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

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

Study of Utilization of Dental High School and according to the Pain Experienced Dental Fear (고등학생의 치과이용실태와 통증 경험에 따른 치과공포에 대한 연구)

  • Jun, Bo-Hye;Choi, Young-Suk
    • Journal of dental hygiene science
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    • v.14 no.1
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    • pp.59-66
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    • 2014
  • The purpose of this study was to study of utilization of dental high school and according to the pain experienced dental fear and anxiety. This survey was conducted on 370 high school students in Suwon from November 21 to 23, 2011. A total of 352 questionnaires were collected and analyzed. The collected data was analyzed using the statistical package SPSS 15.0 using frequency, mean and standard deviation analysis, t-test, one-way ANOVA, Duncan's test correlation analysis and Stepwise multiple regression analysis. The results state that students feel fear and anxiety were feeling anesthetic needle ($3.19{\pm}1.43$), seeing anesthetic needle ($3.14{\pm}1.44$). We found that students feel more rear and anxiety from caries treatment than scaling. It influence that having dental fear with past dental pain experienced during dental treatment and also hearing dental treatment of pain from their family and friends. We found out that there are some influencing factors on dental fear and anxiety, gender, oral health condition, smoking, pain experienced during dental treatment. We need to care dental fear and anxiety continuously and have prevention program. We have to try understanding students have dental fear and anxiety. So it's better they have good experience visiting dental clinic. We should develop the system and specially treat well while they have dental treatment with anesthesia and some sharp instruments.

Analysis of Influencing Factors Related to Health Promotion Behavior in Hospital Radiological Technologists (종합병원 방사선사의 건강증진행위 관련요인 분석)

  • Ko, Jong-Kyung;Kwon, Duk-Mun;Kang, Yeong-Han
    • Journal of radiological science and technology
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    • v.32 no.4
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    • pp.381-391
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    • 2009
  • Purposes : The purpose of this study was to analyze factors that could affect health of radiological technologists, which is useful for health care and development of programs for health promotion. Methods : Subjects were 234 of radiological technologists who work in general hospitals. Some questionnaires were made about perceptions of health condition and promotional behavior of health for this study. The questionnaires of health perception were 20 items that consist of the present condition of health, health concern and sensitivity. The reliability was sufficient(Cronbach's $\alpha=0.79$). The other questionnaires about health promotion behavior were 47 items that consist of self-realization, health responsibility, exercise, nutrition, personal relationships, and stress management. The results turned out to bewas sufficient (Cronbach's $\alpha=0.93$). Every data was treated statistically, comparison of average(t-test, ANOVA), correlation, and multiple regression. Results : Related factors to health promotion behavior were age, marriage, salary, class of one's position, career, employment, and religion, in general features. In health life habit, related factors were smoke and exercise. Results of health promotion behavior was 2.90 of mean score, 0.37 of standard deviation. Correlations between factors of health perception and health promotion behavior was positive(p<0.01). Health promotion behavior were affected by sensitivity, presents condition of health, exercise, smoke, career. Sensitivity was the most affectable variable, which means that promotional behavior score became higher and higher as the score of sensitivity and present condition were increased. In addition, persons who exercise regularly, had been smoked, and has higher career showed higher score of promotional behavior. Conclusion : Radiological technologists have to keep their health, trying not to infected by a disease. Most of all, no smoking and regular exercise are the most important thing to all of members.

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A Study on the Concentration of Hippuric Acid in Urine of Workers Exposed to Toluene (톨루엔에 폭로된 근로자의 뇨중 마뇨산량에 관한 연구)

