Lee, Jae Hee;Lee, So Yeon;Kim, Ja Hyung;Kim, Bong Sung;Hong, Soo-Jong
Clinical and Experimental Pediatrics
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v.46
no.12
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pp.1230-1234
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2003
Purpose : The aim of this study is to evaluate the value of lung biopsies for the management of children with lung disease. Methods : We retrospectively reviewed 19 lung biopsies done at Asan Medical Center, Seoul between 1993 and 2001. Data gathered included demographic information, underlying conditions, diagnosis before biopsy, final diagnosis, change in therapy, morbidity and mortality. Results : Nineteen patients underwent lung biopsy. Among them, 13 patients were male and six patients were female; the median age was 3.6 years(0.8 to 8.6 years). Twelve patients underwent open lung biopsies and seven patients had thoracoscopic biopsies. The overall diagnosis rate was 95 %. The most common diagnosis was interstitial lung disease(12 patients, 64%) and infection was detected in four patients(21%). The biopsy-proven bronchiolitis obliterance was confirmed in two of seven patients suspected by CT findings. Specific treatment was changed after biopsy in 16 patients (85%). The morbidity & overall mortality rates of the patients were 5%(one patient) and 21%(four patients) respectively. Only one complication was seen : empyema. The causes of death were acute respiratory distress syndrome(one patient), respiratory failure(two patients), and septicemia(one patient). Conclusion : The lung biopsy is a safe procedure and it contributes to more accurate diagnosis and proper management of pediatric lung diseases. We recommend lung biopsies should be considered more positively in the diagnosis of pediatric lung diseases.
Park, Hyo-Kuk;Lee, Sang-Kyu;Yoon, Jong-Won;Cho, Jeong-Hee;Kim, Dong-Wook;Kim, Joo-Ho
The Journal of Korean Society for Radiation Therapy
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v.18
no.2
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pp.105-112
/
2006
Purpose: To demonstrate that water bolus in the patient surface can decrease the dose inhomogeneity by patient surface large tissue defect when the surface is in an electron-beam field. And We tried to find a easy way to water control. Methods and Materials: To demonstrate the use of water bolus in the irregular surface clinically, the case of a patient with myxofibrosarcoma of the chest wall who was treated with electrons. We obtained dose distribution using missing tissue option of PINACLE 6.2b (ADAC, USA). We fabricate a Mev-green for water bolus in patient with defect of tissue. Then put the water bolus which is vinyl packed water into the designed Mev-green. We peformed CT scan with CT-simulator. Three-dimensional (3D) dose distributions with and without water bolus in the large irregular chest wall were calculated for a representative patient. Resulting dose distributions and dose-volume histograms of water bolus were compared with missing tissue option and non bolus plans. We fabricate a new water control device. Results: Controlled Water bolus markedly decrease the dose heterogeneity, and minimizes normal tissue exposure caused by the surface irregularities of the chest wall mass. In the test case, The non bolus plan has a maximum target dose of 132%. After applying water bolus, the maximum target dose has been reduced substantially to 110.4%. The maximum target dose was reduced by 21.6% using this technique. Conclusion: The results showed that controlled water bolus could significantly improve the dose homogeneity in the PTV for patients treated with electron therapy using water control device. This technique may reduce the incidence of normal organ complications that occur after electron-beam therapy in irregular surface. And our new device shows handiness of water control.
