• 제목/요약/키워드: 병원 의학

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A STUDY ON THE TEMPERAMENTAL CHARACTERISTICS OF KOREAN CHILDREN USING TODDLER TEMPERAMENT SCALE (걸음마기 기질평가척도를 이용한 한국 아동의 기질 특성 연구)

  • Choi, Sung-Ku;Hong, Sung-Do;Son, Jung-Woo
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.13 no.1
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    • pp.163-176
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    • 2002
  • Objectives:This study was designed to investigate the temperamental characteristics and the differences of temperamental characteristics in Korean children according to the sociodemographic and family environment factors using Toddler Temperament Scale(TTS). Methods:The samples consisted of 1,175 children who were attending twenty-five Samsung Child Care Centers nationwide. Both Korean version of TTS and child developmental questionnaire(designed by the Department of Psychiatry, Samsung Medical Center) were distributed to the parents of these children. Score of 9 temperamental categories was determined using the result of TTS, and determination of 5 temperamental clusters was conducted by the Fullard's criteria. Statistical analyses were performed according to the sex, birth order, existence of siblings, residential city, residential province, marital state of child's parents, and parental relationship to compare the scores of temperamental categories and the distribution of temperamental clusters. Results:The distribution of temperamental clusters was as follows;Easy 35.8%, Intermediate Low (IL) 33.1%, Intermediate High(IH) 11.1%, Slow-To-Warm-Up 6.3%, and Difficult 13.6%. Some of 9 temperamental categories were statistically different according to the sex, birth order, existence of siblings, residential city, residental province, marital state of child's parents, and parental relationship. From the viewpoint of 5 temperamental clusters, there were statistically more Easy and less Difficult children in good relation between each parent(p=.022). In spite of no statistical significance, the children in conditions of first-born, non-existence of siblings, middle or small residential city, Chung-Cheong province, married state of parent had a tendency to be easier to care. Conclusions:The toddler temperamental characteristics of Korean children showed some differences in several sociodemographic and family environment factors. We could confirm that the 'Goodness of Fit' was very important in child temperament.

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Psychosocial Characteristics and Quality of Life in Patients with Functional Gastrointestinal Disorder (기능성위장질환 환자들의 정신사회적 특성과 삶의 질)

  • Lee, Dong-Ho;Lee, Sang-Yeol;Ryu, Han-Seung;Choi, Suck-Chei;Yang, Chan-Mo;Jang, Seung-Ho
    • Korean Journal of Psychosomatic Medicine
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    • v.28 no.1
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    • pp.20-28
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    • 2020
  • Objectives : The aim of this study was to compare psychosocial characteristics of the functional gastrointestinal disorders FGID group, non-FGID group, and control group and determine factors affecting the QOL of patients with FGID. Methods : 135 patients diagnosed with FGID were selected. 79 adults had no observable symptoms of FGID (control group) and 88 adults showed symptoms of FGID (non-FGID group). Demographic factors were investigated. The Korean-Beck Depression Inventory-II, Korean-Beck Anxiety Inventory, Korean-Childhood Trauma Questionnaire, Multidimensional Scale of Perceived Social Support, Connor-Davidson Resilience Scale, Patient Health Questionnaire-15 and WHO Quality of Life Assessment Instrument Brief Form were used to assess psychosocial factors. A one-way ANOVA was used to compare differences among groups. Pearson correlation test was performed to analyze the correlation of psychosocial factors and QOL of the FGID group. Further, a hierarchical regression analysis was conducted to determine factors affecting the QOL of the FGID group. Results : Between-group differences were not significant in demographic characteristics. Depression (F=48.75, p<0.001), anxiety (F=14.48, p<0.001), somatization (F=24.42, p<0.001) and childhood trauma (F=12.71, p<0.001) were significantly higher in FGID group than in other groups. Social support (F=39.95, p<0.001) and resilience (F=17.51, p<0.001) were significantly lower in FGID group than in other groups. Resilience (β=0.373, p<0.01) was the most important explanatory variable. The explained variance was 47.2%. Conclusions : Significantly more symptoms of depression, anxiety, childhood trauma, and somatization were observed for the FGID group. This group also had less social support, resilience, and quality of life than the non-FGID and control groups. The key factor for quality of life of the FGID group was resilience.

