• Journal of Korean Academy of Nursing
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• v.13 no.2
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• pp.22-43
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• 1983

1. Need for and Purpose of the Study. There is an increasing demand for curriculum improvement of the Korean Army Nursing Academy (KANA), since it was upgraded into 4-year institution of higher learning from 3-year one. In particular, it is strongly advocated that the KANA needs the outside expertise for its curriculum improvement-namely not only from the internal military view of points but also from the viewpoints of professional educational society, In line with such a necessity for the study, this study was aimed at 1) analyzing the current actual practices of KANA'S curriculum, 2) investigating the desired practices of KANA'S curriculum, and 3) identifying the discrepancy between the actual and desired practices of curriculum. 2. Problems for the Study This study had 4 problems to be answeared as follows: 1) What are the actual curriculum practices of KANA? 2) What are the desired curriculum practices of KANA? 3) How are the extents of perception of actual and desired curriculum different in four groups (student, faculty & administrator, nurse, and medical doctor in militay hospital) ? 4) What are the restraining forces that impede the change from actual to desired curriculum practices? 5) What are the relationships of curriculum component,』 in actual and desired curriculum practices? 3. Methods and Procedures This study was conducted by means of document analysis in addition to literature review and by means of needs assessment questionnaire which was developed by the researcher. The questionnaire included 62 statments with 7 questions for demographic data collection. The needs assessment questionnaire was managed to a total of 243 subjects (100 students, 46 faculty & administrators, 55 nurses, and 42 medical doctors), The collected data were treated using SPSS computer system so as to calculate mean scores, standard deviations, and correlation coefficients. The significance test was made through t-test and one-way ANOVA. The statistical significance level was set at both .05 and .01 level. 4. Major findings The major findings in this study are as follows: 1) The score of desired practices was significantly greater than that of actual practices, representing a strong need for curriculum betterment. 2) There were significant differences in the perceptions of actual practices as well as desired practices among four groups (student, faculty & administrater, nurse, and medical doctor). 3) The most frequently selected restraining forces were army's inherent character, economical limitation, and educational expertise limitations. 4) Such variables as sex, position attachment to the KANA and grade made a statistically significant effect on the perception of desired curriculum practice, while the variables like marrige, position, and military class made it on the perception of actual curriculum practice. 5) The coefficients among the curriculum components were lower in perception of the actual curriculum practices than those in the desired practices. 5. Conclusions The conclusions based on the major findings of this study are as follows: 1) The current curriculum development procedure of the KANA is not consistent with the theoretical frame of systematic development sarategy of curriculum. 2) There are wide conflicts among the groups who are supposed to participate in curriculnm development, concerning the actual and desired practices of KANN'S curriculum. 3) A great deal of need for curriculum improvement for the KANA is clearly felt, and in particular, in the process of teaching and learning. 4) Each component of curriculum is not intergrated into a whole development procedure, being segregated each other. 5) For better curriculum improvement, such restraining forces as financial and professional limitations should be eliminated. 6. Recommendations 1) For Further Research a. There is a need to replicate this study after in-depth statistical analysis of each item of need assessment questionnaire, and with more representative subjects. b. A study should be conducted which. has its focus on the analysis of restraining forces for the change from actual to desired curriculum practices of the KANA. 2) For KANA'S Curriculum Improvement a. There is a need to promote the professional expertise of the participants in curriculum development and the communication among them. b. It is desirable to establish an institution or section of administration, which is soley in charge of curriculum development. c. To better develop KANA's curriculum not only faculty and administrators but also students should be encouraged to participate in development process, while the military medical doctors' participation should be carefully considered.