Han Sung-Suk;Kim Yong-Soon;Um Young-Rhan;Ahn Sung-Hee
The Journal of Korean Academic Society of Nursing Education
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v.5
no.2
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pp.376-387
/
1999
Purpose : To provide fundamental data to present further direction of education on Nursing Ethics by investigating the status of Nursing Ethics education performed at 4-year-Colleges of Nursing. Korea. Methods : A descriptive survey study The data collected from 28 universities through a questionnaire to examine the status of Nursing Ethics education in Korea. Results : I. Teaching Nursing Ethics class as a independent subject-6(21.4%) universities. 1) The average of 23.67 hours(2 credits) in the total educational hours. 2) Teaching method-theoretical class, discussion of case study, discussion of related issues, presentation of video tapes and discussion, team education, role play, and submission of reports. 3) Education contents-Nursing profession and ethics, the dignity of human life, necessity of bioethics, ethical theory and refutation, code for nurses, ethical issues between nurses and patients, nurses and co-workers, and nurses and nurses 6 universities 4) 5 universities-Included ethical decision making, artificial insemination, external insemination, artificial abortion, organ transplantation, brain death, human subject of study suicide, and euthanasia. II. Teaching Nursing Ethics as an inclusive theme in other subjects-22 (78.57%) universities. 1) Educated in Introduction of Nursing (14 universities), Nursing Management, Nursing Ethics and Philosophy, Special Nursing, Nursing and Law, and Professional Nursing. 2) Educational course-Taught in freshman level at 14 universities, average 9.32 education hours. Conclusion: Showed not only that universities, not operating Nursing Ethics as a independent class, unreasonably operate and assign too many contents in comparing with its education hours and are likely to become only a cramming education but also professors whose major is not Nursing Ethics presently in charge need to take a chance to supplement their knowledge and teaching method.
Purpose : The aims of this study were to test the efficacy of vapocoolant spray to decrease the symptoms associated with pain in newborns undergoing heel stick and intramuscular injection and compare the pain relief effect of oral glucose. Methods : Randomized, controlled study including sixty newborns undergoing heel stick and intramuscular injection. Group 1 was heelsticked, Group 2 was intramuscular injected, Group A did not recieve any treatment, Group B recieved 30% glucose solution orally, Group C was applied vapocoolant spray symptoms and signs associated with pain at heel stick and intramuscular injection were measured with the premature Infant Pain Profile (PIPP) scale. Results : There was no significant difference in the PIPP score between intramuscular injected group control and heel stick group control (P=0.07). The mean PIPP score of Group 1A (control) $10.6{\pm}2.4$, Group 1B $5.5{\pm}2.0$, Group 1C $5.2{\pm}1.8$. The mean PIPP score 1B and 1C were significantly lower than control (1B P<0.001, 1C P<0.001). The mean PIPP score of Group 2A (control) $12.5{\pm}1.4$, Group 2B $7.0{\pm}1.7$, Group 2C $6.4{\pm}1.6$. The mean PIPP score 2B and 2C were significantly lower than control (2B P<0.001, 2C P<0.001). Conclusion : The antinociceptive effect of vapocoolant sparay is as effective as 30% oral glucose solution for pain control. So this study support the use of vapocoolant spray for reducing pain during painful procedure in the neonatal intensive care units.
The BTO-a projects is the types, which has a demand risk among the type of PPP projects in Korea. When demand risk is realized, private investor encounters financial difficulties due to lower revenue than its expectation and the government may also have a problem in stable infrastructure operation. In this regards, the government has applied various risk sharing policies in response to demand risk. However, the amount of government's risk sharing is the government's contingent liabilities as a result of demand uncertainty, and it fails to be quantified by the conventional NPV method of expressing in the text of the concession agreement. The purpose of this study is to estimate the value of investment risk sharing by the government considering the demand risk in the profit sharing system (BTO-a) introduced in 2015 as one of the demand risk sharing policy. The investment risk sharing will take the form of options in finance. Private investors have the right to claim subsidies from the government when their revenue declines, while the government has the obligation to pay subsidies under certain conditions. In this study, we have established a methodology for estimating the value of investment risk sharing by using the Black - Scholes option pricing model and examined the appropriateness of the results through case studies. As a result of the analysis, the value of investment risk sharing is estimated to be 12 billion won, which is about 4% of the investment cost of the private investment. In other words, it can be seen that the government will invest 12 billion won in financial support by sharing the investment risk. The option value when assuming the traffic volume risk as a random variable from the case studies is derived as an average of 12.2 billion won and a standard deviation of 3.67 billion won. As a result of the cumulative distribution, the option value of the 90% probability interval will be determined within the range of 6.9 to 18.8 billion won. The method proposed in this study is expected to help government and private investors understand the better risk analysis and economic value of better for investment risk sharing under the uncertainty of future demand.
