• Title/Summary/Keyword: Level of care

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Current Status and Future Perspective of PET (PET 이용 현황 및 전망)

  • Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.1
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    • pp.1-7
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    • 2002
  • Positron Emission Tomography (PET) is a nuclear medicine imaging modality that consists of systemic administration to a subject of a radiopharmaceutical labeled with a positron-emitting radionuclide. Following administration, its distribution in the organ or structure under study can be assessed as a function of time and space by (1) defecting the annihilation radiation resulting from the interaction of the positrons with matter, and (2) reconstructing the distribution of the radioactivity from a series of that used in computed tomography (CT). The nuclides most generally exhibit chemical properties that render them particularly desirable in physiological studies. The radionuclides most widely used in PET are F-18, C-11, O-15 and N-13. Regarding to the number of the current PET Centers worldwide (based on ICP data), more than 300 PET Centers were in operation in 2000. The use of PET technology grew rapidly compared to that in 1992 and 1996, particularly in the USA, which demonstrates a three-fold rise in PET installations. In 2001, 194 PET Centers were operating in the USA. In 1994, two clinical and research-oriented PET Centers at Seoul National University Hospital and Samsung Medical Center, was established as the first dedicated PET and Cyclotron machines in Korea, followed by two more PET facilities at the Korea Cancer Center Hospital, Ajou Medical Center, Yonsei University Medical Center, National Cancer Center and established their PET Center. Catholic Medical School and Pusan National University Hospital have finalized a plan to install PET machine in 2002, which results in total of nine PET Centers in Korea. Considering annual trends of PET application in four major PET centers in Korea in Asan Medical Center recent six years (from 1995 to 2000), a total of 11,564 patients have been studied every year and the number of PET studies has shown steep growth year upon year. We had 1,020 PET patients in 1995. This number increased to 1,196, 1,756, 2,379, 3,015 and 4,414 in 1996,1997,1998,1999 and 2000, respectively. The application in cardiac disorders is minimal, and among various neuropsychiatric diseases, patients with epilepsy or dementia can benefit from PET studios. Recently, we investigated brain mapping and neuroreceptor works. PET is not a key application for evaluation of the cardiac patients in Korea because of the relatively low incidence of cardiac disease and less costly procedures such as SPECT can now be performed. The changes in the application of PET studios indicate that, initially, brain PET occupied almost 60% in 1995, followed by a gradual decrease in brain application. However, overall PET use in the diagnosis and management of patients with cancer was up to 63% in 2000. The current medicare coverage policy in the USA is very important because reimbursement policy is critical for the promotion of PET. In May 1995, the Health Care Financing Administration (HCFA) began covering the PET perfusion study using Rubidium-82, evaluation of a solitary pulmonary nodule and pathologically proven non-small cell lung cancer. As of July 1999, Medicare's coverage policy expanded to include additional indications: evaluation of recurrent colorectal cancer with a rising CEA level, staging of lymphoma and detection of recurrent or metastatic melanoma. In December of 2001, National Coverage decided to expand Medicare reimbursement for broad use in 6 cancers: lung, colorecctal, lymphoma, melanoma, head and neck, and esophageal cancers; for determining revascularization in heart diseases; and for identifying epilepsy patients. In addition, PET coverage is expected to further expand to diseases affecting women, such as breast, ovarian, uterine and vaginal cancers as well as diseases like prostate cancer and Alzheimer's disease.

Domestic Disabled People's Use of Dental Service Institutes and Their Oral Health Related Quality of Life (재가 장애인의 구강진료기관 이용실태와 구강건강관련 삶의 질)

  • Lee, Hyun-Ok;Yang, Chun-Ho;Kim Jin;Kim, Young-Im
    • Journal of dental hygiene science
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    • v.9 no.5
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    • pp.593-600
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    • 2009
  • In this study, disabled people's life quality according to their use of dental healthcare services were examined, and the factors that influence their life quality were examined. The subjects in this study were 198 domestic disabled people in Jeollabuk-do, on whom a survey was conducted from May 1 to June 1, 2008. After the collected data were analyzed with SPSS WIN 12.0 program, the following findings were acquired: 1. 68.2% of the subjects had an experience of using dental service institutes. Over 80.0% of the physically disabled, the mentally handicapped, and the sensory-disturbance sufferers each used dental service institutes in their locations. Regarding the reason for visiting dental service institutes, 43.4% of the physically disabled visited for regular examination (the largest group for that reason), followed by the mentally handicapped with 37.9%. 43.5% of the sensory-disturbance sufferers visited for pain and fracture. 2. The subjects' life quality level relating to oral health was found to be an average 3.39 point score. There was a statistically significant difference in their life quality levels in terms of demographic features, such as age, religion, marriage/non-marriage, education, and subjective health status variables. Those experienced in using dental service institutes enjoyed higher levels of life quality (p=.011). And, with regard to disability characteristics, the degree of disability and the period of disability influenced the quality of life with a statistical significance. 3. Regarding variables influencing the life quality of subjects, in terms of general characteristic variables, subjective health status were influential variables, and in terms of characteristic variables relating to the use of dental clinics and disability, the experience of using dental service institutes influenced the quality of life. In conclusion, nationwide efforts to nurture separate dental personnels responsible for the disabled, to expand relevant facilities and to improve the health care insurance are required to promote the oral health of domestic disabled people's.

