• 대한임상검사과학회지
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• 제37권2호
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• pp.88-95
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• 2005

Even though the echocardiograph has been recognized as the method of choice among various diagnostic tools to detect congestive heart failure (CHF), there were some limitations in relation to the consumption of time, labor and process. We analyzed results of N-terminal probrain-type natriuretic peptide (NT-proBNP) and various parameters of the echocardiographic findings to clarify the diagnostic usefulness of NT-proBNP in detecting patients with CHF. We analyzed the sera from total of 242 cases from in-patients and out-patients, which were requested from the cardiovascular section of department of Internal Medicine at Chungnam National University Hospital from March 2003 to May 2004. The procedures were performed in order as shown below; sampling, NT-proBNP analysis, data acquisition and data analysis. All data including personal information and echocardiographic findings ware acquired by medical record review. When classifying the study population into six groups according to the degree of left ventricular ejection fraction (LVEF), the serum level of NT-proBNP was higher in the group with 51-60% of LVEF (P=0.023). There were low correlation between the serum level of NT-proBNP and various parameters of the echocardiographic findings with LVESD (r=0.1513), LVEDD (r=0.0831), LVEF (r=0.2035), IVST (r=0.03) and LVPWT (r=0.0728), respectively. When comparing NT-proBNP with atrial and/or ventricular enlargement, the patient group with both left atrial and left ventricular enlargement (p=0.186) or only left atrial (p=0.105) or only left ventricular enlargement (p=0.256) showed higher level of NT-proBNP without statistical significance than patient group with no enlargement. Searching the optimal cutoff of the serum level of NT-proBNP, the sensitivity (98.9%) and the specificity (100%) was highest at the cutoff of 300 pg/mL than any other cutoffs. These findings suggested that the analysis of NT-proBNP in serum might detect the patients with CHF earlier than with the echocardiograph, especially in patients with asymptomatic or mild symptomatic CHF. In conclusion, NT-proBNP test was proved to be clinically useful to diagnose CHF patients.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제19권4호
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• pp.7-18
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• 2013

Purpose: The aim of this paper is to reduce the stress and the disturbance occur in selective action of patient. This article will also help us to control spreading and reduce the order and bacteria produced by leprosy disease among the lepers. This will be achieved with the help of several variables and these variables help us on health benefits is 5S (Sort, Straighten, Shine, Standardize, Sustain) i.e. ratio of sectional morphology, lessor 90 degree angles, day light, universal design building and maximum ventilation. The replies from the questionnaire were collected based on varying levels of satisfaction and gloominess on the scale of 1-10. Methods: The multi-layer methodological framework for maximising the healing environment obtained from the observation of schemes and parameters of ANOVA: (Analysis Of Variance between five deciding factors) are. Firstly applied for the calculation of the patient's satisfaction for U.V light from sun on ECOTECT simulation, secondly the number of $90^{\circ}$ angle, along the corridors. Thirdly understanding the ways to represent people's perceptual structures and way finding with Space Syntax software. Fourthly the ratio of depth to height of the building typology and finally interviewing the subjects describing their special experiences based on scale value. The focus of this testing of human subjects was to receive data for the existence of image scheme in way-finding and to identify the mechanisms by which sun light impacts human (lepers) health. Results: AMPVA studies concluded that there is similarity between I and O plan as well as L and H plan whereas U plan was difference among the five selected architectural shapes. Implications: The purpose of this research is to show the effects of the I-type, L-type, C-type, U-type and O-type plan design, and to analyse the morphology for EBD (Evidence-Based Design) healing environment which is a universal design for Munghopir Karachi, in Pakistan.

• Parasites, Hosts and Diseases
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• 제48권3호
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• pp.203-211
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• 2010

Advancements in the field of proteomics have provided great opportunities for the development of diagnostic and therapeutic tools against human diseases. In this study, we analyzed haptoglobin and amyloid A protein levels of vivax malaria patients with combinations of depletion of the abundant plasma proteins, 2-dimensional gel electrophoresis (2-DE), image analysis, and mass spectrometry in the plasma between normal healthy donors and vivax malaria patients. The results showed that the expression level of haptoglobin had become significantly lower or undetectable in the plasma of vivax malaria patients due to proteolytic cleavage when compared to healthy donors on 2-DE gels. Meanwhile, serum amyloid A protein was significantly increased in vivax malaria patient's plasma with high statistical values. These 2 proteins are common acute phase reactants and further large scale evaluation with a larger number of patient's will be necessary to establish the possible clinical meaning of the existential changes of these proteins in vivax malaria patients. However, our proteomic analysis suggests the feasible values of some plasma proteins, such as haptoglobin and serum amyloid A, as associating factor candidates for vivax malaria.

