• 핵의학기술
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• 제14권1호
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• pp.54-60
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• 2010

본원에 도입된 새로운 소프트웨어는 SPECT나 전신 뼈 영상에만 국한되어 사용되어 지고 있지만 보다 효과적으로 다른 검사에 적용하기 위해 팬텀을 통한 실험과 영상의 비교를 통하여 그 유용성을 찾아보고자 하였다. 실험을 위하여 Body IEC phantom과 Jaszczak ECT phantom, Capillary를 이용한 실린더 팬텀을 이용하였고, 영상의 처리 전후의 계수, statistics를 비교해 보고 contrast ratio나 BKG의 변화들을 정량적으로 분석해 보았다. Capillary source를 이용한 FWHM 비교에서는 PIXON의 경우 처리 전후의 영상에서 차이가 거의 없었고, ASTONISH의 경우 처리 후의 영상이 우수해짐을 확인할 수 있었다. 반면 Standard deviation과 그에 따른 Variance는 PIXON은 다소 감소한 반면 ASTONISH는 큰 폭으로 증가함을 보였다. IEC phantom을 이용한 BKG variability 비교에서는 PIXON의 경우 전체적으로 감소한 반면 ASTONISH는 다소 증가하는 경향을 보였고, 각각의 sphere에 대한 contrast ratio도 두 가지 방법 모두 향상됨을 확인하였다. 영상의 스케일 면에서도 PIXON의 경우 처리 후에는 window width가 약 4-5배 증가하였지만 ASTONISH에서는 큰 차이가 없었다. 팬텀 실험 분석 후 ASTONISH는 정량적 분석을 위해 ROI를 그려야 하는 기타 검사와 대조도를 강조하는 검사에 적용 가능성을 보였고, PIXON은 획득계수가 부족하거나 SNR이 낮은 핵의학 검사에 유용하게 사용될 것으로 생각되었다. 영상의 분석 인자로 많이 사용되는 정량적인 수치들은 소프트웨어의 적용 후 대체로 향상되었지만 감마카메라의 차이보다 소프트웨어간의 알고리즘 특성으로 인한 결과영상의 차이가 많아 모든 핵의학 검사의 적용에 있어서 일관성을 유지하기는 어려울 것으로 사료된다. 또한 전신 뼈 영상과 같이 검사시간의 획기적 단축과 같은 수단으로는 우수한 영상의 질을 기대하기 어렵다. 새로운 소프트웨어의 도입 시 병원의 특성에 맞는 protocol과 임상 적용 전에 많은 연구가 필요할 것으로 사료된다.

• 핵의학기술
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• 제14권1호
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• pp.78-82
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• 2010

현재 우리나라 암발생률을 보면 유방암과 갑상샘암이 매년 빠르게 증가하고 있는 추세이다. 따라서 I-131 scan과 전초림프절 검사인 lymphoscintigraphy가 많이 시행되고 있다. 그러나 이러한 검사는 전통적인 핵의학 영상 검사들과 마찬가지로 병리생태를 영상화하는 데에는 탁월하나 해부학적 정보는 많지 않다. 따라서 트랜스미션 스캔을 실시하여 해부학적 위치를 찾는 데 도움을 주는 등 여러 방법을 사용하고 있으나 만족스럽지 못하다. 이에 착안하여 감마실사영상의 fusion으로 좀 더 해부학적 정보가 많은 영상을 구현하고자 한다. 2009년 4월부터 7월까지 본과를 내원하고 SIEMENS사의 Symbia Gamma Camera를 이용하여 lymphoscintigraphy를 시행한 환자와 I-131 추가 검사를 시행한 환자를 대상으로 하였다. 먼저 감마카메라로 촬영한 후 촬영실 천정에 설치한 hyVISION사의 소형카메라(R-2000)로 동일 위치를 촬영하여 감마영상과 소형카메라의 실사영상을 자체개발한 Gamma Ray Tool Fusion 프로그램을 이용하여 fusion하여 일치도를 평가 하였으며, 환자 및 술자의 피폭선량을 평가하였다. 술자와 환자의 피폭선량은 트랜스미션 스캔을 적용하기 위한 플러드 선원의 제작과정과 실제 트랜스미션 스캔이 적용될 때 방사선피폭이 발생되며 술자의 방사선피폭은 평균 14.1743 ${\mu}Sv$이며, 환자의 방사선피폭은 평균 0.9037 ${\mu}Sv$이다. 또한 fusion 영상에서 감마마커와 실사마커가 일치하였고 플러드 선원에 의한 피폭은 없었다. 본원에서 구축한 감마영상과 실사영상의 fusion 프로그램으로 보다 많은 해부학적 정보를 포함하고 있는 영상을 임상의 및 판독의에게 제공할 수 있고, 업무프로세스가 감소되어 편리한 조작이 가능하게 되었다. 또한 플러드 선원에 의한 피폭을 줄일 수 있어서, 다른 핵의학 검사에도 사용이 가능할 것으로 생각되어진다. 하지만 환자의 사생활이 존중되어야 하기 때문에 검사시행 전, 검사진행 과정과 장점 등을 자세하게 설명한 후 환자가 동의할 경우 검사를 실시하여야 할 것이다.

