• Title/Summary/Keyword: Standardized patients

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The Difference of Lung Cancer Prevalence According to Smoking Habits (흡연 습관에 따른 폐암 발생의 차이)

  • Park, Moo Suk;Chung, Jae Ho;Jung, Jae Hee;Kim, Young Sam;Kim, Se Kyu;Jee, Sun Ha;Chang, Joon;Kim, Sung Kyu
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.3
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    • pp.267-279
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    • 2003
  • Background : The purpose of this study was to analyze the smoking habits in patients with lung cancer and identify any difference of prevalence according to histologic types of lung cancer. Methods : The data were calculated by total amounts of tar and nicotine inhaled during the whole lifetime according to variation of smoking habit. This study was to investigated any difference of prevalence in lung cancer according to smoking habits. The subjects comprised 150 lung cancer cases and 300 hospital control cases that were matched by age and sex. Smoking habits during the whole lifetime were surveyed by standardized questionnaire. Odds ratios were estimated by unconditional logistic regression analysis. Results : There were 104 male and 34 female lung cancer cases. By histologic type, there were 53 cases of squamous cell carcinoma, 67 of adenocarcinoma and 30 of small cell lung carcinoma. The differences between lung cancer cases and controls according to smoking habits were total duration of smoking, total pack years of smoking and number of cigarettes smoked per day during the previous two years. The odds ratio were higher in Kreyberg I, but not in Kreyberg II, for the longer duration of smoking, the greater total pack years of cigarettes consumed, the more cigarettes smoked per day during the previous two years, the longer duration on non-filter smoking, the earlier life cases who began to smoke, and the higher amounts of calculated total tar and nicotine inhaled over the whole lifetime. When we added grade of inhalation to calculation of amounts of tar and nicotine inhaled over the lifetime, the odds ratios of total inhalation amounts of tar and nicotine were as high as those the without them. Conclusions : This study reconfirmed that smoking habits were strongly associated with lung cancer and that there were different associations between smoking habits and histologic types of lung cancer. In particular, calculations of total tar and nicotine amounts inhaled over the whole lifetime were calculated for the first time in trials from lung cancer epidemiologic studies.

A STUDY ON THE MEASUREMENT OF THE IMPLANT STABILITY USING RESONANCE FREQUENCY ANALYSIS (공진 주파수 분석법에 의한 임플랜트의 안정성 측정에 관한 연구)

  • Park Cheol;Lim Ju-Hwan;Cho In-Ho;Lim Heon-Song
    • The Journal of Korean Academy of Prosthodontics
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    • v.41 no.2
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    • pp.182-206
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    • 2003
  • Statement of problem : Successful osseointegration of endosseous threaded implants is dependent on many factors. These may include the surface characteristics and gross geometry of implants, the quality and quantity of bone where implants are placed, and the magnitude and direction of stress in functional occlusion. Therefore clinical quantitative measurement of primary stability at placement and functional state of implant may play a role in prediction of possible clinical symptoms and the renovation of implant geometry, types and surface characteristic according to each patients conditions. Ultimately, it may increase success rate of implants. Purpose : Many available non-invasive techniques used for the clinical measurement of implant stability and osseointegration include percussion, radiography, the $Periotest^{(R)}$, Dental Fine $Tester^{(R)}$ and so on. There is, however, relatively little research undertaken to standardize quantitative measurement of stability of implant and osseointegration due to the various clinical applications performed by each individual operator. Therefore, in order to develop non-invasive experimental method to measure stability of implant quantitatively, the resonance frequency analyzer to measure the natural frequency of specific substance was developed in the procedure of this study. Material & method : To test the stability of the resonance frequency analyzer developed in this study, following methods and materials were used : 1) In-vitro study: the implant was placed in both epoxy resin of which physical properties are similar to the bone stiffness of human and fresh cow rib bone specimen. Then the resonance frequency values of them were measured and analyzed. In an attempt to test the reliability of the data gathered with the resonance frequency analyzer, comparative analysis with the data from the Periotest was conducted. 2) In-vivo study: the implants were inserted into the tibiae of 10 New Zealand rabbits and the resonance frequency value of them with connected abutments at healing time are measured immediately after insertion and gauged every 4 weeks for 16 weeks. Results : Results from these studies were such as follows : The same length implants placed in Hot Melt showed the repetitive resonance frequency values. As the length of abutment increased, the resonance frequency value changed significantly (p<0.01). As the thickness of transducer increased in order of 0.5, 1.0 and 2.0 mm, the resonance frequency value significantly increased (p<0.05). The implants placed in PL-2 and epoxy resin with different exposure degree resulted in the increase of resonance frequency value as the exposure degree of implants and the length of abutment decreased. In comparative experiment based on physical properties, as the thickness of transducer increased, the resonance frequency value increased significantly(p<0.01). As the stiffness of substances where implants were placed increased, and the effective length of implants decreased, the resonance frequencies value increased significantly (p<0.05). In the experiment with cow rib bone specimen, the increase of the length of abutment resulted in significant difference between the results from resonance frequency analyzer and the $Periotest^{(R)}$. There was no difference with significant meaning in the comparison based on the direction of measurement between the resonance frequency value and the $Periotest^{(R)}$ value (p<0.05). In-vivo experiment resulted in repetitive patternes of resonance frequency. As the time elapsed, the resonance frequency value increased significantly with the exception of 4th and 8th week (p<0.05). Conclusion : The development of resonance frequency analyzer is an attempt to standardize the quantitative measurement of stability of implant and osseointegration and compensate for the reliability of data from other non-invasive measuring devices It is considered that further research is needed to improve the efficiency of clinical application of resonance frequency analyzer. In addition, further investigation is warranted on the standardized quantitative analysis of the stability of implant.