• Journal of Gastric Cancer
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• 제14권1호
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• pp.39-46
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• 2014

Purpose: According to current guidelines, perioperative chemotherapy is an integral part of the treatment strategy for advanced gastric cancer. Randomized controlled studies have been conducted in order to determine whether perioperative chemotherapy leads to improved R0 resection rates, fewer recurrences, and prolonged survival. The aim of our project was to critically appraise three major studies to establish whether perioperative chemotherapy for advanced, potentially resectable gastric cancer can be recommended on the basis of their findings. Materials and Methods: We analyzed the validity of the three most important studies (MAGIC, ACCORD, and EORTC) using a standardized questionnaire. Each study was evaluated for the study design, patient selection, randomization, changes in protocol, participating clinics, preoperative staging, chemotherapy, homogeneity of subjects, surgical quality, analysis of the results, and recruitment period. Results: All three studies had serious shortcomings with respect to patient selection, homogeneity of subjects, changes in protocol, surgical quality, and analysis of the results. The protocols of the MAGIC and ACCORD-studies were changed during the study period because of insufficient recruitment, such that carcinomas of the lower esophagus and the stomach were examined collectively. In neither the MAGIC study nor the ACCORD study did patients undergo adequate lymphadenectomy, and only about half of the patients in the chemotherapy group could undergo the treatment specified in the protocol. The EORTC study had insufficient statistical power. Conclusions: We concluded that none of the three studies was sufficiently robust to justify an unrestrained recommendation for perioperative chemotherapy in cases of advanced gastric cancer.

• 한국치위생학회지
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• 제18권2호
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• pp.227-237
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• 2018

Objectives: This study aims to recognize the importance of dental hygiene process diagnosis of dental hygiene process which can comprehensively grasp the patient's problem and to use it as a basis for establishing the patient's preventive treatment plan. Methods: This study did survey to 443 patients who received treatment based on the oral health care program from a dental clinic in Busan from January 2015 to January 2017. Data analysis was performed using IBM SPSS Statistics (Version 21.0), and statistical significance level was set at ${\alpha}=0.05$. Binary logistic regression analysis was performed to the dental hygiene problems affecting the dental hygiene plan. Results: There were significant differences in dental hygiene problems between male and female respondents on various dental problems such as dental plaque deposition, attrition, stain, dental fear, possibility of jaw joint disorder, food pressing, possibility of malocclusion. There were also significant differences in dental hygiene plans between male and female respondents in air-Jet, non-smoking education, and sealant. The most common dental hygiene plan was scaling, The problem of stain showed that the scaling plan was 0.20 times less. The explanatory power of the model was 43.5%, and the Hosmer and Lemeshow tests were 0.345. Conclusions: Therefore, if we continue to study the factors affecting the dental hygiene problems and the plan, we can reduce the burden of the dental hygienists applying the dental hygiene process in the dental clinic. And, it is expected that the oral health care program using the dental hygiene process will spread to the dental clinic as an excellent oral preventive program.

• 대한간호학회지
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• 제53권6호
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• pp.652-665
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• 2023

Purpose: This study aimed to develop a nursing clinical judgment scale (NCJS) and verify its validity and reliability in assessing the clinical judgment of nurses. Methods: A preliminary instrument of the NCJS comprising 38 items was first developed from attributes and indicators derived from a literature review and an in-depth/focus interview with 12 clinical nurses. The preliminary tool was finalized after 7 experts conducted a content validity test based on a data from a preliminary survey of 30 hospital nurses in Korea. Data were collected from 443 ward, intensive care unit, emergency room nurses who voluntarily participated in the survey through offline and online for the verification of the construct validity and reliability of the scale. Results: The final scale comprised 23 items scored on a 5-point Likert scale. Six factors - integrated data analysis, evaluation and reflection on interventions, evidence on interventions, collaboration among health professionals, patient-centered nursing, and collaboration among nurse colleagues - accounted for 64.9% of the total variance. Confirmatory factor analysis supported the fit of the measurement model, comprising six factors (root mean square error of approximation = .07, standardized root mean square residual = .04, comparative fit index = .90). Cronbach's α for all the items was .92. Conclusion: The NCJS is a valid and reliable tool that fully reflects the characteristics of clinical practice, and it can be used effectively to evaluate the clinical judgment of Korean nurses. Future research should reflect the variables influencing clinical judgment and develop an action plan to improve it.

• 한국콘텐츠학회논문지
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• 제22권2호
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• pp.578-592
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• 2022

