• The Korean Journal of Nuclear Medicine Technology
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• v.17 no.1
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• pp.67-70
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• 2013

Purpose: Surge in patients with hepatocellular carcinoma, hepatic artery chemical embolization is one of the effective interventional procedures. The PET/CT examination plays an important role in determining the presence of residual cancer cells and metastasis, and prognosis after embolization. The other hand, the hepatic artery chemical embolization of embolic material used lipiodol produced artifacts in the PET/CT examination, and these artifacts results in quantitative evaluation influence. This study, the radioactivity density and the percentage error was evaluated by the extent of the impact of lipiodol in the image of PET/CT. Materials and Methods: 1994 NEMA Phantom was acquired for 2 minutes and 30 seconds per bed after the Teflon, water and lipiodol filled, and these three inserts into the enough to mix the rest behind radioactive injection with $20{\pm}10MBq$. Phantom reconfigure with the iterative reconstruction method the number of iterations for two times by law, a subset of 20 errors. We set up region of interest at each area of the Teflon, water, lipiodol, insert artifact occurs between regions, and background and it was calculated and compared by the radioactivity density(kBq/ml) and the% Difference. Results: Radioactivity density of the each region of interest area with the teflon, water, lipiodol, insert artifact occurs between regions, background activity was $0.09{\pm}0.04$, $0.40{\pm}0.17$, $1.55{\pm}0.75$, $2.5{\pm}1.09$, $2.65{\pm}1.16 kBq/ml$ (P <0.05) and it was statistically significant results. Percentage error of lipiodol in each area was 118%, compared to the water compared with the background activity 52%, compared with a teflon was 180% of the difference. Conclusion: We found that the error due to under the influence of the attenuation correction when PET/CT scans after lipiodol injection performed, and the radioactivity density is higher than compared to other implants, lower than background. Applying the nonattenuation correction images, and after hepatic artery chemical embolization who underwent PET/CT imaging so that the test should be take the consideration to the extent of the impact of lipiodol be.

• Clinical and Experimental Pediatrics
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• v.52 no.5
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• pp.594-602
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• 2009

Purpose : Transforming growth factor (TGF)-${\beta}1$ reportedly increases neuronal survival by inhibiting the induction of inducible nitric oxide synthase (NOS) in astrocytes and protecting neurons after excitotoxic injury. However, the neuroprotective mechanism of $TGF-{\beta}1$ on hypoxic-ischemic (HI) brain injury in neonatal rats is not clear. The aim of this study was to determine whether $TGF-{\beta}1$ has neuroprotective effects via a NO-mediated mechanism and N-methyl-D-aspartate (NMDA) receptor modulation on perinatal HI brain injury. Methods : Cortical cells were cultured using 19-day-pregnant Sprague-Dawley (SD) rats treated with $TGF-{\beta}1$ (1, 5, or 10 ng/mL) and incubated in a 1% O2 incubator for hypoxia. Seven-day-old SD rat pups were subjected to left carotid occlusion followed by 2 h of hypoxic exposure (7.5% $O_2$). $TGF-{\beta}1$ (0.5 ng/kg) was administered intracerebrally to the rats 30 min before HI brain injury. The expressions of NOS and NMDA receptors were measured. Results : In the in vitro model, the expressions of endothelial NOS (eNOS) and neuronal NOS (nNOS) increased in the hypoxic group and decreased in the 1 ng/mL $TGF-{\beta}1-treated$ group. In the in vivo model, the expression of inducible NOS (iNOS) decreased in the hypoxia group and increased in the $TGF-{\beta}1$-treated group. The expressions of eNOS and nNOS were reversed compared with the expression of iNOS. The expressions of all NMDA receptor subunits decreased in hypoxia group and increased in the $TGF-{\beta}1$-treated group except NR2C. Conclusion : The administration of $TGF-{\beta}1$ could significantly protect against perinatal HI brain injury via some parts of the NO-mediated or excitotoxic mechanism.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.6
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• pp.291-298
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• 2018

