• The Korean Nurse
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• v.34 no.5
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• pp.52-67
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• 1996

As home care in developing and becoming part of the health care delivery system in Korea, it is necessary to examine the use of nursing diagnoses and related nursing interventions with a view to increasing the standardization of nursing recording. This study was done to examine the nursing diagnosis and related nursing interventions used in home care. Data were collected using a chart review of the nursing notes written for the home care given to 38 patients who had pulmonary diseases or traumatic brain or spinal cord injuries and who had received home care as part of a demonstration home care project in a college of Nursing in Seoul. Early on in the project discussions as to format and use to nursing diagnosis was done and a tool was developed based on Gordon's eleven functional catergories with the addition of categories to cover family and environment. This tool was used in the data collection. Data included nursing diagnosis, etiologies and interventions. Real numbers and percentages were used in the analysis. The results show that the most frequently used diagnoses were in the category of physical function (75.6%), followed by the category of emotional and social function (21.8%). The least frequently used category was the one for family and environment (2.6%). The order of the frequency of recorded nursing interventions was the same, 82.3% for physical function, 16.2% of emotional and social function and 1.5% for family and environment. Under the category of physical functioning the most frequently used nursing diagnoses were related to mobility (62.2%), nutrition (23.6%) and elimination (11.9%). The frequencies of nursing interventions for these three diagnostic categories were 69.8%, 16.0% and 10.8% respectively. For emotional and social functioning, the most frequently used diagnoses were for cognition-perception (37.1%), self-perception (30.6%) and perception of health (23.7%). The ordering of the frequency of nursing interventions varied slightly. The most frequently used interventions were for the category of self-perception (31.7%) followed by cognition-perception (24.1%) and perception of health (22.9%). Looking at individual diagnoses, it was found that within the categroy of physical functioning, the most frequently used diagnosis was "impaired physical mobility" (29.5%) and this diagnosis involved 43.9% of the interventions. This was followed by "ineffective breathing pattern" (19.4%) with 17.7% of interventions, and "alteration in nutrition, less than body requirements" (11.2%) with 8.1% of the interventions. For the emotional social category, noncompliance was the most frequently used nursing diagnosis (18.2%) with 19.2% of the interventions. This was followed by "anxiety" (13.4%) with 13.6% of the interventions and by "knowledge deficit" (13.4%) but with only 5.5% of the interventions. The other diagnoses and interventions did not follow this pattern of frequency. Although there were a large number of diagnostic and intervention events, the number of actual diagnoses and interventions used were relatively small ranging from six interventions for "knowledge deficit" to 40 interventions for "imparied physical mobility". From this it can be concluded that the results of this study could be used as basic data for the development of standardized charts with respect to nursing diagnosis and interventions for clients with pulmonary disease and clients with traumatic brain or spinal cord injuries. Interventions that were direct care activities (1178) were much more frequent that education (430), and assessment and observation (148). There were also few diagnoses or interventions related to the family and the environment. This suggests two areas that need to be developed in home care and that need to be considered in the development of standardized records for use in home care.

• The Korean Journal of Nuclear Medicine
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• v.30 no.4
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• pp.560-569
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• 1996

Background and Purpose : Standardized uptake value(SUV) has been used as a quantitative index for differentiating benign and malignant tumors with F-18-FDG PET In this study, we produced whole body parametric images of SUV(WBPIS) by body weight normalization, and validated the values by comparison with SUV's calculated with regional scans. Subjects and Methods : Whole body scans were followed by regional scans sequentially on 23 patients. In whole body study, transmission and emission scans were acquired for 2 minutes and 6 minutes for each bed position, respectively. In regional study, transmission and emission scans were acquired for 20 minutes. Measured and segmented/ smoothed attenuation correction were applied using these 2 min transmission scans in whole body studies. The effects of attenuation correction on SUVs were evaluated quantitatively using F-18 filled cylindrical phantom. The mean and peak SUVs obtained from WBPIS were compared with SUVs of the regional scans. Results : In phantom studies, with any method of attenuation correction using regional or whole body studies of phantom, SUVs were nearly consistent. In whole body scan, SUV obtained using measured attenuation correction method was a little higher than SUV of regional scan. SUV obtained using segmented/smoothed attenuation correction method was a little lower. In patient studies, WBPIS using segmented/smoothed attenuation correction method was much smoother and more readable. SUVs of WBPIS obtained with both methods of attenuation correction were well correlated with SUVs of regional scans(r=0.9). SUVs of WBPIS with measured attenuation correction method were 5% lower than SUVs of regional scans. SUVs of WBPIS with segmented/smoothed attenuation correction method were 10% lower than SUVs of regional scans. The differences of SUVs of WBPIS by the two attenuation correction methods were relatively small compared with the possible differences derived from biological characteristics of tumors. Conclusion : We concluded that WBPIS could be useful in the quantification of tumor as well as in localization of whole body lesions, which were often outside the field of view in regional scan. WBPIS made using segmented/smoothed attenuation correction method could be used in clinical routines and SUVs from attenuation corrected F-18-FDG PET could be used interchangeably with SUVs of regional studies.