본 연구는 국내 요양병원의 의료서비스 품질과 관계의 질 및 환자 충성도 간의 영향 관계를 검증하는 데 목적이 있다. 이를 위해 총 324명의 환자를 대상으로 설문조사를 실시하였으며, 조사 결과는 다음과 같다. 첫째, 요양병원 의료 서비스품질이 관계의 질에 미치는 영향을 분석한 결과, 의료 서비스품질변수 중에서 요양시설장비, 요양의료진, 요양서비스시스템, 요양시설 평판은 관계의 질에 유의미한 정(+)의 영향을 미치는 것으로 나타났으며, 진료비는 유의미한 영향이 없었다. 둘째, 요양병원 환자와 병원 간의 관계의 질이 환자 충성도에 미치는 영향을 분석한 결과, 관계의 질 변수 중에서 신뢰와 관계몰입은 모두 환자 충성도에 유의미한 정(+)의 영향을 미치는 것으로 나타났다. 셋째, 요양병원 의료 서비스품질이 환자 충성도에 미치는 영향을 분석한 결과, 의료 서비스품질 변수 중에서 요양시설장비, 요양의료진, 요양서비스시스템, 요양시설 평판은 환자 충성도에 유의미한 정(+)의 영향을 미치는 것으로 나타났으며, 진료비는 유의미한 영향이 없었다. 넷째, 요양병원 의료 서비스품질과 환자 충성도의 관계에서 관계의 질의 매개효과를 분석한 결과, 요양 진료비를 제외한 요양시설장비, 요양의료진, 요양서비스시스템, 요양시설 평판 모두 환자와 병원 간의 관계의 질을 매개로 하여 환자 충성도에 긍정적인 영향을 미치는 것으로 나타났다.

• 품질경영학회지
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• 제41권4호
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• pp.527-539
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• 2013

Purpose: Methods for increasing health-care service quality are considered for a women-centered hospital located on a local city. A walk-through audit is applied to uncover areas for improvement. Methods: A survey questionnaire with 25 questions is constructed based on a service blueprint for a walk-through audit, and a survey is conducted both to patients and service providers to assess a health-care service quality. Frequency analysis, statistical tests and customer-provider analysis are used to analyze surveyed data. Results: According to customer-provider analysis, 6 attributes belong to 'problem unawareness' zone in which they are rated high by service providers but low by patients, and another 6 attributes belong to 'problem awareness' zone in which they are rated low by both groups. These attributes are considered to be improved with priority. Conclusion: Both patient group and service provider group have lots of different perceptions on most attributes that are examined, and the hospital to be studied is, in general, competitive in technical quality and less competitive in functional quality.

• 대한간호학회지
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• 제50권1호
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• pp.132-146
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• 2020

Purpose: The purpose of this study was to develop a new version of Spirituality Assessment Scale (N-SAS) and verify its reliability and validity. Methods: The total of 59 preliminary items for the N-SAS were selected through a literature review, two rounds of experts' content validation, cognitive interviews, and pre-tests. Verification of its reliability and validity was divided into two phases. In Phase I, questionnaires were collected from 219 adults. Reliability was tested using Cronbach's alpha, validity with item analysis, and exploratory factor analysis. In Phase II, questionnaires developed based on the results of Phase I were collected from 225 adults. Reliability was tested using Cronbach's alpha, validity with confirmatory factor analysis, and criterion validity. Results: The final version of the N-SAS comprised two dimensions (vertical and horizontal), four domains (relationship with God; meaning of life and self-integration; self-transcendence; and relationship with others, neighborhoods, and nature), and 44 items were identified. Total Cronbach's α was .97; those of each subscale ranged from .79 to .98. N-SAS scores were positively correlated with the scores of Howden's Spiritual Assessment Scale (r=.81, p<.001). Conclusion: Findings suggest that the N-SAS can be used to measure spirituality in adults. The use of N-SAS is expected to facilitate perceiving patient's spiritual needs and providing spiritual care.

• 한국의학물리학회지:의학물리
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• 제30권3호
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• pp.65-73
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• 2019

Purpose: We evaluated the motion-induced dosimetric effects on the field-in-field (FIF) technique for whole-breast irradiation (WBI) using actual patient organ motion data obtained from cine electronic portal imaging device (cine EPID) images during treatment. Materials and Methods: Ten breast cancer patients who received WBI after breast-conserving surgery were selected. The static FIF (SFIF) plan involved the application of two parallel opposing tangential and boost FIFs. To obtain the amplitude of the internal organ motion during treatment, cine EPID images were acquired five times for each patient. The outside contour of the breast (OCB) and chest wall (CW) contour were tracked using in-house motion analysis software. Intrafractional organ motion was analyzed. The dynamic FIF (DFIF) reflecting intrafractional organ motion incorporated into the SFIF plan was calculated and compared with the SFIF in terms of the dose homogeneity index (DHI_90/10) for the target and V₂₀ for the ipsilateral lung. Results: The average motion amplitudes along the X and Y directions were 1.84±1.09 mm and 0.69±0.50 mm for OCB and 1.88±1.07 mm and 1.66±1.49 mm for CW, respectively. The maximum motion amplitudes along the X and Y directions were 5.53 and 2.08 mm for OCB and 5.22 and 6.79 mm for CW, respectively. Significant differences in DHI_90/10 values were observed between SFIF and DFIF (0.94 vs 0.95, P<0.05) in statistical analysis. The average V₂₀ for the lung in the DFIF was slightly higher than that of the SFIF in statistical analysis (19.21 vs 19.00, P<0.05). Conclusion: Our findings indicate that the FIF technique can form a safe and effective treatment method for WBI. Regular monitoring using cine EPID images can be effective in reducing motion-induced dosimetric errors.