Purpose: The purpose of this study was to identify the effects of Problem-Based Learning on Academic Resilience, Learning Flow, and Academic Motivation in nursing students. Methods: Research design was a non-equivalent control group pretest-posttest design. The participants were 121 sophomore nursing students from two universities. They were divided into the Problem-Based Learning group (n=61) and Lecture-Based Learning group (n=60). The data were analyzed by Chi-square, paired t-test, and independent t-test. Results: In the PBL group, there was statistically significant improvement in Academic Resilience after intervention (pretest $3.88{\pm}.36$, posttest $4.00{\pm}.38$, p<.001). However, no statistically significant difference was found in the Lecture-Based Learning (LBL) group (pretest $3.86{\pm}.43$, posttest $3.93{\pm}.17$). In terms of Learning Flow, there was statistically significant improvement in the PBL group (pretest $3.31{\pm}.41$, posttest $3.51{\pm}.42$). However, no significant change was identified in the LBL group (pretest $3.45{\pm}.42$, posttest $3.48{\pm}.47$. Academic motivation was improved in the LBL group (pretest $3.32{\pm}.30$, posttest $3.46{\pm}.32$, p=.002) as well as in the PBL group (pretest $3.26{\pm}.23$, posttest $3.47{\pm}.21$, p<.001). Both results were statistically significant. Conclusion: These results suggest that Problem-Based Learning could be more effective for nursing students in improving their academic achievement. Further studies need to be investigated.

• Korean Journal of Psychosomatic Medicine
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• v.11 no.2
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• pp.196-204
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• 2003

Objectives: It is known that sedative hypnotics would make cross tolerance with alcohol and deteriorate quality of sleep in alcoholics. Light therapy is effective non-pharmacological intervention for sleep disturbance in circadian phase disorders, jet-lag, shift-work and age-related sleep disorders. Authors would investigate the effects of morning light therapy on sleep of patients with alcohol dependence during recovery state without withdrawal symptoms. Methods: 13 patients with alcohol dependence who have not any alcohol withdrawal symptom were recruited. Light therapy during 1 hour in the morning had been administered by 2500 Lux light box through serial 3 days. Sleep state of subjects were assessed by sleep log and the subjective satisfaction at sleep was by 100 mm visual analogue scale. Sleepiness, depressive mood, anxiety were evaluated by 100mm visual analogue scale at 8 AM, 2 PM and 8 PM. For assessment of performance ability that would be associated with sleepiness and vigilance, trail making test A, B and digit symbol substitution test were performed by two times on base line and 4th day. Univariate repeated-measures ANOVAs were performed for each measures except performance tests which were analysed by paired t-test. Results: Sleep latency and sleep efficiency were significantly improved with light therapy and satisfaction at sleep was. There was no significant difference in sleepiness at 2 PM with light therapy but sleepiness at 8 AM significantly decreased and at 8 PM increased. The time to complete Trail making test and digit symbol substitution test were significantly shortened at 4th day compared with baseline. Fatigue at 8 AM were not significantly changed with light therapy but at 2 PM and 8 PM significantly decreased. Depressive mood and anxiety were not significantly changed with light therapy. Conclusion: Although this study had some limitations, it showed that light therapy would be effective modality on sleep disturbance of patients with alcohol dependence who have recovered from alcohol withdrawal symptoms. It is proposed that short term light therapy could be used clinically for alcoholics with insomnia. In the future, long term controlled studies using more objective tools for sleep are required to further investigate the effect of light therapy in alcoholics.