A Study on Fall Accident (1개 종합병원 환자의 낙상에 관한 조사)

  • Lee, Hyeon-Suk;Kim, Mae-Ja
    • The Korean Nurse
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    • v.36 no.5
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    • pp.45-62
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    • 1998
  • The study was conducted from November 1995 to May 1996 at the one general hospital in Seoul. The total subjects of this study were 412 patients who have the experience of fall accident, among them 31 was who have fallen during hospitalization and 381 was who visited emergency room and out patient clinic. The purposes of this study were to determine the characteristics, risk factors and results of fall accident and to suggest the nursing strategies for prevention of fall. Data were collected by reviewing the medical records and interviewing with the fallers and their family members. For data analysis, spss/pc+ program was utilized for descriptive statistics, adjusted standardized $X^2$-test. The results of this study were as follows: 1) Total subjects were 412 fallers, of which 245(59.5%) were men and 167(40.5%) were women. Age were 0-14 years 79(19.2%), 15-44 years 125(30.4%), 45-64 years 104(25.2%), over 65 years 104(25.2%). 2) There was significant association between age and the sexes ($X^2$=39.17, P=0.00). 3) There was significant association between age and history of falls ($X^2$=44.41. P= .00). And history of falls in the elderly was significantly associated with falls. 4) There was significant association with age and medical diagnosis ($X^2$=140.66, P= .00), chief medical diagnosis were hypertension(34), diabetis mellitus(22), arthritis(11), stroke(8), fracture(7), pulmonary tuberculosis(6), dementia(5) and cataract(5), 5) There was significant association between age and intrinsic factors: cognitive impairment, mobility impairment, insomnia, emotional problems, urinary difficulty, visual impairments, hearing impairments, use of drugs (sedatives , antihypertensive drugs, diuretics, antidepressants) (P < 0.05). But there was no significant association between age and dizziness ($X^2$=2.87, P=.41). 6) 15.3% of total fallers were drunken state when they were fallen. 7) Environmental factors of fall accident were unusual posture (50.9%), slips(35.2%), trips (9.5%) and collision(4.4%). 8) Most of falls occurred during the day time, peak frequencies of falls occurred from 1pm to 6pm and 7am to 12am. 9) The places of fall accident were roads(22.6%), house-stairs 06.7%), rooms, floors, kitchen (11.2%), the roof-top, veranda, windows(10.9%), hospital(7.5%), ice or snowy ways(5.8%), bathroom(4.9%), playground, park(4.9%), subway-stairs(4.4%) and public-bathrooms (2.2%). 10) Activities at the time of fall accident were walking(37.6%), turning around or reaching for something(20.9%), going up or down stairs09.2%), exereise, working07.4%), up or down from a bed(2.7%), using wheelchair or walking aids, standing up or down from a chair(2.2%) and standing still(2.2%). 11) Anatomical locations of injuries by falls were head, face, neck(31.3%), lower extremities (29.9%). upper extremities(20.6%), spine, thorax, abdomen or pelvic contents(l1.4%) and unspecified(2.9%). 12) Types of injures were fracture(47.6%), bruises03.8%), laceration (13.3%), sprains(9.0%), headache(6.6%), abrasions(2.9%), intracranial hemorrage(2.4%) and burns(0.5%). 13) 41.5% of the fallers were hospitalized and average of hospitalization was 22.3 days. 14) The six fallers(1.46%) died from fall injuries. The two fallers died from intracranial hemorrage and the four fallers died of secondary infection; pneumonia(2), sepsis(1) and cell lulitis(1). It is suggested that 1) Further study is needed with larger sample size to identify the fall risk factors. 2) After the fall accident, comprehensive nursing care and regular physical exercise should be emphasized for the elderly person. 3) Safety education and safety facilities of the public place and home is necessary for fall prevention.

