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A Theory Construction on the Care Experience for Spouses of Patients with Chronic Illness (만성질환자 배우자의 돌봄 경험에 대한 이론 구축)

  • Choi, Kyung-Sook;Eun, Young
    • Journal of Korean Academy of Nursing
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    • v.30 no.1
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    • pp.122-136
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    • 2000
  • Chronic illness requiring attention and management during a long period of time puts great burden onto patients, their family and society. For patients with chronic illnesses, providing social support is the most important, and the fundamental support comes from their spouses. Amount and quality of support from spouses seems to differentiated according to the sex of patients. Female patients tend to believe that their spouses are not very supportive. Therefore, the researchers assessed the burden of husbands of female arthritis patients to discover the factors that result in greater burden. Also, they developed a theoretical model of husbands′ care for their wives through a qualitative research into husbands′ experience. Method 1: The study material was 650 female arthritis patients registered in an arthritis clinic. The questionnaire about the disease experience of female arthritis patients and the burden of husbands were sent. Returned questionnaires numbered 210(32.3%) and 27 were excluded because of inadequate answers. The remaining 183 questionnaires were analyzed. The mean age of the patients was 51 years and the mean age of spouses was 55 years. The mean marital period was 28 years. The average duration since diagnosis was 9.1 years. Education level was varied from primary school to graduate school, and average income/month was 1,517,300 won. Method 2: Initial questionnaire studies on the burden of husbands were performed. Among 183 responding husbands, 23 consented to participate for a qualitative research. Data was obtained by direct and telephone interviews. The mean age of participants was 58 years, and the educational level and socioeconomic status also varied. Result: 1. Husbands′ burden: The average burden was 57.68 with a range of 6-96. 2. Burden and general characteristics: The husband′s burden correlated with the age of the patients, numbers in the family, therapy methods, patient′s level of discomfort, patient′s disease severity, patient′s level of dependence and the husband′s understanding of the level of severity. 3. Linear correlation analysis on burden: The husbands′ burden is explained in 22.5% by husband′s recognition of level of severity and husbands′ age. 4. There were four patterns of the burden on husbands: both objectve burden and subjective burden were high(pattern I), both of objectve burden and subjective burden were low(pattern II), objective burden was high but subjective burden was low(pattern III), objective burden was low but subjective burden was high(pattern IV). The pattern was correlated with the family income, educational level of the patients and their husbands, therapy methods, patient′s level of discomfort, patient′s disease severity, patient′s level of dependence and husband′s understanding of level of severity. 5. The core category of the caring experience of the husbands with arthritis patients was "companionship". The causal factor was the patients′ experience due to symptoms : physical disfigurement, pain, immobility, limitation of house chores, and limitation of social activities. Contextural factors are husbands′ identification of housework and husbands′ concern about the disease. The mediating factors are economic problems, fear of aging, feeling of limitation and family support. The strategy for interaction is mind control and how to solve emotional stress. The "companionship" resulted from caring activities, participation of household activities, helping patients′ to coping with emotional experience. 6. Companionship is established through the process of entering intervention, and caring state of mind. Entering intervention is the phase of participation of therapy and involvement of houseworks. The caring phase consists of decision on therapy, providing therapy, providing direct care, and taking over the household role of wife. Through caring phase, the changing phase set a stage in which husbands consolidate the relationship with their wives, and are reminded of the meaning of marriage. As a result, in changing phase, husbands′ companionship is enhanced. In conclusion, nursing care of chronic illnesses should include a family member especially the spouse. All information on disease shoud be provided to patients and whole family member. Strong support should also be provided to overcome difficulties in taking over role of other sex. Then the quality of life of patients and families will be much improved.

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A Study on the cost allocation method of the operating room in the hospital (수술실의 원가배부기준 설정연구)

