• Title/Summary/Keyword: 임상 결과 예측

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Influence of Clinical Nurses' Intrinsic Motivation, Affective Commitment, and Turnover Intention on Organizational Performance (간호사의 내재적 동기부여, 정서적 몰입 및 이직의도가 조직성과에 미치는 영향)

  • Jung, Min
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.11
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    • pp.594-601
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    • 2017
  • The purpose of this study was to identify the effects of clinical nurses' intrinsic motivation, affective commitment, and turnover intention on organizational performance. Participants were 189 nurses currently working at four general hospitals in C city. Data were collected by a self-report questionnaire and analyzed by using the SPSS/WIN 18.0 program with descriptive analysis, t-test, ANOVA, Pearson correlation coefficient, and multiple regression. Mean scores were as follows: intrinsic motivation($3.02{\pm}0.57$), affective commitment ($3.47{\pm}0.71$), turnover intention ($3.30{\pm}0.59$), and organizational performance ($3.37{\pm}0.52$). Organizational performance was significantly correlated with intrinsic motivation, affective commitment, and turnover intention. Nurses with higher affective commitment and intrinsic motivation showed higher organizational performance, where as higher turnover intention was correlated with lower organizational performance. The factors that influenced organizational performance were affective commitment(${\beta}=.42$), intrinsic motivation(${\beta}=.36$), and turnover intention(${\beta}=-.11$), with an explanatory power of 51.6%. Results of this study indicate the need to evaluate and manage the significant predictors of organizational performance. Further studies are needed to identify the relationships between clinical nurses' intrinsic motivation, affective commitment, turnover intention, and organizational performance.

Factors Affecting the Consciousness of Biomedical Ethics of the Nursing Students before Clinical Practice In Convergence Era (융합 시대의 임상실습 전 간호대학생의 생명의료윤리의식에 대한 영향요인 확인)

  • Cho, Young-Hee
    • Journal of the Korea Convergence Society
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    • v.8 no.10
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    • pp.359-369
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    • 2017
  • The purpose of the study was to identify the factors affecting the consciousness of biomedical ethics of the nursing students before clinical practice. Data were collected among 183 nursing students in G city, from June 12 to 30, 2017. Data were analyzed by using SPSS 22.0 WIN program. The level of attitude on the withdrawal of life sustaining treatment was $3.20{\pm}0.35$, ethical values was $3.55{\pm}0.27$, consciousness of biomedical ethics was $2.69{\pm}0.20$. Models including the variables, ethical values(${\beta}=.52$, p<.001), major satisfaction(${\beta}=.21$, p=.001), attitude on the withdrawal of life sustaining treatment(${\beta}=-.01$ p=.031), explained 36.6% of the variance in the consciousness of biomedical ethics. Based on the outcome of this study, steps should be taken to design intervention programs that emphasize a improve consciousness of biomedical ethics for nursing students in convergence era.

Current Status of Imaging Physics & Instrumentation In Nuclear Medicine (핵의학 영상 물리 및 기기의 최신 동향)

  • Kim, Hee-Joung
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.2
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    • pp.83-87
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    • 2008
  • Diagnostic and functional imaging device have been developed independently. The recognition that combining of these two devices can provide better diagnostic outcomes by fusing anatomical and functional images. The representative examples of combining devices would be PET/CT and SPECT/CT. Development and their applications of animal imaging and instrumentation have been very active, as new drug development with advanced imaging device has been increased. The development of advanced imaging device resulted in researching and developing for detector technology and imaging systems. It also contributed to develop a new software, reconstruction algorithm, correction methods for physical factors, image quantitation, computer simulation, kinetic modeling, dosimetry, and correction for motion artifacts. Recently, development of MRI and PET by combining them together was reported. True integration of MRI and PET has been making the progress and their results were reported. The recent status of imaging and instrumentation in nuclear medicine is reported in this paper.

