• The Korean Journal of Nuclear Medicine Technology
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• v.18 no.1
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• pp.26-32
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• 2014

Purpose: As PET-MRI which has excellent soft tissue contrast is developed as integration system, many researches about clinical application are being conducted by comparing with existing display equipments. Because PET-MRI is actively used for head and neck cancer diagnosis in our hospital, lymph node metastasis before the patient's surgery was diagnosed and clinical usefulness of head and neck cancer PET-MRI scan was evaluated using pathological opinions and idiopathy surrounding tissue metastasis evaluation method. Materials and Methods: Targeting 100 head and neck cancer patients in SNUH from January to August in 2013. $^{18}F-FDG$ (5.18 MBq/kg) was intravenous injected and after 60 min of rest, torso (body TIM coil, Vibe-Dixon) and dedication (head-neck TIM coil, UTE, Dotarem injection) scans were conducted using $Bio-graph^{TM}$ mMR 3T (SIEMENS, Munich). Data were reorganized using iterative reconstruction and lymph node metastasis was read with Syngo.Via workstation. Subsequently, pathological observations and diagnosis before-and-after surgery were examined with integrated medical information system (EMR, best-care) in SNUH. Patient's diagnostic information was entered in each category of $2{\times}2$ decision matrix and was classified into true positive (TP), true negative (TN), false positive (FP) and false negative (FN). Based on these classified test results, sensitivity, specificity, accuracy, false negative and false positive rate were calculated. Results: In PET-MRI scan results of head and neck cancer patients, positive and negative cases of lymph node metastasis were 49 and 51 cases respectively and positive and negative lymph node metastasis through before-and-after surgery pathological results were 46 and 54 cases respectively. In both tests, TP which received positive lymph node metastasis were analyzed as 34 cases, FP which received positive lymph node metastasis in PET-MRI scan but received negative lymph node metastasis in pathological test were 4 cases, FN which received negative lymph node metastasis but received positive lymph node metastasis in pathological test was 1 case, and TN which received negative lymph node metastasis in both two tests were 50 cases. Based on these data, sensitivity in PET-MRI scan of head and neck cancer patient was identified to be 97.8%, specificity was 92.5%, accuracy was 95%, FN rate was 2.1% and FP rate was 7.00% respectively. Conclusion: PET-MRI which can apply the acquired functional information using high tissue contrast and various sequences was considered to be useful in determining the weapons before-and-after surgery in head and neck cancer diagnosis or in the evaluation of recurrence and remote detection of metastasis and uncertain idiopathy cervical lymph node metastasis. Additionally, clinical usefulness of PET-MRI through pathological test and integrated diagnosis and follow-up scan was considered to be sufficient as a standard diagnosis scan of head and neck cancer, and additional researches about the development of optimum MR sequence and clinical application are required.

• Health Policy and Management
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• v.12 no.3
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• pp.1-22
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• 2002

Health is a fundamental human right and a sine qua non for happiness of people and for national development. Government has a responsibility for the provision of health services for their people. Recent changes of disease pattern, i.e. decrease of Infectious diseases and increase of chronic and degenerative diseases Including cancer and cardiovascular diseases, together with universal coverage of health insurance and improved living standard have prompted medical care utilization and skyrocketed the national health expenses. The goal of national health policy is improving the quality of life through the betterment of health level. To achieve this goal it is necessary to establish a healthcare system for lifetime, to improve the efficiency of healthcare delivery system, and to strengthen the public health services for disease prevention and health promotion. The current public health service programs are Inefficient due to an inconsistent policy for health service program, lack of health information system, irrational health program planning and evaluation, and Inadequate training of health workers. Local government has a legal responsibility for health service program planning and promoting the competence of health workers. Thus, municipal and provincial health departments should expand their roles and strengthen their function. The strategies for developing public health service programs at local level are ${\circled}1$ stipulating the goals of health policy, ${\circled}2$ promoting the ability for health program planning and evaluation, ${\circled}3$ establishing health information and surveillance system, ${\circled}4$ training of health workers, ${\circled}5$ establishing an institution for health information management and training of health workers, and ${\circled}61$ collaboration with local universities.