The Usefulness of Rapid Triple Test for Cardiac Marker in Forensic Paragnosis of Sudden Cardiac Death (심장표지물질 간이검사의 급성심장사 법의학적 사후진단 유용성에 관한 연구)

  • Lim, Chae-Won;Kim, Jin-Gak
    • Korean Journal of Clinical Laboratory Science
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    • v.49 no.2
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    • pp.108-113
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    • 2017
  • A sudden cardiac death (SCD) is defined as an unnatural sudden death caused by heart disease. To determine the cause of death, observation of the microscopic change in cardiac muscle tissue is suggested, rather than visual postmortem examination. However, this suggestion is time consuming to be applied in the field, is cost-ineffective, and is inconvenient. Therefore, the purpose of this study is to understand whether temporary inspection used to examine the cardiac marker (Myoglobin, CK-MB, cTn I) in postmortem blood via rapid cardiac triple test kit (which is used by clinics to diagnose patients with acute myocardial infarction) can effectively be utilized for the paragnosis of sudden, unnatural cardiac death. The results of postmortem examination and temporary investigation found that 23 groups (76.7%), among the 30 experimental groups, were assumed to be non-traumatic sudden cardiac deaths, which indicated a positive response (according to comparison with forensic autopsy); 4 groups, among the 10 control groups, were assumed to be cerebrovascular disease, which indicated a negative response; 1 group was assumed to be alcoholic and drug poisoning, indicating a positive response; and 1 group was assumed to be oxygen deficiency due to suffocation, indicating a positive response. Hence, it was found that the level of sensitivity and specificity of cardiac marker's temporary inspection showed significant result, 76.7% and 80% respectively. Given this, temporary inspection can be effectively used for the paragnosis of sudden cardiac death when the medical history, situation of the site, and postmortem interval are considered together. With the result of precedent research on time of first revelation and extinction in blood, and difference in concentration over time progress according to the characteristic of cardiac marker's (myoglobin, CK-MB, cTn I) individual material, further research on concentration of cardiac marker per each post time needs to be conducted in order to estimate time science death (which is required to identify the cause of death and investigation).

Heart Rate Variability in Patients with Anxiety Disorder and Effects of Selective Serotonin Reuptake Inhibitor (불안장애 환자에서의 심박변이도와 세로토닌재흡수억제제투여 후의 치료효과)

  • Lee, Kang-Joon;Kim, Hyun;Lee, Seung-Hwan;Park, Young-Min;Chung, Young-Cho
    • Korean Journal of Psychosomatic Medicine
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    • v.14 no.2
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    • pp.94-101
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    • 2006
  • Objectives : A variety of symptoms are typically reported during anxiety period, several of which are clearly linked to the autonomic nervous system(ANS), such as palpitations, chest pain and shortness of breath. Using spectral analysis of heart rate, several studies have shown that patients with anxiety disorder are characterized by a reduced heart rate variability(HRV), indicative of abnormalities in ANS fuction. To further evaluate the effect of anxiety and medication on autonomic function, 30 patients and 30 matched control subjects were assessed. Methods : Using spectral analysis of heart rate, which consisted of standardised measurements of HRV, we compared ANS between 30 patients with DSM-IV diagnosed anxiety disorder and 30 healthy controls, and investigated the autonomic effects of SSRI treatment. Five-minute HRV recordings were obtained before and after SSRI treatment and were analysed. Results : Five-minute HRV recordings in anxiety disorder patients revealed that a significant reduction in HRV was shown compared to controls. There was no significant changes in HRV between before and after SSRI treatment. Conclusion: Anxiety disorder patients showed a significant reduction in HRV compared to controls. SSRIs do not affect HRV influenced by ANS function. Further study is needed to confirm these things. Patients with anxiety disorder may suffer from functional disturbances in the interaction between the sympathetic and parasympathetic autonomic tree.