• Journal of Oral Medicine and Pain
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• v.33 no.1
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• pp.41-48
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• 2008

The focus of this study is to analyze the effect of stress on the health of bruxism patients using the MBTI system. The most common personality type will be identified among the bruxism patients and by understanding their personality & their handling of stress, more comprehesive and effective treatment plan can be constructed. The study will also conclude that the type of personality has big effect on the cause of bruxism, and that this will be considered in the treatment plan in this hospital. The result of the study is as follow. First, more bruxism patients were type I than type E. It can be suggested that this result is due to the introversive people maintaining their energy how within themselves, and private are less to likely to release there stress than the expressive people. Second, among the bruxism patients significantly more type T were found compared to type F. This implies the bruxism tend to follow principals, scientific and analysing during decision making rather than basing their decision an meanings, emotions and influences. Thirdly, more bruxism patients clarified into ST in comparison to non-bruxism patients. This is thought to be due to probable increased stress and anxiety following ST people's tendency to more strict and realistic thinking according to effectiveness, evidence-based and productivity. Fourth, the type IJ was the most of the bruxism patients. We can come to the conclusion that decision-oriented introversion people who have hard to change, a thoroughgoing preparation characters are likely to grind their teeth by their detailed characters. Fifth, the type IT was the most of the bruxism patients. Bruxism patients are usually influenced by spirit, easily hearted, awed of relationship and attention. So, their intensity of stress is much bigger because of their personality. The last, Type IS was the most of the bruxism patients. It means that introvert sensitive types who have characters of calm, passive but defence to other's emotion, also neutral, keep moderation, and have cold-heartedness are likely to grind their teeth frequently. In conclusion it is evident that bruxism patients have particular personality types. Precisive, analysing and introversive bruxism patients are expected to have higher sensitivities to stress.

• Progress in Medical Physics
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• v.25 no.1
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• pp.53-63
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• 2014

The objective of this study is to investigate the difference of ITV lengths and ITVs between 4DCT and Slow-CT images according to respiratory patterns using a respiratory motion phantom. The respiratory periods 1~4 s and target motion 1~3 cm were applied on each respiratory pattern. 4DCT and Slow-CT images were acquired for 3 times. 4DCT and Slow-CT ITVs were measured with contouring the target in the Eclipse RTP system. The measured ITV lenghts and ITVs in 4DCT and Slow-CT images were compared to the known values. For the ITV lengths and ITVs in the 4DCT, the difference of them were reduced as the respiratory period is longer and target motion is shorter. For the Slow-CT, there was same tendency with change in 4DCT ITV lengths and ITVs about target motion. However, the difference of ITV lengths and ITVs for the respiratory periods were the lowest in respiratory period 1 second and different slightly within respiratory period 2-4 seconds. According to the respiratory patterns, pattern A had the highest reproducibility. Pattern B, C and D were showed the difference similar to each other. However, for pattern E, the reproducibility was the lowest compared with other four patterns. The difference of ITV lengths and ITVs between Slow-CT and 4DCT was increased by increasing the respiratory periods and target motion for all respiratory patterns. When the difference of Slow-CT ITV lengths and ITVs were compared with that of 4DCT ITV lengths and ITVs, Slow-CT ITV lengths and ITVs were approximately 22 % smaller than 4DCT, and the representations of target were different in each pattern. In case of pattern A, B and C, length difference was 3 mm at S (superior) and I (inferior) direction, and the length difference of pattern D was 1.45 cm at only "I" direction whereas the length difference of pattern E was 5 mm longer in "S" direction than "I" direction. Therefore, the margin in SI directions should be determined by considering the respiratory patterns when the margin of Slow-CT is compensated for 4DCT ITV lengths. Afterward, we think that the result of this study will be useful to analyze the ITV lengths and ITVs from the CT images on the basis of the patient respiratory signals.

