• Korean Journal of Radiology
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• v.22 no.2
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• pp.159-167
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• 2021

Objective: The aim of this study was to compare the survival rates of Korean females aged 40 to 49 years with breast cancer detected by supplemental screening ultrasound (US) or screening mammography alone. Materials and Methods: This single-institution retrospective study included 240 patients with breast cancer (mean age, 45.1 ± 2.8 years) detected by US or mammography who had undergone breast surgery between 2003 and 2008. Medical records were reviewed for clinicopathologic characteristics and detection methods. Disease-free survival (DFS) and overall survival (OS) were compared between patients with breast cancer in the US and mammography groups using the log-rank test. Multivariable cox regression analysis was used to identify independent variables associated with DFS and OS. Results: Among the 240 cases of breast cancer, 43 were detected by supplemental screening US and 197 by screening mammography (mean follow-up: 7.4 years, 93.3% with dense breasts). There were 19 recurrences and 16 deaths, all occurring in the mammography group. While the US group did not differ from the mammography group in tumor stage, the patients in this group were more likely to undergo breast-conserving surgery and radiation therapy than the mammography group. The US group also showed better DFS (p = 0.016); however, OS did not differ between the two groups (p = 0.058). In the multivariable analysis, the US group showed a lower risk of recurrence (hazard ratio, 0.097; 95% confidence interval, 0.001-0.705) compared to the mammography group. Conclusion: Our study found that Korean females aged 40-49 years with US-detected breast cancer showed better DFS than those with mammography-detected breast cancer. However, there were no statistically significant differences in OS.

• Korean Journal of Radiology
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• v.24 no.3
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• pp.259-270
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• 2023

Objective: It is unknown whether artificial intelligence-based computer-aided detection (AI-CAD) can enhance the accuracy of chest radiograph (CR) interpretation in real-world clinical practice. We aimed to compare the accuracy of CR interpretation assisted by AI-CAD to that of conventional interpretation in patients who presented to the emergency department (ED) with acute respiratory symptoms using a pragmatic randomized controlled trial. Materials and Methods: Patients who underwent CRs for acute respiratory symptoms at the ED of a tertiary referral institution were randomly assigned to intervention group (with assistance from an AI-CAD for CR interpretation) or control group (without AI assistance). Using a commercial AI-CAD system (Lunit INSIGHT CXR, version 2.0.2.0; Lunit Inc.). Other clinical practices were consistent with standard procedures. Sensitivity and false-positive rates of CR interpretation by duty trainee radiologists for identifying acute thoracic diseases were the primary and secondary outcomes, respectively. The reference standards for acute thoracic disease were established based on a review of the patient's medical record at least 30 days after the ED visit. Results: We randomly assigned 3576 participants to either the intervention group (1761 participants; mean age ± standard deviation, 65 ± 17 years; 978 males; acute thoracic disease in 472 participants) or the control group (1815 participants; 64 ± 17 years; 988 males; acute thoracic disease in 491 participants). The sensitivity (67.2% [317/472] in the intervention group vs. 66.0% [324/491] in the control group; odds ratio, 1.02 [95% confidence interval, 0.70-1.49]; P = 0.917) and false-positive rate (19.3% [249/1289] vs. 18.5% [245/1324]; odds ratio, 1.00 [95% confidence interval, 0.79-1.26]; P = 0.985) of CR interpretation by duty radiologists were not associated with the use of AI-CAD. Conclusion: AI-CAD did not improve the sensitivity and false-positive rate of CR interpretation for diagnosing acute thoracic disease in patients with acute respiratory symptoms who presented to the ED.

• Korean Journal of Radiology
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• v.21 no.10
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• pp.1178-1186
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• 2020