• The Korean Journal of Nuclear Medicine Technology
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• v.18 no.1
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• pp.94-97
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• 2014

Purpose: Standardized uptake value (SUV) is a simple semi-quantitative method that can measure the ratio of the tissue radioactivity between the tumor and normal. SUV is commonly used in PET/CT, however, SUV is affected by various factor. The purpose of this study was to evaluate the impact of the residual activity on SUV depending on the location of catheter insertion device post injection. Materials and Methods: NEMA IEC Body Phantom was imaged using a Discovery 600 PET scanner. In 22 mm diameter sphere, the different activity of $^{18}F-FDG$ (7.4, 14.8, 22.2, 29.6, 37, 55.5 MBq) was filled and background was filled with $^{18}F-FDG$ (5.7 kBq/mL). We scaned the phantom on the assumption that the radioactivity in sphere was residual activity in insertion device. Simulation of PET was divided into three groups based on the location of sphere in Scan FOV (SFOV); inclusion, 1/2 inclusion and exclusion group. Results: Among three groups, the group of excluded sphere showed the highest SUV regardless of the amount of $^{18}F-FDG$ activity. In case of 7.4 MBq, average SUV of inclusion group, 1/2 inclusion and exclusion group was 0.780, 0.840 and 0.896 respectively. However, average SUV of 55.5 MBq showed 0.372, 0.460 and 0.508 with same order. Depend on residual radioactivity in the sphere and position of sphere, the SUV was different minimum of 10.4%, maximum of 62.8%. Conclusion: This study showed that SUV is underestimated as the residual radio-activity is increased. In addition, SUV was a changed according to the position of residual radio-activity. And among the position, exclusion group showed the difference of SUV was lowest. If we measure the residual radio-activity of inserting devices and radio-activity from extra-vasation in the patients, it seems to be more useful in clinical field.

• Journal of Hospice and Palliative Care
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• v.7 no.2
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• pp.200-213
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• 2004

Purpose: The purpose of this study was to create an electronic nursing record form to build a hospice nursing process database to be used in the u-hospital EMR system. Specific aims of the study were: 1. To generate a complete, accurate, and simple electronic nursing record form. 2. To verify its appropriateness following documentation with the standardized hospice protocol. 3. To verify its validity and finalize the hospice nursing process database through discussion among hospice professionals. Methods: Nursing records from three independent hospice organizations were collected and analyzed by five expert hospice nurses with more than 10 years of experience, and a nursing record database was developed. This database was applied to 81 hospice patients at three hospice organizations to verify its completeness. Results: 1. An electronic nursing record form with completeness, accuracy, and simplicity was developed. 2. The completeness of the standardized home hospice service protocol was 95.86 percent. 3. The hospice nursing process database contains 18 items on health problems, 79 items on related causes and major symptoms, and 229 items on nursing interventions. Conclusion: The new nursing record form and database will reduce documentation time and articulate and streamline the working process among team members. They can also improve the quality of hospice services, and ultimately enable us to estimate hospice service costs.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.7 no.1
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• pp.92-109
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• 1996

The objectives of the present study were to provide comprehensive assessment of the impact of epilepsy on the psychological well-being of children with epilepsy and to identify the neurological factors associated with the psychopathology. The participant patients were recruited from the population of children and adolescent aged 7 to 16 attending the OPD of department of pediatric neurology in Seoul National University Hospital in Korea. We exclude mental retardation, pervasive developmental disorder and brain organic pathology. As control group, formal students were chosen and their sex, age, achievement, socioeconomic status were matched to patients. The first author interviewed the children and their family members and obtained the developmental history and family information. We used the following 10 scales for assessing psychological and behavioral problems in patients and their family member. The scales were standardized and their validity and reliability were confirmed before. Parent rating scales : Yale children's inventory, Disruptive behavior disorder scale, Parent's attitude to epilepsy questionnaire, Family environment scale, Symptom check-list-90 revision, Children behavior check-list. Children's self rating scales : Children's depression inventory, Spielberger's state-trait anxiety anxiety, Piers-Harris self-concept inventory and Self-administered Dependency questionnaire for Mother. The result showed the risk factors associated depression were early onset, complex partial seizure, lateralized temporal focal abnormality on EEG, Drug polypharmacy, high seizure frequency and sick factors associated anxiety were old age of patient, lateralized temporal focal abnormality EEG, Drug polypharmacy, high seizure frequency. Also the result of this present study indicated that risk factors associated oppositional defiant disorder, conduct disorder and attention deficit hyperactivity disorder were young age, male, early onset, lateral temporal EEG abnormality and high seizure frequency. According to these results, common risk factors associated psychological and behavioral problems were lateralized EEG temporal abnormality, high seizure frequency in neurological factors.

