• Journal of Hospice and Palliative Care
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• v.1 no.1
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• pp.47-55
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• 1998

Background : It is almost important therapy modality to control pain for the terminal cancer patients for the last 24 hours because those terminally illed patient deserved to have pain free and peaceful time before death. Physician who is deal with terminal cancer patients for their last 24 hours does not need to worry about drug addiction or other untoward side reactions of pain medications. The purpose of this study was to evaluate if terminally illed cancer patient was given pain medication properly and sufficiently and if there was any different behavior to control pain of terminal cancer patients between medical physicians and surgeons in terms of type, amount and administration route and frequency. Methods : A retrospective chart audit of analgesic type, amount and administration route was performed on the medical recorders of 160 hospitalized terminal cancer patients who had died in the Korea University Medical Center Anam Hospital during the period of July 1, 1994 to June 30, 1995. Patients were classified into 103 patients were cared for by medical physicians and 57 patients were cared for by surgeons. After then, we analysed the difference of pain control pattern between them. Different types and amount of analgesics were converted to a common standard, an oral morphine equivalents(OME) relative to 1mg of oral morphine. Results : 1) The total number of patients was 160, male 102 cases(63.8%), and the female was 58 cases(36.2%) respectively. 2) The mean age was 56.4(${\pm}14.62$) years old and mean admission period was 27.8 days(${\pm}34.85$). 3) The frequent cancer site was stomach 42 cases(26.315), lung and liver 29 cases(18.1%) each, pancreas 10 cases(6.2%) in order 4) 125 out of 160 subjects (78.13%) complained pain, and 66 out of 103(64.08%) and 31 out of 57(54.39%) were treated with analgesics to relieve pain. 50 out of 97(51.55%) were able to continue on oral medication. 5) 86 cases(53.75%) were well oriented 24 hours prior to death. 6) The frequent analgesics for regular basis were long acting form of oral morphine 34 cases(Medical phsicians 24, Surgeons 10), intravenous morphine 26 cases(Medical physicians 20, Surgeons 6) in order, and the most common p.r.n.(pro re nata) analgesics used was intravenous morphine. 7) The mean amount of analgesics on regular basis was 115.41 OME by medical physicians and 52.7 OME by surseons(P<0.05). The mean amount of p.r.n. analgesics was significantly larger in patients are for by surgeons(66.64 OME) than medical physicians 23.49 OME(P<0.01). 8) The mean frequency of administrated number of p.r.n. analgesics was 0.62 times/day on medical part and 1.88 times/day on surgical part (P<0.001). Conclusion : Of the 97 patients with advanced cancer, 51.55% were able to take oral medications in the last day of life. The parenteral analgesics were more frequently used in the patients cared for by surgeons than medical physicians. Over the half of terminal cancer patients were well oriented in the last day of life. Doctor's knowledge and attitude towards pain is very important to mange the pain, effectively.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.13 no.1
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• pp.153-162
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• 2002

Summary：This study was designed to examine the effect of mother's depressive mood and parenting related attitude on parenting behavior, focusing on the cases having an ADHD child. Method：A total of 82 parents, 31 parents having children with ADHD and 51 normal, were involved in this study. The children of ADHD and normal group were 6-11 years old. ADHD group were diagnosed as attention-deficit hyperactivity disorder by psychiatric doctor and psychological evaluations using DSMIV criteria and the normal group were excluded by using Diagnostic Rating Scale-Parent, Teacher Form. The mothers of both group completed a series of questionnaire about mother's depressive mood and parenting-related attitude. To investigate the relationships between each variables, Student's t-test, correlation, stepwise regression, and hierarchical regression analysis were performed. Result：In correlation analysis, Mothers with an ADHD child were likely to report more coercive parenting behavior, more negative parenting-related attitudes, and depressive mood than normal group. In regression analysis, mother's parenting stress, dysfunctional thoughts, parenting competence, and depressive mood predicted coercive parenting behavior significantly, total explaining 50% of its variance, and especially depressive mood explained 29% of their coercive parenting behavior. These Results indicated that mother's depressive mood accounted for a substantial portion of coercive parenting behavior. Conclusion：These findings suggested that it is significantly important to reduce Mother's depressive mood through dealing with parenting sense of competence and dysfunctional thoughts, so, both parent education program and cognitive-behavioral therapeutic approach are needed to change parent's coercive parenting behavior. Finally, limitation of the present study and suggestions were discussed for further studies.