  • Park, Eun-Mi;Roh, Jae-Hoon;Moon, Young-Hahn
    • Journal of Preventive Medicine and Public Health
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    • v.20 no.2 s.22
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    • pp.228-235
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    • 1987
  • The objective of this study is to examine the correlation between the toluene concentration in the work environment of organic solvents and the concentration of hippuric acid in urine of workers exposed toluene, and to acquire the fundamental materials of workers' health care and to assist the assessment of the biological permisible exposure limit. The control groups are 72 workers who had never been exposed to toluene and the case groups are 101 workers who had been exposed to toluene. This study was conducted to examine the correlation between the concentration of toluene in work environment and workers' hippuric acid concentration, to investigate the complaint difference of subjective symptoms by means of questionaire, between the case groups and control groups. The results and conclusions are as fellows: 1) The highest mean concentration of toluene in the air is $544.13{\pm}7.75ppm$ in the Printing Department of mixing organic solvents. The concentrations of the others are $463.27{\pm}5.24ppm$ in Department of mixture for organic solvents, and $393.56{\pm}45.69ppm$ in the Printing Department(1), and $248.38{\pm}45.16ppm$ in the Printing Department(2), and $159.38{\pm}18.51ppm$ in the Printing Department(3). 2) The highest mean concentration of hippuric acid in urine is $6034.84{\pm}1298.35mg/l$ in the Printing Department with mixing organic solvents. The concentrations of the others are $4798.44{\pm}784.53mg/l$ in Department of mixture of organic solvents, and $2883.06{\pm}701.90mg/l$ in the Printing Department(1), and $1449.98{\pm}905.19mg/l$ in the Printing Department(2), and $598.52{\pm}299.43mg/l$ in the Printing Department(3). 3) As the toluene concentration in the work environment becomes higher, the concentration of hippuric acid in urine also becomes higher. It is found that the coefficient of correlation between toluene concentration and the concentration of hippuric acid are positive (r=0.868, Y=7.18X+349.57) 4) It is found that the case groups complain of much more subjective symptoms than the control groups.

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Gastroscopic Findings of Rural Residents with Symptoms of Chronic Gastrointestinal Disorder (만성(漫性) 위장장애증상(胃腸障碍症狀)을 가진 농촌주민(農村住民)들의 위내시경(胃內視鏡) 검사소견(檢査所見))

  • Park, Jung-Han;Chun, Byung-Yeol;Lee, Dong-Koo;Choi, Yong-Whan
    • Journal of Preventive Medicine and Public Health
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    • v.19 no.1 s.19
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    • pp.85-90
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    • 1986
  • This study was conducted in July-August, 1984, to define the causes of chronic gastrointestinal symptoms in rural population and to provide data for the management of such patients. A household survey was conducted to identify all the residents of Youngchun and Sungiu counties in Kyungpook province who were over 20 years of age, had chronic upper gastrointestinal symptoms for over the last 6 months, never had medical examination for the symptoms, and volunteered to participate in the gastroscopic examination. Gastroscopy was done for 106 males and 108 females. Gastric ulcer was found in 16.8% of all the examinees, duodenal ulcer in 15.4%, gastritis in 14.0%, and gastric cancer in 3.7%. No lesion was found by gastroscopy in 52.3%. Gastric ulcer more common in male(26.4%) than in female(7.4%) (p<0.01) and the same was true for duodenal ulcer(20.8% of male, 10.2% of female). Gastric cancer was found in 7.5% of the male while none of the female had gastric cancer. A higher proportion of the female (68.5%) showed normal finding in the gastroscopy than the male(35.9%) (p<0.01). No significant association was found between the upper gastrointestinal symptoms and the gastroscopic findings. The higher prevalence rate of gastric ulcer than that of duodenal ulcer in this study which is the reverse of the study findings of urban area in Korea and western countries may be related in part with the dietary habit and social environment of the rural population. Although early diagnosis is the most important for the treatment of gastric cancer, many of the people with chronic upper gastrointestinal complaints defer the diagnosis and treatment. It is may be due to lack of the knowledge of diseases and the health care attitude of the rural people. A national program for the health education and mass screening for the gastric cancer should be developed.

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Significance of Serum Ferritin in Multiple Trauma Patients with Acute Respiratory Distress Syndrome (다발성 외상 환자에서 발생되는 급성 호흡 곤란 증후군의 예측 인자로서 혈청 페리틴의 의의)