• 간호행정학회지
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• 제8권1호
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• pp.55-72
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• 2002

Purpose : This study aimed at understanding the lived experience of new graduate nurse in hospital setting.Method : This study was based on a phenomenological approach. For this study, 8 new graduate nurses participated. The unstructured in-depth interviews were carried out from June to October, 1998. The data was analyzed Van Kaam's method.Results : Clinical new graduate nurses experienced clinical adaptation and endeavor, professional conflict of nursing, disability of nursing performance, work stress and management, maladaptation of human relationships, diverse emotions of interpersonal relationships, change of personal identity, difference between theory and reality of nursing.Clinical adaptation and endeavor included to get familiar with hospital life, satisfaction and worth for nursing, to get familiar with scoldings, calm down by oneself, efforts for self-development. Professional conflicts of nursing included future uncertainties in the hospital, dissatisfactions in work, doubts and regrets in nursing.Disability of nursing performance included lack of knowledges and skills, desolate working, stresses from mistake in working. Work stress and management included psychological signs and symptoms, physical signs and symptoms, management of stress. Maladaptation of human relationships included unsuitabilities in nursing unit climate, difficulties in human relationship. Diverse emotions of interpersonal relationships included regrets and absurdities to clients, thanks and regrets to colleagues, difficulties with doctors, sense of rivalry with colleague nurses. Change of personal identity included to become narrowing life circle, change of personality. The differences between theoretical knowledge and practice included needs of systematic pre-education for clinical nursing practice, differences between nursing educations and clinical practices.Conclusion : Therefore, the human resource management reflecting new graduate nurses' experiences should be developed.

• 간호행정학회지
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• 제4권2호
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• pp.419-437
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• 1998

Nurses use a nursing process. that is a scientific approach method. in order to understand the clients' condition and to solve their problems. Professional nurses have accepted the nursing process as a standard framework for nursing activities, and the first step of the nursing process is nursing assessment. The purpose of this study was to develop a nursing assessment tool for emergency patients. Assessment is a first step in the nursing process, and scientific assessment helps to better understand the patients. Thus the development of an assessment tool for emergency patients will improve of nursing quality and advance to efficacy of emergency room(ER) management. The study involved the development of a conceptual framework, preliminary tool, content validity verification process. and reliability verification process. The conceptual framework was developed through a review of the literature. and preliminary tool was developed from the conceptual framework that based on care flow sheet' developed James A. Haley. The preliminary tool was evaluated for validity and reliability by seven experts, one ER nurse manager, two ER head nurses, two emergency medicine doctors. and two ER charge nurses and by ten nurses with one to five year careers in ER nursing. The results of this study was as follows 1. The conceptual framework which was developed was composed of three parts. They were triage criteria, first assessment and secondary assessment. 2. The preliminary tool which was developed had 31 items based on the conceptual framework. 3. To test expert validity a 4-point scale was used. items which had gained 3-4 points from six persons of the seven experts were selected. All 31 items from the preliminary tool were selected. 4. The reliability test was done by ten nurses educated in the use of the assessment tool. Two pairs of nurses simultaneously assessed the same patients. A total agreement percentile was calculated and result was 87.3% agreement. 5. After the validity and reliability testing. the final emergency patient nursing assessment tool was finalized with 31 items. and a check-list for the responses. This study concludes that the tool which was developed is both valid and reliable will advance quality care for emergency patients. This emergency nursing assessment tool was also found to be an adequate tool for assessment of emergency patients.

