• Journal of Preventive Medicine and Public Health
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• v.26 no.3 s.43
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• pp.400-411
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• 1993

The aim of this study is to analyze the variations among hospitals and hospital groups in resource use and procedures of diagnostic and therapeutic process, such as laboratory tests, radiologic examinations, tissue diagnosis, timing of surgery after admission, the time required for operation. The study was performed for five procedures including cesarean section (C/S), appendectomy, cholecystectomy, cataract extraction, and pediatric pneumonia. The 2,316 subjects were selected from medical insurance claims list, and from this list 413 cases were sampled for medical record review. The patterns of resource utilization and process of treatment were described according to hospitals and characteristics of hospital groups. The major results were as follows : 1. The numbers of laboratory and radiologic tests showed significant difference among hospitals and hospital groups. In case of hospital groups, we could find tendencies of more tests with increasing hospital bed size. 2. In general, the proportion of operative cases evaluated by tissue diagnosis postoperatively among all operations ranged from 28.3% to 100%. The proportion varied among hospital groups, of which general hospital A group(more than 15 specialty) showed the highest proportion. 3. Post-admission delay until operation and the time required for operative procedure were not invariable among hospitals and hospital groups. The duration of operation in tertiary hospitals was slightly shorter than general hospitals, with varying statistical significance. We could find that probably there were differences of quality among hospitals in some components of procedures, which suggested that the implementation of quality assurance activities would be mandatory. In this study, we simply described the patterns of resource utilization and some features of clinical process, with institution of the need for advanced studies with in-depth analyses for each component of diagnosis and treatment procedures.

• Journal of Preventive Medicine and Public Health
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• v.40 no.3
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• pp.197-204
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• 2007

Objectives : This study was conducted to evaluate the public's awareness of the importance of hand washing and to compare perceptions on the habit of hand washing with actual hand washing behavior. Methods : Data were collected by observing 2,800 participants washing their hands after using public restrooms in seven cities nationwide and by surveying 1,000 respondents (age > 14 years) through telephone interviews using a structured questionnaire. Results : Although 94% of the survey respondents claimed to mostly or always wash their hands after using public restrooms, only 63.4% of the observed participants did wash their hands after using public restrooms. Significant factors related to increased adherence to hand washing were female gender, approximate ages of 20 to 39 years by their appearance, and the presence of other people from the observation. About 79% of the survey respondents always washed their hands after using bathrooms at home, 73% washed their hands before handling food, and 67% washed their hands upon returning to their home. However, 93.2% and 86.3% of the survey respondents did not wash their hands after coughing or sneezing and after handling money, respectively. Although most of the survey respondents (77.6%) were aware that hand washing is helpful in preventing communicable diseases, 39.6% of the survey respondents did not do so because they were 'not accustomed' to washing their hands and 30.2% thought that washing their hands is 'annoying'. Conclusions : This is the first comprehensive report on hand washing behavior and awareness of the general population in Korea. The result of this study in terms of individual behavior and awareness of hand washing are comparable with similar studies conducted in other countries. However adherence to hand washing is still low and needs to be increased. The results of this study can be used as a baseline in setting up strategies and activities to promote adherence to hand washing.

• Journal of the Korean Society of Radiology
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• v.11 no.3
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• pp.153-159
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• 2017

Chronic kidney disease can be treated if it is detected early, but as the disease progresses, it becomes impossible to recover. Finally, renal replacement therapy such as transplantation or dialysis should be used. Ultrasonography is used to diagnose kidney cancer, inflammatory disease, nodular disease, and chronic kidney disease. It is used to identify information about degree of inflammation using information such as kidney size, internal echo characteristics. Currently, the degree of disease in the clinic uses the value of glomerular filtration rate. However, even in ultrasound, changes in the degree of inflammation and disease can be observed. In this study, we used ultrasound images to quantify the changes in brightness, size, cortex, and subclinical changes of the kidney with progression of the disease, and compared them with the glomerular filtration rate used in clinical practice. In 105 cases, we performed 35 cases of normal kidney, 35 cases of early kidney disease, and 35 cases of terminal kidney. The brightness of the cortex of the image was obtained and the difference in brightness between the cortex and the proximal portion was obtained by the slope. The graph of the portion which was not smooth due to the ultrasonic characteristics was used as the function regrass. The size reduction was obtained from the original data. The results were as follows: It was proportional to the glomerular filtration rate. It is considered that the algorithm can be applied to the disease if the algorithm study continues.