• Journal of Hospice and Palliative Care
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• v.10 no.3
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• pp.128-136
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• 2007

Purpose: The purpose of this study is to investigate the current state of the home-based cancer patient management project of public health centers throughout the country. The results of the investigation is employed to identify obstacles to the execution of the program and, finally, to develop an efficient management program of home-based cancer patients. Methods: Data on the home-based cancer patient management project were collected and analyzed through visiting interviews or telephone interviews with 225 public health centers throughout the country for six months from July to December, 2006. Results: Obstacles to the present execution of the home-based cancer patient management project were identified. Some of them are : (1) patients' low trust in cancer patient management by local health centers, (2) absence of programs customized to local communities, (3) lack of personnel and vehicles for home-based cancer patient management, (4) lack of education program for personnel in charge of home-based cancer patient management, (5) problems in public health doctors, weak connection to private medical institutions, (6) absence of medical institutions and hospice facilities for cancer patients, and (7) non-standardized volunteer workers, so on. Considering all these problems, some effective management methods are proposed. The basic concept is to keep the autonomy and variety of the local helath centers. And based on this concept, three models of (1) public health center controlled model, (2) medical institutions and hospice facilities-entrusted model and (3) medical institutions and hospice facilities-cooperative model are developed. Conclusion: By adopting an adequate model among proposed three models, the public health centers are expected to achieve an efficient utilization of material resources and manpower. In addition, by inventing their own programs that are proper for the local societies, they can improve the home-based cancer patient management.

• The Korean Journal of Nuclear Medicine
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• v.33 no.5
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• pp.439-451
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• 1999

Purpose : It is important to differentiate malignant from benign lesions of intraocular masses in choosing therapeutic plan. Biopsy of intraocular tumor is not recommended due to the risk of visual damage. We evaluated the usefulness of F-18-FDG PET imaging in diagnosing intraocular neoplasms. Materials and Methods: F-18-FDG PET scan was performed in 13 patients (15 lesions) suspected to have malignant intraocular tumors. There were 3 benign lesions (retinal detachment, choroidal effusion and hemorrhage) and 10 patients with 12 malignant lesions (3 melanomas, 7 retinoblastomas and 2 metastatic cancers). Regional eye images ($256{\times}256$ and $128{\times}128$ matrices) were obtained with or without attenuation correction. Whole body scan was also performed in eight patients (3 benign and 6 malignant lesions). Results: All malignant lesions were visualized while all benign lesions were not visualized. The mean peak standardized uptake value (SUV) of malignant lesions was $2.64{\pm}0.57g/ml$. There was no correlations between peak SUV and tumor volume. Two large malignant lesions ($> 1000 mm^3$) showed hot uptake on whole body scan. But two medium-sized lesions ($100-1000mm^3$) looked faint and two small ($<100mm^3$) lesions were not visualized. The images reconstructed with $256{\times}256$ matrix showed lesions more clearly than those with $128{\times}128$ matrix Conclusion: F-18-FDG PET scan is highly sensitivity in detecting malignant intraocular tumor For the evaluation of small-sized intraocular lesions, whole body scan is not appropriate because of low sensitivity. A regional scan with sufficient acquisition time is recommended for that purpose. Image reconstruction in matrix size of $256{\times}256$ produced clearer images than the ones in $128{\times}128$, but it does not affect the diagnostic sensitivity.

• Journal of Oral Medicine and Pain
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• v.37 no.4
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• pp.233-242
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• 2012