• Korean Journal of Psychosomatic Medicine
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• v.11 no.2
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• pp.149-158
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• 2003

Objectives: The authors studied the anxiety, depression and psychological characteristics of medical out-patients, which are diagnosed as peptic ulcer disorder and essential hypertension. We also examined the state of psychiatric consultation. Methods: The subjects were composed of 56 patients with peptic ulcer disorder, 44 patients with essential hypertension and 116 controls. STAI, BDI and SCL-90R was administered to all subjects. Chart review, telephone interview and Self report questionnaire of etiology and severity of illness, drug compliance and so forth were performed in disease groups. Results: Considerable depression was noticed in 39.3% among the patients with peptic ulcer disorder, 27.7% in hypertension and 12.1% in control group by BDI. State anxiety was noticed in 44.6% among the patients with peptic ulcer disorder, 54.5% in hypertension and 18.1% in control group by State anxiety. Trait anxiety was noticed in 42.9% among the patients with peptic ulcer disorder, 34.1% in hypertension and 25.8% in control group by Trait anxiety. The higher SOM, BDI, STAI, the lower drug compliance and rapport. Psychological problems are considered of the most important etiology in 48.2% of peptic ulcer group and 45.7% of hypertensive group. But psychiatric consultation is made only in 1.8% of peptic ulcer group and 2.3% of hypertensive group. Conclusions: Anxiety and depression are common phenomena in medical outpatients. In comparison with the normal control group, peptic ulcer group showed significantly higher trait anxiety and depression and hypertensive group higher state anxiety. These characteristics are related to the drug compliance and doctor-patient relationship. These results suggested the needs of active psychiatric consultation.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.2
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• pp.33-37
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• 2010

Purpose: In the early stage of using PET/CT, it was used to damper revision but recently shows that CT with MDCT is commonly used and works well for an anatomical diagnosis. This hospital makes the accuracy and convenience more higher in the diagnosis and evaluate of coronary heart disease through concurrently running myocardial perfusion SPECT examination, myocardial PET examination with FDG, and CT coronary artery CT angiography(coronary CTA) used PET/CT with 64-slice. This report shows protocol and image based on results from about 400 coronary heart disease examinations since having 64 channels PET/CT in July 2007. Materials and Methods: An Equipment for this examination is 64-slice CT and Discovery VCT (DVCT) that is consisted of PET with BGO ($Bi_4Ge_3O_{12}$) scintillation crystal by GE health care. First myocardial perfusion SPECT with pharmacologic stress test to reduce waiting time of a patient and get a quick diagnosis and evaluation, and right after it, myocardial FDG PET examination and coronary CTA run without a break. One-stop evaluation protocol of ischemic heart disease is as follows. 1)Myocardial perfusion SPECT with pharmacologic stress: A patient is injected with $^{99m}Tc$-MIBI 10 mCi and does not have any fatty food for myocardial PET examination and drink natural water with ursodeoxcholic acid 100 mg and we get SPECT image in an hour. 2)Myocardial FDG PET: To reduce blood fatty content and to increase uptake of FDG, we used creative oral glucose load using insulin and Acipimox to according to blood acid content. A patient is injected with $^{18}F$-FDG 5 mCi for reduction of his radiation exposure and we get a gated image an hour later and get delay image when we need. 3) Coronary CTA: The most important point is to control heart rate and to get cooperation of patient's breath. In order to reduce a heart rate of him or her below 65 beats, let him or her take beta blocker 50 mg ~ 200 mg after a consultation with a doctor about it and have breath-practices then have the examination. Right before the examination, we spray isosorbide dinitrate 3 to 5 times to lower tension of bessel wall and to extension a blood wall of a patient. It makes to get better the shape of an anatomy. At filming, a patient is injected CT contrast with high pressure and have enough practices before the examination in order to have no problem. For reduction of his radiation exposure, we have to do ECG-triggered X-ray tube modulation exposure. Results: We evaluate coronary artery stenosis through coronary CTA and study correlation (culprit vessel check) of a decline between stenosis and perfusion from the myocardial perfusion SPECT with pharmacologic stress, coronary CTA, and can check viability of infarction or hibernating myocardium by FDG PET. Conclusion: The examination makes us to set up a direction of remedy (drug treatment, PCI, CABG) because we can estimate of effect from remedy, lesion site and severity. In addition, we have an advantage that it takes just 3 hours and one-stop in that all of process of examinations run in succession and at the same time. Therefore it shows that the method is useful in one stop evaluation of ischemic heart disease.