• The Korean Journal of Nuclear Medicine
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• v.31 no.1
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• pp.83-89
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• 1997

About one-third of radiologically indeterminate solitary pulmonary nodules (SPN) are eventually turned out to be malignant. It is very important to noninvasively determine whether the SPN is malignant or not for the decision of its way of management. PET imaging is highlighted by its unique ability of imaging the function and metabolism of cells. Glucose metabolism is increased in malignant transformed cells. We peformed FDG-PET studies in patients who had radiologically indeterminate SPN and compared the findings with histologic diagnoses to assess the diagnostic accuracy in the detection of malignancy and to decide which parameter is the most suitable for clinical practice among peak SUV (pSUV), average SUV (aSUV), 50/10 ratio, and time-activity curve (TAC), Thirty patients were included in this study and the most useful parameter was pSUV. The sensitivity and specificity in the detection of malignant SPN using 3.5 as a cut off pSUV were both 87%. Interestingly, all 2 false-negative cases were bronch-ioloalveolar carcinoma on histologic examination. If these cases, which could be strongly suspected by CT findings, were excluded, the sensitivity of pSUV was 100%. In conclusion, PET imaging is very helpful for determining malignancy in indeterminate SPN and pSUV is a conveniently measurable parameter which is valuable for interpretation.

• Journal of Hospice and Palliative Care
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• v.12 no.3
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• pp.115-121
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• 2009

Despite a recent increased nation's attention given to improving end-life care, we professionals need to be more critical and reflective on our realities surrounding hospice palliative care. The aim of this paper is to suggest that palliative care models can be used for patients/families in the last phase of life and examine whether they are appropriate for caring them in congruence with philosophy of hospice. The hospice experience model (HEM) of Eagan & Labyak and the developmental model of Byock are introduced and examined for their congruence with philosophy of hospice in applying to clinical practice. The HEM as a patient/family value-directed end of life care model emphasizes three principles; unique experience of patient/family, interactions/relationships among multiple dimensions of personhood and between family, and personal growth and development in the face of suffering through a life-completion. The developmental model stipulates dying as the last stage of living, a stage of life cycle in which patients/family may have growth through life-completion in multidimensional relationships of personhood. The model includes the developmental landmarks and tasks for life-completion as the framework to guide a means of professionals' to recognize their opportunity to grow. The landmarks and tasks include worldly and social affair, individual relationships, intrapersonal, and transcendent dimension. The models could work as appropriate palliative care models for patients/families in the last stage of living. The professionals need to be encouraged to apply the models to end of life care setting.

• The Korean Journal of Nuclear Medicine Technology
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• v.18 no.1
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• pp.158-162
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• 2014

Purpose: Reference material (RM) is defined as material that is safe and homogeneous enough about specified characteristic that is made with a purpose of using test of measurement or nominal characteristic. Certified reference material (CRM), which is issued by authorized organization, is defined as reference material that provides characteristic value, link uncertainty and retroactivity. The purpose of this paper was to evaluate recovery of radioimmunoassay by Certified Reference Material enclosed with a certificate and therefore to enhance reliability of test. Materials and Methods: WHO certified reference material is purchased from NIBSC (National Institute for Biological Standard and Control, United Kingdom) and made of 3 levels that are C-1 (low concentration), C-2 (medium concentration) and C-3 (high concentration) and measured for kit at the Seoul National University Hospital. Recovery rate is evaluated after measurement at four different days. Results: Recovery rate results using WHO certified reference material are T4 90%, Ferritin 88%, PSA 94%, Prolactin 99%, AFP 94% and TSH 93%. Conclusion: A procedure that appropriate accuracy, precision, specificity, sensitivity, reproducibility, and validate on the subject of kit for radioimmunoassay is essential. Recovery rate assay as extraction efficiency of analysis process is percent about already measuring results of analysis result after all measuring process. This is very important assessment standards of performance evaluation of immunoassay kit. Recovery rate results of 6 type used WHO CRM are satisfactory to 88~99%. This demonstrates that the radioimmunoassay is a very accurate measurement, which is very effectively utilized in clinical practice.

