• Title/Summary/Keyword: Korean Medical school

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Quantitative Analysis of GBCA Reaction by Mol Concentration Change on MRI Sequence (MRI sequence에 따른 GBCA 몰농도별 반응에 대한 정량적 분석)

  • Jeong, Hyun Keun;Jeong, Hyun Do;Kim, Ho Chul
    • Journal of the Institute of Electronics and Information Engineers
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    • v.52 no.2
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    • pp.182-192
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    • 2015
  • In this paper, we introduce how to change the reaction rate as mol concentration when we scan enhanced MRI with GBCA(Gadolinium Based Contrast Agent), Also show the changing patterns depending on diverse MRI sequences which are made by different physical principle. For this study, we made MRI phantom ourselves. We mixed 500 mmol Gadoteridol with Saline in each 28 different containers from 500 to 0 mmol. After that, MR phantom was scanned by physically different MRI sequences which are T1 SE, T2 FLAIR, T1 FLAIR, 3D FLASH, T1 3D SPACE and 3D SPCIR in 1.5T bore. The results were as follows : *T1 Spin echo's Total SI(Signal Intensity) was 15608.7, Max peak was 1352.6 in 1 mmol. *T2 FLAIR's Total SI was 9106.4, Max peak was 0.4 1721.6 in 1 mmol. *T1 FLAIR's Total SI was 20972.5, Max peak was 1604.9 in 1 mmol. *3D FLASH's Total SI was 20924.0, Max peak was 1425.7 in 40 mmol. *3D SPACE 1mm's Total SI was 6399.0, Max peak was 528.3 in 3 mmol. *3D SPACE 5mm's Total SI was 6276.5, Max peak was 514.6 in 2 mmol. *3D SPCIR's Total SI was 1778.8, Max peak was 383.8 in 0.4 mmol. In most sequences, High signal intensity was shown in diluted lower concentration rather than high concentration, And also graph's max peak and pattern had difference value according to the each different sequence. Through this paper which have quantitative result of GBCA's reaction rate depending on sequence, We expect that practical enhanced MR protocol can be performed in clinical field.

Reliability and Validity of the Fatigue Severity Scale among University Student in South Korea (대학교 재학생에서 Fatigue Severity Scale의 신뢰도 및 타당도 연구)

  • Lee, Junghyun H.;Jeong, Hyeonseok S.;Lim, Soo Mee;Cho, Han Byul;Ma, Ji-Young;Ko, Eun;Im, Jooyeon J.;Lee, Sun Hea;Bae, Sujin;Lee, Yu-Jin;Lyoo, In Kyoon;Jeong, Do-Un
    • Korean Journal of Biological Psychiatry
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    • v.20 no.1
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    • pp.6-11
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    • 2013
  • Objectives There are only a limited number of studies on instruments assessing fatigue in university students, although fatigue exerts negative influences on their health and academic performances and fatigue-related complaints are more frequently reported in young adults than middle-aged adults. The aim of this study was to validate the 9-item Fatigue Severity Scale (FSS) among university students including both undergraduate and graduate students in South Korea. Methods A total of 176 university students completed a battery of self-report questionnaires, including the FSS, the Brief Fatigue Inventory (BFI), the Beck Depression Inventory-II (BDI-II), the Beck Anxiety Inventory (BAI), the Medical Outcomes Study Short Form 36 version 2 (MOS-SF36v2), and the Inclusion of Community in the Self Scale (ICS). The data were collected from February of 2012 to June of 2012. The reliability, convergent validity, divergent validity, and exploratory factor analyses were conducted to assess psychometric properties of the FSS. Results The mean FSS score was 3.20 (standard deviation = 1.43). The FSS demonstrated an excellent internal consistency (Cronbach's ${\alpha}$ = 0.93) and item-total correlations ranged from 0.56 to 0.90. Correlations of the FSS with the BFI (r = 0.71, p < 0.01), BDI-II (r = 0.54, p < 0.01), BAI (r = 0.46, p < 0.01), MOS-SF36v2 physical component summary (r = -0.28, p < 0.01), MOS-SF36v2 mental component summary (r = -0.55, p < 0.01), and ICS (Spearman's rho = -0.07, p = 0.33) showed acceptable convergent and divergent validity. Exploratory factor analysis defined one underlying factor (eigenvalue = 5.67) that explained 93.50% of the total variance. Conclusions To the best of our knowledge, this is the first study to investigate reliability and validity of the FSS in university students. The FSS exhibits good psychometric properties for evaluation of fatigue among university students in South Korea. Since the FSS is easy to administer, score, and interpret, it could be a useful tool in research and practice for assessing fatigue among university students.

