• The Korean Journal of Nuclear Medicine Technology
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• v.18 no.2
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• pp.39-47
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• 2014

Purpose As breast cancer patients continue to increase every year, cases of BSGI are on the rise with a heavier reliance on it. However, BSGI protocol in hospitals was not studied enough despite it was covered by hospital's condition and recommendation of manufacturers. The objective of the study was an examination of methods to be applicable to BSGI protocols, putting the self-development phantom to use in quality assessment of the images. Materials and Methods Dilon 6800 (Dilon Technologies Inc, Newport News, USA) was used in the study and five different sizes of sphere were distinctively produced in the phantom. The study used $^{99m}TcO_4$. The cases were classified in to three categories that background radioactivity to region of interest as ratio of 2: 4: 8, They were acquired images for 5, 7, 10mins. The acquired image was set region of interest according to the size of sphere, and We analyzed quantitative and qualitative analysis. The acquired data statistically analyzed with SPSS ver.18.0. Results As the result of quantitative and qualitative analysis, count rate of each sphere in accordance with difference of injection dose showed that higher count rate as injection dose and sphere size increased (P<0.005). Count rate of each sphere in accordance with difference of acquisition time showed that higher count rate as acquisition time and sphere size increased (P<0.005). Contrast noise ratio of each sphere in accordance with difference of injection dose showed that higher contrast noise ratio as injection dose increased. Particularly, Contrast noise ratio of eight times ratio images was the highest among. Contrast noise ratio of each sphere in accordance with difference of acquisition time showed that higher contrast noise ratio as acquisition time increased. And, Contrast noise ratio of seven minute image was the highest among (P<0.005). Conclusion There was significant change of Contrast noise ratio through quantitative and qualitative analysis. Moreover, We found usefulness of phantom. If Institutions identified image through the phantom study and they made BSGI protocol, We expected to help the improvement of diagnostic value of the images.

• Journal of Hospice and Palliative Care
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• v.5 no.2
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• pp.111-124
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• 2002

Purpose : Although the average life expectancy has increased due to advances in medicine, mortality due to cancer is on an increasing trend. Consequently, the number of terminally ill cancer patients is also on the rise. Predicting the survival period is an important issue in the treatment of terminally ill cancer patients since the choice of treatment would vary significantly by the patents, their families, and physicians according to the expected survival. Therefore, we investigated the prognostic factors for increased mortality risk in terminally ill cancer patients to help treat these patients by predicting the survival period. Methods : We investigated 31 clinical parameters in 157 terminally ill cancer patients admitted to in the Department of Family Medicine, National Health Insurance Corporation Ilsan Hospital between July 1, 2000 and August 31, 2001. We confirmed the patients' survival as of October 31, 2001 based on medical records and personal data. The survival rates and median survival times were estimated by the Kaplan-Meier method and Log-rank test was used to compare the differences between the survival rates according to each clinical parameter. Cox's proportional hazard model was used to determine the most predictive subset from the prognostic factors among many clinical parameters which affect the risk of death. We predicted the mean, median, the first quartile value and third quartile value of the expected lifetimes by Weibull proportional hazard regression model. Results : Out of 157 patients, 79 were male (50.3%). The mean age was $65.1{\pm}13.0$ years in males and was $64.3{\pm}13.7$ years in females. The most prevalent cancer was gastric cancer (36 patients, 22.9%), followed by lung cancer (27, 17.2%), and cervical cancer (20, 12.7%). The survival time decreased with to the following factors; mental change, anorexia, hypotension, poor performance status, leukocytosis, neutrophilia, elevated serum creatinine level, hypoalbuminemia, hyperbilirubinemia, elevated SGPT, prolonged prothrombin time (PT), prolonged activated partial thromboplastin time (aPTT), hyponatremia, and hyperkalemia. Among these factors, poor performance status, neutrophilia, prolonged PT and aPTT were significant prognostic factors of death risk in these patients according to the results of Cox's proportional hazard model. We predicted that the median life expectancy was 3.0 days when all of the above 4 factors were present, $5.7{\sim}8.2$ days when 3 of these 4 factors were present, $11.4{\sim}20.0$ days when 2 of the 4 were present, and $27.9{\sim}40.0$ when 1 of the 4 was present, and 77 days when none of these 4 factors were present. Conclusions : In terminally ill cancer patients, we found that the prognostic factors related to reduced survival time were poor performance status, neutrophilia, prolonged PT and prolonged am. The four prognostic factors enabled the prediction of life expectancy in terminally ill cancer patients.

