• Journal of Home Health Care Nursing
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• v.6
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• pp.33-45
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• 1999

The purpose of this study was to develop a basic framework and criteria for evaluation of quality care provided to patients with the attributes of disease in the home care nursing field, and to provide measurement tools for home health care in the future. The study design was a developmental study for evaluation of hospital-based HCN(home care nursing) in Korea. The study process was as follows: a home care nursing study team of College of Nursing. Yonsei University reviewed the nursing records of 47 patients who were enrolled at Yonsei University Medical Center Home Care Center in March, 1995. Twenty-five patients were insured at that time, were selected from 47 patients receiving home care service for study feasibility with six disease groups; Caesarean Section (C/S), simple nephrectomy, Liver cirrhosis(LC), chronic obstructive pulmonary disease(COPD), Lung cancer or cerebrovascular accident(CVA). In this study, the following items were selected : First step : Preliminary study 1. Criteria and items were selected on the basis of related literature on each disease area. 2. Items were identified by home care nurses. 3. A physician in charge reviewed the criteria and content of selected items. 4. Items were revised through preliminary study offered to both HCN patients and discharged patients from the home care center. Second step : Pretest 1. To verify the content of the items, a pretest was conducted with 18 patients of which there were three patients in each of the six selected disease groups. Third step : Test of reliability and validity of tools 1. Using the collected data from 25 patients with either cis, Simple nephrectomy, LC, COPD, Lung cancer, or CVA. the final items were revised through a panel discussion among experts in medical care who were researchers, doctors, or nurses. 2. Reliability and validity of the completed tool were verified with both inpatients and HCN patients in each of field for researches. The study results are as follows: 1. Standard for discharge with HCN referral The referral standard for home care, which included criteria for discharge with HCN referral and criteria leaving the hospital were established. These were developed through content analysis from the results of an open-ended questionnaire to related doctors concerning characteristic for discharge with HCN referral for each of the disease groups. The final criteria was decided by discussion among the researchers. 2. Instrument for measurement of health statusPatient health status was measured pre and post home care by direct observation and interview with an open-ended questionnaire which consisted of 61 items based on Gorden's nursing diagnosis classification. These included seven items on health knowledge and health management, eight items on nutrition and metabolism, three items on elimination, five items on activity and exercise, seven items on perception and cognition, three items on sleep and rest, three items on self-perception, three items on role and interpersonal relations, five items on sexuality and reproduction, five items on coping and stress, four items on value and religion, three items on family. and three items on facilities and environment. 3. Instrument for measurement of self-care The instrument for self-care measurement was classified with scales according to the attributes of the disease. Each scale measured understanding level and practice level by a Yes or No scale. Understanding level was measured by interview but practice level was measured by both observation and interview. Items for self-care measurement included 14 for patients with a CVA, five for women who had a cis, ten for patients with lung cancer, 12 for patients with COPD, five for patients with a simple nephrectomy, and 11 for patients with LC. 4. Record for follow-up management This included (1) OPD visit sheet, (2) ER visit form, (3) complications problem form, (4) readmission sheet. and (5) visit note for others medical centers which included visit date, reason for visit, patient name, caregivers, sex, age, time and cost required for visit, and traffic expenses, that is, there were open-end items that investigated OPD visits, emergency room visits, the problem and solution of complications, readmissions and visits to other medical institution to measure health problems and expenditures during the follow up period. 5. Instrument to measure patients satisfaction The satisfaction measurement instrument by Reisseer(1975) was referred to for the development of a tool to measure patient home care satisfaction. The instrument was an open-ended questionnaire which consisted of 11 domains; treatment, nursing care, information, time consumption, accessibility, rapidity, treatment skill, service relevance, attitude, satisfaction factors, dissatisfaction factors, overall satisfaction about nursing care, and others. In conclusion, Five evaluation instruments were developed for home care nursing. These were (1)standard for discharge with HCN referral. (2)instrument for measurement of health status, (3)instrument for measurement of self-care. (4)record for follow-up management, and (5)instrument to measure patient satisfaction. Also, the five instruments can be used to evaluate the effectiveness of the service to assure quality. Further research is needed to increase the reliability and validity of instrument through a community-based HCN evaluation.