• Journal of Nutrition and Health
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• v.52 no.4
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• pp.332-341
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• 2019

Purpose: Poor nutrition in hospitalized patients is closely linked to an increased risk of infection, which can result in complications affecting mortality, as well as increased length of hospital stay and hospital costs. Therefore, adequate nutritional support is essential to manage the nutritional risk status of patients. Nutritional support needs to be preceded by nutrition screening, in which accuracy is crucial, particularly for the initial screening. To perform initial nutrition screening of hospitalized patients, we used the Catholic Kwandong University (CKU) Nutritional Risk Screening (CKUNRS) tool, originally developed at CKU Hospital. To validate CKUNRS against the Patient-Generated Subjective Global Assessment (PG-SGA) tool, which is considered the gold standard for nutritional risk screening, results from both tools were compared. Methods: Nutritional status was evaluated in 686 adult patients admitted to CKU Hospital from May 1 to July 31, 2018 using both CKUNRS and PG-SGA. Collected data were analyzed, and the results compared, to validate CKUNRS as a nutrition screening tool. Results: The comparison of CKUNRS and PG-SGA revealed that the prevalence of nutritional risk on admission was 15.6% (n = 107) with CKUNRS and 44.6% (n = 306) with PG-SGA. The sensitivity and specificity of CKUNRS to evaluate nutritional risk status were 98.7% (96.8 ~ 99.5) and 33.3% (28.1 ~ 39.0), respectively. Thus, the sensitivity was higher, but the specificity lower compared with PG-SGA. Cohen's kappa coefficient was 0.34, indicating valid agreement between the two tools. Conclusion: This study found concordance between CKUNRS and PG-SGA. However, the prevalence of nutritional risk in hospitalized patients was higher when determined by CKUNRS, compared with that by PG-SGA. Accordingly, CKUNRS needs further modification and improvement in terms of screening criteria to promote more effective nutritional support for patients who have been admitted for inpatient care.

• Journal of the Korean Society of Radiology
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• v.17 no.2
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• pp.231-242
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• 2023

This study aims to provide basic data to reduce the incidence of radiation dermatitis and improve patient satisfaction by investigating the management status and satisfaction level of radiation dermatitis in patients undergoing radiation therapy. From October 28, 2022, to April 4, 2023, a survey was conducted on 137 breast cancer patients who received radiation therapy at G Hospital in Busan. The Radiation Therapy Oncology Group (RTOG) cutaneous acute radiotherapy toxicity score was used as the standard for measuring skin reactions, and the association between cancer stage and RTOG was analyzed. SPSS program (ver. 18.0) was used for statistical analysis. The frequency of radiation dermatitis occurrence was relatively low, with 73% in the RTOG 0-1 group and 27% in the 2-3 group. Patient satisfaction after radiation therapy varied significantly depending on the RTOG group, with lower levels of dermatitis resulting in higher satisfaction and higher levels resulting in dissatisfaction (p=0.001). Although there was no statistically significant difference in RTOG group and skin satisfaction depending on the frequency of aloe mist use (p=0.065), the group that used it 1-2 times a day (69.3%) showed a higher satisfaction level. The perceived effects of aloe mist use were statistically significant for decreasing heat sensation (p=0.001), pain (p=0.033), itching (p=0.001), and psychological stability (p=0.027), especially in the higher RTOG groups. Additionally, as cancer stage increased, the severity of radiation dermatitis also increased, which was statistically significant (p=0.001). In conclusion, radiation dermatitis is the most common side effect of radiation therapy, and it can appear in various forms depending on individual skin sensitivity and external factors during treatment. Adequate education before treatment and the use of MD Cream and aloe vera mist are recommended to reduce the incidence and manage radiation dermatitis effectively.