Objective: To evaluate the incidence and risk factors of emetic complications associated with the intravenous administration of low-osmolality iodinated contrast media (ICM) in children undergoing computed tomography (CT). Materials and Methods: All children who underwent contrast-enhanced CT between April 2017 and July 2019 were included. Pediatric patients were instructed on the preparative dietary protocol at our institution. Experienced nurses in the radiology department monitored the children during the CT scans and recorded any emetic complications in their electronic medical records. These data were used to calculate the incidence of emetic complications. Various patient factors and technical factors, including fasting duration, the type and volume of ICM, and ongoing chemotherapy, were evaluated to identify risk factors for emetic complications using univariate and multivariate logistic regression analyses. Results: Among the 864 children (mean age, 8.4 ± 5.7 years) evaluated, 18 (2.1%) experienced emetic complications (6 experienced nausea only and 12 experienced nausea and vomiting). None of the children developed aspiration pneumonia. The mean fasting duration of patients with emesis was 7.9 ± 5.7 hours (range, 3-21 hours), whereas that of patients without nausea was 8.7 ± 5.7 hours (range, 0-24 hours). Fasting duration was not associated with the development of nausea and vomiting (p = 0.634). Multivariate logistic regression analysis revealed that ongoing chemotherapy (odds ratio [OR] = 4.323; 95% confidence interval [CI] = 1.430-13.064; p = 0.009), iomeprol use (OR = 7.219; 95% CI = 1.442-36.146; p = 0.016), and iohexol use (OR = 5.241; 95% CI = 1.350-20.346; p = 0.017) were independent risk factors for emetic complications. Conclusion: Only a small proportion (2.1%) of children experienced nausea or vomiting after exposure to low-osmolality ICM. Many children underwent excessive fasting; however, fasting duration was not associated with nausea and vomiting. Moreover, ongoing chemotherapy and the use of iomeprol or iohexol were identified as potential risk factors for emetic complications in children.

• The Journal of the Convergence on Culture Technology
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• v.10 no.4
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• pp.121-132
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• 2024

This study attempted to determine the effects of job stress, nursing problem-solving ability, nursing work performance, and job stress and nursing problem-solving ability on nursing work performance according to the MBTI type of nurses. The study subjects were 141 nurses working at a medical institution in G Province, and data collection was conducted from March 01 to March 31, 2024. The collected data were analyzed using correlation and multiple regression analysis. Among the psychological function types of MBTI, the SF type (sympathetic and friendly type) was the most common, and among the psychological temperament types, the SP type (sensuous and open type) was the most common. Nursing work performance had a negative correlation with job resource stress, a positive correlation with nursing problem-solving ability, and a positive correlation with problem recognition, information collection, planning ability, and evaluation. The variable that had a significant impact on nursing work performance was job resources, and problem recognition, a subfactor of nursing problem-solving ability, was found to be the best predictor of nursing work performance, followed by planning ability. The explanatory power was 17.8%. The results of this study are expected to be used as basic data to develop efficient nursing management guidelines by not only improving understanding of the personality of nurses but also investigating factors related to nurses' work performance. Through the development of programs and measures to improve nursing performance, it is necessary to revitalize programs, provide educational opportunities, and provide institutional support from hospital organizations to enable high-quality nursing care through skilled nursing work.

• Clinical and Experimental Pediatrics
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• v.49 no.9
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• pp.952-958
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• 2006

Purpose : The survival rate of infants weighing less than 1,000 g at birth(extremely low birth weight infants, ELBWI) has increased due to recent advances in perinatal and neonatal intensive care. The purpose of this study was to evaluate the survival rates of ELBWI born at Seoul National University Hospital during the last six years. Methods : A total of 99 infants were divided into three groups(period I: 2000 to 2001, period II: 2002 to 2003, period III : 2004 to 2005) based on date of birth. We compared the survival rate of ELBWI over the three periods, using CRIB II score for adjustment for clinical severity. Results : Overall survival rate of ELBWI was 74.7 percent. The survival rate of ELBWI increased over the three periods(period I: 60.7 percent, period II : 73.3 percent, period III : 85.3 percent). The threshold of viability(defined as survival of at least 50 percent of infants) was 25 weeks of gestation and 600 g at birth. The birth weight-specific survival rates increased considerably over the three periods for infants <750 g at birth(period I: 10 percent, period II: 46.2 percent, period III : 70.6 percent). The survival rates of ELBWI over the three periods increased much remarkably after adjustment for clinical severity by CRIB II score. Conclusion : In our institution, survival rates of ELBWI during the last six years continued to improve, particularly for infants weighing <750 g at birth. This increase in survival rates was not associated with the clinical severity of ELBWI.

• Journal of Society of Preventive Korean Medicine
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• v.2 no.1
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• pp.87-111
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• 1998