  • Kim, Hwi-Jung;Jung, Key-Sun;Choi, Sung-Woo
    • Korea Journal of Hospital Management
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    • v.8 no.1
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    • pp.135-164
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    • 2003
  • The operating room is the major facility that costs the highest investment per unit area in a hospital. It requires commitment of hospital resources such as manpower, equipments and material. The quantity of these resources committed actually differs from one type of operation to another. Because of this, it is not an easy task to allocate the operating cost to individual clinical departments that share the operating room. A practical way to do so may be to collect and add the operating costs incurred by each clinical department and charge the net cost to the account of the corresponding clinical department. It has been customary to allocate the cost of the operating room to the account of each individual department on the basis of the ratio of the number of operations of the department or the total revenue by each operating room. In an attempt to set up more rational cost allocation method than the customary method, this study proposes a new cost allocation method that calls for itemizing the operation cost into its constituent expenses in detail and adding them up for the operating cost incurred by each individual department. For comparison of the new method with the conventional method, the operating room in the main building of hospital A near Seoul is chosen as a study object. It is selected because it is the biggest operating room in hospital A and most of operations in this hospital are conducted in this room. For this study the one-month operation record performed in January 2001 in this operating room is analyzed to allocate the per-month operation cost to six clinical departments that used this operating room; the departments of general surgery, orthopedic surgery, neuro-surgery, dental surgery, urology, and obstetrics & gynecology. In the new method(or method 1), each operation cost is categorized into three major expenses; personnel expense, material expense, and overhead expense and is allocated into the account of the clinical department that used the operating room. The method 1 shows that, among the total one-month operating cost of 814,054 thousand wons in this hospital, 163,714 thousand won is allocated to GS, 335,084 thousand won to as, 202,772 thousand won to NS, 42,265 thousand won to uno, 33,423 thousand won to OB/GY, and 36.796 thousand won to DS. The allocation of the operating cost to six departments by the new method is quite different from that by the conventional method. According to one conventional allocation method based on the ratio of the number of operations of a department to the total number of operations in the operating room(method 2 hereafter), 329,692 thousand won are allocated to GS, 262,125 thousand won to as, 87,104 thousand won to NS, 59,426 thousand won to URO, 51.285 thousand won to OB/GY, and 24,422 thousand won to DS. According to the other conventional allocation method based on the ratio of the revenue of a department(method 3 hereafter), 148,158 thousand won are allocated to GS, 272,708 thousand won to as, 268.638 thousand won to NS, 45,587 thousand won to uno, 51.285 thousand won to OB/GY, and 27.678 thousand won to DS. As can be noted from these results, the cost allocation to six departments by method 1 is strikingly different from those by method 2 and method 3. The operating cost allocated to GS by method 2 is about twice by method 1. Method 3 makes allocations of the operating cost to individual departments very similarly as method 1. However, there are still discrepancies between the two methods. In particular the cost allocations to OB/GY by the two methods have roughly 53.4% discrepancy. The conventional methods 2 and 3 fail to take into account properly the fact that the average time spent for the operation is different and dependent on the clinical department, whether or not to use expensive clinical material dictate the operating cost, and there is difference between the official operating cost and the actual operating cost. This is why the conventional methods turn out to be inappropriate as the operating cost allocation methods. In conclusion, the new method here may be laborious and cause a complexity in bookkeeping because it requires detailed bookkeeping of the operation cost by its constituent expenses and also by individual clinical department, treating each department as an independent accounting unit. But the method is worth adopting because it will allow the concerned hospital to estimate the operating cost as accurately as practicable. The cost data used in this study such as personnel expense, material cost, overhead cost may not be correct ones. Therefore, the operating cost estimated in the main text may not be the same as the actual cost. Also, the study is focused on the case of only hospital A, which is hardly claimed to represent the hospitals across the nation. In spite of these deficiencies, this study is noteworthy from the standpoint that it proposes a practical allocation method of the operating cost to each individual clinical department.

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Effects of a Self-Help Program including Stretching Exercise on Reduction of Symptom in Patients with Fibromyalgia (신장운동을 포함한 자조관리프로그램이 섬유조직염환자의 증상완화에 미치는 효과)