• Tuberculosis and Respiratory Diseases
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• v.55 no.1
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• pp.59-68
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• 2003

Background : In intubated patients, cultures of endotracheal aspirates (EA) are apt to contamination throughout the endotracheal tube. Therefore, the identification of etiologic agents via conventional EA cultures is not always reliable. In order to differentiate a pulmonary infection from a non-infectious disease, and to identify the true etiologic agent of acute pulmonary infection, blinded protected specimen brushing (PSB) was used, and its efficacy evaluated. Methods : In 51 intubated patients, with suspected pneumonia, blind PSB were performed, and the results compared with blood and EA cultures. A protected specimen brush was introduced through the endotracheal tube, and settled at the affected large bronchus. A specimen brush was introduced to the expected region using the blind method. The tip of the brush was introduced with an aseptic technique after vigorously mixed for 1 minute in $1cm^3$ of Ringer's lactate solution. The specimens were submitted for quantitative culture within 15 minutes, with a culture being regarded as positive if the colony forming units were above $10^3/ml$. Results : Of the 51 patients, 15 (29.4%) had community-acquired pneumonia (CAP), 27 (52.9%) hospital-acquired pneumonia (HAP) and 9 (17.6%) non-infectious diseases. The sensitivity and specificity of the quantitative PSB culture for the diagnosis of pneumonia were 52.4 and 88.9%, respectively. The sensitivity and specificity of EA were 78.6 and 77.8%, respectively. The blind PSB was superior to the EA for the identification of true etiologic agents. Of 53 episodes of 27 HAP patients, MRSA (Methicillin-resistant staphylococcus aureus) (41.5%) was the most common causative agent followed by Pseudomonas aeruginosa (15.1%), Klebsiella sp. (7.5%) and Acinetobacter sp. (7.5%). Conclusions : As a simple, non-invasive diagnostic modality, the blind PSB is a useful method for the differentiation of a pulmonary infection from non-infectious diseases and to identify the etiologic agents in intubated patients. A blind PSB can be performed without bronchoscopy, so is safer, more convenient and cost-effectiveness for patients where bronchoscopy can not be performed.

• Journal of the Korean Society of Radiology
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• v.5 no.2
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• pp.73-80
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• 2011

Questionnaires were distributed to Radiology departments at hospitals with 300 sickbeds throughout the Pohang region of North Gyeongsang Province concerning awareness and performance levels of infection control. The investigation included measurements of the pollution levels of imaging equipment and assistive apparatuses in order to prepare a plan for the activation of prevention and management of hospital infections. The survey was designed to question respondents in regards to personal data, infection management prevention education, and infection management guidelines. The ATP Public Heath Monitering System was used to measure seven items for pollution levels of imaging equipment and assistive apparatuses in the Radiology Department. Data was analysed using SPSS version 12.0 for paired t-test and Pearson coefficient with a statistically significant level of 0.05. The results of the survey showed a total awareness level of infection management prevention education averaged at $3.73{\pm}0.64$ and performance levels resulted at $3.39{\pm}0.83$ which were statistically significant (p = 0.01). Also the measurements of pollution levels for equipment with high patient contact showed a Pearson Coefficient of over 0.5 implying a focus on pathogenic bacterium. There was no statistical significance with the frequency of imaging (p < 0.05). Therefore for general hospitals with high patient contact, there is a need to supply analyzing equipment for real time monitoring and the implementation of disinfection management that uses a Ministry of Health and Welfare approved antiseptic solution twice every minute.