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Questionnaire survey for the clinical trial participants who experienced both digital and conventional impression (디지털 인상법과 종래인상법을 동시에 경험한 임상시험자를 대상으로 한 설문지분석)

  • Yang, Eunbee;Kim, Bongju;Lee, Jun Jae;Lee, Seung-Pyo;Lim, Young-Jun
    • Journal of Dental Rehabilitation and Applied Science
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    • v.34 no.4
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    • pp.270-279
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    • 2018
  • Purpose: The aim of this study was to assess the patients' perception, acceptance, and preference of the difference between a conventional impression and digital impression through questionnaire survey. Materials and Methods: Thirteen (6 male, 7 female) subjects who experienced both digital and conventional impression at the same day were enrolled in this study. Conventional impression were taken with polyvinylsiloxane and digital impression were performed using a newly developed intra-oral scanner. Immediately after the two impressions were made, a survey was conducted with the standardized questionnaires consisting of the following three categories; 1) general dental treatment 2) satisfaction of conventional impression 3) satisfaction of digital impression. The perceived source of satisfaction was evaluated using Likert scale. The distribution of the answers was assessed by percentages and statistical analyses were performed with the paired t-test, and P < 0.05 was considered significant. Results: There were significant differences of the overall satisfaction between two impression methods (P < 0.05). Digital impression showed high satisfaction in less shortness of breath and odor to participants compared to conventional impression. The use of an oral scanner resulted in a discomfort of TMJ due to prolonged mouth opening and in lower score of the scanner tip size. Conclusion: It was confirmed that the preference for the digital impression using intraoral scanner is higher than the conventional impression. Most survey participants said they would recommend the digital impression to others and said they preferred it for future prosthetic treatment.

Evaluation of Dental Hygienist Job Validity according to Judgment Standard of Medical Practice in Medical Law (의료행위 기준에 따른 치과위생사 직무 타당도 평가)

  • Bae, Soo-Myoung;Shin, Sun-Jung;Lee, Hyo-Jin;Shin, Bo-Mi
    • Journal of dental hygiene science
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    • v.18 no.6
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    • pp.357-366
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    • 2018
  • The purpose of this study was to evaluate the validity of dental hygienist job according to judgment standard of medical practice in medical law. In this study, we conducted a self-administered questionnaire survey to evaluate the validity of dental hygienist job for 12 professors of dental college in Gangneung-Wonju National University from November 10 to 20, 2017. We investigated whether the dental hygienist job conforms to the three criteria of medical practice such as disease prevention and treatment, patient care, and health hazard. The response rates were scored and classified into four categories according to the final score. As a result of this study, dental hygienist job are classified into four categories according to judgment standard of medical practice. The higher the level of the category, the higher the degree of difficulty, and the higher the level of expertise and skills required. More than 50% of respondents answered that measuring the gingival pocket, bleeding on probing, professional tooth cleaning, oral health education, counseling after dental treatment are all three criteria for medical treatment. And these were classified into Level 4 group which requires the difficulty and expertise in the final score 4.3. It is necessary to develop and utilize standardized guidelines on the level of knowledge, education, and qualification standards required for dental practice in order to effectively allocate work among the dental personnel while ensuring the health rights of patients in the dental clinic field in Korea. In addition, there is a need to evaluate the various aspects of cost effectiveness, dental health service productivity, and health promotion contribution to dental hygienist jobs, And based on this evidence, it is necessary to continue to expand and adjust the dental hygienist job and to reorganize the dental workforce system.