• 대한한방부인과학회지
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• 제19권4호
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• pp.148-158
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• 2006

Purpose : Sanhupung(産後風) is not completed golden standards of diagnosis therefore doctors diagnose through symptoms and signs of patients in clinic same as progress of treatments. We polled oriental gynecologic specialists and non-specialisst to find out cognitive differences on Sanhupung. Subjects : We surveyed 83 specialists and 87 non-speciailist from May 15 2005 to Oct 15. We analyzed the result of respondants, 39 (47%) specialists and 65 (75%) nono-specialits). Methods : We sorted all symptoms in previous studies then we categorized them into 4 fields. The results are analyzed by frequency, importance and impact(frequency percentage${\times}$average importance). Results : Except back pain, all pain symptoms were lower evaluated in non-specialist on frequency. Except inguinal region pain, pain of lower limbs and back pain, all pain symptoms were lower evaluated in non-specialist on importance. Except the numbness of limbs, all items of whole body were lower evaluated in non-specialist on frequency. Except edema, numbness of hand and foot and discharge from the uterus, all items were lower evaluated in non-specialist on importance. All items of neuropsychotic symptoms were lower evaluated in non-specialist on frequency and importance.

• Archives of Plastic Surgery
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• 제34권6호
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• pp.697-704
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• 2007

Purpose: The objective of the study is to identify plastic surgeons' views on the effects of online communication between doctors and patients.Methods: Cross-sectional online survey of members of the Korean Society of Plastic and Reconstructive Surgeons was made to identify their evaluation on the accuracy and the relevance of the internet health information and their perceptions of the effects of discussing the information with the patients on time-efficiency, requests for specific interventions, health outcomes, and the doctor-patient relationship. A questionnaire with 25 items was sent to the surgeons' e-mails, and 111 replied. SPSS Win version 12.0 was used to analyze the statistical differences and meanings among data.Results: The percentage of the plastic surgeons who were experiencing the online communication was 65.8%, and the most frequent medium used was homepage of the clinic/hospital. Even though the percentage of the plastic surgeons who were using the online communication for their everyday practice was high, the percentage of patients who visited the clinic/hospital after using the website of the clinic/hospital was relatively low. The effects of online communication on doctor-patient relationship were neutral in 40(36.0%) and positive in 39(35.1%). The effects on the efficiency of the practice was positive in 45(40.5%), and the effects on the quality of care and the patients' outcome were positive in 46(41.4%) respectively.Conclusion: The ratio of surgeons who are experiencing the online communication is relatively high, whereas the ratio of patients who are using online communication is low. Most of plastic surgeons are positive on the effects of the online communication on doctor-patient relationship, quality of care, and patients' outcome.

• 보건행정학회지
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• 제28권2호
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• pp.128-137
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• 2018

Background: This study aims to utilize Organization for Economic Cooperation and Development (OECD) data to identify macroscopic determinants of health at national level and to utilize it in health policy development through comparison and analysis with Korea. Methods: The potential years of life lost (PYLL) were used as dependent variables and 19 indicators were selected as health determinants to be independent variables based on the results of previous studies. Data analysis was done using SAS ver. 9.4 package (SAS Institute Inc., Cary, NC, USA) and model used in technical statistics concerning PYLL by countries, multi-linearity test between independent variables and OECD economic studies were modified and used. Results: From 1994 to 2012, the average PYLL for OECD countries was 4,262.9 years, the highest in Estonia and the lowest in Iceland. As a result of the analysis using the fixed effect model, the significant variables affecting PYLL were four variables: gross domestic product, nitric oxide, tobacco consumption, and number of doctors. The health determinants that had more influence on the PYLL of Korean people compared to other OECD countries were tobacco consumption, calorie consumption, fat intake and total health expenditure. Conclusion: In order to effectively reduce unnecessary deaths, we must continue to strengthen our smoking policy and nutrition policies such as calorie and fat intake. It is necessary to prevent the increase of total health expenditure due to the increase in the prevalence of chronic diseases and to strengthen the public health aspect.

• Nutritional Sciences
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• 제8권2호
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• pp.125-132
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• 2005