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Isolation of Nontuberculous Mycobacteria by DNA Probe and Clinical Characteristics of Patients with NTM Pulmonary Disease (DNA probe를 이용한 비결핵항산균의 분리 및 폐질환자들의 임상적 특징)

  • Kim, Hee Kyoo;Kim, Yu Ri;Park, Jung Pil;Kim, Nang Hee;Ok, Chul Ho;Jung, Maan Hong;Jang, Tae Won;Jeong, Seok Hoon;Kim, Cheol Min;Park, Hee Kyung
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.3
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    • pp.248-256
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    • 2005
  • Background : Nontuberculous mycobacterial (NTM) infections are increasingly being recognized as a cause of chronic pulmonary disease. This study describes the prevalence of NTM species from clinical specimens and the clinical characteristics of NTM pulmonary disease. Material and Methods : The NTM isolated from March 2003 to December 2003 at the Kosin Medical Center were identified using an oligonucleotide chip containing the internal transcribed space (ITS) sequence. The medical records of the patients with the NTM isolates, who fulfilled the 1997 ATS diagnostic criteria for NTM pulmonary disease, were analyzed, retrospectively. Results : Twenty four species (24.2%) of NTM were isolated from 99 cultured AFB specimens. M. avium complex (MAC) (13 isolates), M. szulgai (3), M. kansasii (2), M. malmoense (2), M. abscessus (1), M. chelonae (1), M. scrofulaceum (1), and unclassified (1). Of the 23 patients with isolated NTM, 11 patients were found to be compatible with a NTM pulmonary infection according to the ATS criteria; MAC was found in 6 cases (54.5%), M. szulgai in 2 cases (18.2%), and M. abscessus, M. szulgai, M. kansasii and M. malmoense in 1 case each (9.1%). Ten patients (91%) were male and the median age at diagnosis was 61 years. In the pre-existing diseases, malignant disease was found in 6 cases including 5 patients with lung cancer, and history of old pulmonary tuberculosis was identified in 4 cases. The radiological patterns showed lung destruction lung in 3 cases, a cavitary mass in 3 cases, a nodular pattern in 2 cases, and reticulonodular, consolidation and a bronchiectasis pattern were in 1 case each. Conclusion : Various types of NTM pulmonary diseases were found in a tertiary hospital at Busan, Korea. The NTM pulmonary diseases were caused by MAC, M. szugai, M. kansasii, M. malmoense, M. abscessus, M. chelonae, and M. scrofulaceum in the order of frequency.

A Study on Achiles Tendon Reflex in Normal Korean Persons and Various Thyroid Diseases (정상한국인(正常韓國人) 및 각종갑상선질환(各種甲狀腺疾患)에서의 아킬레스건반사시간(腱反射時間)에 관(關)한 연구(硏究))

  • Kang, Jin-Yung;Kim, Myung-Duk;Lee, Hong-Kyu;Lee, Jung-Sang;Koh, Chang-Soon;Lee, Mun-Ho
    • The Korean Journal of Nuclear Medicine
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    • v.12 no.1
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    • pp.17-28
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    • 1978
  • A simplified photoelectric apparatus producing graphic records of the free Achilles tendon reflex allowed us to study the reflex quantitatively in subjects with normal and abnormal thyroid function. In this study Achilles tendon reflex times were tested in 340 normal Korean persons, 89 hyperthyroid patients, 19 hypothyroid patients and 85 other thyroid disease patients who were euthyroid in thyroid function tests. In normal Korean persons, the Achilles tendon reflex time was delayed with increasing age and slower in female than in male. They showed good correlationship with various thyroid function tests which included ETR, $T_3RU,\;^{131}I$ thyroid uptake and serum TSH. Diagnostic accuracy of them was 71% in hyperthyroidism and 90% in hypothyroidism. Finally the serial measurements of them were very useful tests in evaluating the clinical coures of hyperthyroidism and hypothyroidism once treatment was begun.

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The Usefulness of $^{18}F-FDG $ PET as a Cancer Screening Test ($^{18}F-FDG $ PET의 암 선별검사로서의 유용성)