• Journal of the Korean Society of Radiology
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• v.14 no.5
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• pp.669-676
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• 2020

The purpose of this study was to analyze the changes in the values of Hounsfield Unit (HU) according to the changes in monoenergy (keV) and dilution ratio of the contrast agent, using the spectral CT. Spectral CT was used as the testing device, while 20 cc syringe phantom was used to set a total of six dilution ratios of the contrast agent: 8:2, 7:3, 6:4, 5:5, 4:6, and 3:7. Here, the non-ionic iodine solution (350 mg/ml) was used as a contrast agent. The syringe axial image was reconstructed by adjusting the obtained data on nine MonoE levels; 40 keV, 45 keV, 50 keV, 55 keV, 60 keV, 65 keV, 70 keV, 75 keV, and 80 keV. The HU values were measured at the three points of the reconstructed syringe axial image. The measurements were taken 1,620 times in total. In the analysis of the HU values according to the changes in keV and dilution ratio of the contrast agent, the highest and lowest HU values were obtained from dilution ratio 8:2 and dilution ratio 3:7, respectively, across every MonoE in the comparison of HU according to dilution ratio per MonoE (p<0.05), while the highest and lowest HU values were obtained from 40 keV and 80 keV, respectively, across all dilution ratios in the comparison of HU according to MonoE per dilution ratio (p<0.05). For the correlation per each parameter, a negative correlation of -15.014 ± 0.298 was found for HU per keV (R²=0.519) and a negative correlation of -61.372 ± 3.608 was found for HU per dilution ratio (R²=0.152) (p<0.05). To conclude, an increase in keV or dilution ratio of the contrast agent was shown to decrease the HU, and the findings in this study are anticipated to serve as the basic data in the research of HU-related parameters in Spectral CT.

• The Korean Journal of Pharmacology
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• v.32 no.1
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• pp.67-74
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• 1996

Cholecystokinin octapeptide (CCK-8), acetylcholine (ACh) and KCl caused a dose dependent contraction in muscle cells enzymatically digested from cat gallbladder. Maximal contraction was obtained at concentration of $10^{-9}M$ for CCK-8, $10^{-5}M$ for ACh and 20mM for KCl. CCK-8 induced contraction was unaffected in calcium free physiological salt solution (PSS) and was completely blocked by strontium substitution for calcium (p<0.001). In contrast, KCl evoked contraction was blocked in calcium free PSS (p<0.01) but was unaffected by strontium replacement of calcium. The contraction elicited by ACh was only slightly reduced in calcium free PSS (p<0.05) and was unaltered by strontium. Muscle cells permeabilized with saponin contracted in response to inositol 1,4.5-trisphosphate $(IP_3)$ and CCK-8. The contraction was blocked by the calmodulin antagonist CGS 9343B (p<0.001), whereas heparin completely blocked the effect of $IP_3$ (p<0.001). The protein kinase C (PKC) antagonist H7 had no effect on either agonist. We conclude that CCK-8 induced gallbladder muscle contraction is mediated by $IP_3$ dependent intracellular calcium release from intracellular stores and a calmodulin dependent pathway; ACh may utilize both extracellular and intracellular calcium. KCl causes muscle contracrion through influx of extracellular calcium and a calmodulin independent machanism.

• Journal of the Korean Society of Radiology
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• v.10 no.8
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• pp.619-627
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• 2016

The purpose of this study is to investigate the effect of CT contrast agent and MRI contrast agent on the area dose in the body when using automatic exposure control system in general radiography. After making rectangular holes in the center of the abdominal thickness paraffin phantom, CT contrast agent and MRI contrast agent were respectively diluted with physiological saline solution for contrast medium dilution ratio of 10:0, 9:1, 8:2, 7:3, 6:4, 5:5, 4:6, 3:7, 2:8, 1:9, 0:10%. Each experiment was set to 78 kVp, 320 mA, which is the proper condition for KUB photography, and thereafter a total of 30 inspections were made for each dilution ratio using an automatic exposure control device, and the area dose corresponding to the dilution ratio of each contrast agent, Average comparison and correlation analysis were performed on the exposure index. As a result, the CT contrast agent and the MRI contrast agent appeared different in area dose according to the dilution ratio(p<0.05), and as the dilution ratio increased, the area dose increased for CT contrast agent and MRI contrast agent(P<0.05). In each test, the exposure index showed the manufacturer's recommendation of 200-800 EI value, and the exposure index and area dose increased as the area dose increased(p<0.05). In conclusion, CT contrast agent and MRI contrast agent confirmed to increase the area dose by general imaging test using all automatic exposure control device. Therefore, it is considered that it is necessary to perform it after the contrast medium has been excreted sufficiently when using usual imaging test after using the contrast agent in CT and MRI examination.