• The Korean Society of Law and Medicine
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• v.17 no.1
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• pp.107-135
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• 2016

Medical tour can be said to be a new high added-value tour industry of 21st century. The development of varied and distinguished medical tour products by each country will further vitalize the medical tour industry. As the interest in such medical tour increases, it is necessary to analyze the demand and interests of tourists accurately and prepare medical tour products to be provided in order to develop and promote medical tour products. The government considers the medical tour industry as an industry with high expected effects in job creation through promotion of experts in global healthcare industry and national economy development through high added-value creation, and has expanded aid policies in medical tour field with improvement of medical tour immigration system, one-stop service system for medical tourists, and medical tour labor force promotion system. Nevertheless, there are disputes between foreign patients and medical tour inviting businesses, along with medical accident disputes between foreign patients and medical staff and disputes with those working in the tourism industry. This article reviews the types of disputes occurring around the inviting businesses related to medical tours and tried to review the resolutions. Through this, it was found that medical tour inviting businesses have the responsibility to connect the mediated benefits and risks and also the responsibility to process the tasks. Thus, in case dispute occurs due to passive actions from establishing agency agreement to active mediation results, it is difficult to escape the liabilities. Also, in a medical tour agency contract, the inviting business must be aware that it bears the responsibility to explain and advise the details on benefits and risks to foreign patients. The "Guide to arbitration system for resolution of medical disputes with foreign patients" by Korea Health Industry Development Institute Act presents a method to resolve disputes according to the [laws on medical accident damage relief and medical dispute arbitration] in case a dispute due to medical accidents occurs to foreign patients when the foreign patients prepare diagnosis agreement, Whether such method is sufficient to protect foreign patients, however, is thought to require discussions from more diverse perspectives. In order to vitalize medical tourism, the development of diverse products is also important, but the countermeasures against related disputes should also be prepared. Such is expected to contribute to a greater advancement based on trust of foreign medical tourists alongside excellent medical technologies.

• Neonatal Medicine
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• v.16 no.2
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• pp.213-220
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• 2009

Purpose: Hearing loss is one of the common birth defects in humans, with a reported prevalence of 1-3 per 1000 newborns. We investigated the incidence of hearing loss and evaluated the use of neonatal hearing screening test in neonatal intensive care unit (NICU) graduates who are at greater risk for hearing loss than normal newborns. Methods: The neonates admitted to the NICU of Asan Medical Center from 1 March, 2003 to 30 March, 2008 who were available for follow-up were included. Those who failed the first auditory brainstem response prior to discharge were retested with the stapedial reflex test, auditory brainstem response and tympanometry in the Otolaryngology department. Results: Of 2,137 neonates, 2,000 (93.5%) neonates were tested prior to discharge. Sixty-seven neonates (3.4%) failed the first newborn hearing screening test. Of 67 infants, 52 infants were retested for a second hearing test. Excluding 10 infants (19.2%) who were lost during follow-up, 16 infants were confirmed to have hearing impairment of which 12 and 4 infants had unilateral and bilateral hearing loss, respectively. Of 16 infants, 5 did not meet the criteria set by the Korean National Health Insurance Corporation. Conclusion: The prevalence of hearing impairment in NICU graduates is about 0.8%, excluding those who were lost for follow up, necessitating a systemic and effective hearing assessment program among these high risk infants and more generous national insurance coverage.

• Korean Journal of Biological Psychiatry
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• v.14 no.2
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• pp.115-121
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• 2007

Objetives : Identification of target genes for ethanol in neurons is important for understanding its molecular and cellular mechanism of action and the neuropathological changes seen in alcoholics. The purpose of this study is to identify of altered gene expression after acute treatmet of ethanol in rat gliom cells. Methods : We used high density cDNA microarray chip to measure the expression patterns of multiple genes in cultured rat glioma cells. DNA microarrays allow for the simultaneous measurement of the expression of several hundreds of genes. Results : After comparing hybridized signals between control and ethanol treated groups, we found that treatment with ethanol increased the expression of 15 genes and decreased the expression of 12 genes. Upregulated genes included Orthodenticle(Drosophila) homolog 1, procollagen type II, adenosine A2a receptor, GATA bindning protein 2. Downregulated genes included diacylglycerol kinase beta, PRKC, Protein phosphatase 1, clathrin-associated protein 17, nucleoporin p58, proteasome. Conclusion : The gene changes noted were those related to the regulation of transcription, signal transduction, second messenger systems. modulation of ischemic brain injury, and neurodengeneration. Although some of the genes were previously known to be ethanol responsive, we have for the most part identified novel genes involved in the brain response to ethanol.