• Journal of radiological science and technology
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• v.30 no.4
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• pp.381-389
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• 2007

The purpose of this study is investigation of radiation dose in CT scan. Data were collected from various references and organizations. Doses measured by CT scanners of each medical organization were analyzed and they were calculated through the examination protocol. The results are as follows : 1. $CTDI_W$ value per 100mAs measured by Head Phantom was the highest in <4-slice MDCT scanner> of 24.20 mGy. $CTDI_W$ values were significantly different among scanner generations(p < 0.01). 2. $CTDI_W$ value per 100 mAs measured using body phantom was the highest in <4-slice MDCT scanner> of 13.58 mGy and the $CTDI_W$ values were significantly different among scanner generations(p < 0.01). 3. When contrast medium was not used, the highest scanner was <16 slice MDCT> of $818.83\;mGy{\codt}cm$ in exposure dose in brain scan(p < 0.05). When the contrast medium was used, the highest scanner was <4 slice MDCT> and its average was $1,460.77\;mGy{\cdot}cm$(p < 0.1). 4. When the contrast medium was not used, the highest scanner was <16-slice MDCT> of $521.63\;mGy{\cdot}cm$ on average in terms of the exposure dose in chest inspection(p<0.05). when the contrast medium was used, the highest scanner was found in 8 slice MDCT scanner and its average was $1,174.70\;mGy{\cdot}cm$. There was no statistically significant difference among scanners. 5. When the contrast medium was not used, the highest scanner was <16-slice MDCT> and its average was $856.27\;mGy{\cdot}cm$ in exposure dose on the abdomen-pelvis(p<0.05). when the contrast medium was used, the highest scanner was <16-slice MDCT> and its average was $1,720.64\;mGy{\cdot}cm$ on average (p < 0.05). 6. When the contrast medium was not used, the highest scanner was <8-slice MDCT> and its average was $612.07\;mGy{\cdot}cm$ in exposure dose in liver inspection(p < 0.05). when the contrast medium was used, the highest scanner was <8-slice MDCT scanner> and its average was $2,197.93\;mGy{\cdot}cm$ in exposure dose(p < 0.1). seventy six point two percent of medical facilities were in risk of radiation exposure while the number of phase was three to four times in their dose inspection of contrast medium.

• Clinical and Experimental Pediatrics
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• v.49 no.8
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• pp.875-881
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• 2006

Purpose : The aims of this study were to analyze the clinical characteristics of children with Kikuchi's disease(KD) at a medical center and to investigate the etiologic role of human herpesvirus 8(HHV 8) or Epstein-Barr virus(EBV) in children with KD. Methods : Twenty six children who were diagnosed as KD between Jan. 1998 and Dec. 2005 were included. Medical records were reviewed on the clinical characteristics of children with KD. Follow up data were collected by chart review and telephone contact. Polymerase chain reaction(PCR) was performed in order to detect HHV 8 DNA, and in situ hybridization(ISH) was perfomed in order to detect EBV RNA from 20 lymph node tissues. Results : There were 15 girls and 11 boys with a mean age of 13 years. Posterior cervical lymph nodes were involved in 72 percent(18/25) of the patients. Extracervical lymphadenopathy was associated in one patient. Fever was an associated symptom in 31 percent(8/26) of the patients. Leukopenia was observed in six (46 percent) patients. The cervical lymphadenopathy usually resolved spontaneously within 6 months. Only one patient had a recurrence of lymphadenopathy with fever during follow-up. No children with KD in our series developed systemic lupus erythematosus. HHV 8 DNA was not amplified by nested PCR in any of the cases, and all cases were negative for EBV RNA by ISH. Conclusion : KD should be differentiated as a cause of cervical lymphadenopathy in children. HHV 8 and EBV may not play major causative roles in KD in children.

