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• 2018

Purpose: There is a lack of scholarly reports on pediatric emergency department (PED) exposure to hyperbilirubinemia. We aimed to describe the epidemiology of hyperbilirubinemia in patients presenting to a PED over a three-year period. Methods: This was a retrospective cohort study, completed at an urban quaternary academic PED. Patients were included if they presented to the PED from 2010 to 2012, were 0 to 18 years in age, and had an elevated serum bilirubin for age. A chart review was completed to determine the incidence of hyperbilirubinemia, etiology, diagnostic work up and prognosis. The data set was stratified into four age ranges. Results: We identified 1,534 visits where a patient was found to have hyperbilirubinemia (0.8% of all visits). In 47.7% of patients hyperbilirubinemia was determined to have arisen from an identifiable pathologic etiology (0.38% of all visits). First-time diagnosis of pathologic hyperbilirubinemia occurred in 14% of hyperbilirubinemia visits (0.11% of all visits). There were varying etiologies of hyperbilirubinemia across age groups but a male predominance in all (55.0%). 15 patients went on to have a liver transplant and 20 patients died. First-time pathologic hyperbilirubinemia patients had a mortality rate of 0.95% for their initial hospitalization. Conclusion: Hyperbilirubinemia was not a common presentation to the PED and a minority of cases were pathologic in etiology. The etiologies of hyperbilirubinemia varied across each of our study age groups. A new discovery of pathologic hyperbilirubinemia and progression to liver transplant or death during the initial presentation was extremely rare.

• Journal of muscle and joint health
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• v.17 no.1
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• pp.25-34
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• 2010

Purpose: The aim of the present study was to examine the effects of a 4-week aromatherapy on pain and inflammation in patients suffering from rheumatoid arthritis. Methods: A quasi-experimental study using a nonequivalent control group, pretest-posttest non-synchronized design was used. To analyze the data, descriptive statistics, Chi-square test, independent samples t-test, and Fisher's exact test were used. Results: After a 4-week aromatherapy, tender joint count (M=5.67 to 4.17), swollen joint count (M=4.13 to 2.54), and patient's assessment of pain (M=43.33 to 31.08) decreased significantly for the aromatherapy participants compared to the control group. But there was no significant difference between the groups in erythrocyte sedimentation rate. Conclusion: These findings suggest that aromatherapy could decrease joint pain, tenderness, and swelling in patients with rheumatoid arthritis, but some modifications in aromatherapy intervention and research method will be required to examine the effects of aromatherapy on inflammatory level in this population.

• Korean Journal of Clinical Pharmacy
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• v.28 no.3
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• pp.188-193
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• 2018

Background: Previous studies have noted that the simultaneous use of sulfonylureas and antimicrobials, which is common, could increase the risk of hypoglycemia. In particular, an age of 65 years or older is a known risk factor for sulfonylurea-related hypoglycemia in hospitalized patients. Therefore, we performed this study to determine the potential risk of hypoglycemia from the concurrent use of antimicrobials and sulfonylureas. Methods: We performed a cross-sectional study on the National Health Insurance Service-National Sample Cohort from 2013. The eligibility criteria included patients of 65 years of age or older taking a sulfonylurea with 25 different antimicrobials. Different risk ratings of severity in drug-drug interactions (potential DDIs), level X, D, or C in Lexi-$Interact^{TM}$ online, and contraindicated, major, or moderate severity level in $Micromedex^{(R)}$ were included. SAS version 9.4 was used for data analysis. Results: A total of 6,006 elderly patients with 25,613 prescriptions were included. The largest age group was 70 to 74 (32.7%), and 39.7% of patients were men. The mean number of prescriptions was 4.3 per patient. The most frequently used antimicrobials were levofloxacin (6,583, 25.7%), ofloxacin (6,549, 25.6%), fluconazole (4,678, 18.0%), and ciprofloxacin (2,551, 9.8%). Among sulfonylureas, glimepiride was prescribed most frequently, followed by gliclazide, glibenclamide, and glipizide. Conclusion: Of the antimicrobials with a high potential of hypoglycemia, levofloxacin, ofloxacin, fluconazole, and ciprofloxacin were used frequently. Thus, the monitoring of clinically relevant interactions is required for patients concurrently administered sulfonylureas and antimicrobials.