• Journal of agricultural medicine and community health
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• v.25 no.1
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• pp.113-131
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• 2000

Transtheoretical model of change has been proven very effective in explaining both the acquisition and cessation of many health related behaviors. The objectives of this study were to describe the distribution of smokers by stage of change of smoking, alcoholic drinking, and exercising in rural residents and to develope health promotion strategies. This study was done in Okchun County of Chungbuk Province. The representative sample were 892 residents over 30 years old. The questionnaires of interview included socio-demographic, the six stage distribution of smoking, alcoholic drinking, and exercising. In male, 50.6% of smokers were in the precontemplation stage, 32.5% in the contemplation. In female, corresponding figures were 60.6% and 28.8%. Precontemplation and contemplation stage of drinker were 72.8%, 19.3% in male and 80.3%, 15.5%. Distribution of exercise were 80.6%, 1.8% in male, 87.6%, 1.2% in female, respectively. The stage distribution of smoker, alcoholic drinker, and exerciser was shift to left of the distribution. And the stage distribution was slightly differ with each health behavior. The stage of change with smoking, drinking and exercising was correlated with each other but not concordant. So interventions in rural residents need to take into account the large proportion of precontemplators repeatedly observed among smoker, drinker, and non-exerciser. And intervention strategies of each risk behavior should be different approach. Result of concordance analysis suggest reconstruct validity of the transtheoretical model in our country due to ethnic and sociocultural difference. This results and theory should be tested in prospective intervention studies for seeking the possible gateway of health behavior.

• Korean Journal of Psychosomatic Medicine
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• v.27 no.1
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• pp.35-41
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• 2019

Objectives : Although delirium is a common complication among patients hospitalized in intensive care units(ICUs), little is known about the roles that diagnostic and therapeutic procedures play in its development. This study investigates the procedure-related risk factors of delirium in ICU patients. Methods : All the consecutive patients admitted to the ICU between June 2016 and May 2017 were routinely evaluated for delirium by psychiatrists. In total, 1156 patients met the inclusion criteria and were retrospectively analyzed. A multiple logistic regression analysis was conducted to investigate independent risk factors of delirium development while adjusting for other characteristics. Results : The age, Acute Physiology and Chronic Health Evaluation (APACHE II) score, proportion of patients who had undergone an operation, and proportion of patients who were foley catheterized, mechanically ventilated, and physically restrained were higher in the delirium group. The multiple logistic regression analysis confirmed that the use of restraint was an independent risk factor of delirium (odds ratio : 10.006 ; 95% confidence interval : 6.120-16.360 ; p<0.001). The patient factors independently associated with delirium were an advanced age and a higher APACHE II score. The incidence of delirium was 15.3%. Conclusions : There is a high prevalence of delirium influenced by potentially harmful procedures in patients in ICU settings. The use of physical restraint had the strongest association with the development of delirium. These findings advocate the need to target procedure-related risk factors such as the use of restraints as preventive intervention measures for ICU delirium.

• 한국노년학
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• v.28 no.4
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• pp.1041-1054
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• 2008

This study aimed to identify the severity and types of prostate symptom, to identify the relationship of prostate symptom, sleep quality and quality of life of the elderly in korea, so to provide basic data for developing nursing interventions for the elderly's prostate symptom management. This study used a descriptive correlational research design. The subjects of this study were 100 elderly men over 65yr in an urban city. Data were collected through personal interviews using questionnaires from September 2006 to March 2007. The IPPS, PSQI and SF-36-K were administered. The collected data were analyzed by descriptive statistics and Pearson's correlation. The major findings of this study were as follows: 1) 44% of the participants have moderate to severe Prostate symptom(IPSS>7). 2) Prostate symptom has positive relationship with sleep quality(r=.272, p=.006) and negative relationship with health related quality of life(r=-.197, p=.049). The results of this study indicate that prostate symptom is related to sleep quality and quality of life. So it is necessary to give information to the elderly about the effective coping method of prostate symptom and about the life style which have positive effect to prostate symptom.