• The Journal of Korean Academic Society of Nursing Education
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• v.5 no.2
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• pp.177-190
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• 1999

This study has been conducted on the basis of the literature review of Nursing Education Research in China from 1990 through August 1998. Its purpose was to support the basic data of nursing education which is risen as major revolutionary of nursing in China and those for exchange of information between Korea-China nursing education. It is retrospective and descriptive research analyzing one hundred eighty articles published in The Journal of China Nursing. The results of the study were as follows. 1. Only 33.3% of the professors of Technical Nursing School who have played of major role of nursing education in China have carried out the study related to nursing education. Baccalaureate program professors have marked 22.2% of all studies, and diploma program professors have done 12.2% of all. Therefore, the professors of above the diploma program have done total 44.4%. It explains that the professors of baccalaureate and diploma programs have done more studies related to nursing education than those of Technical Nursing School. 2. In terms of the study design, most of the studies(38.8%) were case studies introducing the curriculum contents that were done at education institutions. And then, 28.5% were reviewing the articles, and 15.6% were descriptive studies. 3. In terms of the content of the study, 38.3% were relevant to education of Technical Nursing School, 15.0% were about baccalaureate education, and 10.4% is about diploma. 4. To analyze the specific contents of the studies ; a. In baccalaureate program, human resources (professor or teaching), course extension, lab, classes, teaching method, education philosophy, goal of education, evaluation method, and human resource development were included. b. In diploma program, teaching contents evaluation method, teaching method, and educational system were included c. In the technical school, there were qualification of professors , teaching method, evaluation method, opening the courses, teaching contents, goal of education and so on. d. Beyond these, there were practice guidance and appraisement, teaching method, and opening new courses which were not specially indicated as educational curriculum and score management as continuing education. What is above tell us that the study regarding development of university system has been progressed actively and widely. It has been for the effort of revolution which based on the China government force to reform of nursing education process during last 10 years. On the base of the result, we suggest the following questions and the alternatives. 1) Since most articles are case studies related to teaching methods and the others doesn't propose the research method. the study which is applied more exact research method is needed. 2) No study is regarding social change and health policy. Because University program, founded in 1983 is on the beginning point, the research about curriculum have to be taken as a top priority as well as to reflect social needs which are based on social changes and national health policy 3) Only one review article study tells nursing Human resource. To appear in large numbers in nursing manpower, avoid the present hospital nurses training system. Then, the study for manpower development which is able to accomplish in many fields has to be advanced. 4) Most studies did not have literature review processes, so it was impossible for researcher to know the past study tendency and there is no relation among studies as to same subject, the education about research method is needed.

• Tuberculosis and Respiratory Diseases
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• v.44 no.6
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• pp.1234-1244
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• 1997

Background : Nowadays drug resistant tuberculosis is making problems in the treatment of pulmonary tuberculosis and its number is increasing. Several reasons for this are considered including irregular medication, poor drug compliance and wrong regimens. But there are treatment failure cases in spite of regular medication with short-term standard regimens. We reviewed clinical data of 50 patients to find out possible causes of this. Method : Subject of this study was 50 patients who failed in the primary treatment of pulmonary tuberculosis in spite of regular medication with short-term standard regimens. All of them were under treatment with secondary regimens in National Masan Tuberculosis Hospital on Oct 1996. The patient's records were analyzed retrospectively and direct interviews with patients were done. Results : There were relatively more patients in the age of 20th. Male overwhelmed in number. There were smoking in 22 patients and drinking in 24 patients during medication. 17(34%) patients had family history of tuberculosis. Public health center was the most common site for the initial diagnosis among medical institutes. 42 patients had subjective symptoms for pulmonary tuberculosis. 38 patients got sufficient explanation from medical institute about tuberculosis and medication courses. 24 patients had bilateral lesions on chest X-ray film and 43 patients had cavitary lesions. 29 patients had past history for pulmonary tuberculosis with regular medication. The results of drug sensitivity test showed resistance in 41 patients of whom we could get the results. Conclusion : Main cause of treatment failure of pulmonary tuberculosis in spite of regular medication with short-term standard regimens was drug resistance. Several factors were considered to be related to high prevalence of drug resistance, including age of 20th, male, family history for tuberculosis, bilateral lesions or remaining cavitary lesion on chest X-ray film.