• Journal of Nutrition and Health
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• v.12 no.3
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• pp.9-23
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• 1979

The known risk factors for atherosclerosis include plasma low density lipoproteins (LDL)or Cholesterol, low PUFA in the diet, hypertension, and high Na intake, obesity, diabetes, lack of exercise, cigarette smoking, sugar, low fiber and nicotinic acid in the diet, sources of Protein foods, and Psychological factors. Among various dietary factors, fat is known as the most serious causative agent for atherosclerosis. The genetic factor is a18o known as an important one but is out of scope in this paper. Since atherosclerosis is a progressive disease which may develop for many years before showing any definitive symptoms, it is very important to develop preventive programs especially in the country like Korea that is not quite overdevelopted as some western countries. In this paper all the factors mentioned above were reviewed and the dietary suggestion were made on the basis of the content of polyunsaturated and saturated fat in the diet to prevent or/and to cure this disease. Most of the available data on diet therapy with emphasis. on P/S ratio were tabulated together. after tile patient's habitual dietary intake is analized the guidelines of personalized fat-controlled diet can be recommended. It is of utmost importance to develop Korean diets for beth prevention and cure of atherosclerosis emphasizing individual eating habit in the near future which can be more Practicaly used both at home and in the hospital.

• Biomedical Science Letters
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• v.18 no.4
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• pp.399-405
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• 2012

The brain is the body's most organized and controlled organ, and it governs various psychological and mental functions. A brain abnormality could greatly affect one's physical and mental abilities, and consequently one's social life. Brain disorders can be broadly categorized into three main afflictions: stroke, brain tumor, and dementia. Among these, stroke is a common disease that occurs owing to a disorder in blood flow, and it is accompanied by a sudden loss of consciousness and motor paralysis. The main types of strokes are infarction and hemorrhage. The exact diagnosis and early treatment of an infarction are very important for the patient's prognosis and for the determination of the treatment direction. In this study, texture features were analyzed in order to develop a prototype auto-diagnostic system for infarction using computer auto-diagnostic software. The analysis results indicate that of the six parameters measured, the average brightness, average contrast, flatness, and uniformity show a high cognition rate whereas the degree of skewness and entropy show a low cognition rate. On the basis of these results, it was suggested that a digital CT image obtained using the computer auto-diagnostic software can be used to provide valuable information for general CT image auto-detection and diagnosis for pre-reading. This system is highly advantageous because it can achieve early diagnosis of the disease and it can be used as supplementary data in image reading. Further, it is expected to enable accurate medical image detection and reduced diagnostic time in final-reading.

• Korean Journal of Digital Imaging in Medicine
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• v.10 no.2
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• pp.11-16
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• 2008

Images of medical treatment on PACS environment are digitized and they make saving and transmission of patient's information easy with CD format causing increase of patients transfer rate between hospital and data transmission as well. Figuring out the configuration of confining status of copied images of medical treatment with CD format and present the appropriate way of identification for personal information. 20 general hospital over 500 beds which are utilizing PACS currently. Questionnaire investigation focusing on PACS operation center and it's management people. In accordance with the law of securing personal information of public organizations, it says "Anyone who wants to see his or her information via representative he or she needs to make a letter of attorney and turn in this to the president of it's possessing facility" in the article 16. Based on the investigation of general hospital for CD copy issue status near metropolitan area, 8 out of 20, were issuing CD copy through personal identification process(the person oneself and representative) and 10 general hospital were doing by getting signature of receiptor only without identification of the person oneself and 2 general hospital confirmation process is not at all. By the law of securing personal information of public organization, article 16, confirmation process is supposed to mandate lawfully with a letter of attorney when there is any request of reading and/or copies of one's information. But in reality, there were no consistent rules on reading, the process and coverage of copy issue, rejection coverage of copy issue of CD copy in each general hospital PACS operation center. Therefore there is a big need for consolidated format which is applicable by law when the representative requests to issue of CD copy that is storing medical treatment images. By issue through this consolidated format, securing medical information of individual and systemic operation and management will be valid and effective.