Financial Impact of Off-Pump Coronary Artery Bypass (체외순환 없이 시행하는 관상동맥우회술의 경제성 분석)

  • Lim, Cheong;Chang, Woo-Ik;Kim, Ki-Bong;Kim, Yoon
    • Journal of Chest Surgery
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    • v.35 no.5
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    • pp.365-368
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    • 2002
  • Background: Coronary artery bypass grafting(CABG) imposes large amount of medical costs, which are greatly affected by the surgical approach, quality of perioperative care and associated co-morbidities. Recently, off-pump CABG(OPCAB) has been introduced and performed with increasing frequency. To evaluate the efficacy of OPCAB in view of financial impact, we analyzed the costs and medical resources of OPCAB and compared with conventional CABG. Material and Method: From January 1998 to July 1999, 184 patients underwent CABG operation; 111 patients with OPCAB(group I) and 73 patients with conventional CABG(group II). We prospectively collected clinical data including risk factors and retrospectively reviewed the hospital resources. Result: Preoperative parameters including risk factors, postoperative mortality, morbidity and length of hospital stay were not different between the two groups, Duration of stay in the intensive care unit(ICU) (51.3 vs 128.3 hours, p<0.01) and ventilator, support time(14.9 vs 56.2 hours, p<0.01) were significantly shorter in the OPCAB group. Total hospital coats were 17,220,000 add 21,250,000(Korean Won) in group I and II, respectively(p<0.01). There were significant differences in operation fee, costs for operative materials, transfusion and diagnostic radiology between two groups. In group I, all the resources except diagnostic radiology were significantly decreased compared with group II. Conclusion: OPCAB has a beneficial effect on hospital charge and resource utilization. Shorter duration of the ICU stay and ventilatory support time may reduce the total hospital costs.

A Search of the Community between Eight Constitution Medicine and Disease Ecology: A Perspective from Medical Geography (8체질의학과 질병생태학의 공통성에 관한 연구: 의료지리학적 접근을 중심으로)

  • Kim, Changkeun;Ryu, Je-Hun;Kim, Younghoon;Park, Sookyung;Jang, YoungHun;Han, JungHoon
    • Journal of the Korean Geographical Society
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    • v.49 no.6
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    • pp.897-916
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    • 2014
  • There is a considerable community between Eight Constitution Medicine and disease ecology in that they examine the relationship between humans and environment in terms of genetic, environmental and cultural factors, in addition to the factor of germs. In this respect, the purpose of this research aims to investigate the community between Eight Constitution Medicine, a branch of Eastern Medicine and disease ecology in geography. The research method is to analyse the clinical results from 647 patients and the data from a field survey on the Yeonggwang-gun County, Jeollanam-do Province. The results are summarized as the following: First, geographical distribution of patients varies depending on the type of physical constitution; it is also divided into two types, an oceanic type and an inland type. Second, it is highly probable that there is a significant relation between a vulnerable disease in association with a type of physical constitution and patient's native place; there are diseases that are not associated with all the patients who have the same constitution; they might be incurred by the eating or life habits in association with the characteristics of geographical environment. Third, the case study of Yeonggwang-gun County, Jeollanam-do Province, with a focus on the mutual relationship among the three factors. shows that patients, who share in common the eating or life habits that coincide with their own personal types of constitution, maintain a good health condition; if not, they tend to be exposed to a various kinds of disease. Because the study on the community between Eight Constitution Medicine and disease ecology is now at the early stage, diverse types of approaches should be tried to be applied in the future.