Evaluation of Standardized Uptake Value and Metabolic Tumor Volume between Reconstructed data and Re-sliced data in PET Study (PET 검사 시 Reconstructed data와 Re-sliced data의 표준섭취계수와 Metabolic Tumor Volume의 비교 평가)

  • Do, Yong Ho;Lee, Hong Jae;Kim, Jin Eui
    • The Korean Journal of Nuclear Medicine Technology
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    • v.20 no.2
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    • pp.3-8
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    • 2016
  • Purpose SUV is one of the parameters that assist diagnosis in origin, metastasis and staging of cancer. Specially, it is important to compare SUV before and after chemo or radiation therapy to find out effectiveness of treatment. Storing PET data which has no quantitative change is needed for SUV comparison. However, there is a possibility to loss the data in external hard drive or MINIpacs that are managed by department of nuclear medicine. The aim of this study is to evaluate SUV and metabolic tumor volume (MTV) among reconstructed data (R-D) in workstation, R-D and re-sliced data (S-D) in PACS. Materials and Methods Data of 20 patients (aged $60.5{\pm}8.3y$) underwent $^{18}F-FDG$ PET (Biograph truepoint 40, mCT 40, mCT 64, mMR, Siemens) study were analysed. $SUV_{max}$, $SUV_{peak}$ and MTV were measured in liver, aorta and tumor after sending R-D in workstation, R-D and S-D in PACS to syngo.via software. Results R-D of workstation and PACS showed the same value as mean $SUV_{max}$ in liver, aorta and tumor were $2.95{\pm}0.59$, $2.35{\pm}0.61$, $10.36{\pm}6.15$ and $SUV_{peak}$ were $2.70{\pm}0.51$, $2.07{\pm}0.43$, $7.67{\pm}3.73$(p>0.05) respectively. Mean $SUV_{max}$ of S-D in PACS were decreased by 5.18%, 7.22%, 12.11% and $SUV_{peak}$ 2.61%, 3.63%, 10.07%(p<0.05). Correlation between R-D and S-D were $SUV_{max}$ 0.99, 0.96, 0.99 and $SUV_{peak}$ 0.99, 0.99, 0.99. And 2SD in balnd-altman analysis were $SUV_{max}$ 0.125, 0.290, 1.864 and $SUV_{peak}$ 0.053, 0.103, 0.826. MTV of R-D in workstation and PACS show the same value as $14.21{\pm}12.72cm^3$(p>0.05). MTV in PACS was decreased by 0.12% compared to R-D(p>0.05). Correlation and 2SD between R-D and S-D were 0.99 and 2.243. Conclusion $SUV_{max}$, $SUV_{peak}$, MTV showed the same value in both of R-D in workstation and PACS. However, there was statistically difference in $SUV_{max}$, $SUV_{peak}$ of S-D compare to R-D despite of high correlation. It is possible to analyse reliable pre and post SUV if storing R-D in main hospital PACS system.

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The study of MDCT of Radiation dose in the department of Radiology of general hospitals in the local area (일 지역 종합병원 영상의학과 MDCT선량에 대한 연구)

  • Shin, Jung-Sub
    • Journal of the Korean Society of Radiology
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    • v.6 no.4
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    • pp.281-290
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    • 2012
  • The difference of radiation dose of MDCT due to different protocols between hospitals was analyzed by CTDI, DLP, the number of Slice and the number of DLP/Slice in 30 cases of the head, the abdomen and the chest that have 10 cases each from MDCT examination of the department of diagnostic imaging of three general hospitals in Gyeongsangbuk-do. The difference of image quality, CTDI, DLP, radiation dose in the eye and radiation dose in thyroid was analyzed after both helical scan and normal scan for head CT were performed because a protocol of head CT is relatively simple and head CT is the most frequent case. Head CT was significantly higher in two-thirds of hospitals compared to A hospital that does not exceed a CTDI diagnostic reference level (IAEA 50mGy, Korea 60mGy) (p<0.001). DLP was higher in one-third of hospitals than a diagnostic reference level of IAEA 1,050mGy.cm and Korea 1,000mGy.cm and two-thirds exceeded the recommendation of Korea and those were significantly higher than A hospital that does not exceed a diagnostic reference level (p<0.001). Abdomen CT showed 119mGy that was higher than a diagnostic reference level of IAEA 25mGy and Korea 20mGy in one-third. DLP in all hospitals was higher that Korea recommendation of 700mGy.cm. Among target hospitals, C hospital showed high radiation dose in all tests because MPR and 3D were of great importance due to low pitch and high Tube Curren. To analyze the difference of radiation dose by scan methods, normal scan and helical scan for head CT of the same patient were performed. In the result, CTDI and DLP of helical CT were higher 63.4% and 93.7% than normal scan (p<0.05, p<0.01). However, normal scan of radiation dose in thyroid was higher 87.26% (p<0.01). Beam of helical CT looked like a bell in the deep part and the marginal part so thyroid was exposed with low radiation dose deviated from central beam. In addition, helical scan used Gantry angle perpendicularly and normal scan used it parallel to the orbitomeatal line. Therefore, radiation dose in thyroid decreased in helical scan. However, a protocol in this study showed higher radiation dose than diagnostic reference level of KFDA. To obey the recommendation of KFDA, low Tube Curren and high pitch were demanded. In this study, the difference of image quality between normal scan and helical scan was not significant. Therefore, a standardized protocol of normal scan was generally used and protective gear for thyroid was needed except a special case. We studied a part of CT cases in the local area. Therefore, the result could not represent the entire cases. However, we confirmed that patient's radiation dose in some cases exceeded the recommendation and the deviation between hospitals was observed. To improve this issue, doctors of diagnostic imaging or technologists of radiology should perform CT by the optimized protocol to decrease a level of CT radiation and also reveal radiation dose for the right to know of patients. However, they had little understanding of the situation. Therefore, the effort of relevant agencies with education program for CT radiation dose, release of radiation dose from CT examination and addition of radiation dose control and open CT contents into evaluation for hospital services and certification, and also the effort of health professionals with the best protocol to realize optimized CT examination.