  • Ko, Doo-Heun;Choi, Joon-Young;Song, Yun-Mi;Lee, Su-Jin;Kim, Young-Hwan;Lee, Kyung-Han;Kim, Byung-Tae;Lee, Moon-Kyu
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.6
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    • pp.444-450
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    • 2008
  • Purpose: The aim of this study was to evaluate the usefulness of whole body positron emission tomography (PET) using $^{18}F-fluorodeoxyglucose$ ($^{18}F-FDG$) for cancer screening in asymptomatic subjects. Materials and Methods: The subjects were 1,762 men and 259 women who voluntarily underwent $^{18}F-FDG$ PET for cancer screening as a part of a routine health examination. Final diagnosis was decided by other diagnostic studies, pathological results or clinical follow-up for 1 year. Results: Of 2,021 subjects, 40 (2.0%) were finally proved to have cancer. Abnormal focal $^{18}F-FDG$ uptake suggesting malignancy was found in 102 subjects (5.0%). Among them, 21 subjects (1.0%) were proved to have cancer. Other tests in the routine health examination could not find 9 of 21 cancers (42.9%) detected by PET. The sensitivity, specificity, positive predictive value, and negative predictive value of PET for cancer screening were 52.5%, 95.9%, 20.6%, and 99.0%, respectively. Pathologies of cancers missed on PET were adenocarcinoma (n = 9; 3 colon cancers, 3 prostate cancers, 2 stomach cancers, and 1 rectal cancer), differentiated thyroid carcinoma (n = 6), bronchioalveolar cell carcinoma (n = 2), urinary bladder cancer (n = 1), and melanoma (n = 1). More than half of cancers which were not detected by PET were smaller than 1 cm in diameter. Conclusion: $^{18}F-FDG$ PET might be useful for cancer screening in asymptomatic subjects due to its high specificity and negative predictive value and playa supplementary role to the conventional health check-up, but it could not replace due to limited sensitivity for urological cancers, small-sized tumors and some hypometaboic cancers.

The Research of Comparison Evaluation on the Decline in Artifact Using Respiratory Gating System in PET-CT (PET-CT 검사 시 호흡동조 시스템을 이용한 인공물 감소에 대한 비교 평가)

  • Kim, Jin-Young;Lee, Seung Jae;jung, Suk;Park, Min-Soo;Kang, Chun-Goo;Im, Han-Sang;Kim, Jae-Sam
    • The Korean Journal of Nuclear Medicine Technology
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    • v.19 no.2
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    • pp.63-67
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    • 2015
  • Purpose Among various causes that influence image quality degradation, various methods for decrease in Artifact occurred by respiration of patients are being used. Among them, this study intended to evaluate CTAC Shift correction method and additional scan compare to the Scan(Q static scan) using respiratory gated system. Materials and Methods This study was conducted on 10 patients, and used PET-CT Discovery 710 (GE Healthcare, MI, USA) and Varian's RPM system. 5.18 Mbq per kg of $^{18}F$-FDG was injected on patients, asked them to take a rest for 1 hour in the bed, and conducted test after urination. Images were visualized through Q static scan, CTAC Shift correction method, Additional scan based on the Whole body scan(WBS) with Artifact. Decrease in Artifact was compared in each image, conducted Gross Evalution, and measured changes of SUVmax. Results For image obtained through the CTAC Shift correction method through WBS with Artifact, 12~56%, Q static scan image showed 17~54% of change rate and Additional Scan showed -27~46% of change rate. In Blind Test, the CTAC Shift correction image showed the highest point with 4 points, Q static scan image showed 3.5 points, and Additional scan image showed 3.4 points. The standardized WBS scan through Oneway ANOVA and three types of Scan method showed significant difference(p<0.05), and did not show significant difference between the three Scan methods(p>0.05). However, the three Scan methods showed significant difference in Blind test. Conclusion Additional scan and Q static scan require more time than the CTAC Shift correction method, there is concern about excessive exposure to patients by CT rescan and Q static scan is difficult to apply on patients with inconsistent respiration or irregular respiration cycle due to pain. For CTAC Shift correction method, limited correction is possible and the range is limited as well. It is considered as a useful method of improving diagnostic value when hospitals use the system appropriately and develop various advantageous factors of each method.