• Journal of Preventive Medicine and Public Health
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• v.20 no.2 s.22
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• pp.312-321
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• 1987

To investigate the maternal and child factors associated with early detection of cerebral palsy, 74 mothers of cerebral palsy children who were born since January 1, 1980 and being treated at Taegu Rehabilitation Center for the Handicapped, Rehabilitiation Center of Taegu University, St. Paul Children's House and Pusan Welfare Association of Cerebral Palsy Children were interviewed from February to April 1987. There is no association between age of child when parents noticed the child's abnormality and educational level of father but it tend to be detected earlier when education level of mother is college or above compared with high school or under. There is a trend of earlier detection of child's abnormality although statistically not significant in case father is professional or managerial worker, monthly income of father is over \610,000, child is first-born, age of the parents is 34 years or under, child is a boy, and child has periodic well-baby check-up. The child's abnormality is detected earlier when mothers had 7 prenatal visits or more compared with those who had 6 visits or less (p<0.05). Parents noticed the child's abnormality first in 85.1% of the cases whereas doctors detected it first in 2.7% and this percentage was not different whether the child had periodic well-baby check-up or not. The first physician's diagnosis of the children was cerebral palsy in 36.5% and the rest was normal, need for observation, uncertain, etc. Parents took the child to doctor for diagnosis 2-3 months after they noticed the child's abnormality and after the child was diagnosed as cerebral palsy parents either took no therapeutic measure or brought the child to physiotherapy or acupuncture or gave herb medicine before they started specific rehabilitative therapy. For early detection of the cerebral palsy children, teaching of evaluation method for child development should be reinforced both in medical school and clinical training course and should train the specialist for diagnosis and treatment of crippling conditions. Also, public education is needed for the importance of early detection of crippling conditions and currently available methods for diagnosis and treatment.

• Clinical and Experimental Pediatrics
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• v.52 no.5
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• pp.576-580
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• 2009

Purpose : Growth-promoting attempts are widespread in Korea, but little is known about their prevalence or associated factors. This study was designed to assess the prevalence of growth-promoting attempts among children visiting a university growth clinic. Methods : A questionnaire-based survey was carried out with 823 children (416 boys, 407 girls) who visited the growth clinic at Paik Hospital. Results : The mean age of the subjects was $10.4{\pm}2.6$ yr, and the height z-score was $-1.58{\pm}0.91$. Approximately 33.4% of the children had tried growth promotion. Among the height-gain methods, herbal medicine was the most frequently used (37.8%), followed by health-promoting supplements (37.1%), exercise or machine (3.0%), and growth hormone treatment (2.9 %). The mean age at which the parents began to worry about their children's height was 7.7 yr. The mean age at which they started height-gain methods was 8.9 yr for herbal medicine, 9.1 yr for health-promoting supplements, 9.4 yr for exercise or machine, and 9.9 yr for growth hormone treatment. Motivating factors included advice from relatives or friends (36.0%), advertisements in the Internet or newspaper (28.4%), advice from pharmacist (16.8%), and advice from their medical doctor (5.5%). The degree of satisfaction from the height-gain methods was 29.1% with growth hormone treatment, 6.6% with exercise or machine, 6.4% with herbal medicine, and 2.8% with growth-promoting supplements. Conclusion : Approximately one third of the children reported use of growth-promoting methods, but the satisfaction rate was not high. The benefits of growth-promoting methods should be carefully weighed against their costs and side effects.