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Depressive Symptoms in Patients with Parkinson's Disease (파킨슨병 환자에서의 우울증상)

  • Lee, Moon-Sook;Yang, Chang-Kook;Hah, Hong-Moo;Kim, Jae-Woo
    • Korean Journal of Psychosomatic Medicine
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    • v.11 no.1
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    • pp.25-35
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    • 2003
  • Objectives: The aim of this study was to investigate 1) the prevalence of depressive symptoms, 2) the severity of depressive symptoms, 3) the correlation of depressive symptoms with clinical variables, and 4) factors that contribute to depressive symptoms in patients with Parkinson's disease. Methods: One hundred eighteen patients with Parkinson's disease referred from the Parkinson's Disease Clinic of Dong-A University Hospital, Busan, Korea, completed a self-administered questionnaire package, which included basic demographic data, the Beck Depression Inventory, the Parkinson's disease quality of life questionnaire, the Symptom Checklist-90-Revision(SCL-90-R), and the Spielberger's State-Trait Anxiety Inventory. In addition, a structured interview and a complete neurological examination, including the Hoehn and Yahr stage, the motor part of the Unified Parkinson's Disease Rating Scale(some selected scales of UPDRS part III), the Schwab and England Activities of Daily Living scale(ADL), and the Korean version of Mini-Mental State Examination were performed. Results: 1) Based on BDI score, subjects were divided into four groups:severely(40.7%), moderately(13.6%) and mildly(12.7%) depressive and non-depressive(33.1%). 2) The severity of depressive symptom in Parkinson's disease was positively correlated with Hoehn and Yahr(H & Y) stage(r=0.34, p<0.0001), the severity of motor symptom(r=0.35, p<0.0001), and trait anxiety inventory(r=0.33, p<0.001). On the other hand, the severity of depressive symptom was negatively correlated with educational level(r=-0.34, p<0.001), ADL(r=-0.37, p<0.0001) and Parkinson's disease quality of life (PDQL)(r=-0.69, p<0.0001). Among several clinical variables, the PDQL was the most influential factor predicting whether the depressive symptom was present or not. Conclusion: This study suggests that depressive symptom is very prevalent among patients with Parkinson's disease. Data from this study indicate that medical staffs who take care of patients with Parkinson's disease should pay attention to finding and treating depressive symptom among their patients. With appropriate psychiatric intervention, patient's depressive symptom can be minimized or alleviated and thus, the quality of life in these patients is likely enhanced.

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Awareness and Need as Factors in an Incremental Oral Health Care Program for Korean Adults (일부 성인의 계속구강관리프로그램 인식과 요구도)

  • Jang, Ho-Yeol;Lee, Su-Ryeon;Lee, Yun-Ji;Lee, Soo-Bin;Lee, Ha-Neul;Lee, Hye-Bin;Hwang, Soo-Jeong
    • Journal of dental hygiene science
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    • v.16 no.6
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    • pp.442-448
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    • 2016
  • Dental caries and periodontal disease are considered to be chronic, but can be prevented through an incremental oral health program covering all ages. The National Oral Health Program for adults provides oral health exam and scaling, and is covered by national health insurance for those over 20 years of age in Korea. The aim of this study was to collect basic data for developing an oral health program for adults by identifying factors related to awareness and need. The data were obtained by convenience sampling of 303 subjects. The use of dental plaque disclosing agents affected tooth brushing frequency, toothbrushing time and use of oral auxiliary devices. Education on toothbrushing methods affected toothbrushing time and use of oral auxiliary devices. Of those surveyed, 93.1% replied that an incremental oral health program for adults was needed, and 68.0% intended to participate. In a regression model, the factors that had an effect on the perceived need for an oral health program were education level, use of oral hygiene auxiliary devices, and toothbrushing time, and the factors affecting intent to participate were education for prevention of periodontal disease and the use of oral hygiene auxiliary devices. The subjects stated that the following oral health programs were needed: an oral bacteria exam (74.3%), toothbrushing education (71.6%), a bad breath exam (69.3%), education on use of oral hygiene auxiliary devices (46.9%), a dental plaque exam (42.9%) and a saliva exam (37.6%). Oral health education appears to be an important factor for participation in an incremental oral health program.