Using Artificial Intelligence Software for Diagnosing Emphysema and Interstitial Lung Disease (폐기종 및 간질성 폐질환: 인공지능 소프트웨어 사용 경험)

  • Sang Hyun Paik;Gong Yong Jin
    • Journal of the Korean Society of Radiology
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    • v.85 no.4
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    • pp.714-726
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    • 2024
  • Researchers have developed various algorithms utilizing artificial intelligence (AI) to automatically and objectively diagnose patterns and extent of pulmonary emphysema or interstitial lung diseases on chest CT scans. Studies show that AI-based quantification of emphysema on chest CT scans reveals a connection between an increase in the relative percentage of emphysema and a decline in lung function. Notably, quantifying centrilobular emphysema has proven helpful in predicting clinical symptoms or mortality rates of chronic obstructive pulmonary disease. In the context of interstitial lung diseases, AI can classify the usual interstitial pneumonia pattern on CT scans into categories like normal, ground-glass opacity, reticular opacity, honeycombing, emphysema, and consolidation. This classification accuracy is comparable to chest radiologists (70%-80%). However, the results generated by AI are influenced by factors such as scan parameters, reconstruction algorithms, radiation doses, and the training data used to develop the AI. These limitations currently restrict the widespread adoption of AI for quantifying pulmonary emphysema and interstitial lung diseases in daily clinical practice. This paper will showcase the authors' experience using AI for diagnosing and quantifying emphysema and interstitial lung diseases through case studies. We will primarily focus on the advantages and limitations of AI for these two diseases.

A Therapeutic Effect of Ozonated Oil on Bovine Mastitis (젖소 유방염에 대한 Ozonated oil의 치료효과)

  • Jo Sung-Nam;Liu Jianzhu;Lee Sang-Eun;Hong Min-Sung;Kim Duck-Hwan;Kim Myung-Cheol;Cho Sung-Whan;Jun Moo-Hyung
    • Journal of Veterinary Clinics
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    • v.22 no.4
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    • pp.318-321
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    • 2005
  • Forty- nine quarters from 24 lactating cows with chronic mastitis were selected. The cows were raised on dairy farms in Gongju, Jochiwon and Yeongi in Chungnam province, and Iksan in Jeonbuk province, Korea. The 49 quarters with bovine mastitis were divided into control (7 quarters) and experimental (42 quarters) groups. The experimental quarters were assigned to experimental group A (10 quarters, somatic cell count: $50-100\times10^4/ml)$, experimental group B (14 quarters, somatic cells count: $100-300{\times}10^4/ml)$, and experimental group C (18 quarters, somatic cells count: $>300\times10^4/ml$), according to the number of the somatic cells in their milk. The quarters of control group were treated with norfloxacin ointment (10 g/tube) based on the result of sensitivity, twice a day for 3 days. The quarters or experimental groups were infused 10ml or ozonated oils twice a day for 3 days. After treatment, the milk of the control group contained non-significantly lower numbers of somatic cells and bacteria on day 7, compared with pretreatment levels. Experimental groups A, B and C had lower somatic and bacterial cells in their milk on day 7, compared with pretreatment levels. Experimental group B and C had significantly lower numbers of somatic cells in their milk ell day 7 than before treatment (p<0.01). However, no significant difference in somatic cell numbers was detected between the control alld experimental groups. It was concluded that ozone therapy with ozonated oil applied on bovine mastitis might be effective.