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Predictive Factors of Hope in Patients with Cancer (암환자의 희망 예측요인)

  • Lee, Hwa Jin;Sohn, Sue Kyung
    • Korean Journal of Adult Nursing
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    • v.12 no.2
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    • pp.184-195
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    • 2000
  • It has been believed that cancer is an omnious factor threatening the future and life itself. Patients having the disease experience anxiety, fear, feeling of weakness, depression and feelings of uncertainty and hopelessness. Most cancer patients, however, have expectations of possible recovery and a better future, very different from the patients who feel hopeless. Therefore. hope allows people to respond effectively to the fatal disease they have and prevents them from detoriorating physically and spiritually, positively influencing their survival, response to treatment and sense of security. Studies previously performed showed that hope is positively correlated with social and family supports, self-esteem, spiritual well-being, responsive action, health promotion behavior and quality of life. Thus, the study attempted to provide basic information on nursing cancer patients by investigating their levels of hope and determining predictive factors which influence hope. For the study 200 cancer patients in two university hospitals located in Pusan were sampled as subjects. Data were collected for twenty nine days from Feburary 1, 1999 to March 1. Instrumets for the study included 10 items from the self-esteem scale by Rosenberg (1965), 39 hope measurements by Kim and Lee(1965), 16 of the social support scale by Tae(1986) and 16 of the general characteristics scale, all of which totaled 81 items. The data were analyzed using the SPSS program. General characteristics of the investigated based on numbers and percentage. Hope, self-esteem and social support were analyzed using means, minimum, maximum and standard deviation. Relations among the foregoing three factors were analyzed using Pearson' correlation coefficient. Levels of hope in cancer patients were determined using t-test, ANOVA and Scheffe test. Predictive factors influencing hope were investigated using multiple stepwise regression analysis. Results of the study are summarized as follows: 1. An average level of hope was $185.55{\pm}23.39$ points(96 min. and 234 max.) 2. Levels of hope showed a significant difference among them according to sex (t=-3.69, P=.000), age(F=4.714, P=.000), job(F=3.247, P=.008), monthly income (F=6.113, P=.003), treatment charge (F=3.796, P=.011), supportive resources (F=10.554, P=.000), diagnosis(F=2.287, P=.029), perceived health status(F=22.184, P=.000), level of pain(F=3.334, P=.021), religion (F=4.911, P=.001) and religion's effect in life (F=11.706, P=.000), 3. For the subjects, self-esteem and social support were $38.32{\pm}7.21$(13 min, and 50 max.) and $52.97{\pm}8.49$points(28 min, 80 max.). Concerning social support, average levels of family support and medical support were found $35.95{\pm}6.05$(18 min, and 40 max) and $27.02{\pm}4.99$ points(20 min and 40 max). The hope the cancer patients showed significant correlations with self-esteem (r=.588, P=.000), family support(r=.224, p=.001) and medical support(r=.221, P=.002). 4. The five variables related to hope (self-esteem, religion's effect in life, perceived health status, social support and age) accounted for 54.2 percent of the hope level; especially, self-esteem was the highest at 34.6%. As shown in the above results, predictive factors which most influence hope in cancer patients were self-esteem and religion's effect of life. Therefore, nursing interventions to increase self-esteem should be developed. Regarding religion's effects, studies on spiritual aspects should be carried out in a way that contributes to promotion of hope.