A Study on the Status of Medical Equipment and Radiological Technologists using Big Data for Health Care: Based on Data for 2020-2021 (보건의료 빅데이터를 활용한 의료장비 및 방사선사 인력 현황 연구 : 2020-2021년 자료를 기준으로)

  • Jang, Hyon-Chol
    • Journal of the Korean Society of Radiology
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    • v.15 no.5
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    • pp.667-673
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    • 2021
  • As we enter the era of the 4th industrial revolution, it is judged that the scope of work of radiologists will be further expanded according to the innovation and advancement of radiation medical technology development. In this study, the current status of medical equipment and radiology technicians was identified, and basic data were provided for the plan for nurturing talents in the field of radiation medical technology in the era of the 4th industrial revolution, as well as career and employment counseling. Data from the second quarter of 2020 and the second quarter of 2021 were analyzed using health and medical big data. As a result of comparing the status of medical equipment by type in 2021 compared to 2020, C-Arm X-ray examination equipment increased by 5.83% to 6,638 units, followed by MRI examination equipment 1,811 units 5.29%, and angiography equipment 725 units 5.22% , general X-ray examination equipment 21,557 units increased 3.99%, CT examination equipment 2,136 units 3.03%, and breast examination equipment 3,425 units increased 3.00%. As a result of a comparison of the total number of radiologists in 2021 compared to 2020, the number was 29,038, an increase of 2.73%. As a result of comparing the status of radiographers by region, the increase was highest in the Gyeonggi region with 5.96%, followed by the Gangwon region with a 5.66% increase and the Chungnam region with a 3.81% increase. In a situation where the number of medical equipment and radiologist manpower is increasing, universities are developing specialized knowledge and practical competency through subject development related to the understanding and utilization of customized artificial intelligence and big data that can be applied in the medical radiation technology field in the era of the 4th industrial revolution. It is necessary to nurture qualified radiographers, and at the level of the association, it is thought that active policies are needed to create new jobs and improve employment.

Cardiac Intracoronary Stenting vs CABG: Prevention of Medical Accident (심장 스텐트 시술과 의료사고 예방)

  • Kim, Kyoung Reay;Park, Kook Yang
    • 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.

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Predictable risk factors and clinical courses for prolonged transient tachypnea of the newborn (지속성 신생아 일과성 빈호흡을 예측하게 하는 위험인자와 임상경과)

  • Chang, Ji Young;Kim, Chang Ryul;Kim, Ellen A;Kim, Ki Soo
    • Clinical and Experimental Pediatrics
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    • v.53 no.3
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    • pp.349-357
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    • 2010
  • Purpose : Transient tachypnea of the newborn (TTN) is usually benign and improves within 72 hours. However, it can also progress to prolonged tachypnea over 72 hours, profound hypoxemia, respiratory failure, and even death. The aim of this study is to find predictable risk factors and describe the clinical courses and outcomes of prolonged TTN (PTTN). Methods : The medical records of 107 newborns, >$35^{+0}$ weeks of gestational age with TTN, who were admitted to the NICU at Seoul Asan Medical Center from January 2001 to September 2007 were reviewed. They were divided into 2 groups based on duration of tachypnea. PTTN was defined as tachypnea ${\geq}72$ hours of age, and simple TTN (STTN) as tachypnea <72 hours of age. We randomly selected 126 healthy-term newborns as controls. We evaluated neonatal and maternal demographic findings, and various clinical factors. Results : Fifty-five infants (51%) with total TTN were PTTN. PTTN infants had grunting, tachypnea >90/min, $FiO_2$ >0.4, and required ventilator care more frequently than STTN infants. PTTN had lower level of serum total protein and albumin than STTN. The independent predictable risk factors for PTTN were grunting, maximal respiration rate >90/min, and $FiO_2$ >0.4 within 6 hours of life. Conclusion : When a newborn has grunting, respiration rate >90/min, and oxygen requirement >0.4 of $FiO_2$ within 6 hours of life, the infant is at high risk of having persistent tachypnea ${\geq}72$ hours. We need further study to find the way to reduce PTTN.