• Journal of Gastric Cancer
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• v.5 no.2
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• pp.95-100
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• 2005

Purpose: Critical pathways (CP), also known as clinical pathways, are management plans that display goals for patients and have led to improved outcomes for many disease entities. This study was aimed at developing a critical pathway for the surgical treatment of gastric cancer patients and evaluating its usefulness. Materials and Methods: A CP was developed and implemented by a team of surgeons, nurses, nutritionists, and administrative officials. Among the 117 patients who received curative gastrectomies for gastric cancer at Kangnam St. Mary's Hospital, The Catholic University of Korea, between October 2003 and August 2004, 26 patients were treated according to the CP. We evaluated its usefulness by comparing the clinical characterisctics, postoperative progress, hospital stays, and costs between the CP and the non-CP groups. Patient satisfaction was also surveyed with questionnaires. Results: Of the initial 26 patients in the CP group, two were excluded from the final evaluation; one patient had a duodenal stump leakage, and the other had a gastric stasis postoperatively. In 8 patients, protocol violation occurred; six patients refused to be discharged on the $7^{th}$ postoperative day, one patient who had an gastric staisis postoperatively stayed for 2 additional days, and one patient who needed ICU care stayed for 4 additional days. The drop-out rate was $7.7\%$ (2/26), and the variance rate was $30.8\%$ (8/26). The mean hospital stay was 11.3 days ($10\~15$ days) for the CP group compared with 17.5 days ($9\∼68$ days) for the non-CP group, resulting in a difference of about 6 days (P<0.05). The mean hospital stays after surgery were 10.3 days ($7\∼68$ days) and 8.3 days ($7\∼12$ days) for the non-CP and the CP groups, respectively, but the difference was statistically not significant (P>0.05). The mean charge during the hospital stay was higher in the non-CP group ( $\\$ 6,292,200) than in the CP group ( $\\$ 4,863,685). The charge per hospital day was higher in the CP group ( $\\$ 430,414) than in the non-CP group ( $\\$ 359,554). Patient satisfaction was higher in the CP group than in the non-CP group. Conclusion: By developing and applying a critical pathway in the surgical treatment of stomach cancer patients, we could reduce the length of hospital stay as well as the cost. A multi-centered prospective study to establish a standard treatment pathway and to demonstrate its effectiveness is needed in the future.

• Radiation Oncology Journal
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• v.22 no.1
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• pp.1-10
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• 2004

Locally advanced (Stage III) non-small cell lung cancer (NSCLC) accounts for approximately one third of all cases of NSCLC. Few patients with locally advanced NSCLC present with disease amenable to curative surgical resection. Historically, these patients were treated with primary thoracic radiation therapy (RT) and had poor long term survival rates, due to both progression of local disease and development on distant metastases. Over the last two decades, the use of multidisciplinary approach has improved the outcome for patients with locally advanced NSCLC. Combined chemoradiotherapy is the most favored approach for treatment of locally advanced unresectable NSCLC. There are two basic treatment protocols for administering combined chemotherapy and radiation, sequential versus concurrent. The rationale for using chemotherapy is to eliminate subclinical metastatic disease while improving local control. Sequential use of chemotherapy followed by radiotherapy has improved median and long term survival compared to radiation therapy alone. This approach appears to decrease the risk of distant metastases,, but local failure rates remain the same as radiation alone. Concurrent chemoradiotherapy has been studied extensively. The potential advantages of this approach may include sensitization of tumor cells to radiation by the administration of chemotherapy, and reduced overall treatment time compared to sequential therapy; which is known to be important for improving local control in radiation biology. This approach Improves survival primarily as a result of improved local control. However, it doesn't seem to decrease the risk of distant metastases probably because concurrent chemoradiation requires dose reductions in chemotherapy due to increased risks of acute morbidity such as acute esophageal toxicity. Although multidisciplinary therapy has led to improved survival rates compared to radiation therapy alone and has become the new standard of care, the optimal therapy of locally advanced NSCLC continues to evolve. The current issues in the multidisciplinary management of locally advanced NSCLC will be reviewed in this report.