• The Korean Society of Law and Medicine
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• v.18 no.2
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• pp.163-194
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• 2017

Coronary artery disease has increased in Korea as the country enters the aged society. It is well known that the incidence of coronary artery disease is related to aging, hypertension, diabetes, hyperlipidemia, and dietary habit. For effective treatment of significant coronary stenosis, close coordination between cardiac surgery and cardiology team is essential. Especially cardiologists' decision whether to do the stent placement or CABG is very important because the cardiologists usually start to consult the patients for their treatment. Recently, non-surgical interventions(that is stent placement) in cardiology field have dramatically increased as the national insurance system removed the limitation of the number of stents deployed. However, accidents are often caused by inappropriate use of stents, especially in patients with triple coronary disease or left main disease with heavy coronary calcifications. Another aspect of stent placement is to cope with an emergency case in the event of coronary rupture or pericardial tamponade during coronary interventions without cardiac surgeons. In the past two years, the Korea Consumer Agency (Consumer Dispute Coordination Committee) analyzed eight cases of medical dispute settlement. Only two hospitals were manned with both cardiologists and cardiac surgeons. Seven patients died of procedures of stenting and five patients died on the day of the procedure. Among the 8 cases, 5 cases showed 3 vessel disease and the rest of the cases had either severe calcification, complete occlusion or poor coronary antomies for stenting According to a 2017 national data registry of coronary stenting, less than 3 drug-eluting stents were implanted in 98% of all patients. In 2015, the number of stent procedures was 38,922, and approximately in 800 (2%) cases, more than four stents were used per patient. We emphasize that it is necessary to seriously consider the cost-benefit analysis between stent and CABG. The patient has the right to choose the right procedure by asking the liability of 'instruction explanation obligation'. He should be well informed of the pros and cons of both procedures to avoid overuse of stent. It can be solved by intimate discussion of individual cases with the cardiac surgeon and the patient. Unilateral dialogue with the patient, forceful restriction on the number of stenting, lack of surgeon's backup in difficult cases should all be avoided. It is also necessary to solve the problem not only at the hospital level, such as multidisciplinary integrated medical care, but also a nationwide solution such as expanding cardiac surgeons as essential personnel to public officials.

• The Korean Journal of Nuclear Medicine Technology
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• v.17 no.1
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• pp.30-35
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• 2013

Purpose: One of the current services, providing information to the patients and their guardians by using promotion materials induces positive responses and contributes to the improvement of the hospital reliability. Therefore, the objective of this study is to evaluate the effectiveness of audio visual materials, one of the means of promotion, as a way to give accurate medical information to resolve patient's curiosity about purpose and procedure of their examination and deplete complains about waiting which attributes negative effect to service quality assessment. Materials and Methods: 60 patients(mean age $53.97{\pm}12.24$, male : female = 26 : 34) who had $^{18}F-FDG PET/CT$ scan from July 2012 to August 2012 in Seoul Asan Medical Center were referred to the study. All of the patients having PET/CT scan were asked to watch an informative video material before the injection of radiopharmaceutical ($^{18}F-FDG$) and to fill in a questionnaire. Results: As a result of analyzing the contents of questionnaire, 52% of 60 patients had PET/CT scan for the first time and 72.4% of the patients read the PET/CT guidebook offered from their outpatient department or inpatient wards before their scan. After we searched the level of previous knowledge of the purpose and method of PET/CT scan, the patients answered 25.1% "know well", 34% "not sure", 40.9% "don't know" respectively. And 84.7% of the patients answered that watching the PET/CT guide video before the injection helps understanding what exam they were having and 15.3% of the patients did not. For the question asking ever the patients have experienced using our homepage or smart phone QR code to see the guide video before they visit out PET center, only 3.3% of them answered "yes". Lastly, the patients answered 60.1% "yes", 31.4% "so so" and 8.5% "no" respectively for the question asking whether watching the video makes the patients to fill the waiting time short. Conclusion: It is found that understanding of objective and method of the PET/CT scan and level of satisfaction was improved after the patients watched the guide video whether they had PET/CT scan before and read the PET/CT guidebook or not. Also, watching the video was effective for the reduction of perceptible waiting time. But while displaying the PET/CT guide video is useful for providing information about the scan and shortening the waiting time as one of the medical service, utilization of service was actually very poor because of the passive promotion and indifference of the patients about their examination. Therefore, from now on, it is necessary to construct the healthcare system which can be offered to more patients through the active promotion.