• The Korean Journal of Nuclear Medicine Technology
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• v.18 no.1
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• pp.62-68
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• 2014

Purpose: After I-131 therapy, SPECT/CT is useful in identifying location of thyroid remnants and metastasis of thyroid cancers. An excessive uptake of thyroid leads to a ringing artifact in the SPECT images. The aim of this study is to investigate and suggest a proper post filters to remove ringing artifact and produce better image quality. Materials and Methods: A low-cost, customized thyroid-mimicking phantom, consisting of an acrylic bottle and a hollow sphere was used for SPECT/CT Discovery (GE Healthcare, USA). It was filled with I-131 solution. The ratio of hollow sphere to background were varied as 50:1, 200:1, 1000:1 and 4000:1. Acquired images were reconstructed by OSEM (2 iterations, 10 subsets) with and without Evolution (resolution recovery correction, GE). Three different post-filters were applied; Butterworth (cut off: 0.38 to 0.58 with intervals of 0.05), Hanning (cut off: 0.8 to 1 with intervals of 0.05) and Gaussian (FWHM: 3 to 5 with intervals of 0.5) filters. Contrast, background variability, air area variability, and full width half maximum (FWHM) were compared. Results: Higher contrasts were obtained from the SPECT images with Evolution than without Evolution. In the case of images without Evolution, image distortion such as star artifact was generated. For all sphere-to-background ratio, the Butterworth filter showed better constrasts and FWHMs than other two filters, but the ringing artifact was still generated in all studies except 50:1 and it was decreased as cutoff value was increased. The ringing artifact didn't appear with Hanning and Gaussian filters at all studies, however constrats and FWHMs with Gaussian was worse than Hanning filter. For the images having ringing artifacts, the background variability and air area variability were increased. Conclusion: In this study, we suggested that it is desirable to use Hanning filter when the ringing artifact is generated and to use Butterworth filter when ringing artifact is not generated in I-131 SPECT.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.23 no.1
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• pp.34-40
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• 2014

There are several treatment options for rehabilitation of partial edentulism including the use of conventional or implant-retained fixed prostheses. However, such prosthetic options cannot always be possible because of compromised general and oral health (i.e. loss of supporting tissues, medical reasons, extensive surgical protocol and osseointegration failure of dental implant) as well as the affordability of patients. In some cases, removable partial denture provides easier access for oral hygiene procedures and the ability to correct discrepancies in dental arch relationships than implant fixed prosthesis. Recently, Implant Supported Removable Partial Denture (ISRPD) where to place dental implant in strategic position has been suggested to improve the limitation and shortcomings of conventional RPD. ISPRD can overcome mechanical limition of conventional RPD by placing implant in a favorable position and can be cost-effective, prosthetic solution for partially edentulous patients who are not immediate candidates for extensive, fixed implant supported restorations. Incorporation of dental implants to improve the RPD support and retention and to enhance patient acceptance should be considered when treatment planning for RPD. In this case, 59 years old male patient who received dental treatment of implant fixed prosthesis on both side of the upper jaw and implant overdenture on lower jaw showed implant abutment screw fracture on #15i and osseointegration failure on multiple number of implants. After removing failed implants, we planned ISRPD using #15i,24i,25i,26i and #23 natural tooth for RPD abutment. We fabricated #23 surveyed crown,#24i=25i=26i surveyed bridge and #15i gold coping for support,retention and stability for RPD. Periodic follow up check for 2years has been performed since the ISRPD delivery to the patient. No sign of screw loosening, fracture or bone resorption around abutment implants were detected.