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Effect of Overcorrection (-)Lens on Stereo-acuity and Angle of Deviation in Intermittent Exotropia (간헐외사시에서 과교정 (-)렌즈가 입체시 및 사시각에 미치는 영향)

  • Kim, Young Cheong;Park, Sang Woo
    • Journal of Korean Ophthalmic Optics Society
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    • v.18 no.3
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    • pp.305-311
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    • 2013
  • Purpose: This study was conducted to evaluate the effect of prescription of overcorrection (-) lens, which is the one of the non-surgical treatments, on stereo-acuity and angle of deviation in intermittent exotropia. Methods: Twenty four children with intermittent exotropia were enrolled from October 2011 to December 2011. The angle of deviation(${\Delta}$), stereo-acuity (arcsec), monocular and binocular visual acuity (BVA, LogMAR), control of exodeviation and fusional ability using Worth 4 dot test were evaluated at near (33 cm) and far (6 m), under the overcorrecting (-)lens of -1.00, -.00, and -.00 D. Results: As a baseline finding, the angle of exodeviation was $20.9{\pm}9.7$ at near and $23.0{\pm}7.5$ at far. The angle of exodeviation at near decreased to $18.5{\pm}10.0$ (p<0.01), $15.8{\pm}9.0$ (p<0.01), $14.0{\pm}9.1$ (p<0.01) compared with baseline angle of exodeviation at near, as increasing diopters of (-) lens from -.00 D, -2.00 D and -.00 D, respectively. The angle of exodeviation at far also decreased to $21.4{\pm}5.2$ (p=0.01), $19.6{\pm}6.3$ (p<0.01) compared with baseline, as increasing minus lens from -2.00 D and -3.00 D, respectively. However, BVA, control of exodeviation, fusional ability and stereo-acuity showed no significant decrease despite of increasing diopters of (-)lens. Conclusions: The prescription of overcorrection (-)lens is an effective therapeutic method in intermittent exotropia which can reduce the near and far angle of exodeviation, and binocular visual acuity and stereo-acuity maintained without significant decrease despite of application of overcorrection (-)lens.

Evaluation of Temperature and Humidity of a Thermo-Hygrostat of PET/CT Equipment using a Temperature and Humidity Sensor(BME 280) (온·습도센서(BME 280 센서)를 이용한 PET/CT 장비의 항온 항습기 온·습도 평가)

  • Ryu, Chan-Ju;Kim, Jeong-A;Kim, Jun-Su;Yun, Geun-Yeong;Heo, Seung-Hui;Hong, Seong-Jong
    • Journal of the Korean Society of Radiology
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    • v.14 no.1
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    • pp.15-22
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    • 2020
  • PET(Positron Emission Tomography) devices are used as PET/CT or PET/MRI devices fused with the devices of CT or MRI for obtaining anatomical information. Therefore, the devices are constructed in circular ring-type structure whose length of gantry(the main part of filming) becomes wider and the interior depth becomes longer in comparison to other common medical equipments. scintillator, one of the components in PET devices, is inside the gantry, and as it is consisted of crystal which is sensitive to the change of temperature and humidity, large temperature change can cause the scintillator to be damaged. Though scintillator located inside the gantry maintains temperature and humidity with a thermo-hygrostat, changes in temperature and humidity are expected due to structural reasons. The output value was measured by dividing the inside of the gantry of the PET/CT device into six zones, each of which an Adafruit BME 280 temperature and humidity sensor was placed at. A thermo-hygrostat keeps the temperature and humidity constant in the PET/CT room. As the measured value of temperature and humidity of the sensor was obtained, the measured value of temperature and humidity appeared in the thermohygrostat was taken at the same time. Comparing the average measured values of temperature and humidity measured at each six zones with the average values of the thermo-hygrostat results in a difference of 2.71℃ in temperature and 21.5% in humidity. The measured temperature and humidity of PET Gantry is out of domestic quality control range. According to the results of the study, if there is continuous change in temperature and humidity in the future, the aging of the scintillator mounted in the PET Gantry is expected to be aging, so it is necessary to find a way to properly maintain the temperature and humidity inside the Gantry structure.