Objectives: The purpose of this study was to examine the characteristics and the psychosocial factors associated to the referral to psychiatric care in the suicide attempters visiting emergency center. Methods: We conducted a systematic chart review of 377 suicidal attempters visiting emergency center of the Korea University Ansan Hospital between January 2008 and December 2011. We gathered a data contain 20 items including psychosocial characteristics and factors related to suicide and factors related to psychiatric treatment. Multivariate logistic regression models were fitted to data to estimate the unique effects of sex, drunken status, companion, suicidal methods, place of suicide and current use of psychiatric medication on the referral to psychiatric care. Results: The female gender(OR=1.63, 95% CI=0.99-2.69), suicidal attempts at home(OR=3.40, 95% I= 1.21-9.56) and drunken state at visit(OR=2.34, 95% CI=1.10-5.01) are the factors that predict the risk of the non-referral of the patients to psychiatric intervention. Place of suicidal attempt was the most important factor do play a role in determining whether referral to psychiatric care will take place or not. Current use of psychiatric medication showed a trend toward significance(p=0.08, OR=1.67, 95% CI=0.95-2.95). Conclusions: These results suggest that when deciding whether to adapt or to refuse the referral to psychiatric care, the factors such as suicidal intent, lethality of suicide methods, familiar factors and alcohol may contribute onto the referral to psychiatric care. Additional research is required to investigate an association of these factors with referral to psychiatric care.
Purpose: The diagnostic utility of fluorine-18 2-deoxy-D-glucose positron emission tomograhpy ($^{18}F-FDG $PET) for the non-invasive differentiation of focal lung lesions originated from cancer or inflammation disease by combined visual image interpretation and semi-quantitative uptake value analysis has been documented. In general, Standardized Uptake Value(SUV) is used to diagnose lung disease. But SUV does not contain dynamic information of lung tissue for the glucose. Therefore, this study was undertaken to hypothesis that analysis of dynamic kinetics of focal lung lesions base on $^{18}F-FDG$ PET may more accurately determine the lung disease. So we compared Time Activity Curve(TAC), Standardized Uptake Value-Dynamic Curve(SUV-DC) graph pattern with Glucose Metabolic Rate(MRGlu) from Patlak analysis. Methods: With lung disease, 17 patients were examined. They were injected with $^{18}F-FDG$ over 30-s into peripheral vein while acquisition of the serial transaxial tomographic images were started. For acquisition protocol, we used twelve 10-s, four 30-s, sixteen 60-s, five 300-s and one 900-s frame for 60 mins. Its images were analyzed by visual interpretation TAC, SUV-DC and a kinetic analysis(Patlak analysis). The latter was based on region of interest(ROIs) which were drawn with the lung disease shape. Each optimized patterns were compared with itself. Results: In TAC patterns, it hard to observe cancer type with inflammation disease in early pool blood area but over the time cancer type slope more remarkably increased than inflammation disease. SUV-DC was similar to TAC pattern. In the result of Patlak analysis, In time activity curve of aorta, even though inflammation disease showed higher blood activity than cancer, at first as time went by, blood activity of inflammation disease became the lowest. However, in time activity curve of tissue, cancer had the highest uptake and inflammation disease was in the middle. Conclusion: Through the examination, TAC and SUV-DC could approached the results that lung cancer type and inflammation disease type has it's own difference shape patterns. Also, it has outstanding differentiation between cancer type and inflammation in Patlak and MRGlu analysis. Through these analysis methods, it will helpful to separation lung disease.