According to Sa-Sang constitution, people can be classified into 4 types, Tae-Yang-In, Tae-Eum-In, So-Yang-In, and So-Eum-In. 1he purpose of this study was to examine any significance between types of Sa-Sang constitution and dietary factors. Physical and constitutional examinations as well as a questionnaire survey were conducted on a group of 483 college students. Among the group of 483 college students, only 428 subjects were determined to have identical constitution through both the questionnaire survey and Korean traditional medical doctors' inquiries. Of 428 subjects, $29.7\%$ were determined to be Tae-Eum-Ins; $35.5\%$ were identified as So-Yang-Ins; $34.8\%$ were classified as So-Eum-Ins. Tae-Eum-Ins showed a statistically significant difference in BMI and higher smoking rate in comparison with groups of So-Yang-Ins and So-Eum-Ins. So-Eum-Ins had a tendency to take vegetables and fruits more often but they had lower preferences for balanced diets. Tae-Eum-Ins showed higher propensity to eat a visible fat protein. In terms of degrees of doneness of meat, So-Yang-Ins showed a higher tendency to prefer well-broiled meat Tae-Eum-Ins also tended to have significantly higher iron, potassium, sodium, vitamin $B_1$, niacin, $\beta$-carotene and vitamin E in their diet So-Eum-Ins had significantly lower intakes of protein, phosphorous, and folate. Considering the fact that most chronic degenerative diseases could be developed by any lifestyle factors, it is necessary to conduct educational programs about lifestyles including dietary habits for maintaining good health; On the basis of the results of this study, it is expected that the scientific, objective and accurate diet information depending upon individual's type of constitution will be provided.

• 기본간호학회지
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• 제2권2호
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• pp.183-197
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• 1995

This study was performed to investigate the characteristic of physical touch in caring situation. The subjects of this study were adults in caring situation, therefore they were composed of 7 patients, 6 nurses, 3 doctors, 3 pharmacologists, 3 men in paramedicine area, 3 nursing educators and 13 normal general adults. The datas were gathered through nonstructured questionaire from June, 20th to September, 15th in 1995. The datas were subjects' descriptions about the intention, perception, and form of physical touch in caring situation and analysed by content analysis. The results as follow : The datas were divided into four areas. There were the situation being necessiated the physical touch, meaning of physical touch, form of physical touch and perception about physical touch in caring situation. The situation being necessiated physical touch were the situation that required physical treatment, to deliver the active expression of concern about the patients, to determine the treatment due to the identification of physical condition of patients and to induce the psychological eqilibrium into patient's mind. The meanings of physical touch in caring situation were - Good meanings that intention is to encourage, to be have hope about health and to deliver the affection willing to help patient. - therapeutic methods that were to facillitate the circulation of blood, to reduce the pain perception and to facillitate the circulation of qi. - interpersonal affectionate relation that the intentions were to deliver the understanding of patient's pain, were to delivery the meaning to the patient not be alone. The forms of physical touch in caring situation were none invasive forms just like laying hands on hand, head, shoulder, gentle knocking on the shoulder or back, massage of legs and back and finger pressure on acupuncture points. The perception of physical touch in caring situation divided into two parts. In family, the perceptions of physical touch in caring situation were to promote health status because physical touch induce the psychological peace, and to evoke the importance of relationship among family members. In relation with care giver, perception of physical touch in caring situation were inevitable process in treatment, and to deliver the trust and concern about patients.

• 지역사회간호학회지
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• 제8권2호
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• pp.381-394
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• 1997

This study was conducted to investigate breast self examination ( = BSE) - related knowledge, attitudes and practice of junior nursing college students in Kwangju. Chonnam province. The subjects were 161 nursing students in 3 junior nursing colleges among 10 colleges in K city and Chonnam province. The data was collected from Nov. 16, 1997 to Dec. 16, 1997 and analyzed by an SAS program for t or F test and Pearson's correlation coefficient. The results were as follows: 1. The mean score of BSE - related knowledge was 18.2, that of BSE-related attitudes was 29.1 and that of BSE-related practice was 3.1. 2. The first advantage of BSE-related practice was the early detection of breast cancer. Reasons for not practicing BSE were difficulty in practicing(33%), and indifference to practicing(29%) in that order. 3. In the relationship between BSE-related characteristics and the scores of BSE-related knowledge, groups having breast cancer history in relatives or neighbors tended to have higher scores than groups not having them significantly(t=2.07, p=0.042). In the relationship between BSE-related characteristics and the scores of BSE-related attitudes, groups practicing BSE(t=1.67, p<0.10) and groups not receiving breast examinations from doctors(t=-1.83, p<0.10) tended to have significantly higher scores than those of others. In the relationship between BSE-related characterestics and the scores of BSE-related practice, the group having a breast cancer history in relatives or neighbors tended to have significantly higher scores than those of others(t=2.05, p=0.04). 4. In the correlation among the scores of BSE-related knowledge, attitude and practice, there was slight or little correlation between the score of BSE-related knowledge and that of BSE-related attitude(r=0.30) ; as well as between attitude and practice (r=0.18).