Different Uptake of Tc-99m ECD and Tc-99m HMPAO in the Normal Brains: Analysis by Statistical Parametric Mapping (정상 뇌 혈류 영상에서 방사성의약품에 따라 혈류 분포에 차이가 있는가: 통계적 파라미터 지도를 사용한 분석)

  • Kim, Euy-Neyng;Jung, Yong-An;Sohn, Hyung-Sun;Kim, Sung-Hoon;Yoo, Ie-Ryung;Chung, Soo-Kyo
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.4
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    • pp.244-254
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    • 2002
  • Purpose: This study investigated the differences between technetium-99m ethyl cysteinate dimer (Tc-99m ECD) and technetium-99m hexamethylpropylene amine oxime (Tc-99m HMPAO) uptake in the normal brain by means of statistical parametric mapping (SPM) analysis. Materials and Methods: We retrospectively analyzed age and sex matched 53 cases of normal brain SPECT. Thirty-two cases were obtained with Tc-99m ECD and 21 cases with Tc-99m HMPAO. There were no abnormal findings on brain MRIs. All of the SPECT images were spatially transformed to standard space, smoothed and globally normalized. The differences between the Tc-99m ECD and Tc-99m HMPAO SPECT images were statistically analyzed using statistical parametric mapping (SPM'99) software. The differences bgetween the two groups were considered significant ant a threshold of corrected P values less than 0.05. Results: SPM analysis revealed significantly different uptakes of Tc-99m ECD and Tc-99m HMPAO in the normal brains. On the Tc-99m ECD SPECT images, relatively higher uptake was observed in the frontal, parietal and occipital lobes, in the basal ganglia and thalamus, and in the superior region of the cerebellum. On the Tc-99m HMPAO SPECT images, relatively higher uptakes was observed in subcortical areas of the frontal region, temporal lobe, and posterior portion of inferior cerebellum. Conclusion: Uptake of Tc-99m ECD and Tc-99m HMPO in the normallooking brain was significantly different on SPM analysis. The selective use of Tc-99m ECD of Tc-99m HMPAO in brain SPECT imaging appears especially valuable for the interpretation of cerebral perfusion. Further investigation is necessary to determine which tracer is more accurate for diagnosing different clinical conditions.

Factors Associated with Conversion from Conservative to Surgical Treatment in Single-Level Lumbar Spinal Stenosis Patients (보존적 치료 중인 단분절 요추관 협착증 환자에서 수술적 치료로 전환과 관련된 연관 인자)

  • Ahn, Young-Joon;Im, Se-Hyuk;Park, Byung-Kyu
    • Journal of Korean Society of Spine Surgery
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    • v.25 no.4
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    • pp.160-168
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    • 2018
  • Study Design: Retrospective study of prospectively-collected data. Objectives: To determine the factors associated with conversion from conservative to surgical treatment in single-level lumbar spinal stenosis patients. Summary of Literature Review: Various reports have presented clinical outcomes after the surgical and nonsurgical treatment of spinal stenosis. However, few reports have investigated factors predicting conversion to surgery during the course of conservative treatment. Materials and Methods: We analyzed 40 patients who visited our hospital from May 2010 to May 2015 and were traceable for at least 3 years after being advised to undergo surgery following 3 months of conservative treatment. Of these patients, 20 underwent surgery and 20 did not. We then investigated the factors associated with conversion to surgical treatment. Clinical assessments were conducted using a questionnaire, and the overall area of the spinal canal and the muscle area within the spinal canal were measured using magnetic resonance imaging. Results: The average area of the spinal canal was $81.40{\pm}53.61mm^2$ in the surgical group, compared to $127.75{\pm}82.55mm^2$ in the nonsurgical group (p=0.042). The muscle area in the spinal canal was $5.17{\pm}1.30cm^2$ in the surgical group, whereas it was $6.40{\pm}1.56cm^2$ in the nonsurgical group (p=0.010). The patients in the surgical group were more likely to have experienced repetitive strain and to have frequently visited health clubs (p=0.047, p=0.037, respectively). However, regular stretching was more common in the nonsurgical group (p=0.028). Conclusions: The factors associated with conversion to surgical treatment were a narrow spinal canal, a small muscle area within the spinal canal, visiting health clubs, repetitive sprain, and not stretching. A small muscle area within the spinal canal can be considered as a key factor related to surgical conversion.