Reduction Effect of Aromatherapy on Stress and Insomnia (아로마요법의 스트레스 및 수면장애 감소효과)

  • Park, Sang-Ock;Kim, Seok-Beom;Lee, Kyeong-Soo;Kang, Pock-Soo
    • Journal of agricultural medicine and community health
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    • v.27 no.2
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    • pp.17-26
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    • 2002
  • Reducing the level of stress and insomnia by aromatherapy is proposed as a method of self-care and health promotion in the future. Of the people who received aromatherapy from July, 1999 to February, 2000 at the Complementary and Alternative Medicine Center at the Gyeongu City Health Center, 48 people agreed to participate in a questionnaire survey, presented before and after their aromatherapy, and the data were analyzed. When the people received aromatherapy at the Complementary and Alternative Medicine Center, they inhaled the aroma from a vaporizer and when at home, they inhaled from a tissue, gauze or washbowl. Two sessions per week (2 hrs./session) were provided at the Center in the total 1-month duration of the therapy. The oil made from a blend of clarysage, geranium, rose at a ratio of 3:2:1 was used for relieving stress, and the oil made from a blend of clarysage, lavender, and lemon at 2:2:1 ratio was used for relieving insomnia. The scores of stress of 92.5 17.5 points before aromatherapy significantly reduced to $87.4{\pm}4.2$ points after therapy(p<0.01), and the scores of insomnia of $2.5{\pm}1.2$ points before aromatherapy significantly reduced to $1.0{\pm}1.1$ points after therapy(p<0.01). The reduction in stress and insomnia from aromatherapy was more significant in those who were experiencing high levels of stress and insomnia. Therefore, stress and its related insomnia can be effectively relieved with proper application of aromatherapy. With benefits such as little side-effects, convenient and simple education, low cost, and the do-it-yourself feature. aromatherapy can be expanded into a self-management program for promoting health of the community people.

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Oral Health Status of Some Patients with Chronic Mental Illness in Korea (일부 만성 정신질환자의 구강건강 상태)

  • Seo, Hye-Yeon;Jeon, Hyun-Sun;Park, Su-Kyung;Park, Ki-Chang;Chung, Won-Gyun;Mun, So-Jung
    • Journal of dental hygiene science
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    • v.13 no.4
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    • pp.493-500
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    • 2013
  • The study aims to determine the status of oral health of mental illness patients and establish the preliminary data. The examinations and questionnaire survey were done 92 psychiatric patients to measure sociodemographic characteristics, decayed, missing and filled teeth (DMFT) index, patient hygiene performance (PHP) index, community periodontal index of treatment need (CPITN). Result of the missing teeth index in the state of oral health was higher in the hospital group (6.42) while the filled teeth index was higher in the center group (4.78). In the DMFT index, mental illness patients were higher than the national sample. The oral health status of medical aid recipients was poorer as the subjects were older and less educated (p<0.05). The PHP index was 3.41, close to the bad oral hygiene state. The hospital group (81.7%) required higher need for periodontal treatment. The periodontal health state was much poorer especially when the subject was in the age of 40's and 60's, received less education, and had no family (p<0.05). $CPITN_3$ was higher in the hospital group (13.3%) than the national sample (5.7%). The mental illness patients were socially vulnerable, therefore oral health care program should be needed and age, education level, health insurance type, presence of family and other factors needs to be considered in this approach.

Antioxidant and Anti-wrinkling Effects of Aruncus dioicus var. kamtschaticus extract (눈개승마 추출물의 항산화 및 주름개선 효과)

  • Youn, Jin-Suk;Shin, Seung-Yong;Wu, Yongxiang;Hwang, Ju-Young;Cho, Jae-Ho;Ha, Yong-Geun;Kim, Jin-Ki;Park, Min-Jeong;Lee, Seon-Ho;Kim, Tae-Hoon;Kim, Tae-Wan
    • Food Science and Preservation
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    • v.19 no.3
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    • pp.393-399
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    • 2012
  • In this study, the antioxidant and anti-wrinkling effects of extracts from Aruncus diocius var. kamtschaticus (ADV) were investigated. According to the results, the ethanol extract has better antioxidant and anti-wrinkling effects than the water extract. The amounts of total polyphenol and flavonoid compounds in the ethanol extract were 122 and 36 mg/g, respectively, while those in the water extract were 87 and 26 mg/g. The antioxidant activities of the ethanol and water extracts were 395 and 4,682 ${\mu}g/mL$ as the $RC_{50}$ values for the DPPH radical scavenging activity, and 227 and 366 ${\mu}g/mL$ for the $ABTS^+$ radical scavenging activity, respectively. The reducing power of the ethanol extract (1.58 at 2 mg/mL) was higher than that of the water extract (0.88 at 2 mg/mL). The astringent activities of the ethanol and water extracts were 91.27 and 16.35% at 10 mg/mL, respectively. Furthermore, the ADV ethanol extract treatment of the fibroblast cell after UV irradiation resulted in increased cell viability (10% at 100 ${\mu}g/mL$) and collagen biosynthesis (33% at 100 ${\mu}g/mL$), with a lowering in the MMP-1 expression level (16.8 % at 100 ${\mu}g/mL$). These results demonstrate that AVD provides a remarkable and significant tensor and anti-wrinkling effect on the skin, which could be of a great use in anti-aging skin care products.