  • Ji, Yae-Sub;Kim, Nak-Hee;Jung, Ho-Geun;Ha, Dong-Yeup;Jung, Ki-Hoon
    • Journal of Trauma and Injury
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    • v.20 no.2
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    • pp.57-64
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    • 2007
  • Purpose: Clinically, acute respiratory distress syndrome (ARDS) occurs within 72 hours after acute exposure of risk factors. Because of its high fatality rate once ARDS progresses, early detection and management are essential to reduce the mortality rate. Accordingly, studies on early changes of ARDS were started, and serum ferritin, as well the as injury severity score (ISS), which has been addressed in previous studies, thought to be an early predictive indicator for ARDSMethods: From March 2003 to March 2005, we investigated 50 trauma patients who were admitted to the intensive care unit in Dongguk University Medical Center, Gyeongju. The patients were characterized according to age, sex, ISS, onset of ARDS, time onset of ARDS, serum ferritin level (posttraumatic $1^{st}\;&\;2^{nd}$ day), amount of transfused blood, and death. Abdominal computed topography was performed as an early diagnostic tool to evaluate the onset of ARDS according to its diagnostic criteria. The serum ferritin was measured by using a $VIDAS^{(R)}$ Ferritin (bioMeriux, Marcy-1' Etoile, France) kit with an enzyme-linked fluorescent assay method. For statistical analysis, Windows SPSS 13.0 and MedCalc were used to confirm the probability of obtaining a predictive measure from the receiver operating characteristics (ROC) curve. Results: The ISS varied from 14 to 66 (mean: 33.8) whereas the onset of ARDS could be predicted with the score above 30 (sensitivity: 90.0%, specificity: 60.0%, p<0.05). On the posttraumatic $1^{st}$ day, the serum ferritin levels were measured to be from 31 mg/dL to 1,200 mg/dL (mean: 456 mg/dL), and the onset of ARDS could be predicted when the value was over 340 mg/dL (sensitivity: 80.0%, specificity: 65.0%, p<0.05). On the posttraumatic $2^{nd}$ day, the serum ferritin levels were measured to be from 73 mg/dL to 1,200 mg/dL (mean: 404 mg/dL), and the onset of ARDS could be predicted when the value was over 627 mg/dL (sensitivity: 60.0%, specificity: 92.5%, p<0.05). The serum ferritin levels and the ISS were significantly higher on the posttraumatic $1^{st}$ and $2^{nd}$ day in the ARDS group, suggesting that they are suitable indices predicting the onset of ARDS, however relationship between the serum ferritin levels and the ISS was not statistically significant. Conclusion: In this study, we discovered increasing serum ferritin levels in multiple- trauma patients on the posttraumatic $1^{st}$ & $2^{nd}$ day and concluded that both the serum ferritin level and the ISS were good predictors of ARDS. Although they do not show statistically significant relationship to each other, they can be used as independent predictive measures for ARDS. Since ARDS causes high mortality, further studies, including the types of surgery and the methods of anesthesia on a large number of patients are essential to predict the chance of ARDS earlier and to reduce the incidence of death.

A Study on Netwotk Effect by using System Dynamics Analysis: A Case of Cyworld (시스템 다이내믹스 기법을 이용한 네트워크 효과 분석: 싸이월드 사례)

  • Kim, Ga-Hye;Yang, Hee-Dong
    • Information Systems Review
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    • v.11 no.1
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    • pp.161-179
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    • 2009
  • Nowadays an increasing number of Internet users are running individual websites as Blog or Cyworld. As this type of personal media has a great influence on communication among people, business comes to care about Network Effect, Network Software, and Social Network. For instance, Cyworld created the web service called 'Minihompy' for individual web-logs, and acquired 2.4milion users in 2007. Although many people assumed that the popularity of Minihompy, or Blog would be a passing fad, Cyworld has improved its service, and expanded its Network with various contents. This kind of expansion reflects survival efforts from infinite competitions among ISPs (Internet Service Provider) with focus on enhancing usability to users. However, Cyworld's Network Effect is gradually diminished in these days. Both of low production cost of service vendors and the low searching/conversing costs of users combine to make ISPs hard to keep their market share sustainable. To overcome this lackluster trend, Cyworld has adopted new strategies and try to lock their users in their service. Various efforts to improve the continuance and expansion of Network effect remain unclear and uncertain. If we understand beforehand how a service would improve Network effect, and which service could bring more effect, ISPs can get substantial help in launching their new business strategy. Regardless many diverse ideas to increase their user's duration online ISPs cannot guarantee 'how the new service strategies will end up in profitability. Therefore, this research studies about Network effect of Cyworld's 'Minihompy' using System-Dynamics method which could analyze dynamic relation between users and ISPs. Furthermore, the research aims to predict changes of Network Effect based on the strategy of new service. 'Page View' and 'Duration Time' can be enhanced for the short tenn because they enhance the service functionality. However, these services cannot increase the Network in the long-run. Limitations of this research include that we predict the future merely based on the limited data. We also limit the independent variables over Network Effect only to the following two issues: Increasing the number of users and increasing the Service Functionality. Despite of some limitations, this study perhaps gives some insights to the policy makers or others facing the stiff competition in the network business.