The Expression of Adhesion Molecules on BAL Cells and Serum Soluble ICAM-1 Level after the Radiotherapy for the Lung Cancer and Its Relationship to the Development of of Radiation Pneumonitis and Fibrosis (방사선 치료후 기관지-폐포세척액내 폐포대식세포 및 임파구의 접착분자발현 변화와 방사선에 의한 폐렴 및 폐섬유증발생의 예측인자로서의 의의)

  • Kim, Dong-Soon;Paik, Sang-Hoon;Choi, Eun-Kyung;Chang, Hye-Sook;Choi, Jung-Eun;Lim, Chae-Man;Koh, Yun-Suck;Lee, Sang-Do;Kim, Woo-Sung;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.1
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    • pp.75-87
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    • 1996
  • Background: Lung cancer is the second most frequent malignancy in man in Korea. Surgery is the best treatment modality for non-small cell lung cancer, but most patients were presented in far advanced stage. So radiation therapy(RT) with or without chemotherapy is the next choice and radiation-induced pneumonitis and pulmonary fibrosis is the major limiting factor for the curative RT. Radiation pneumonitis is manifested with fever, cough and dyspnea, 2~3 months after the termination of radiotherpy. Chest X ray shows infiltration, typically limited to the radiation field, but occasionally bilateral infiltration was reported. Also Gibson et al reported that BAL lymphocytosis was found in both lungs, even though the radiation was confined to one lung. The aim of this study is to investigate the change of adhesion molecules expression on BAL cells and serum soluble ICAM-1(sICAM-1) level after the RT and its relationship to the development of radiation pneumonitis. The second aim is to confirm the bilaterality of change of BAL cell pattern and adhesion molecule expression. Subjects: BAL and the measurement of sICAM level in serum and BALF were done on 29 patients with lung cancer who received RT with curative intention. The BAL was done before the RT in 16 patients and 1~2 month after RT in 18 patients. 5 patients performed BAL before and after RT. Result: Clinically significant radiation pneumonitis developed in 7 patients. After RT, total cell count in BAL was significantly increased from $(20.2{\pm}10.2){\times}10^6\;cells/ml$ to $(35.3{\pm}21.6){\times}10^6\;cells/ml$ (p=0.0344) and %lymphocyte was also increased from $5.3{\pm}4.2%$ to $39.6{\pm}23.4%$ (p=0.0001) in all patient group. There was no difference between ipsilateral and contraleteral side to RT, and between the patients with and without radiation-pneumonitis. In whole patient group, the level of sICAM-1 showed no significant change after RT(in serum: $378{\pm}148$, $411{\pm}150\;ng/ml$, BALF: $20.2{\pm}12.2$, $45.1{\pm}34.8\;ng/ml$, respectively), but there was a significant difference between the patients with pneumonitis and without pneumonitis (serum: $505{\pm}164$ vs $345{\pm}102\;ng/ml$, p=0.0253, BALF: $67.9{\pm}36.3$ vs $25.2{\pm}17.9\;ng/ml$, p=0.0112). The expression of ICAM-1 on alveolar macrophages (AM) tends to increase after RT (RMFI: from $1.28{\pm}0.479$ to $1.63{\pm}0.539$, p=0.0605), but it was significantly high in patients with pneumonitis ($2.10{\pm}0.390$) compared to the patients without pneumonitis ($1.28{\pm}0.31$, p=0.0002). ICAM-1 expression on lymphocytes and CD 18 (${\beta}2$-integrin) expression tended to be high in the patients with pneumonitis but the difference was statiastically not significant. Conclusion: Subclinical alveolitis on the basis of BAL finding developed bilaterally in all patients after RT. But clinically significant pneumonitis occurred in much smaller fraction and the ICAM-1 expression on AM and the sICAM-1 level in serum were good indicator of it.