The purposes of this study were to compare psychological profiles, to investigate the differences in the clinical characteristics, and to compare treatment outcomes between myogenous pain and arthrogenous pain subgroups of temporomandibular disorder (TMD) based on Research Diagnostic Criteria for Temporomandibular disorders (RDC/TMD). Two hundred and fifty two patients diagnosed as TMD were divided into three groups based on the RDC/TMD axis I diagnostic guidelines; myogenous pain group, arthrogenous pain group, and mixed pain (both myogenous pain and arthrogenous pain) group. RDC/TMD history questionnaire was administered to each patient and depression, somatization, jaw disability, pain intensity, disability days, and graded chronic pain scale were analyzed. Bruxism, clenching, insomnia, headache, and unilateral chewing were assessed in a standardized TMD dysfunction questionnaire and the duration of onset, chronicity of pain, treatment period, the effectiveness of the treatment, and improvement of symptoms also analyzed. Myogenous pain group had higher depression (p=0.002), and somatization scales (p<0.001) than the arthrogenous pain group. Mixed pain group showed higher pain intensity (p=0.008), disability days (p<0.001), graded chronic pain scale (p=0.005), somatization (p<0.001), and depression scores (p=0.002) than the arthrogenous pain group. Jaw disability did not show any significant differences among the three groups (p=0.058). Arthrogenous pain group reported more limitation of mouth opening than myogenous pain group (p=0.007). Duration of onset showed that the arthrogenous pain group had lowest prevalence of chronicity among three groups (p=0.002). Mixed pain group patients showed lowest symptom improvements among three groups (p=0.007). Multiple linear regression analysis results showed that the treatment effectiveness was significantly associated with somatization score (${\beta}$=-0.251, p=0.03).

• Tuberculosis and Respiratory Diseases
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• v.42 no.1
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• pp.84-92
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• 1995

Background: Nasal applied continuous positive airway pressure(CPAP) is a highly effective method of treatment for obstructive sleep apnea syndrome. More than a decade of accumulated experience with this treatment modality confirmed that it is unquestionably the medical treatment of choice for patients with obstructive sleep apnea syndrome. However it takes long time to reach optimal CPAP pressure. To save the time to reach optimal pressure, it is necessary to clarify the time to reach optimal pressure for treatment of obstructive sleep apnea syndrome. Method: CPAP pressure is titrated during an overnight study according to a standardized protocol. Just before the presleep bio-calibration procedures, the technician applies the nasal mask and switches on the clinical CPAP unit. Initial positive for pressure is typically 3.0 centimeters of water pressure. After sleep onset, the technician gradually increases the pressure until sleep-disordered breathing events disappear or become minimal. The pressure must maintain maximal airway patency during both NREM and REM sleep to be considered effective. Before recommending a final pressure setting, sleep recording and oximetry data are reviewed by an American Board of Sleep Medicine certified Sleep Specialist and a Registrered Polysomnographic Technologist. Results: We examined the time required to reach optimal pressure during routine CPAP titration in 127 consecutively evaluated individuals diagnosed with sleep-disordered breathing. Results indicate that 33% of patients required more than four hours to attain satisfactory titration. This indicates that a four-hour session is marginally enough time, at best, to determine a proper CPAP pressure setting. Moreover, 60 of 127 patients required further adjustment after optimal pressure was reached. These additional pressure trials were needed to confirm that higher pressures were not superior for eliminating sleep-disordered breathing events. Conclusions: The data presented underscore the logistical difficulty of titrating CPAP during split-night studies without modifying the titration procedure. Futhermore, the time needed to reach optimal pressure makes it improbable that proper CPAP titration can be performed during a 2-3 hour nap study.

• Journal of Gastric Cancer
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• v.4 no.4
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• pp.230-234
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• 2004

Purpose: The use of laparoscopic surgery for gastric disease has been gaining popularity. However, there has been the controversy over the indications and the standard techniques of laparoscopic gastric surgery in the early gastric cancer (EGC). The purposes of this study were to compare the clinical outcomes among a hand-assisted laparoscopic distal gastrectomy (HALDG), a laparoscopy-assisted distal gastrectomy (LADG), and an open distal gastrectomy (ODG) and to discuss the role of these procedures in the treatment of EGC. Materials and Methods: Between August 2001 and July 2004, laparoscopic surgery was performed in our institution on 25 patients, LADG (n=7) and HALDG (n=18) with EGC. Analysis was performed on clinical data such as the operative time, the hospital stay, the start of oral intake, and the number of harvested lymph nodes. Patients were categorized into early and late groups by using the date of surgery and were also grouped by surgical procedure. To evaluate the feasibility and efficacy of laparoscopic surgery for EGC, we compared the clinical data with those for ODGs performed during the same period. Results: There was no difference in the number of harvested lymph nodes between the laparoscopic group and the open group, but the operation time in the laparoscopic group was longer than that in the open group (P<0.05). Also, no significant differences in other clinical data were found between the two groups. Comparing the early and the late periods of the series, the number of harvested lymph nodes for a HALDS increased from $22.31\pm4.29\;to\;29.40\pm3.21$ (P<0.05). Conclusion: Our early experience with laparoscopic gastric surgery shows that a wide range of possibilities exist for applying laparoscopic gastric surgery to selected gastric cancer patients. However, the surgical procedure should be standardized, and the outcomes of laparoscopic surgery, in comparison to those of open surgery, need to be confirmed based on a large randomized study. (J Korean Gastric Cancer Assoc 2004;4:230-234)