For the newly approach of policy with the old aged era at hand, the result which examines the 1,200 students attending professional colleges and upward in three small-to-medium sized cities, for two months, from October 1, 1996 to November 30, in order to know the change of consciousness of the growing modern young intellectual age group is as follows. 1. The objects of survey consist of 72.1% of women, 40.4% of 20 to 21 age, 49.1% of atheists, and people from big cities and fishing and agrarian village occupy equally 40.2%. Concerning the long-termed residents, 49% of them dwell in big cities. In case of the parents' age is more than 55, 31.5% in fathers, and 10.9% in mothers. 2. The types of housing in which they desire to reside in their getting older are : 72.8% of them hope to live in individual houses, 16.6% in apartments or villas, and 3.4% in social welfare facilities. Out of respondents, compared with other groups, man rather than woman, those who are 20 to 21 age group and from fishing and agrarian villages and have over 7 family members and live with their parents have a higher preference for independent houses. 3. The districts in which they hope to live when they are old are : 41.6% of them, with the highest percent, hope to live in farming villages, the older they are, the more they hope to live in agricultural district, and women of 21 years and upward hope to live in big cities. On the other hand, the preferable degree for social welfare facilities is higher each in people who are 24 years and upward, buddhists, self-boarding students, and the more poorly they are off, the higher the percent is. 4. The types of preferable welfare facilities for the elderly are : 58.2% of them think silver towns desirable, 28.4% think the charged (or free) elderly welfare facilities. Compared with other groups, the percentage which prefer silver towns is higher in women, people from big cities, residents of main family, long-termed city residents, people with higher income, people having grandparents alive, and people who had experience of taking lectures on hygienics or social welfare. 5. 50.3% of the respondents insist that provision of living expenses against old age should be insured by social security system, and 42.8% by the elderly themselves. The percentage of the former shows higher in people of 21 years and upward, women, residents of fishing and agrarian villages, christians, people in more needy circumstances and people who have experience of using a medical institution. 6. Compared with other nations, 54.5% of the respondents have an opinion that elderly welfare and welfare work in Korea stays in insufficient level and most of them are women, people from farming village, residents of head family, people having younger parents and people being worse health condition, and they have a more positive attitude about the elderly welfare work. 7. 92.3% of the respondents answered that a national budget for the elderly welfare is scarce, and the percentage is higher in people who are older, residents of big cities, people in lower living condition and people in worse health condition. 8. 35.2% of the respondents answered that the proper cost of their old age must be over 220mi11ion. The more a family's total income is, the higher the percentage is. 9. The factors which have an effect on the preference of silver towns are sex(p<0.01, the type of the present residence(p<0.05), and a family's total income(p<0.05). 10. From the survey result of the above, we comes to the conclusion that, for the sake of welfare of the increasing elderly population, government authorities and parties concerned must exert their utmost for the elderly welfare by increasing a budget of it and establishing a number of facilities of the elderly welfare and silver towns located in fresh and comfortable villages. In addition, they have to set up a course of hygienics in all the colleges and instruct the contexts on hygienic welfare as well.

• The Journal of the Korean bone and joint tumor society
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• v.9 no.1
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• pp.18-23
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• 2003

Purpose: Delay in the diagnosis of the primary malignant bone tumors may critically influence the chance of the patients' survival and the limb sparing, but the primary malignant bone tumors are so rare that most doctors have little experience in these challenging diseases. The purpose of the current study is to examine the initial symptoms of osteosarcoma and chondrosarcoma, and to shorten the delay of diagnosis. Materials and Methods: The data was based on the questionnaires and the medical records from 139 patients whose histological diagnoses were confirmed in the authors' institution. There were 108 patients of osteosarcoma and 31 patients of chondrosarcoma. Eighty-six were male and fifty-three were female. The mean age of the patients was 20.2 years in osteosarcoma, and 42.4 years in chondrosarcoma. Results: The most common symptom that the patient consult the doctor was pain (93.5% of osteosarcoma patients and 61.3% of chondrosarcoma patients). Among them, 76.2% of osteosarcoma and 57.8% of chondrosarcoma patients complained the night pain. The history of trauma was evident in 48.5% of osteosarcoma patients and one patient of chondrosarcoma. At the first medical visit, the malignant bone tumor was suspected in 61.1% of osteosarcoma and 64.5% of chondrosarcoma patients. Fracture was the most common misdiagnosis in osteosarcoma (16.7%), and the osteomyelitis in chondrosarcoma (19.4%). Initial radiographic examination and the adult age were shown to increase the rate of correct diagnosis of both diseases (p<0.05). Patient's delay and doctor's delay were significantly longer in chondrosarcoma patients than in osteosarcoma. Initial radiography led to shorten the doctor's delay, and the axial location of the tumor lengthened the doctor's delay. Trauma and the young age were believed to shorten the patient's delay. Conclusion: Careful history taking, including the night pain and trauma, would be mandatory for the early diagnosis of the primary malignant bone tumors, and the initial radiographic examination and periodic follow-up can increase the rate of correct diagnosis.