Recently, It is increasing popularity to research on the soil remediation in aspect of management by reason of the hazardous impact on the contaminated soil in Korea. It was investigated high levels of arsenic salts in soil near abandoned five mines(Darak, Daduk, Jingok, Dalsung, Ilkwang) located in Youngnam area. Arsenic, classified as group A(Human Carcinogens) from IRIS, have shown statistically significant increment in skin cancer with oral exposure. This paper was conducted to predict excess cancer risk value (to the skin cancer) based on multiple pathway such as soil ingestion, dermal uptake and food(plant) ingestion contaminated by arsenic, and also, to identify the remedial goal regarded in future land use. The mine having the highest arsenic level was Daduk(mean : 1950mg/kg) and the next rank was Jingok(1690mg/kg), Ilkwang(352.37mg/kg), Dalsung(86.08mg/kg), Darak(0.83mg/kg). The chronic daily intake to the multiple exposure were calculated using Monte-Carlo simulation regarded in future land use and used q: value was $1.5(mg/kg/day)^{-1}$ to the oral proposed by IRIS(1997). The computated excess cancer risk 95th value to all the mine regarding future land use as residential and rural area were more than $10^{-4}$. If the level of acceptable risk is aimed for 1$\times$$10^{-6}$, it could be used Darak as commercial and industrial area without soil remediation due to the lowest risk value(6$\times$$10^{-8}$ and 3$\times$$10^{-8}$). Computated remedial goal based on 1$\times$$10^{-6}$ of acceptable risk to the future land use as the residential, rural, commercial and industrial area were 0.02mg/kg, 0.003mg/kg, 97.31mg/kg and 194.62mg/kg, respectively.
Park, Hyun-Soo;Cho, Sang-Soo;Yoon, Eun-Jin;Bang, Seong-Ae;Kim, Yu-Kyeong;Kim, Sang-Eun
Nuclear Medicine and Molecular Imaging
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v.41
no.4
/
pp.280-290
/
2007
Purpose: Gender differences in personality are considered to have biological bases. In an attempt to understand the gender differences of personality on neurobiological bases, we conducted correlation analyses between regional brain glucose metabolism and temperament factors of personality in males and females. Materials and Methods: Thirty-six healthy right-handed volunteers (18 males, 33.8$\pm$17.6 y; 18 females, 36.2$\pm$20.4 y) underwent FDG PET at resting state. Three temperament factors of personality (novelty seeking (NS), harm avoidance (HA), reward dependence (RD)) were assessed using Cloninger's 240-item Temperament and Character Inventory (TCD within 10 days of FOG PET scan. Correlation between regional glucose metabolism and each temperament factor was tested using SPM2. Results: In males, a significant negative correlation between NS score and glucose metabolism was observed in the bilateral superior temporal gyri, the hippocampus and the insula, while it was found in the bilateral middle frontal gyri, the right superior temporal gyrus and the left cingulate cortex and the putamen in females. A positive HA correlation was found in the right midbrain and the left cingulate gyrus in males, but in the bilateral basal ganglia in females. A negative RD correlation was observed in the right middle frontal and the left middle temporal gyri in males, while the correlation was found in the bilateral middle frontal gyri and the right basal ganglia and the superior temporal gyrus in females. Conclusion: These data demonstrate different cortical and subcortical metabolic correlates of temperament factors of personality between males and females. These results may help understand biological substrate of gender differences in personality and susceptibility to neuropsychiatric illnesses.
Journal of the Korean Society for Marine Environment & Energy
/
v.9
no.4
/
pp.243-252
/
2006
Influence of the increasing carbon dioxide concentration in seawater on various marine organisms is assessed in this article with regard to the impacts of anthropogenic $CO_2$ introduced into surface or deep oceans. Recent proposals to sequester $CO_2$ in deep oceans arouse the concerns of adverse effects of increased $CO_2$ concentration on deep-sea organisms. Atmospheric introduction of $CO_2$ into the ocean can also acidify the surface water, thereby the population of some sensitive organisms including coral reefs, cocolithophorids and sea urchins will be reduced considerably in near future (e.g. in 2100 unless the increasing trend of $CO_2$ emission is actively regulated). We exposed bioluminescent bacteria and benthic amphipods to varying concentrations of $CO_2$ and also pH for a short period. The ${\sim}l.5$ unit decrease of pH adversely affected test organisms. However, amphipods were not influenced by decreasing pH when HCl was used for the seawater acidification. In this article, we reviewed the biological adverse effects of $CO_2$ on various marine organisms studied so for. Theses results will be useful to predict the potential risks of the increase of $CO_2$ concentrations in seawater due to the increase of atmospheric $CO_2$ emission and/or sequestration of $CO_2$ in deep oceans.
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