  • Han, Sang-Sook
    • Journal of muscle and joint health
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    • v.5 no.1
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    • pp.39-56
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    • 1998
  • This study was an quasi-experimental study, done to identify factors Influencing the reduction of symptoms in patients with fibromyalgia. The primary purpose of the study was to develop a Self-Help Program suitable for patients with fibromyalgia in Korea. The secondary purpose was to identify the effects of a Self-Help Program which included stretching exercise. This study was carried out between Feb. 24 and July 8, 1997 and patients in the study Included out patient diagnosed with fibromyalgia based on the criteria developed by the American College of Rheumatology(1990) and H, University which is a tertiary patient care clinic for Rheumatism. The experimental group included 38 patients who were residents of Seoul or Kyungi province, and a control group of 38 patients who were residents of other areas. The control patients were matched to the experimental group patients and they were selected considering the number of tender points on the Fibromyalgia Impact Questionnaire score and a score of self-efficacy. The experimental group participated in a Self-Help Program based on the American Arthritis Foundation(1995) guidelines. The program participants participated in a small group which consisted of 12-15 members attending the program once a week, for 6 weeks with each program lasted two to two and a half hours. The stretching exercise was carried out in each patient's home every day following the video tape exercise provided by the researcher, and the researcher provided encouragement and concern to the patients by calling them once a week. The number times the exercise was performed was divided by the number of participants to calculate the percentage of performance and determine the amount of exercise. Self-efficacy was measured by the Self-Efficacy Scale developed by Lorig et al. (1989) for arthritis patients. The degree of pain was converted to scores based on the Visual Analog Scale, the number of tender points was converted to scores based on the criteria of the ACR(1990) and of Yunus. Depression was measured by CES-D and physical disability, sleep disturbance, fatigue, and anxiety of patients with fibromyalgia were measured by the Fibromyalgia Impact Questionnaire. The level of the exercise performance was converted to scores using the number of times the exercise was performed following the video tape prepared by Association of Rheumatology Health Professionals. Data were analyzed by SPSS windows and the results ire described below. 1. The experimental group which participated in the Self-Help Program showed higher efficacy scores than the control group when both groups were analyzed for depression and the number of tender points as common variables(F=9.146, p=.003). 2. The experimental group which participated in the Self-Help Program showed lower scores than the control group, for pain, the number of tender points, depression, physical disability, fatigue, sleep disturbance and anxiety. These symptoms of fibromyalgia can all be seen to have subsided(F=9.483, p=.003 : F=32.680, p=.001 ; F=11.104, p=.001, F=5.344 : p=.024, F=7.630 : P=.007, F=15.6512, p=.003 : F= 7.5412, p=.008). 3. In the experimental group, the self-efficacy score for the first three weeks showed a positive correlation with the exercise-performance score for four to six weeks (r=.387, p=.043). 4. In the experimental group, the relationship between the level of exercise-performance and the reduction of symptoms showed a significant correlation only to physical disability(r= -.500, p=.001). 5. In the experimental group, the relationship between the self-efficacy score and pain, the number of tender points, depression, physical disability, fatigue, sleep disturbance and anxiety score showed inverse correlations and thus, a reduction of symptoms occured when the self-efficacy score increased(r=-.325, p=.004 ; r= -.253, p=.027, r=-.452, p=.001 : r=-.434, p=.001 ; r=-.316, p=.005 ; r=-.460, p=.001 ; r=-.397, p=.014). Therefore, self-efficacy improved following the Self-Help Program including the stretching exercise. It was also found that physical symptoms (pain, number of tender points, level physical disability) and psychological symptoms (depression, fatigue, sleep disturbance, anxiety) were reduced. Moreover, It was found that the higher the self-efficacy, the the higher the degree of achievement of goals set for the stretching exercises. In addition, the level of exercise-performance influenced the level of physical disability, one of the symptoms of fibromyalgia. Accordingly, the conclusions from this study are that exercise-performance and the reduction of symptoms is achieved through promotion of self-efficacy. Therefore, it is proposed that are the Self-Help Program including stretching exercises is an appropriate nursing intervention for the reduction of symptoms of fibromyalgia.

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The Effects of Metaphors in the Interface of Smartphone Applications on Users' Intention to Use (사용자환경의 메타포가 스마트폰 애플리케이션 사용의도에 미치는 영향)