Demands for Health Education through Internet in Middle and High School Students (중.고등학교 학생들의 인터넷을 이용한 보건교육 요구도)

  • Kang, Pock-Soo;Choi, Yeun-Hwa;Lee, Kyeong-Soo;Hwang, Tae-Yoon
    • Journal of Yeungnam Medical Science
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    • v.21 no.1
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    • pp.23-39
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    • 2004
  • Background: It is important to provide health education to students to ensure a healthy life. Using the internet for health education may be a way to overcome the practical barriers to health education such as time and content. This study was conducted to investigate the demands for health education using the internet. Subjects and methods: Six hundreds and twenty-four and male female students in middle and high schools, who lived on Gyeongju-si and Seongju-gun in Gyeongsangbuk-do province, were interviewed by means of structured questionnaires, from March 5 to March 28, 2003. Results: More than 90% of the subjects had their own computers, and nearly 38% of those possessing their own computers had accessed internet sites related to health and medicine. Middle school students and in particular, female students were more desirous for health education through e-mail. Regarding content, the three major topics which the respondents wanted to learn about were healthy lifestyles, growth and development, and disease prevention. In terms of the interval for providing educational materials, over half of the students wanted information once a week. Most of the students wanted to have the quantity of the material be one page. In addition, there were numerous additional topics requested by the students such as sleep and health, contraception and family planning, safety education, cancer prevention, emotional instability of juveniles, the utilization of medical care facilities, stress management, etc. Conclusion: The students had a desire for health education through the use of e-mail, and methods and materials should be developed for appropriate health education using the internet.

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A Study on Curriculum Development For Community Health Practitioners (보건진료원 직무교육 교과과정 개선을 위한 일 연구)

  • 조원정;이경자
    • Journal of Korean Academy of Nursing
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    • v.22 no.2
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    • pp.207-226
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    • 1992
  • This study was designed to develop a conceptual framework for the curriculum and develop the details of the learning content for the education of Community Health Practitioners (CHPs). Since education programs for CHPs started 10 years ago, concepts related to CHP services have changed because of changes in society. The objectives of the study were as follows : 1) to analyse the usefulness of the present education program for CHPs, 2) to analyse the Job performance and self -confidence of the CHPs, 3) to identify the health needs of the clients served by the CHPs and the community problems related to health. 4) to develop a conceptual framework for the curriculum, for the education of CHPs, 5) to develops details for the learning content of the education program for CHPs. Phase I of the study was conducted by questionnaires to 150 CHPs who have worked in remote rural areas for more than 2 years. Among them, 147 responded. Data was collected from August 16, to August 25, 1990. In order to identify the health needs of the community people, research within the last five years was reviewed and analyzed. The data on 1, 842 communities gathered by the WHO Nursing Collaborations Center of the College of Nursing, Yonsei University was utilized to identify community problems related to health and the self - confidence in job performance of the CHPs. Psase II of the study consisted of a workshop with 13 professionals including Community Health Practitioners to evaluate the existing education program and a conceptual framework of the curriculum for the job education of CHPs. The results of the study are Summariged below : 1. The only 26 among 45 content items of the education program related to job skills was used by 80% of the responding CHPs. The knowledge of $\ulcorner$Networking community organization$\lrcorner$ was used by only 53.7% of the respondents. Educational content about $\ulcorner$Mental disease$\lrcorner$ was used by less than 50% of CHPs because of a knowledge deficit. 2. The CHPs reported that their activities concentrated on clinical services during the last six months. The survey showed that they seemed to neglect the activities for health promotion and disease prevention. Thus, $\ulcorner$Education for community loaders$\lrcorner$(15.9%), $\ulcorner$Activity for eavironmental health$\lrcorner$(16.3%) and $\ulcorner$Social work for needey people$\lrcorner$(23.3%) were done by less than 30% of CHPs. 3. More than 90% of CHPs reported being self - confident for the activities of $\ulcorner$Health education and counselling$\lrcorner$, $\ulcorner$Medicine prescription$\lrcorner$ and $\ulcorner$Immunization$\lrcorner$. But 50% of CHPs reported that they were not have self - confident in $\ulcorner$Management of water and environmental health$\lrcorner$ and only 25.6% of CHPs could insert an IUD independently. 4. It was identified that respiratory diseases and the gastrointestinal diseases were most common problems for the community people, followed by musculoskeletal and skin problems. 5. The community problems were classified into eight categories : physical environmental problems, environmental hygiene, health problems, health behavior, social problem, lack of resources, financial problem and the problems of the cultural and value system. 6. The conceptual framework consisted of the target population and their health status, nursing process working site and primary health care services such as health promotion, disease prevention, treatment and rehabilitation. 7. The contents of curriculum of education program for CHPs were formulated from the results of this study.