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Clinical Characteristics of Paradoxical Response to Chemotherapy in Pulmonary Tuberculosis (항결핵제 사용 중 폐병변의 일시적 악화를 보인 환자의 임상상)

  • Kim, Soo-Hee;Chung, Hyo-Young;Lee, Ghie-Dong;Shin, Min-Ghie;Jung, Tae-Sik;Jin, Byung-Cheol;Kim, Hyun-Jung;You, Jin-Jong;Lee, Jong-Deog;Hwang, Young-Sil
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.1
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    • pp.27-35
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    • 2002
  • Background : The paradoxical response refers to an enlargement of old lesions or unexpected new ones during apparently adequate antituberculous therapy. This response has been reported in cases of intracranial tuberculoma, tuberculous lymphadenopathy, tuberculous pleurisy and pulmonary tuberculosis. However, there are few reports on its frequency and clinical characteristics. Materials and Methods : This study enrolled 205 patients who were treated with first line antituberculous agents for more than 6 months. We retrospectively studied 155 patients with pulmonary tuberculosis and 57 patients with pleural tuberculosis (7 patients had both) from July 1998 to March 2000. The patients were divided into the paradoxical response group and the non-paradoxical group. The clinical characteristics of the paradoxical response group and the non-paradoxical group. The clinical characteristics of the paradoxical group were investigated. Statistical analysis was done with an independent sample T-test and Chi-squared test. Results : 29 of the 205 patients(14.1%) had paradoxical response. Among the 29 patients, there were 19 pulmonary tuberculosis, 8 tuberculous pleurisy(2 patients had both). Paradoxical response appeared 32 days (mean 35 days in pulmonary tuberculosis, mean 25 days in tuberculous pleurisy) after the beginning of chemotherapy. The duration to regress less than half of initial chest lesion was 114 days in pulmonary tuberculosis and 124 days in tuberculous pleurisy, respectively. Most common clinical manifestation of paradoxical response patients was coughing in both pulmonary tuberculosis and tuberculous pleurisy. Male sex, high blood WBC count and high level of pleural fluid LDH were related with paradoxical response. Conclusion : These findings suggest that presponse usually appears 1 month and disappears within 4 months after the beginning of anti-tuberculous chemotherapy. Paradoxical response was relatively correlated with male sex, high blood WBC count and high level of pleural fluid LDH.

Clinical Outcome and Prognostic Factors of Acute Respiratory Distress Syndrome in Children (소아 급성 호흡곤란 증후군의 치료 성적 및 예후 인자)

  • Ko, Jung-Min;Ha, Eun-Ju;Lee, Eun-Hee;Lee, So-Youn;Kim, Hyo-Bin;Hong, Soo-Jong;Park, Seong-Jong
    • Clinical and Experimental Pediatrics
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    • v.48 no.6
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    • pp.599-605
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    • 2005
  • Purpose : The purpose of this study was to examine the causes, clinical courses and outcomes in children with acute respiratory distress syndrome(ARDS), and evaluate the physiologic variables as prognostic factors in the patients. Methods : Retrograde medical chart review was carried out in 24 patients who were diagnosed with ARDS at the pediatric intensive care unit(PICU) during 20-month period. Results : The incidence of ARDS among all PICU admission was 3.7 percent and the mortality rate was 37.5 percent, which was 14.8 percent of overall deaths in PICU. The most common causes of ARDS were pneumonia and sepsis. We found significant differences between survivors and nonsurvivors in $PaO_2/FiO_2$ ratio(P/F ratio), alveolar arterial oxygen gradient and oxygenation index(OI) on the second day from the onset of ARDS. Therapies for ARDS such as high frequency oscillator ventilation(HFOV), recruitment maneuver and low dose corticosteroid improved the P/F ratio and OI, especially in survivors. Conclusion : The mortality rate of children with ARDS was 37.5 percent; an important cause of death in PICU. HFOV, recruitment maneuver and low dose corticosteroid seemed to be effective in pediatric ARDS. The P/F ratio, alveolar arterial oxygen gradient and OI on the second day from the onset of ARDS may be useful as prognostic factors.