• The Korean Journal of Nuclear Medicine Technology
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• v.17 no.2
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• pp.53-58
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• 2013

Purpose: To optimize correction method for SPECT/CT, image quality consisting of resolution and contrast was evaluated using three radioisotopes ($^{99m}Tc$, $^{201}Tl$ and $^{131}I$) and three different correction methods; attenuation correction (AC), scatter correction (SC) and both attenuation and scatter correction (ACSC). Materials and Methods: Images were acquired with a SPECT/CT scanner and a conventional CT protocol with an OESM reconstruction algorithm (2 iterations and 10 subsets). For resolution measurement, fixed radioactivity (2.22 kBq) was infused into a spatial resolution phantom and full width at half maximum (FWHM) was measured using a vendor-provided software. For contrast evaluation, radioactive source with a ratio of 1:8 to background was filled in a Flanged Jaszczak phantom and percent contrast (%) were calculated. All the parameters for image quality were compared with non-correction (NC) method. Results: As compared with NC, image resolution of all three isotopes were significantly improved by AC and ACSC, not by SC. In particular, ACSC showed better resolution than AC alone for $^{99m}Tc$ and $^{201}Tl$. Image contrast of all three radioisotopes in a sphere with the largest diameter were enhanced by all correction methods. ACSC showed the highest contrast in all three radioisotopes, which was the most accurate in $^{99m}Tc$ (85.9%). Conclusion: Image quality of SPECT/CT was improved in all the radioisotopes by CT-based attenuation correction methods, except SC alone. SC failed to improve resolution in any radioisotopes, but it was effective in contrast enhancement. ACSC would be the best correction method as it improved resolution in radioisotopes with low energy levels and contrast in radioisotope with low energy levels. However, in radioisotope with high energy level, AC would be better than ACSC for resolution improvement.

• Journal of Yeungnam Medical Science
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• v.15 no.2
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• pp.325-340
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• 1998

A cross-sectional study was conducted to evaluate the relationship between sick building syndrome(SBS) and the environmental factors affecting SBS on 130 underground workers and 60 controls. The study consisted of 1) a review of environmental condition 2) measurement of temperature, $O_2$, $CO_2$, CO, and formaldehyde and 3) a questionnaire survey of symptom prevalence and perception of environmental conditions using indoor Air Quality questionnaire recommended by National Institute for Occupational Safety and Health. Bronchitis and dust allergy were more prevalent in underground workers significantly(p < 0.05). Among the 18 symptoms related to the indoor air pollution, the experience rate of dry, itching or irritated eyes, sore or dry throat, chest tightness, tired or strained eyes and dry or itchy skin symptom was significantly different between the underground workers and controls. The diagnostic criteria of SBS was defined as at least 1 symptom is experienced 1-3 times a week during the last 1 month among 18 indoor air pollution related symptoms which can be relieved by moving out of the underground. Applying the criteria, the mean symptom score was significant higher in underground workers than controls significantly (p < 0.05). These resalts indicated that underground workers are under inappropriate ergonomic and physical condition and inadequate ventilation. Their experience rate of symptoms related to indoor air pollution and prevalence of SBS was significantly higher than controls. To reduce the prevalence of SBS of underground workers, the surveillance system of indoor air quality, restriction of using fuel in underground and legislative regulations for the environment are needed to establish a better indoor air quality. Early detection, treatment and prevention of SBS through medical attention is also needed.

• Journal of agricultural medicine and community health
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• v.15 no.2
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• pp.97-106
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• 1990