The Characteristic of Research Regulation in Recent Japanese Medical World (최근 일본의 의학계 연구규율의 특색)

  • Song, Young-mi
    • The Korean Society of Law and Medicine
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    • v.20 no.2
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    • pp.173-206
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    • 2019
  • This research examines the characteristic of regulation on Japanese clinical research in recent years. First, Japan has had a severe punishment policy on research misconduct like Korea, but, in recent days, Japan has changed the direction of research ethics policy from restriction to research publicness securement by educational training, in addition, Act of Clinical Research, effected April 2018, has recruited excellent researchers, and then integrated clinical research and medicine clinical trial through raising transparency of funding and integrating ethics screening by mandating announcement on funding information of clinical research. Second, Japan has integrated and organized ethics guideline from dual system that consists of ethics guideline on dynamic research(here after, referred to as 「dynamic guideline」) and ethics guideline on clinical research(here after, referred to as 「clinical guideline」) to ethics guideline on medical research aimed at human(here after, referred to as 「integrated guideline」), thus, it complements repetition and deficit of ethics guideline needed in clinical research and dynamic research, and it has risk evaluation system for protecting human subjects, and also it clarifies the concept of 「invasiveness」, a preliminary consideration of evaluation. 「Evaluation issue of risk and profit」, common contents of international regulation related clinical research, is the method to check whether the research is designed appropriately or not, this is the method for Institutional Review Board to decide whether the risk on human subjects could be justified, and also this is the important standard for future human subjects to participate in clinical trial. Therefore, it is meaningful to define 「invasiveness」 concept, a preliminary consideration of risk evaluation for human subjects. This research examines Japanese clinical trial focusing on change of awareness on prevention of research misconduct, efficiency improvement of research through research screening and integration of human subjects, and clarification and extension of range of 「invasiveness」 concept, a preliminary of risk evaluation to protect human subjects.

Consideration of Standardized Uptake Value (SUV) According to the Change of Volume Size through the Application of Astonish TF Reconstruction Method (Astonish TF 재구성 기법의 적용을 통한 체적 크기의 변화에 따른 표준섭취계수(SUV)에 관한 고찰)

  • Lee, Juyoung;Nam-Kung, Sik;Kim, Ji-Hyeon;Park, Hoon-Hee
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.1
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    • pp.115-121
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    • 2014
  • Purpose: In addition to improving the quality of the PET image, through much research, the development of various programs are performed. Astonish TF reconstruction techniques by Philips can confirm the improved contrast of the lesion. Also, It's image reconstruction of 2 mm is possible with rapid reconstruction rate than conventional. In this study, we compared and evaluated Standardized Uptake Value (SUV) in accordance with the 2 mm reconstruction techniques and traditional 4 mm from the $^{18}F-FDG$ PET whole body image. Materials and Methods: In the phantom experiment, NEMA IEC body phantom (sphere: 10, 13, 17, 22, 28, 37 mm) was used to obtain images by using GEMINI TF 64 PET/CT (Philips, Cleveland, USA). Also, In the clinical images, we performed $^{18}F-FDG$ PET/CT examination to 30 women (age: $55.1{\pm}11.3$, BMI: $24.1{\pm}2.9$) with a diagnosis of breast cancer. After that, we reconstructed images in 2 mm and 4 mm respectively. The region of interest was drawn to acquired images. Since then, we measured SUV and statistically analyzed with SPSS ver.18 by using EBW (Extended Brilliance Workstation) NM ver.1.0. Results: After analyzing the result of the phantom study, there was a tendency that the bigger hot sphere size, the higher SUV. If you compared the 2 mm reconstruction techniques to 4 mm, it increased 95.78% in 10 mm, 50.60% in 13 mm, 25.00% in 17 mm, 30.04% in 22 mm, 31.81% in 28 mm, and 27.84% in 37 mm. Through the result of the analysis of the 2 mm reconstruction techniques and 4 mm in clinical images, it appeared that SUV of 2 mm was higher than that of 4 mm. Also the smaller the volume was, the more the change rate increased. Conclusion: After analyzing the result of the clinical picture and phantom experiments applied by Astonish TF reconstruction techniques, as the size of the volume was small, the change rate of the SUV increased. Therefore, it was necessary to further research about the SUV correction for accurate and active utilization of 2 mm reconstruction techniques which had excellent lesion discrimination ability and contrast in clinic.