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Knowledge and Performance of Universal Precautions by Nursing Students (일부 간호대학생의 혈액매개질환 예방 지침에 대한 지식과 실천 정도)

  • 김경미;김민아;정여숙;김남초
    • Journal of Korean Academy of Nursing
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    • v.29 no.4
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    • pp.929-939
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    • 1999
  • The purpose of this study was to identify knowledge of universal precautions and its performance in practice. The research was conducted from November 2 to 30, 1998. A total 515 student nurses ; 249 from a baccalaureate nursing college and 266 from second and third year of a 3-year community nursing college were surveyed. The results are as following : 1. The average score for universal precautions knowledge was 270.41$\pm$19.43/300(range 150-300). The results showed that 99.2% of students avoid injury from used needles, 98.6% answered that they always wash their hands if they had contact with the patient's blood and they always dispose of used needles in special collectors (97.7%) for needles. But, 39.2% responsed that they dispose of used needles after recapping them. 2. The average score for universal precautions knowledge of the senior students in the 4-year college was the highest (277.65$\pm$13.99). 3. The average score for the performance of universal precautions knowledge was 53.18 $\pm$5.91(range 14-70). The items : ‘I cautiously avoid injury from the used needles’(4.92$\pm$0.33), ‘I always wash my hands if there has been contact with the patient's blood’(4.91$\pm$0.34), and ‘I always disposed of used needles in the appropriate collector’(4.89$\pm$0.42) showed the highest performance. However ‘I always dispose of used needles after recapping them’(2.19$\pm$1.39) and ‘I always use protection goggles when in danger of contamination’(2.19$\pm$1.20) showed low performance level. 4. The highest average score for universal precautions performance was shown among the second year students in 3-year nursing college (54.19$\pm$6.92) between the groups. It showed that the level of the universal precautions performance was higher for those who had education on university precautions prior to performance of the universal precautions than for those without any prior education. 5. The percentage of students who reported the experience of direct contact with patients' blood and/or body fluids was 42.30%. The experience of direct contact with blood and/or body fluids of the educational group was significantly higher than those were not educated. 6. The most frequent cause of the direct contact was ‘needle pricking and/or skin cut’(63.04%). The most frequent substance with which the students contact was ‘blood’(59.85%). The majority of the sample had answered that the mode of contamination was ‘unknown’(63.54%). The majority of the sample answered that strategies used after contamination included ‘washing with soap’(33.61%). Reviewing the chart of patients or asking other health professionals(28.85%). 7. The number of students who had the experience of a needle stick and/or skin cut was 145(28.16%). The clinical practice places where the incidents occurred were mainly in the internal medicine unit (45.07%) and the surgical unit (31.92%) followed by the intensive care unit and the emergency unit in order. The experience of a needle stick and/or skin cut happened during on intra-muscular injection 47.34% and intravenous injection 21.81%. The causes of the needle stick and/or skin cut were ‘putting the needle cap back on 77(35.81%)’. The number of students who took an appropriate post management blood test and/or vaccination was 27(18.62%). 8. The Pearson Correlation Coefficient between the knowledge of universal precautions and performance of universal precautions in practice showed a positive correlation.

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