• Journal of agricultural medicine and community health
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• v.17 no.1
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• pp.34-45
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• 1992

In this county, the gap between the urban 'haves' and the rural 'have-nots' continues to be an increasing problem. WHO and UNICEF see primary health care(PHC) as the key to achieving an acceptable level of health throughout the world as a community development. PHC is essential health care made accessible to individuals and families in the community by means acceptable to them. It is the first level of contact of individual, the family, and community with the national health system. It includes at least education on health system. It includes at least education on health problems, promotion of food supply, MCH including family planning, immunization against infectious diseases, control of endemic diseases, treatment of common diseases and injuries, promotion of mental health, and provision of essential drugs. However, of the aboves, education concerning of mental health problems and the methods to identify, prevent, and control them is the principal step of establishment. In Korea, the category of PHC worker includes the physician as public doctor and nurse as primary health care practitioner and community health leader as village health worker. PHC workers of the aboves will thus function best if they are appropriately trained to respond to the health needs of the community. However in this country, since the national PHC service project launched in 1980, the government has not developed and performed appropriate and enough education and training activities. In light of above reasons, several categories of health education activities had been planned and performed being aimed at above specific target groups and the main focus was on the village health workers for about one year from July 1991 to July 1992 in Yeoju Kun of Kyonki Province. At the end of the period, evaluation of education input was carried out to measure the improvement of healthful life of people in terms of awareness, attitude, and practice. At the end of the period, evaluation of education input was carried out to measure the improvement of healthful life of people in terms of awareness, attitude, and practice. The totals of 80 village health workers, 13 public health practitioners and 9 public docters took in the course of health education for a few hours at every month and the evaluation works of educational effect were taken. The results the study were as follows. 1) Number of persons who realized the maxim "health care of the people is a duty of the government" increased after the education course, On the other hand, the rate of satisfaction on the effort of government for health promotion of the people decreased. 2) Public doctors and primary health care practitioners(nurses) liked and enjoyed the education schedule as a meeting of peer group. It provided chances of communication with staffs of Korea University Hospital. It was said that lectures covered great deal of knowledge and technic they urgently needed in the field. 3) After finishing the education course, more of village health workers(VHW) thought they adapted themselves to their roles and functions showing increased number of home visit and contact with primary health care practitioners by month. 4) In case of patient refer, VHW preferred primary health care practitioners to public doctors. 5) Capability of VHWs in most of their functions increased dramatically after when the education course finished except tuberculosis control.

• The Korean Journal of Nuclear Medicine Technology
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• v.17 no.1
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• pp.43-47
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• 2013

Purpose: A duplicated ureter is congenital renal malformations with ureter in two. Patients with duplicated ureter are in force to $^{99m}Tc-DMSA$ scan at surgery before and after. In existing examination, at produce result after $^{99m}Tc-DMSA$ scan, didn't compare to upper pole and lower pole with malformed kidney and compared to only relative uptake ratio. Therefore, this study will examine about utility of set a partial region of interest and to functional recovery of renal cell through change of upper pole uptake ratio of malformed kidney by setting each partial region of interest in upper pole and lower pole of malformed kidney in $^{99m}Tc-DMSA$ examination in surgery before and after. Materials and Methods: Pediatric patients with malformed kidney of incomplete duplicated ureter, 15 patients were enrolled in this study. Scanning were scan 3 to 4 hours after injection of $^{99m}Tc-DMSA$ 1.5 ~ 1.9 MBq/kg. Region of interest were each set in normal kidney, upper pole and lower pole with malformed kidney. Region of interest were set with same condition and method to images of surgery before and after that radio technologist 1 person, resident of nuclear medicine 1 person and doctor of urology together. Therefore, this study were compared to uptake ratio (A: B: C) that normal kidney (A), lower pole of malformed kidney (B) and upper pole of malformed kidney (C) about uptake ratio changes of malformed kidney in follow-up examination of surgery before and after. Results: When compared to 15 patients, uptake ratios were increased 7 persons and decreased 8 persons. Among increased 7 persons, it were periods of follow-up examination that 2 persons were 14 months, 4 persons were 12 months and 1 person was 8 months after surgery. Among decreased 8 persons, it were periods of follow-up examination that 4 persons were 12 months 3 persons were 6 months and 1 persons were 4 months after surgery. Conclusion: Existing study could not see the exact uptake ratio changes of malformed kidney because using only the overall Left-Right kidney uptake ratios. But a setting partial region of interest was able to see exactly what changes in the uptake of each upper pole and lower pole of malformed kidney. Because recovery of renal parenchymal cells is difficult in an evaluation of short period of time, follow-up examination should be made in long period of time. How to set up partial region of interest be thought that it would be useful.