  • Jung, Wonjin;Hong, Suk-Ki
    • Asia pacific journal of information systems
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    • v.24 no.3
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    • pp.255-279
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    • 2014
  • It is not too much to say that smartphones have become an essential part of our lives due to their versatility. Nevertheless, they still have less overall capabilities than their desktop counterparts. Specifically, they have small screens and low resolutions, which make their applications difficult to have a usable interface. To account for these limitations, the interface of smartphone applications should be designed carefully and properly. Good interface design to any application is critical. However, a comprehensive information systems (IS) literature review found that there has been little research on the user interface design of smartphone applications. More specifically, there has been little empirical evidence and understanding about how metaphors, an imaginative way of describing objects and concepts, in the user interface of smartphone applications affect users' intention to use the applications. Thereby, the research goals of this study are to examine 1) the effects of the metaphors in the user interface of smartphone applications on the interaction between users and applications and 2) the effects of mediating variables including the interaction between users and applications, users' beliefs and attitudes, on users' intention to use the applications. A survey was conducted to collect data. University students and practitioners participated in the survey. A 24-item questionnaire was developed on a 5-point Likert-type scale. The measurement items were mostly adapted from the previous studies in the IS literature and modified to fit the context of this study. First, a principal component factor analysis was performed to explore the inter-relationships among a set of variables. The analysis showed that most of the items loaded quite strongly on the six components. The analysis also revealed the six components with eigenvalues exceeding 1, explaining a total of 70.7 per cent of the variance. The reliabilities of the items were also checked. Most Cronbach alpha values were above 0.8, so the scales were considered reliable. In sum, the results of the analysis support the decision to retain the six factors for further investigation. Next, the structural model was analyzed with AMOS structural equation modeling. The values of GFI, AGFI, NFI, TLI, CFI, and RMSEA were checked. The values showed that the research model considerably have a good fit in general. Next, the convergent and discriminant validities of all constructs were examined. The values for the standardized regression weights and critical ration (CR) indicated sufficient convergent validity for all constructs. In addition, the square root of the average variance extracted (AVE) of each construct was compared with its correlations with all other constructs. The results supported discriminant validity for all constructs. In sum, the results of analysis demonstrated adequate convergent and discriminant validities for all constructs. Finally, path coefficients between the variables were examined. Methphor was found to have an impact on interaction (${\beta}$ = .457, p = .000). There were also significant effects of the interaction on perceived usefulness (${\beta}$ = .273, p = .000) and ease of use (${\beta}$ = .405, p = .000). User attitude was significantly influenced by these two beliefs, perceived usefulness (${\beta}$ = .386, p = .000) and ease of use (${\beta}$ = .347, p = .000) respectively. Further, the results of analysis found that users' intention to use smartphone applications was significantly influenced by user attitude (${\beta}$ = .567, p = .000). Based upon the analyses, all hypotheses were supported. This study found that the metaphors used in the interface of smartphone applications affect not only the interaction between users and applications, but also users' intention to use the applications through the mediating variables, perceived usefulness and ease of use. These findings imply that if the metaphors used in the user interface of application are easy enough to understand for smartphone users, then the application can be perceived useful and easy to use, which in turn make users to have an intention to use the application. In conclusion, this study contributed not only to validate and extend Technology Acceptance Model (TAM) partially, but also to develop the construct of metaphor in smartphone settings. However, since a single empirical study cannot be enough to validate the findings, some limitations should be considered.

Evaluating and managing hypertension in children: a survey of Korean cardiologists and nephrologists (소아 고혈압의 평가와 관리 방법; 한국 소아심장 전문의와 소아신장 전문의 설문)

  • Lee, Eun Hee;Yim, Hyung Eun;Jang, Gi Young;Yoo, Kee Hwan;Son, Chang Sung;Hong, Young Sook;Lee, Joo Won
    • Clinical and Experimental Pediatrics
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    • v.51 no.9
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    • pp.992-997
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    • 2008
  • Purpose : Hypertension (HTN) is no longer an exclusively adult disease; the prevalence of pediatric HTN is increasing. To understand the evaluation and treatment of childhood HTN in Korea, we investigated, via a questionnaire, how hypertensive children are currently assessed and managed by pediatric cardiologists (CA) and nephrologists (NE). Methods : We surveyed 82 pediatric CA and 77 NE, regarding how they manage hypertensive children in Korea. Results : A total 75 replies were received to our questionnaire request (response rate: 47.15%). Routine blood pressure (BP) checks were more frequently performed by NE (CA: 5.7%, NE: 25%, P=0.03), but most respondents (86%) did not check BP routinely. Mercury sphygmomanometers were the most commonly used devices and ambulatory blood pressure monitoring was not frequently used. The goal BP in treated patients was set at the 95th percentile by 61% of respondents. NE used a lower BP goal in hypertensive children with renal disease (CA: 24%, NE: 64%, P=0.004) or DM (CA: 12.5%, NE: 50%, P=0.003). Angiotensin converting enzyme (ACE) inhibitors were the most commonly used agents (mean: 59%); following ACE inhibitors, CA preferred diuretics for hypertensive children with renal disease or cardiovascular disease, and NE preferred calcium channel blockers, regardless of underlying disease. Self-monitoring was the most frequent method for BP monitoring at home. Conclusion : In Korea, BP measurement is not yet a routine examination in treating hypertension. There are some differences in management strategies vis-$\grave{a}$-vis hypertension, between pediatric cardiologists and nephrologists. For the appropriate management and prevention of secondary disease in long-term studies, standard guidelines and education are needed for pediatricians.