• The Korean Journal of Pain
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• v.12 no.1
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• pp.36-42
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• 1999

Background: The current maximal recommended doses of lidocaine are 7 mg/kg with $5\;{\mu}g/ml$ of epinephrine. But in clinical practice, sometimes more doses of lidocaine are required to produce adequate regional anesthesia. Method: Twenty-two healthy women patients were divided into two groups and pretreated with valium 5 mg p.o., morphine 5 mg i.m., and midazolam 2 mg i.v. before operation. Of these, 7 mg/kg of 2% lidocaine with $5\;{\mu}g/ml$ of epinephrine were given to 11 patients epidurally. Initial 3 ml of epinephrine mixed lidocaine was given as a test dose and remaining doses were given 5 ml/30 sec with 3 min intervals. Radial arterial blood were drawn at 5, 10, 15, 20, 30, 45, 60, 90, 120 min to measure plasma lidocaine concentrations. After confirming all of the peak plasma concentrations of 7 mg/kg lidocaine were absolutely under $5\;{\mu}g/ml$, the other 11 patients were given 10 mg/kg of 2% lidocaine with $5\;{\mu}g/ml$ of epinephrine epidurally and blood samplings were taken according to the same method of 7 mg/kg group. The peak plasma concentration ($C_{max}$), time to reach to $C_{max}$ ($T_{max}$), time to reach to $T_4$, maximal sensory block level, systemic toxicity, and vital sign changes were investigated. Result: $C_{max}$ was significantly higher in 10 mg/kg group ($5.1{\pm}1.3\;{\mu}g/ml$) than 7 mg/kg group($3.3{\pm}0.5\;{\mu}g/ml$), but $T_{max}$ ($10.5{\pm}2.7$ min vs $10.9{\pm}3.1$ min) was not different. Time to reach $T_4$ was significantly shorter in 10 mg/kg group ($9.5{\pm}2.7$ min) than 7 mg/kg group ($12.7{\pm}3.2$ min) but maximal sensory block level ($T_{3.7{\pm}0.7}$ vs $T_{2.7{\pm}1.0}$) was not different. In four patients of 10 mg/kg group, peak plasma concentrations exceeded $5\;{\mu}g/ml$, but no systemic toxicities appeared. No significant vital sign changes were observed. Conclusion: The current maximal recommended doses of lidocaine, merely based on body weight are not always appropriate. Further studies are needed to determine more precise guideline of maximal doses that include various pharmacokinetic components.

• Journal of Korean society of Dental Hygiene
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• v.9 no.2
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• pp.111-124
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• 2009