1. Background Women's health and their involvement in health care are essential to health for everyone. If they are ignorant, malnourished or over-worked, the health &-their families as well as their own health will suffer. Women's health depends on broad considerations beyond medicine. Among other things, it depends upon their work in farming. their subordination to their families, their accepted roles, and poor hygiene with poorly equipped housing and environmental sanitation. 2. Objectives and Contents a. The health status of rural women : physical and mental complaints, experience of pesticides intoxication, Farmer's syndrome, experiences of reproductive health problems. b. participation in and attitudes towards housework and farming c. accessibility of medical care d. status of maternal health : fertility, family planning practice. induced abortion, and maternal care 3. Research method A nationwide field survey, based on stratified random sampling, was conducted during July, 1986. Revised Cornell Medical index(68 out of 195 items). Kawagai's Farmers Syndrome Scale, and self-developed structured questionnaires were used to rural farming wives(n=2.028). aged between 26-55. 4. Characteristics of the respondents mean age : 40.2 marital status : 90.8% married mean no. of household : 4.9 average years of education : 4.7 yrs. average income of household : \235,000 average years of residence in rural area : 36.4 yrs average Working hours(household and farming) : 11 hrs. 23 min 5. Health Status of rural women a. The average number of physical and mental symptoms were 12.4, 4.7, and the rate of complaints were 22.1%, 38.8% each. revealing complaints of mental symptomes higher than physical ones. b. 65.4% of rural women complained of more than 4 symptoms out of 9, indicating farmer's syndrome. 11.9 % experienced pesticide overdue syndrome c. 57.6% of respondents experienced women-specific health problems. d. Age and education of respondents were the variables which affect on the level of their health 6. Utilization of medical services a. The number of symptoms and complaints of respondents were dependent on the distance to where the health-care service is given b. Drug store was the most commonly utilized due to low price and the distance to reach. while nurse practitioners were well utilized when there were nurse practitioner's office in their villages. c. Rural women were internalized their subordination to husbands and children, revealing they are positive(93%) in health-care demand for-them but negative(30%) for themselves d. 33.0% of respondents were habitual drug users, 4.5% were smokers and 32.3% were alcohol drinkers. and 86.3% experienced induced-abortion. But most of them(77.6%) knew that those had negative effects on health. 7. Maternal Health Care a. Practice rate of contraception was 48.1% : female users were 90.9% in permanent and 89.6% in temporary contraception b. Induced abortions were taken mostly at hospital(86.3%), while health centers(4.7%), midwiferies(4.3%). and others(4.5%) including drug stores were listed a few. The repeated numbers of induced abortion seemed affected on the increasing numbers of symptoms and complaints. c. The first pre-natal check-up during first trimester was 41.8%, safe delivery rate was 15.6%, post-natal check-up during two months after delivery. Rural women had no enough rest after delivery revealing average days of rest from home work and farming 8.3 and 17.2. d. 86.6% practised breast feeding, showing younger and more educated mothers depending on artificial milk 8. Recommendations a. To lessen the multiple role over burden housing and sanitary conditions should be improved, and are needed farming machiner es for women and training on the use of them b. Health education should begin at primary school including health behavior and living environment. c. Women should be encouraged to become policy-makers as well as administrators in the field of women specific health affairs. d. Women's health indicators should be developed and women's health surveillance system too.

• Childhood Kidney Diseases
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• v.6 no.2
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• pp.155-168
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• 2002