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Performance of Occupational Health Services by Type of Service : Cost Benefit Analysis (사업장 보건관리 사업의 형태별 수행성과 분석 -비용편익 분석을 중심으로-)

  • Cho, Tong Ran;Kim, Hwa Joong
    • Korean Journal of Occupational Health Nursing
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    • v.4
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    • pp.5-29
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    • 1995
  • Occupational health services in Korea have been operated as dual types : one is operated by occupational health care manager and the other is health care agency without their own personnel. The performance of occupational health service should be different due to the variety of characteristics of health care manager and workplace, qualification of health care manager. This study is to analyze performance of occupational health care services with a particular consideration of job performance shape and efficiency, based on comparing those two types of health care management to show on the basic data for the settlement of more qualitative health care management system at workplace. For this study, total 391 places in Seoul and Inchon city area ; 154 places (39.4%) managed by designated health care manager and 237 places (60.6%) by the agency with their commission are selected as research samples. Tools for data collection are questionnares that have been investigated during the period of 20 September 1993-20 December 1993. Those data are compared with percentiles, mean, standard deviation and B/C ratio using SPSS PC program. Conclusions observed from the tests and each comparison could be summerized as follows : 1. Occupational health care have been accomplished at workplaces with designated people than with agencies people, and coverage rate of the occupational health care services has differences, due to management types. The reason of these results is due to visit only one or two times monthly by the agencies, while their own health care manager obsess, at the workplaces all the times. 2. Most of the expense for environmental control of all health care services expenditures shows that there is almost no fundamental improvement because more expenses are needed for procuring personal protective equipment and measuring work environment instead of environmental improvement. 3. It is investigated how much the cost of occupational health care services needs per worker, and calculated how much the cost needs per service hour per worker. The results from this show that the cost of occupational health services at workplaces with their own managers used less than the cost of health care agencies, eventually the former gives better services with less cost than the latter. 4. Benefit/Cost ratio is also produced by total benefit/total cost. The result from the above way reads 4.57 as a whole, while their own manager having workplaces reads 4.82 and the agencies do l.56. Even if their own manager performing workplaces spent more cost, this system produces more benefit than the agencies management. 5. The B/C ratio for medical organization such as local clinic, health care center and pharmacy shows more than or equal to at the workplaces controlled by the agencies. It is inferred that benefit would be much less than the cost used, with so being inefficient. 6. It is assumed that the efficiency ratio of health education is equal to reduction rate of workers medical organization visit. Estimated reduction rate 5%, 10%, 15%, show that the efficiency ratio of health education have an effect on producing benefits. It is estimated that more benefit can be produced if more qualitative education will be provided for enhancing health care efficiency. 7. Results of this study cannot be generalized because there are large scale of deviation in case of workplaces with less than 300 full time workers, but B/C ratio reads 2.69 as a whole and 3.25 at workplaces with their own health care manager are higher than 1.63 at the workplaces manged by the agencies. Finally, all the benefit concerning health care services could not be quantified, measured and shown on the value of money. This is a reason that a considerable part of benefits are so underestimated. This is also thought that measurement tools should be developed for measuring benefits of health care services with a comprehensive quantification. in the future. It is also expected that efficiency of occupational health care services should be investigated using cost-effectiveness analysis.

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