• The Korean Journal of Nuclear Medicine Technology
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• v.25 no.2
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• pp.25-28
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• 2021

Purpose CA 72-4 is a tumor marker that uses two monoclonal antibodies, CC49 and B72.3, to measure tumor-related glycoprotein(TAG72) in the serum. CA 72-4 is used to diagnose stomach, ovarian, and pancreatic cancers, and is known to perform high specificity for stomach cancer. The purpose of this study is to re-evaluate the reference value provided by the manufacturer through revalidation of the reference value in CA 72-4. Furthermore this study was conducted to provide useful help when making a clinical diagnosis at gastric cancer center. Materials and Methods We selected 271 patients who had been to health care center in national cancer center for the month of November 2020. The gender of the subjects was 140 males and 131 females, and the age group was from 30s to 60s. The reagent used in the study was a CA 72-4 IRMA KIT (ISOTOPES, Hungary) and the results were measured using a Dream Gamma-10 gamma counter (Shinjin medics, Korea). Results Statistical analysis of the results of this study used Hoffmann's method and Bayesian's method, which are primarily used in setting reference value. As a result of measuring CA 72-4 of 271 patients, the mean value was 4.54 U/mL and the median value was 3.30 U/mL. 24 people who deviated from 3SD were excluded from the measured value, the mean calculated after that was 3.53 U/mL, median was 3.00 U/mL and SD was 1.89. The reference value calculated based on this results was set to 7.31 U/mL. Conclusion The reference value provided by the manufacturer is less than 4 U/mL. It is slightly different from the value calculated in this study, 7.31 U/mL, so it seems necessary to reset the reference value according to the laboratory environment. Currently, we are receiving inquiries about the reference value from the center for gastric cancer at National Cancer Center. If additional research is carried out along with this study, it will be possible to set more accurate reference value.

• Journal of Korean Public Health Nursing
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• v.18 no.2
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• pp.342-357
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• 2004

A descriptive correlation study was done to provide a basic data for comprehensive nursing care by analyzing the relationship between spiritual wellbeing, hope and perceived health status of the rural elderly. 130 respondents who lived at their homes and nursing homes for elders in D county. Kyungbuk province were selected and their age was over 60 years old. Paloutzian and Ellison(1982)'s spiritual wellbeing scale. Nowotny(l989)'s hope scale and Northern Illinois University's health self rating scale was used. From September 2nd to September 30th, 2002, ready made questionnaires were handed out by researcher and two well trained nurse research assistants. to those who can fill it out and for those who cannot fill out the questionnaires alone, the researcher and assistants read it and finished by interview. This study used Pearson's correlation coefficient for the hypothetic test and the average point and standard deviation of spiritual wellbeing, hope, and perceived health status were checked. To find out the difference between spiritual wellbeing, hope, and perceived health status by general characteristics ANOVA and Tukey test were used. The results are as follows : 1. The mean score for spiritual wellbeing of the rural elders was $49.94(\pm5.62)$ in a possible range of 20-80. The mean score of religious wellbeing was $25.20(\pm3.91)$ and that of existential wellbeing was $24.74(\pm2.83)$ in a possible range of 10-40. The average point of religious wellbeing was $2.52(\pm0.39)$ points and existential wellbeing was $2.47(\pm0.28)$ points to 4 point full marks. 2. The mean score for hope was $67.68(\pm10.92)$ in a possible range of 29-116. The average point of hope was $2.33(\pm0.38)$ points to 4 point full marks. 3. The mean score for perceived health status was $9.95(\pm2.66)$ in a possible range of 4-14. The average point of perceived health status was $2.15(\pm0.72)$ point to 4 point full marks. 4. In testing the hypothesis concerning the relationship between spiritual wellbeing and hope, there was a statistically positive correlation(r=0.621. p=0.000). 5. In testing the hypothesis concerning the relationship between hope and perceived health status, there was a statistically positive correlation(r=0.305, p=0.000). 6. There were significant differences in spiritual wellbeing according to age(F=5.60, p=0.000), religion(F=11.61. p=0.000), family status(F=2.86, p=0.040) and average monthly pocket money(F=4.32, p=0.015). 7. There were significant differences in hope according to age(F=16.49, p=0.000), religion (F=3.56, p=0.009), educational level(F=8.94, p=0.000), present occupation(t=-3.13, p=0.002), family status(F=5.90, p=0.001) and average monthly pocket money(F=3.41. p=0.036). 8. There were significant differences in perceived health status according to present occupation(t=-2.16, p=0.033) average monthly pocket money(F=4.11, p=0.019). From the above results it can be concluded that: There was a positive correlation between spiritual wellbeing and hope, hope and perceived health status. There was no positive correlation between spiritual wellbeing and perceived health status. For futher study, adequate spiritual wellbeing scale and hope scale for rural elders should be developed and, age and religion factors has to be reconsidered. When the nurse implicate the nursing intervention which can be promote the spiritual wellbeing and hope, rural elder's spiritual wellbeing and hope can be improved and at the same time, their perceived health status also can be improved.