Purpose; Systemic lupus erythematosus(SLE) is an autoimmune disease with multi-system involvement and renal damage is a major cause of morbidity and mortality in children. Renal involvement is more common and severe in children than in adults. Therefore, renal biopsy plays a crucial role in planning effective therapy. In this study, we investigated the clinical and pathological findings of lupus nephritis in children to aid clinical care of the disease. Methods: The clinical and pathological data of 40 patients who were diagnosed as SLE with renal involvement in Shinchon Severance Hospital from Jan. 1990 to Sep. 2002 were analyzed retrospectively. Results: The ratio of male to female patients was 1:3 and the median age at diagnosis was 12.1(2-18) years old. FANA(95.0%), anti-ds DNA antibody(87.5%), malar rash(80.0%) were the most common findings among the classification criteria by ARA. Microscopic hematuria with proteinuria(75.0%), nephrotic syndrome(55.0%), and microscopic hematuria alone(15.0%) were the most common renal presentations in the respective order at diagnosis. There were 27 cases with WHO class IV lupus nephritis confirmed by renal biopsy and 3 cases with pathological changes of WHO class type. Different treatment modalities were carried out : prednisolone only in 5 cases, prednisol-one+azat-hioprine in 9 cases, prednisolone+azathioprine+intravenous cyclophosphamide in 14 cases, prednisolone+cyclosporine A+intravenous cyclophosphamide in 12 cases, plasma exchange in 9 cases and intravenous gamma-globulin in 2 cases. The average follow-up period was $51.8{\pm}40.5$ months. During $51.8{\pm}40.5$ months. During follow-up, 4 patients expired. The risk factors associated with mortality were male, WHO class IV and acute renal failure at diagnosis. Conclusion: Renal involvement was noted in 63.5% of childhood SLE, and 67.5% of renal lesion was WHO class IV lupus nephritis which is known to be associated with a poor prognosis. Therefore aggressive treatment employing immunosuppressant during the early stages of disease could be helpful in improving long-term prognosis. But careful attention should be given to optimize the treatment due to unique problems associated with growth, psychosocial development and gonadal toxicity, especially in children.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.3 no.2
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• pp.141-151
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• 1993

Blood samples obtained from 200 adults who had visited the "S" general hospital were analyzed to compare the zinc protoporphyrin (ZPP) levels quantified by high performance liquid chromatograph (HPLC) and by hematofluorometer (HF) to investigate the methodological difference if any and the relationship between the levels of blood lead and ZPP among no-lead exposed adults. Also investigated were the distribution of ZPP and protoporphyrin IX (PPIX) concentrations, the establishment of normal levels of blood ZPP and blood lead, and the contribution of age and sex factors to these values. These subjects had no previous occupational exposure to lead. The results obtained were as follows : 1. The mean values of blood lead for male and female subjects were $9.46{\pm}2.44{\mu}g/dl$ and $8.09{\pm}2.17{\mu}g/dl$, respectively. The difference observed in the mean concentrations between male and female subjects was statistically very significant. 2. The mean values of blood ZPP by HPLC for male and female subjects were $15.94{\pm}4.55{\mu}g/dl$ and $22.26{\pm}6.61{\mu}g/dl$, respectively. The difference observed in the mean concentrations between male and female subjects was statistically not significant. The mean values of blood PPIX by HPLC for male and female subjects were $2.51{\pm}1.78{\mu}g/dl$ and $2.81{\pm}1.56{\mu}g/dl$, respectively. The difference observed in the mean concentrations between male and female subjects was statistically not significant. 3. The mean values of blood ZPP by HF for male and female subjects were $28.44{\pm}7.11{\mu}g/dl$ and $37.77{\pm}8.04{\mu}g/dl$, respectively. The difference observed in the mean concentrations between male and female subjects was statistically very significant. 4. No statistically significant correlation was found between the levels of blood ZPP and blood lead. 5. The ratio of ZPP and protoporphyrin IX (PPIX) concentration to erythrocyte protoporphyrin (EP, EP=ZPP+PPIX) concentration was 87.4% and 12.6%, respectively. 6. A statistically very significant correlation was found between the ZPP concentrations determined by HPLC and the values by HF (r=0.7565). The ZPP concentraitons quantified by HF were 1.75 times as high as the values obtained by HPLC. 7. The blood ZPP concentrations quantified by HPLC, HF, and spectrofluorometer (SF) from the blood samples obtained from 14 lead-exposed workers and from 16 no-lead exposed adults showed wide variations. The ZPP concentrations by HF were the highest followed by the levels obtained by SF and by HPLC. In the exposed group, no statistically significant difference was found among three methods of quantifying blood ZPP levels. In the no-lead exposed group, however, statistically significant difference was observed among these methods. The ZPP concentrations by HF were about twice as high as those of by HPLC or by SF. Among three methods of quantifying blood ZPP (HPLC, SF and HF), the results revealed significant difference. Therefore it is suggested that objective methods of quantifying blood ZPP and a system of correcting different ZPP levels be developed by the ministry of Labor.