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The Effect of Adequate Radiation Shield Production for Radiation Worker (방사선 차폐체 제작을 통한 작업종사자 피폭 감소 방안)

  • Kim, Ki;Hong, Gun-Chul;Kwak, In-Suk;Park, Sun-Myung;Choi, Choon-Ki;Seok, Jae-Dong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.2
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    • pp.41-44
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    • 2010
  • Purpose: Along with recent advances in PET/CT instrumentation and imaging technology, the number of patients has also been steadily increasing. This resulted in the increased radiation exposure to radiation workers in PET/CT rooms. In this study, we installed a radiation shield and investigated whether it could reduce radiation exposure to the workers and thus enhance job satisfaction. Materials and Methods: A radiation shield is composed of 5 cm thick lead and has a structure in which a radiation worker sits and watches a patient through lead glass while injecting radiopharmaceutical to the patient. Quarterly absorbed dose of radiation workers was measured using thermoluminescence dosimeters (TLD) and the results were compared for six months each before and after installation of the radiation shield. Exposure dose was also measured using a pocket dosimeter placed at the same location in the front and the back of the radiation shield. In addition, frequency of use of the shield and job satisfaction of radiation workers were investigated using a survey. Results: Quarterly absorbed dose of radiation workers was 2.70 mSv on average before installation of new radiation shield, whereas that dropped to 2.13 mSv after installation of radiation shield, reducing radiation exposure dose by 21%. Exposure dose on the front side of the shield was 61.2 R, whereas that on the back side of shield was 2.8 R. According to the survey, 85% of workers used the shield and were satisfied with the outcome: each radiation worker made injections to patients average of 6.5 times/day and preferred sitting to standing while injecting radiopharmaceutical to patients. Conclusion: Use of radiation shield reduced the exposure dose of radiation workers, which is the ultimate goal of radiation protection to minimize radiation exposure and is an appropriate method for the improvement of hospital working environment. Furthermore, we found that use of radiation shield not only relieves physical and psychological burden of radiation workers but also enhances job satisfaction. This result indicates that use of radiation shield is important for improvement of the radiation workers' job environment in terms of radiation protection.

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Evaluation of Reliability about Short TAT (Turn-Around Time) of Domestic Automation Equipment (Gamma Pro) (국산 자동화 장비(Gamma Pro)의 결과보고시간 단축에 대한 유용성 평가)

  • Oh, Yun-Jeong;Kim, Ji-Young;Seok, Jae-Dong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.2
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    • pp.197-202
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    • 2010
  • Purpose: Recently, many hospitals have been tried to increase the satisfaction of the outpatients through blood-gathering, exam, result notice and process in a day. Each laboratory has been used the automatic equipment for the rapid requests of the result notice and the increase of the reliability and efficiency. Current automatic equipments that have been limited short TAT(Turn-Around Time)because of the restricted batch lists and 1 tip-5 detectors. The Gamma Pro which is made in Korea to improve the shortcomings of existing automation equipment, complemented with capacity to perform a wide range of domestic automation equipment. In this study, we evaluated the usefulness and reliability of short TAT by comparing Gamma Pro with current automatic equipment. Materials and Methods: We studied the correlation between Gamma Pro and RIA-mat 280 using the respective 100 specimens of low or high density to the patients who were requested the thyroid hormone test (Total T3, TSH and Free T4) in Samsung Medical Center Sep. 2009. To evaluate the split-level Gamma Pro, First, we measured accuracy and carry over on the tips. Second, the condition of optimal incubation was measured by the RPM (Revolution Per Minute) and revolution axis diameter on the incubator. For the analysis for the speed of the specimen-processing, TAT was investigated with the results in a certain time. Result: The correlation coefficients (R2) between the Gamma Pro and RIA-mat 280 showed a good correlation as T3 (0.98), TSH (0.99), FT4 (0.92). The coefficient of variation (C.V) and accuracy was 0.38 % and 98.3 % at tip 1 and 0.39 % and 98.6 % at tip 2. Carry over showed 0.80 % and 1.04% at tip 1 and tip 2, respectively. These results indicate that tips had no effect on carry over contamination. At the incubator condition, we found that the optimal condition was 1.0mm of diameter at 600RPM in 1.0mm and 1.5mm of at 500RPM or 1.0mm and 1.5 mm of diameter at 600 RPM. the Gamma Pro showed that the number of exam times were increased as maximum 20 times/day comparing to 6 times/day by current automatic equipment. These results also led to the short TAT from 4.20 hour to 2.19 hours in whole processing. Conclusion: The correlation of between the Gamma Pro and RIA-mat 280 was good and has not carry over contamination in tips. The domestic automation equipment (Gamma Pro) decreases the TAT in whole test comparing to RIA-280. These results demonstrate that Gamma Pro has a good efficiency, reliability and practical usefulness, which may contribute to the excellent skill to process the large scale specimens.

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