• Journal of Hospice and Palliative Care
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• v.8 no.2
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• pp.183-189
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• 2005

Purpose: Despite the advance of medical science, the number of cancer patient have increased and the mortality rate is also on the rise. Therefore, a perfect cure for cancer is crucial, but the value and meaning of the remaining life for the patient are also becoming more and more important. The principal aim of this study is to examine the differences in the quality of life, physical and psychosocial symptoms according to the performance status of terminal cancer patients. Methods: We evaluated the performance status, demographical data, blood analysis and quality of life of cancer patients who visited the Department of family Medicine at Myoung-ji Hospital in Korea between September 1, 2003 and August 31, 2005. Their performance status (ECOG) was divided into two groups ($ECOG\;0{\sim}1/ECOG\;2{\sim}4$) and analyzed by ANOVA to see if there was a difference in their blood analysis and quality of life. A P value of less than 0.05 was considered to be significant. Results: A total of 104 patients were evaluated, among which 71 patients (23 male and 48 female) scored $0{\sim}1$, and 33 patients (8 males and 25 females) scored $2{\sim}4$ in the ECOG. The blood analysis showed that patients whose performance status was $2{\sim}4$ had lower levels of lymphocytes, hemoglobin, protein, albumin and sodium. The evaluation on their quality of life showed that the overall health status of patients with $2{\sim}3$ functional ability were poor (P=0.02). Also, from a functional perspective, these patients had poor physical (P=0.05) and role (P=0.01) scores, and in terms of symptoms, they showed a significant loss of appetite. Conclusion: If a patient's performance status was poor, levels related to certain nutritions were also found to fall in blood tests, thereby leading to an overall weakened state of health. However, there was no difference in symptoms except for a loss of appetite. In conclusion, it is most important to increase the appetite in patients with poor performance status.

• Journal of agricultural medicine and community health
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• v.31 no.1
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• pp.35-46
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• 2006

Objectives: In recently. the management and protection on individual information in patient's medical & nursing records have been very important, and that need a guideline. The purpose of this study was to investigate the status of using the patient's nursing records of nursing students in clinical practice, to find and discuss the patient's informed consent, and status of education and management concerned to patient's nursing records. Methods: This study used a mailing survey. data collected from September 24th to October 31th in 2002. The subject were 333 professors who are major in adult nursing, pediatric nursing, psychological nursing of 111 university of nursing department and nursing college. And then we received the survey mail from 103 professors that respondent rate was 30.9%. Results: The characteristics of study subjects showed 49.0% of university. 51.0% of college of nursing. 50.0% of the subjects practiced point the patient by oral approval in clinical practice. But when the decision of the patient was very difficult, 21.6% of the subjects take to informed consent from his or her families. During the clinical practice, 49.0% of the subjects were explain to patient about clinical practice and contents of the nursing student, only 7.8% of the subjects were explain to patient with nursing records. 52.0% of the subjects were took out records from the hospital, only 17.6% of the subjects had standard of the patient's informed consent and standard of handling practice records. 17.6%-92.2% of the subjects that educate and manage concern to patient's nursing records.