A Study on the Relationship Between Entrepreneur Characteristics and the Performance of Small Firms (창업자 특성과 소기업 사업성과 간 관계에 관한 연구)

  • Kim, Wan-Jae;Chung, Hwa-Young
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.2 no.3
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    • pp.33-60
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    • 2007
  • This study alms to analyze the entrepreneur characteristics of founder on enterprise performance from the strategic viewpoint as well as features of founder of small firms such as background feature of founder, psychological features and management skill. As considered by Background features of founder include educational background of founder, his experience in business creation, consultation or course related to business creation. This study verified the effects of factor which business performance (financial, non financial) on small firms. Also, this study considered psychological features of founder include achievement desire, risk-free propensity, level of patience on vagueness and control position. And it analyzed that between such factors and performance of small firms were examined in related. In the mean time, management ability of founder, entrepreneur ability, technical and function ability were considered for management skill of founder and alalyzed effect of the factors on performance of small firm were examined. Effects of strategic intention of founder of small firm were analyzed by the strategic viewpoint. At this time, strategy of small firm was divided into product-service reform differentiation strategy, marketing differentiation strategy and cost leadership strategy. This study distributed questionnaire on CEO of small firms in Daejeon and Chungnam area for accomplish the study objective and it collected a total of 145 copies of questionnaires. As a result of analyzing collected questionnaire, this study deduced the following study results and suggestions. First, results different from those of existing studies were found Since sales, net income and profit rate of small firm were not high cause economic depression on the whole. Second, entrepreneur ability was found to be required for success of business creation. Entrepreneur ability of founder was the factor that affects both financial and non - financial performance of small firm. As such, entrepreneur ability can be regarded as the most important factor for success in business creation of small firm. Accordingly, entrepreneur ability is the most important source for success in business creation of small firm. Third, strategy of small firm was found to be the important factor that affects the non-financial performance even if it could not give significant effects on financial performance. Thus, product service reform differentiation strategy, marketing differentiation strategy and cost leadership strategy have significant effects on non - financial performance of small firm. Accordingly, it is required to operate small firm with strategic mind - set for small firm to achieve success. This study analyzed the effects of feature of founder and strategy of small firm on business performance of small firm through practical analysis on small firms in Daejeon and Chungnam area, and deduced meaningful results. However, Since this study collected data on small firms in Daejeon and Chungnam only, there is a limit in generalizing the results of this study to all small firms in Korea. Companies answering to this questionnaire process were mainly wholesale and retail service companies. In addition, there is a limit in that it failed to analyze feature of representative type of industry due to limit in number of sample, it is required to divide representative type of industry and to compare and analyze types of industry in future studies.

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Influence of User Innovativeness and Knowledge Base on Acceptance of Voice Shopping (사용자의 혁신성 및 지식수준이 가상비서 기반 음성쇼핑의 이용에 미치는 영향)

  • Jo, Woong;Ahn, Suho;Chung, Doohee
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.15 no.2
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    • pp.153-169
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    • 2020
  • A new way of shopping based on virtual assistant, so called voice shopping, is drawing attention. The voice shopping market is growing around the world, and Korea is on the verge of full-scale commercialization of this new shopping. For the development of voice shopping-related industries, it is necessary to research on specific issues related to this new shopping methods, such as the quality of services, efficient processes tailored to new ways, and ways to build customer relationships. As part of such an attempt, the study seeks to determine the factors that affect consumers' perception and attitudes toward voice shopping. The study conducted the analysis based on survey response data of 171 online shopping users. In addition to the typical factors of the technology acceptability model(TAM) such as perceived usefulness and ease of use, the impact of perceived playfulness was included for analyzing the intention on the acceptance of voice shopping. In particular, this study focuses on the impact of user attributes. For the spread of voice shopping, it is necessary to set up a valid target customer and understand users for establishing an effective customer relationship. Therefore, this study tries to analyze how the perceptions on the voice shopping(perceived usefulness, ease of use, and perceived playfulness) are affected by users' attributes, such as user innovativeness and user knowledge level. The result of analysis shows that user innovativeness have a positive relationship with all of perceived usefulness, ease of use, and perceived playfulness. The user knowledge base, however, was not significant to all these three variables. The user knowledge base is shown to have a positive effect on user innovativeness which is the source of positively significant factor for the variable of the perceptions on the voice shopping. Meanwhile, among the variables of extended technology acceptance model, perceived usefulness and perceived playfulness have positive effects on the acceptance of voice shopping, while ease of use has no significant impact on the voice shopping acceptance. Ease of use has a positive relationship with perceived usefulness and playfulness. This study is meaningful in providing implications on the development of voice shopping platforms and related services, and establishment of customer relationship.