• Journal of Korean Academy of Nursing
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• v.27 no.4
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• pp.975-987
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• 1997

The purpose of this study was to investigate the current status of curriculum operation of the basic medical sciences in nursing education at college of nursing, department of nursing and junior college of nursing, ultimately to provide the basic data to improve a curriculum of basic medical science in nursing education. 78 professors who were in charge of basic medical science at 22 colleges of nursing and department of nursing, and 20 junior colleges of nursing responded the questionnaire consisted of 22 question items about the status of objectives, lectures, laboratory practice and characteristics of professors, and mailed to the author. The findings of this study were as follows : 1. The subjects of basic medical science were identified as physiology, anatomy, biochemistry, pathology, microbiology, pharmacology in the most colleges of nursing and junior colleges of nursing. 2 colleges of nursing and department of nursing(9.1%) and 19 junior colleges of nursing(95%) did not open biochemistry, 1 college of nursing and department of nursing(5%) did not open pathology and pharmacology. 2 Junior colleges of nursing(10%) did not open pharmacology, 1 junior college of nursing(5%) did not open pathology, the other 1 junior college of nursing did not open microbiology. 2. Credits of the subjects were ranged from 1 to 4. Lecture hours of one semester of physiology at school of nursing and junior college of nursing was average 103.6 and average 102.67, that of anatomy was average 127.1 and average 98, that of microbiology was average 109.7 and average 86.33, that of biochemistry was average 105, that of pathology was average 91 and average 94, that of pharmacology was average 86 and average 85.75. 3. Most of schools used 1 textbook for lectures, 3 school of nursing and department of nursing recommended references without using textbook, while all 36 junior colleges of nursing used textbooks. 4. 5 among 10 schools of nursing and department of nursing had a laboratory practice in physiology, 4 among 7 schools in anatomy, 4 among 6 schools in biochemistry, 2 among 6 schools in pathology 5 among 6 schools in microbiology. Not all the schools had a laboratory practice in pharmacology. 4 among 9 junior colleges of nursing had a laboratory practice in physiology. 1 among 4 schools in anatomy, 2 among 7 schools in microbiology. Not all the junior colleges of nursing had a laboratory practice in pathology and pharmacology. 11 among 20 colleges of nursing and department of nursing, 4 among 7 junior schools of nursing used a textbook of laboratory practice. 5. All the subjects at school of nursing and department of nursing responded that content of lectures and laboratory practices of basic medical science should be different from that of medical education, 34 junior schools of nursing responded that content of lecture of basic medical science in nursing education should be different from that of medical education. 33 junior schools of nursing responded that content of practice of basic medical science in nursing education should be different from that of medical education. 6. The final degree of 25 professors who were in charge of basic medical science were doctors of. medicine, that of 5 professors were masters of medicine, that of 5 were doctor of pharmacology, that of 2 were a master of pharmacology, that of 1 was physical science. The final degree of 8 professors who were in charge of basic medical science were masters of medicine, 7 doctors of medicine, 4 masters of nursing science, 4 masters of pharmacology, 2 doctors of nursing, 2 doctors of physical science, 2 doctors of pharmacology and 1 master of public health. 9 full professors, 13 associate professors, 11 assist ant professors, 3 full time instructors, and 6 part time instructors were in charge of basic medical science at college of nursing and department of nursing, 20 part time instructors, 8 associate professors, 6 assistant professors, and 2 full professors were in charge of has basic medical science at junior college of nursing. Based on these results, curriculum of basic medical science in nursing education should be reviewed deeply based on nursing model.