A Study on the Sasang Constitutional Distribution Among the People in the United States of America (북미지역주민(北美地域住民)의 사상체질(四象體質) 분포(分布)에 관(關)한 연구(硏究))

  • Koh, Byung-hee;Kim, Seon-ho;Park, Byung-gwan;Lavelle, Jonathan D;Tecun, Marianne;Anthony Jr., Ross;Hobbs, Ron;Zolli, Frank;Chin, Kyung-hee
    • Journal of Sasang Constitutional Medicine
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    • v.11 no.2
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    • pp.119-150
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    • 1999
  • In spite of recent remarkable recent development in both western and oriental medical sciences, there is still only a shallow understanding of individual differences for various prognoses of incurable diseases and immunopathy diseases. Nevertheless, the care, cure and prevention methods of Sasang Constitutional Medicine are broadly used as an effective treatment of incurable diseases like immunopathy diseases and stress-related diseases and diseases due to aging. In this sense, the establishment of classification norms is urgent and essential for the worldwide application of Sasang Constitutional Medicine(SCM). This study began with the confirmation process of whether Sasang Constitutional types exist in Americans. To accomodate for cultural differences, the distinguishing tool was readjusted so that Sasang Constitutional Types in Americans could be determined. Hence, the selected tool is the new QSCCII+, which is a newly revised English version of the QSCCII. QSCCII was made and standardized by Dept. of SCM in Kyung Hee Medical Center and Dr. Kim7). The evaluation methods of the old version were improved in the new QSCCII+ through necessary statistical manipulation. The original QSCCII was officially authorized by the Korean Society of Sasang Constitutional Medicine as the only computerized version of Sasang diagnostics. This study is the first attempt to design a new diagnostic tool for the classification of Sasang Constitutional types in North Americans with the revision of QSCCII. The subjects of this study were selected from the cooperative people among the students and staffs of the University of Bridgeport and the patients who visited the Clinic in the Health Science Center. This study takes for about 1 year from 1998. 8 to 1999. 8 The conclusions of the study can be summarized as follows: 1. Sasang constitutional types also exist in Americans. It can also naturally be inferred that Sasang Constitutional types exist in all human beings, for there are many different human races in America. 2. There are more So-Yang In's than any other types in American white people. This result confirms the hypothesis that there also exist Sasang Constitutional types in westerners. 3. The result of repetitive tests suggests that the new QSCCII+ is an effective diagnostic tool for westerners when we consider the constant diagnostic results of the QSCCII+. 4. Sasang Constitutional types exit in the sample group regardless of racial difference. 5. The question items that were not often checked by Americans need to be modified into more understandable expressions. 6. The standardization of diagnosis for Americans should be established by use of the QSCCII+ 7. It can be guessed that there are many Tae-yang In's among the 71 persons who could not be clearly classified by the QSCCII+. Due to the scarcity of Tae-yang-In in general, it is important to improve upon the discernability of the QSCC II+. 8. The results of the Sasang Constitutional distribution in North Americans are as follows: The percentage of So-yang In distribution in the sample group is 36.25%(87persons), that of Tae-eum In is 13.75%(33persons), and that of So-eum In is 20.41%(49persons).

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