• Journal of Chest Surgery
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• v.39 no.7 s.264
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• pp.511-519
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• 2006

Background: Loss of cardiomyocytes in the myocardial infarction leads to regional contractile dysfunction, and necrotized cardiomyocytes in infracted ventricular tissues are progressively replaced by fibroblasts forming scar tissue. Although cardiomyoplasty, or implantation of ventricular assist device or artificial heart was tried in refractory heart failure, the cardiac transplantation was the only therapeutic modality because these other therapeutic strategies were not permanent. Cell transplantation is tried instead of cardiac transplantation, especially bone marrow is the most popular donated organ. But because bone marrow aspiration procedure is invasive and painful, and it had the fewer amounts of cellular population, the adipose tissue is recommended for harvesting of mesenchymal stem cells. Material and Method: After adipose tissues were extracted from abdominal subcutaneous adipose tissue and intra-abdominal adipose tissue individually, the cellular components were obtained by same method. These cellular components were tried to transformation with the various titers of 5-azacytidine to descript the appropriate concentration of 5-azacytidine and possibility of transformation ability of adipose tissue. Group 1 is abdominal subcutaneous adipose tissue and Group 2 is intra-abdominal adipose tissue-retroperitoneal adipose tissue and omentum. Cellular components were extracted by collagenase and $NH_4Cl$ et al, and these components were cultured by non-induction media - DMEM media containing 10% FBS and inducted by none, $3{\mu}mol/L,\;6{\mu}mol/L,\;and\;9{\mu}mol/L$ 5-azacytidine after the 1st and 2nd subculture. After 4 weeks incubation, tile cell blocks were made, immunostaining was done with the antibodies of CD34, heavy myosin chain, troponin T, and SMA. Result: Immunostaining of the transformed cells for troponin T was positive in the $6{\mu}mol/L\;&\;9{\mu}mol/L$ 5-azacytidine of Group 1 & 2, but CD34 and heavy myosin chain antibodies were negative and SMA antibody was positive in the $3{\mu}mol/L\;&\;6{\mu}mol/L$ 5-azacytidne of Group 2. Conclusion: These observations confirm that adult mesenchymal stem cells isolated from the abdominal subcutaneous adipose tissues and intra-abdominal adipose tissues can be chemically transformed into cardiomyocytes. This can potentially be a source of autologous cells for myocardial repair.

• Investigative Magnetic Resonance Imaging
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• v.10 no.1
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• pp.20-25
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• 2006

Purpose : To evaluate the NMR relaxation properties of newly developed high performance paramagnetic complexes. Materials and methods : 4-aminomethylcyclohexane carboxylic acid (0.63g, 4 mmol) was mixed with the suspension solution of DMF (15mL) and DTPA-bis-anhydride (0.71g, 2 mmol) to synthesize the ligand. The ligand was then mixed with Gd2O3 (0.18g, 0.5 mmol) to synthesize Gd-chelate. For the measurement of magnetic relaxivity of paramagnetic compounds, the compounds were diluted to 1mM and then the relaxation times were measured at 1.5T(64 MHz). Inversion-recovery pulse sequence was employed for T1 relaxation measurement and CPMG(Carr-Purcell-Meiboon-Gill) pulse sequence was employed for T2 relaxation measurement. Using MATLAB(Version 7.1) program, T1 magnetic relaxation map, R1 map, T2 magnetic relaxation map and R2 map were developed to represent magnetic relaxation time and magnetic relaxivity as image. Results : Compared to $R1=4.9mM^{-1}sec^{-1}$ and $R2=4.8mM^{-1}sec^{-1}$ of Omniscan (Gadodiamide), which is commercially available paramagnetic MR agent, R1 of SUK090(Gd-C32H74N5O24) was $12.46mM^{-1}sec^{-1}$ and R1 of SUK091(Gd-C34H78N5O24) was $12.77mM^{-1}sec^{-1}$. However, R1 of SUK092(Gd-C30H56N5O17) was decreased to $2.09mM^{-1}sec^{-1}$. In case of R2, SUK090(Gd-C32H74N5O24) was $8.76mM^{-1}sec^{-1}$ and SUK091(Gd-C34H78N5O24) was $7.60mM^{-}1sec^{-1}$ whereas SUK092(Gd-C30H56N5O17) was decreased to $1.82mM^{-1}sec^{-1}$. Conclusion : Among three new paramagnetic complexes, SUK090(Gd-C32H74N5O24) and SUK091(Gd-C34H78N5O24) showed higher T1, T2 magnetic relaxation rates than that of commercially available paramagnetic MR agent and thus expected to have more contrast enhancement effect.