This study analyzes through the review of literature and laws the exposure time, clinical frequency, and radiation exposure of intraoral and extraoral radiography as well as of panoramic radiography performed by dental hygienists in dental clinics, compares the dental radiology curriculums of radiological science and dental hygiene departments, and proposes the expansion of dental hygienists' radiography operations. The radiology curriculums were compared between the radiological science and dental hygiene departments of colleges. For new analysis by radiography for dental diagnosis, the exposure time, radiation absorbed dose, effective dose, and number of days of natural radiation were compared by the type of oral radiation films and radiographical techniques proposed by domestic and international studies. The exposure time of panoramic radiography is 15 seconds and it takes about two minutes for completion, whereas the exposure time of the standard radiography is 0.2~0.8 seconds and it takes 10 times longer for completion of the radiography of full mouth than the panoramic radiography. The standard radiography can cause distortions of radiation at severely curved parts of dental arch and palatopharyngeal reflex. However, panoramic radiography can be performed even for lock jaw patients, causes less inconvenience to patients and is much simpler than the standard radiography. The percentage of dental clinics where radiography is performed by dental hygienists was 92.0%, and the percentage of standard film radiography by dental hygienists was 98% whereas the percentage of panoramic radiography by dental hygienists was 92%. For the absorbed dose which is an indicator of radiation exposure, the When the effective dose which is an indicator of the danger of radiation exposure was converted to the number of days of natural radiation, it was 3.3 days for panoramic radiography, but 13.9 days for the full mouth standard radiography by bisecting angle technique which was 4.2 times longer than the panoramic radiography. There were two colleges that had a dental radiology course with two credits in the departments of radiological science. The credits for dental radiology courses in the department of dental hygiene ranged varied by college, ranging from 3 to 8; on average, the theory course was 2.2 credits and the practice course was 2.02 credits. To summarize the above results, the percentage of dental clinics where panoramic radiography is performed by dental hygienists under the guidance of dentists is high. Panoramic radiography has become an essential facility for dental clinics. It is faster than standard film radiography and less dangerous due to low radiation exposure. Panoramic radiography is a simple mechanical job that does not require training of oral radiography by radiotechnologist. Because panoramic radiography is one of major operations which must be performed at all times in dental clinics, it must be designated as intraoral technique rather than extraoral technique, or legalized for inclusion in the scope of operations of dental hygienists.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.8
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• pp.5492-5500
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• 2015

Low-density lipoprotein cholesterol (LDL-C) is a major modifiable risk factor for cardio- cerebrovascular disease. In clinical practice, however, it is primarily calculated using the Friedewald formula as a cost-effective method. The aim of this study was to compare Friedewald-estimated and directly measured LDL-C values and assess the concordance in guideline LDL-C risk classification between the two methods. The data were derived from the 2009 and 2010 Korea National Health and Nutrition Survey (KNHANES). Analysis was done for 4,319 subjects with lipid panels-total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), directly measured LDL-C using an enzymatic homogeneous assay, and triglycerides (TG). For subjects with TG lower than 400 mg/dL, Friedewald-estimated and directly measured LDL-C were highly correlated (r = 0.958, p < 0.001) and overall concordance was 82.7%. As TG increased, overall concordance decreased. Overall concordance was 85.4% at TG lower than 150 mg/dL; 78.2% at TG of 150-199 mg/dL; and 71.4% at TG of 200-399 mg/dL. The Friedewld equation tended to overestimate LDL-C when TG are of < 150 mg/dL; however, underestimate LDL-C when TG are of ${\geq}150mg/dL$. As a result, Friedewald estimation misclassified 382 subjects (9.1%) in a higher category versus 348 subjects (8.3%) in a lower category. Our findings suggest that overestimation of LDL-C by the Friedewald formula can be a great problem as well as underestimation.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.5
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• pp.2267-2277
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• 2012

The purpose of this study was to evaluate the effects of 7 minutes a day, 3 times a week, for 4 weeks of abdominal meridian massage with aroma oils (AMMAO) by Volunteers on the relief of constipation among hospitalized disability patients with brain lesions. One group pretest-posttest quasi experimental research design was used. Subjects were 38 hospitalized disability patients with brain lesions. Data were collected from May 9 to June 19, 2011. Frequencies, mean, standard deviation and Repeated Measures ANOVA with SPSS 19.0 were used to evaluate the effects of AMMAO. The results were as follows; 1. There were significant difference noted in the amount of defecation(F=3.56, p=.033) by time. 2. There were no significant difference was noted in the frequency of defecation, the frequency of suppository or enema application by time. Accordingly, it is concluded that AMMAO would be an effective nursing intervention in relief of constipation among hospitalized disability patients with brain lesions. Therefore it is recommended that AMMAO be used in clinical practice as an effective nursing intervention for hospitalized disability patients with brain lesions.