• 한국노년학
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• v.38 no.3
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• pp.569-592
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• 2018

This study purported to investigate the current state of human rights of older adults residing in rural areas of Korea. The study utilized, as an analytic framework, 4 priority directions (1. "older persons and development", 2. "rural area development", 3. "advancing health and well-being into old age", and 4. "ensuring enabling and supportive environments") with 13 task actions recommended by Madrid International Plan of Action on Ageing (MIPAA). Furthermore, the study examined gender differences in all items included in the analytic framework. Data was collected by the face-to-face survey on 800 subjects aged 65 and over. Statistical analyses were conducted using STATA 13.0 program. The main results were summarized in order of 4 priority directions as follows. First, average working hours per day were 6.2, and men reportedly participated in economic activities and needed job training more than women, while women participated in lifelong education programs more than men. Awareness of fire and disaster prevention facilities was low in both genders. Second, accessibility to the support center for the elderly living alone as well as protective services for the vulnerable elderly was found to be low. IT-based services and networking were used more by men than women, and specifically, IT-based financial transactions and welfare services were least used. Third, medical check-ups and vaccinations were well received, while consistent treatments for chronic illnesses and long-term care services were relatively less given. In addition, accessibility to mental health service centers was considerably low. Fourth, although old house structures and the lack of convenience facilities were found to be circumstantial risk factors for these elders, experiences of receiving housing support services were scarce. The elderly were found to rely more on informal care, and concerns for their care were higher in women than men. Plus, accessibility to elderly abuse services was markedly low. Based on these results, discussed were implications for implementing policies and practical interventions to raise the levels of the human rights for this population.

• Journal of Preventive Medicine and Public Health
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• v.27 no.2 s.46
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• pp.200-216
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• 1994

In present study, the authors investigated the possible effect of coffee consumption on serum cholesterol level in 1017 men between the ages of 40 and 59 years, who were randomly selected from the members of Seoul Cohort Study. Serum total cholesterol data was collected with other serologic indices (e.g. systolic blood pressure, diastolic blood pressure, hight, weight, etc.) through the program of biennial health check-up offered by Korean Medical Insurance Corporation (KMIC). The amount of coffee consumption was assessed by a self-administered questionnaire through mailing. Other confounding factors, such as age, body mass index, cigarette smoking, alcohol consumption, physical activity, and other dietary intake pattern were also determined by the questionnaire. The differences in means of serum total cholesterol in compared to non consumers were $-0.4{\pm}3.56mg/dl$ for those drinking less than 1 cup a day, $-0.6{\pm}3.60mg/dl$ for those drinking 1 cup a day, and $7.1{\pm}3.41mg/dl$ for those drinking more than 2 cups a day. Since smoking interacted the relationship between coffee consumption and serum total choleaterol, we re-analyzed those relationship in smokers and non-smokers separately Other atherogenic behaviors were well correlated with total cholesterol, so we adjusted the mean values of serum total cholesterol through multivariate model selection with age(r=0.12), total cigarette index (cigarette-years; r=0.10), Quetelet's index ($Kg/m^2$, r=0.16), daily calory expenditure (kcal/day, r=0.06), weekly meat and poultry consumption(g/week, r=0.05), weekly fish consumption (g/week, r=0.08), other caffeinated beverage intake (cups/week), and the amount of sugar and prim added to the coffee. Among those variables only age, Quetelet's index, fish consumption, and total cigarette index (in smokers) were remained in the models. After adjustment, the corresponing differences of total cholesterol in smokers were changed to $0.4{\pm}5.24mg/dl,\;-0.5{\pm}4.97mg/dl,\;and\;8.9{\pm}4.78mg/dl$, which were significantly different among themselves (P=0.011). In non-smokers, however, the differences were not statistically significant (P=0.76). Adjusted mean values of systolic blood pressure and diastolic blood pressure were also determined to evaluate the direct effect of coffee to cardiovascular system, but their means were not significantly different by coffee consumption(p=0.18 for SBP, p=0.48 for DBP). Asuming instant coffee in the most popular type of coffee in Korea, the association observed in our study between coffee and serum total cholesterol, especially in smokers, is very interesting finding for the connection between coffee and serum total cholesterol, because only 'boiled coffee' tend to show significant lipid raising effect rather than to other types of coffee, like filtered or espresso, in most of the western countries. We concluded that people who drink coffee more than 2 cups a day have significantly higher serum total cholesterol level than those who never drink coffee, especially in smokers.