Quantitative Assessment using SNR and CNR in Cerebrovascular Diseases : Focusing on FRE-MRA, CTA Imaging Method (뇌혈관 질환에서 신호대 잡음비와 대조도대 잡음비를 이용한 정량적평가 : FRE-MRA, CTA 영상기법중심으로)

  • Goo, Eun-Hoe
    • Journal of the Korean Society of Radiology
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    • v.11 no.6
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    • pp.493-500
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    • 2017
  • In this study, data analysis has been conducted by INFINITT program to analyze the effect of signal to noise ratio(SNR) and contrast to noise ratio(CNR) of flow related enhancement(FRE) and computed tomography Angiography(CTA) on cerebrovascular diseases for qualitative evaluations. Based on the cerebrovascular image results achieved from 63 patients (January to April, 2017, at C University Hospital), we have selected 19 patients that performed both FRE-MRA and CTA. From the 19 patients, 2 were excluded due to artifacts from movements in the cerebrovascular image results. For the analysis conditions, we have set the 5 part (anterior cerebral artery, right and left Middle cerebral artery, right and left Posterior cerebral artery) as the interest area to evaluate the SNR and CNR, and the results were validated through Independence t Test. As a result, by averaging the SNR, and CNR values, the corresponding FRE-MRA achieved were: anterior cerebral artery ($1500.73{\pm}12.23/970.43{\pm}14.55$), right middle cerebral artery ($1470.16{\pm}11.46/919.44{\pm}13.29$), left middle cerebral artery ($1457.48{\pm}17.11/903.96{\pm}14.53$), right posterior cerebral artery ($1385.83{\pm}16.52/852.11{\pm}14.58$), left posterior cerebral artery ($1318.52{\pm}13.49/756.21{\pm}10.88$). by averaging the SNR, and CNR values, the corresponding CTA achieved were: anterior cerebral artery ($159.95{\pm}12.23/123.36{\pm}11.78$), right middle cerebral artery ($236.66{\pm}17.52/202.37{\pm}15.20$), left middle cerebral artery ($224.85{\pm}13.45/193.14{\pm}11.88$), right posterior cerebral artery ($183.65{\pm}13.47/151.44{\pm}11.48$), left posterior cerebral artery ($177.7{\pm}16.72/144.71{\pm}11.43$) (p < 0.05). In conclusion, MRA had high SNR and CNR value regardless of the cerebral infarction or cerebral hemorrhage observed in the 5 part of the brain. Although FRE-MRA consumed longer time, it proved to have less side effect of contrast media when compared to the CTA.

Evaluating the Impact of Attenuation Correction Difference According to the Lipiodol in PET/CT after TACE (간동맥 화학 색전술에 사용하는 Lipiodol에 의한 감쇠 오차가 PET/CT검사에서 영상에 미치는 영향 평가)