• Journal of the Korean Wood Science and Technology
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• v.33 no.1 s.129
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• pp.87-96
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• 2005

This study was carried out to evaluate the shear bond strength and adhesive bond durability of structural glued laminated timber (glulam) manufactured with mixed species lumber of Korean red pine, Korean pine and Japanese larch, using resorcinol adhesive and water-based polymeric-isocyanate adhesive (WPI). Each board used as a glulam lamina was graded by visual inspection. The visual lumber grade of the all species was very low due to the large size and number of knots and the steep slope of grain. In view of the results, appropriate pruning, sawing and drying processes might be needed to produce high grade lamina lumber with small knot size and drying defect free. Shear bond strength of every tested glulam specimen ranged between 7.9 and $9.9N/mm^2$, and much higher than the Korean Standard (KS) for glulam shear bond strength, $7.1N/mm^2$. There was not much shear bond strength difference between wood/resorcinol and wood/WPI. The resorcinol adhesive bond durability exceeded KS requirements. However, delamination on the end-grain surfaces of WPI glulam submerged in both room temperature and boiling water severely occurred, and its durability did not meet KS requirements. Further investigations may be required, and special care should be taken, to ensure long service life of WPI glulam used for exterior application. Results of this study are expected to be useful for improvement of mechanical properties and structural performance of mixed species glulam.

• Journal of dental hygiene science
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• v.9 no.4
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• pp.375-380
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• 2009

The purpose of this study was to help improve oral health care planning for the elderly in an effort to promote the oral health of elderly people in preparation for aging society. The subjects in this study were 200 elderly people who were selected by random sampling from senior centers in Seoul. An interview was conducted to gather data from June to September 2008, and the data collected were analyzed.: 1. The mean number of residual tooth was 13.71. 2. Concerning connections between gender and subjective oral symptoms, gender had a statistically significant relationship to temporomandibular joint dysfunction(p=0.000), dry mouth(p=0.001) and halitosis(p=0.006). The men underwent more oral symptoms than the women. 3. As for the relationship of mastication(p=0.000), oral pain(p=0.010), temporomandibular joint dysfunction(p=0.010) and dry mouth(p=0.001) to subjective oral health state, the elderly people who were not in a good oral health suffered more oral symptoms, and the gap between them and the others was statistically significant. 4. A larger number of tooth led to less mastication difficulties, less dry mouth and more gingival diseases, and the relationship between the factors was statistically significant. A better oral health state led to less mastication difficulties, less oral pain, less dry mouth and less bad breath, and the relationship between the factors was statistically significant. Through this study the oral health the elderly people perceive wss concerned with oral symptom, and the number of residual teeth also had links to subjective oral symptoms. Therefore, to maintain original teeth of the elderly people, the management system of oral health and the education program for oral health in order to prevent disease relateded with oral and enhance the perception standard of oral state are indispensably necessary to the elderly people.