• Journal of Chest Surgery
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• v.42 no.1
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• pp.22-27
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• 2009

Background: Coronary artery bypass grafting (CABG) is the standard surgical treatment for coronary artery disease. Although there are many clinical reviews of the long term results after CABG in the Western countries, not many such studies have been done for Korea. Therefore, we reviewed the long term clinical results for the patients who underwent CABG at our hospital. Material and Method: We retrospectively reviewed the medical records of 342 patients who underwent CABG at our hospital from February 1984 to December 2006, which is when CABG was first performed in our institution. A total of 286 patients (83.6%) were able to be followed-up, and the mean follow-up period was $75.7{\pm}46.1$ months. Result: The early mortality rate was 5.6%, and late mortality rate was 23.1%. The one-year survival rate, the five-year survival rate, the ten-year survival rate and the fifteen-year survival rate were 91.5%, 82.1%, 60.7% and 50.0%, respectively. The survival rate was significantly lower for the patients over the age of 60 (p=0.002) and for those with diabetes mellitus (p=0.000), hypertension (p=0.002), multivessel disease (p=0.006) and left ventricular dysfunction (p=0.015). No significant difference was observed between the genders. Multivariate analysis showed that the statistically significant risk factors were diabetes mellitus (p=0.001), age (p=0.005) and those cases for which the left internal thoracic artery was not used (p=0.037). Conclusion: CABG is the effective method of treatment for coronary artery disease. Therefore, active usage of the internal thoracic artery and appropriate medical treatment after surgery, and especially for diabetes mellitus patients, are mandatory for achieving good long-term survival.

• Clinical and Experimental Pediatrics
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• v.46 no.3
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• pp.250-258
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• 2003

Purpose : The actual clinical examples of co-appliance of catheter intervention with surgical procedures in the treatment of pulmonary atresia with an intact ventricular septum(PA/IVS) which we have experienced in our institution are here shown, and the anatomical and hemodynamical profiles between each method is compared. Methods : Medical records of 33 patients with PA/IVS who underwent various treatment from January, 1995 to December, 2000 were reviewed for a retrograde study. Results : In three out of 10 patients who underwent percutaneous balloon pulmonary valvotomy (PPV), residual pulmonary stenosis were observed in their out patient department(OPD) follow-ups, eventually necessitatig balloon pulmonary valvuloplasty(BPV). One out of three patients exhibited deterioration of tricuspid regurgitation after BPV, requiring surgical tricuspid annuloplasty(TAP). Two out of the seven patients who received primarily surgical right ventricle outlet tract(RVOT) repair without any systemic-pulmonary shunt or intervention needed additional intervention employing cardiac catheterization after operation. Two patients received interventional catheterization before surgical RVOT repair. In five out of 11 cases of Fontan type operation, coil embolization of collateral circulation was done before total cavo-pulmonary connection(TCPC), and in three cases, interventional catheterization was needed after TCPC. Conclusion : Both medical and surgical treatment modalities are widely used in management of PA/IVS patients, and recent results prove that medico-surgical cooperative treatment is essential.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.4
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• pp.186-196
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• 2018

Junior colleges are higher education institutions that have played a major role in the economic development of Korea by providing the necessary human resources for its industrial development. Recently, however, they have experienced difficulties due to the reduction in the number of students. Therefore, it is time for junior colleges as a representative higher vocational education institution to change their role in this rapidly changing environment, and adopt a survival strategy through mutual cooperation and competition. The purpose of this study was to analyze the current state of the national health universities, to investigate the policy changes adopted by colleges and universities, and to utilize the results as data. This study analyzed the current status of health science colleges nationwide and investigated the policy changes as well as the directions presented to the colleges, in order to use the results as the basic data to promote the diversification of the class periods and degree programs. This study surveyed 636 professors from health sciences departments and industry workers from May 1 to May 30, 2017. 70.7% of the respondents supported the transition of the existing three-year systems of the health science departments to four-year systems. The reason for this is that it is possible to strengthen the field practice and personality education of the students by having a sufficient number of class periods, and to provide them with an equal educational background. The most anticipated effect of the transition to a four-year system is to improve the social status of medical personnel and to improve the educational environment of the colleges/universities. Moreover, the universities, associations of medical personnel and Ministry of Education are expected to play a leading role in the transition to the four-year system. Based on the results of this study, it was concluded that a more systematic and advanced vocational education system for the training of professional healthcare workers is needed in the upcoming fourth Industrial Revolution era. Also, this transition is expected to actively foster the education of advanced health care workers thanks to the diversification of the degree programs through the adjustment of the class periods which can be completed by general university (4-year) graduates.