• The Korean Journal of Nuclear Medicine
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• v.8 no.1_2
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• pp.57-62
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• 1974

이 논문(論文)은 1973년(年) ICSH주최로 열린 panel에서 적혈구파괴(赤血球破壞) 장소(場所)를 결정(決定)하기 위한 생체(生體) 체표계측법(醫表計測法)의 표준화(標準化)에 관(關)한 토론(討論) 결과(結果)를 초록(抄錄)한 것이다. 체표계측(體表計測)은 체외(體外)에서 계측기(計測器)를 이용(利用)하여 각(各) 장기(臟器)에서의 방사표지물질(放射標識物質)의 분포(分布) 및 시간경과(時間經過)에 따른 변화(變化)를 측정(測定)하는 것으로서 $^{51}Cr$를 사용(使用)하여 적혈구수명(赤血球壽命)을 측정(測定)할 때 간(肝), 비(脾), 심장(心臟)의 방사능(放射能)을 계측(計測)한다. 이 방법(方法)은 각(各) 장기(臟器)에서의 적혈구파괴(赤血球破壞)의 정도(程度)를 예측할 수 있다. 특(特)히 용혈성(溶血性) 빈혈환자(貧血患者)에서 비장적출(脾臟摘出) 여부를 결정(決定)하는데 도움이 된다. 이 panel에서는 주(主)로 오차(誤差)의 원인(原因)이 되는 여러가지 요인(要因)에 대(對)하여 토론(討論)하였으며 일반적으로 다음과 같은 것에 의견(意見)의 일치(一致)를 보았다. 즉(卽) 비장(脾臟)의 위치(位置)는 $^{99m}Tc$로 비주사(脾走査)를 실시하여 결정(決定)하는것이 좋고, $^{51}Cr$은 체중(體重) 1kg당 $1.5{\mu}Ci$를 사용하여, 계측기(計測器)는 NaI crystal(직경이 5cm이상, 두께가 3.75cm이상)의 scintillation doctor를 사용하고, 계측(計測)은 $^{51}Cr$로 표지(標識)된 적혈구(赤血球) 주입후(注入後) 15분(分) 이후(以後)에 하고 다음날 계측(計測)한 후(後) 2주(週) 동안에 적어도 6번 계측(計測)한다. Data 처리는 excess count법(法)과 비(脾)와 간(肝)의 비(比)로서하는 것이 좋다.定値)에 차이(差異)가 있어 그 결과(結果)의 해석(解釋) 및 비교(比較) 검토(檢討)에 적지않은 난점(難點)이 생겨 표준화(標準化)된 공통적(共通的)인 방법(方法)의 사용(使用)이 중요(重要)하다는 사실(事實)이 인식(認識)되게 되었다. 1966년(年) 호주(濠洲)의 Sydney에서 개최(開催)되었든 제11차(第11次) 국제혈액학회(國際血學會)때 열린 제4차(第4次) International Committee for Standardization in Haematology(ICSH)에서 Diagnostic Applications of Radioisotopes in Haematology에 관(關)한 expert panel을 갖을것을 의결(議決)하여 다음과 같은 12명(名)의 위원(委員)이 결정(決定)되었으며 위원회(委員會)의 의장(議長)에 Dr. Szur, 총무(總務)에 Dr. Glass가 각각(各各) 선임(選任)되었다. 그간(間) 1967년(年) 영경(英京) London에서 첫 회합(會合)이 있은후(後) New York, Vienna(IAEA후원(後援)) Brthesda(NIH후원(後援))에서 전문위원회(專門委員會)를 갖고 적혈구수명측정법(赤血球壽命測定法)에 관(關)한 의견(意見)의 일치(一致)를 보았다. ICSH와 국제혈액학회(國際血學會)에서는 이번에 결정(決定)된 적혈구수명측정법(赤血球壽命測定法)을 널리 소개(紹介)하며, 측정법(測定法)과 얻어진 결과(結果)의 해석(解釋)에 표준화(標準化)를 기(期)할 목적(目的)으로 이에 연관성(聯關性)있는 전문지(專門誌)에 게재(揭載)할 것을 요청(要請) 받었기에 이에 전문(全文)을 소개(紹介)하는 바이다. 이들은 방사성(放射性) chromium 법(法)의 모든 세부적(細部的)인 면(面)을 표준화(標準化)하고 있으며 그간(間) 가장 논란(論難)의 대상(對象)이 되었던, $^{51}Cr$-표지방법(標識方法)에 있어서의 세가지 변법(變法),