  • Cha, Eun Sun;Hong, Gun chul;Park, Hoon;Choi, Choon Ki;Seok, Jae Dong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.1
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    • pp.67-70
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    • 2013
  • Purpose: Surge in patients with hepatocellular carcinoma, hepatic artery chemical embolization is one of the effective interventional procedures. The PET/CT examination plays an important role in determining the presence of residual cancer cells and metastasis, and prognosis after embolization. The other hand, the hepatic artery chemical embolization of embolic material used lipiodol produced artifacts in the PET/CT examination, and these artifacts results in quantitative evaluation influence. This study, the radioactivity density and the percentage error was evaluated by the extent of the impact of lipiodol in the image of PET/CT. Materials and Methods: 1994 NEMA Phantom was acquired for 2 minutes and 30 seconds per bed after the Teflon, water and lipiodol filled, and these three inserts into the enough to mix the rest behind radioactive injection with $20{\pm}10MBq$. Phantom reconfigure with the iterative reconstruction method the number of iterations for two times by law, a subset of 20 errors. We set up region of interest at each area of the Teflon, water, lipiodol, insert artifact occurs between regions, and background and it was calculated and compared by the radioactivity density(kBq/ml) and the% Difference. Results: Radioactivity density of the each region of interest area with the teflon, water, lipiodol, insert artifact occurs between regions, background activity was $0.09{\pm}0.04$, $0.40{\pm}0.17$, $1.55{\pm}0.75$, $2.5{\pm}1.09$, $2.65{\pm}1.16 kBq/ml$ (P <0.05) and it was statistically significant results. Percentage error of lipiodol in each area was 118%, compared to the water compared with the background activity 52%, compared with a teflon was 180% of the difference. Conclusion: We found that the error due to under the influence of the attenuation correction when PET/CT scans after lipiodol injection performed, and the radioactivity density is higher than compared to other implants, lower than background. Applying the nonattenuation correction images, and after hepatic artery chemical embolization who underwent PET/CT imaging so that the test should be take the consideration to the extent of the impact of lipiodol be.

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Comparative Study on Acoustic Characteristics of Vocal Fold Paralysis and Benign Mucosal Disorders of Vocal Fold (성대마비와 양성 성대점막질환의 음향학적 특성비교)

  • Kong, Il-Seung;Cho, Young-Ju;Lee, Myung-Hee;Kim, Jong-Seung;Yang, Yun-Su;Hong, Ki-Hwan
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.18 no.2
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    • pp.122-128
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    • 2007
  • This study aims to analyze the voices of the patients with voice disorders including vocal fold paralysis, vocal fold cyst and vocal nodule/polyp in the aspect of acoustic phonetics. This study intends to collect subsidiary acoustic data in order to make a speech treatment and an standardization of vocal disorders. Subjects and Methods: The subjects of this study were 64 adult patients who underwent indirect laryngoscopy and laryngostroboscopy, and were diagnosed as vocal fold paralysis, vocal fold cyst or vocal nodule/polyp. Experimental group consisted of 20 patients who were diagnosed as vocal fold paralysis, 21 patients who were diagnosed as vocal fold cyst and had the average age of 42.0 $({\pm}10.03)$ ; and 23 patients who were diagnosed as vocal nodule/polyp and had the average age of 40.9 $({\pm}13.75)$. For the methodology of this study, the patients listed above were asked to sit in a comfortable position at intervals of 10cm apart from the patient's mouth and a microphone, and subsequently to phonate a vowel sound /e/ for the maximum phonation time with natural tone and vocal volume then the sound was directly inputted on a computer. During recording, sampling rate was set to 44,100Hz and the 1-second area corresponding to stable zone except the first and the last stage of waveform of the vowel sound /e/ vocalized by the individual patients was analyzed. Results: First, there was no statistically significant difference in jitter and shimmer between vocal fold paralysis and vocal fold cyst, while there was highly statistically significant difference in them between vocal fold paralysis and vocal nodule/polyp. Second, looking into the mean values obtained from NNE, HNR and SNR results associated with noise ratio, the disease showing the most abnormal characteristics was vocal fold paralysis, followed by cyst and nodule/polyp in order. For NNE, there was statistically significant difference between vocal nodule/polyp, and cyst or paralysis. In other words, it was found that the NNE of vocal nodule/polyp was weaker than that of cyst or paralysis. Similarly, HNR and SNR also showed the same characteristics; there was statistically significant difference between vocal fold paralysis and vocal fold cyst or nodule/polyp, and HNR and SNR values of vocal fold paralysis were lower than those of vocal fold cyst or nodule/polyp. Conclusion: For vocal fold paralysis, the abnormal values of acoustic parameters associated with frequency, amplitude and noise ratio were statistically significantly higher than those of vocal fold cyst and nodule/polyp. This finding suggests that the voices of the patients with vocal fold paralysis are the most severely injured due to less stability of vocal fold movement, asymmetry and incomplete glottic closure. In addition, there was no statistically significant difference in the acoustic parameters of tremor among vocal fold paralysis, vocal fold cyst and vocal nodule/polyp. Further studies need to ascertain reasonable acoustic parameters with various vocal disorders as well as to clarify the correlation between acoustics-based objective tools and subjective evaluations.

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