• Title/Summary/Keyword: public medicine

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The Usability Evaluation of the Usefulness of Bismuth Shields in PET/CT Examination (PET/CT 검사에서 비스무스(bismuth) 차폐체의 적용에 따른 유용성 평가)

  • Park, Hoon-Hee;Lee, Juyoung;Kim, Ji-Hyeon;Nam, Kun-Sik;Lyu, Kwang-Yeul;Lee, Tae Soo
    • Journal of radiological science and technology
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    • v.37 no.1
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    • pp.49-56
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    • 2014
  • Recently with CT developed, various studies for reduction of exposure dose is underway. Study of bismuth shields in these studies is actively underway, and has already been applied in the clinical. However, the application of the PET/CT examination was not activated. Therefore, through this study, depending on the application of bismuth shields in the PET/CT examination, we identify the quality of the image and the impact on the Standard Uptake Value (SUV). In this study, to apply to the shielding of the breast, by using the bismuth shields that contains 0.06 mm Pb ingredients, was applied to the PET/CT GEMINI TF 64 (Philips Healthcare, Cleveland, USA). Phantom experiments using the NEMA IEC Body Phantom, images were acquired according to the presence or absence of bismuth shields apply. Also, When applying, images were obtained by varying the spacing 0, 1, 2 cm each image set to the interest range in the depth of the phantom by using EBW-NM ver.1.0. When image of the PET Emission acquires, the SUV was in increased depending on the use of bismuth shields, difference in the depth to the surface from deep in the phantom increasingly SUV increased (P<0.005). Also, when using shields, as the more gab decreased, SUV is more increased (P<0.005). Through this study, PET/CT examination by using of bismuth shields which is used as purpose of reduction dose. When using shields, the difference of SUV resulting from the application of bismuth shields exist and that difference when gab is decrease and surface is wider. Therefore, setting spacing of shield should be considered, if considering the reduction of the variation of SUV and image quality, disease of deep organs should be a priority rather than superficial organ disease. Use of bismuth shielding factor considering the standard clinical examination, decrease unnecessary exposure can be expected to be considered.

A Study on Denture Satisfaction in Rural Elderly People (농촌지역 노인의 의치만족도)

  • Lee, Ga-Ryoung;Yoo, Wang-Keun
    • Journal of agricultural medicine and community health
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    • v.35 no.1
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    • pp.56-66
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    • 2010
  • Objectives: The study aimed to explore dental status and denture satisfaction in some rural elderly people. Methods: A total of 546 participants aged over 65 years was surveyed cross-sectionally. The subjects were surveyed with regard to their denture satisfaction by a structured questionnaire. The Wilcoxon or Kruskal-Wallis test was used for analysis. Results: As for respondents' satisfaction for dentures by the Likert scale of 5 score, aesthetic satisfaction (3.73) was highest, followed by general satisfaction (3.56) and masticatory functions satisfaction (3.45). In addition, the educational level, occupation, monthly income, the number of remaining teeth, use of denture variables have statistically significant difference in the denture satisfaction of those elderly people interviewed. Conclusions: The results showed that denture satisfaction in some rural elderly people was different in each categories. Consequently, providing tailor-made oral health education programs for the effective denture management of the elderly people should be needed in order to improve the quality of life of the aged.

The effect of oral care program for the elderly women of the Visiting oral health care (방문구강보건사업 여성노인 대상자의 구강관리프로그램 효과)

  • Lee, Yun-Hui;Lee, Sung-Kook
    • Journal of Korean society of Dental Hygiene
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    • v.12 no.2
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    • pp.365-377
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    • 2012
  • Objectives : This research was conducted to determine the effect of the Visiting Oral Health Care Program by examining the oral health of the elderly women, who are the beneficiaries of this Visiting Oral Care Program. Methods : This research was conducted from November of 2011 to February of 2012, in Chilgok-gun in the Kyeongbuk Province, South Korea. One hundred and twenty five (125) elderly women among the beneficiaries of the Visiting Oral Care Program within the area were randomly selected for the research. The research subjects would regularly visit the area senior citizen center, and they were divided into two groups, with 64 of them belonging to a control group, and the rest (61 people) belonged to a intervention group. The research subjects were examined for their dental health condition, and we investigated the effect of the Visiting Oral Care Program through this research. Results : 1. When they were asked about how many times they wash their dentures, the majority of the control group, 57.4% of them answered that they do it "once" a day. The majority of the intervention group answered "more than 3 times", with 35.2% of group mentioning that they wash their dentures more than 3 times a day(p<.001). 2. When the research subjects were asked to scale their overall quality of life before and after the Visiting Oral Care Program, the control group had rated 49.3 before the Service and 56.8 after the Service (p<.01), and scores for the individual factors to determine the overall quality of life has significantly improved as well (p<.01, p<.01, p<.01, p<.01, p<.01, p<.01, p<.01). 3. The oral hygiene condition after the Visiting Oral Care Program has shown improvement as well. The control group scored 64.2 for the severity of the symptoms of dental plaque before the dental care, and scored 46.8 after the dental care (p<0.1). The control group was diagnosed for the symptoms of coated tongue, and the severity of the symptoms were scaled as 3.7 before the Program and 2.0 after the Program (p<.01). Furthermore, the overall functionality of the oral cavity was improved as well. The control group showed 1.0 time increase in repetitive voluntary swallowing test (p<0.1), increased amount of sublingual saliva from 0.8mm to 1.4mm, and from 1.6mm to 2.0mm in dorsum linguae(p<0.1). Also, the control group showed an improvement in mouth opening as well, increased from 3.9 to 4.0cm after the oral care program (p<.05). When compared the result with the examination after the Visiting Oral Care Program, the two groups showed a significant difference with the control group showing a significant improvement compared to the intervention group(p<.01, p<.01, p<.01, p<.01, p<.05). 4. The correlation between the dental hygiene condition and the functionality of oral was made for the result of examining the beneficiaries for Visiting Oral Care Program. The amount of saliva showed a negative correlation with the severity of dental plaque (p<.05), and a positive correlation with the repetitive voluntary swallowing count (p<0.1). Also, mouth opening showed a positive correlation with repetitive voluntary swallowing count (p<.05). Conclusions : After the Visiting Orall Care Program, the beneficiaries of the program experienced improvement in their quality of life related to oral health, overall oral hygiene and functionality of oral.

Case Report of Radiotherapy to a Breast Cancer Patient with a Pacemaker (인공심장박동기가 이식된 유방암환자의 방사선 치료에 대한 사례 보고)

  • Chae, Seung-Hoon;Park, Jang-Pil;Lee, Yang-Hoon;Yoo, Suk-Hyun;Seong, Won-Mo;Kim, Kyu-Bo
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.2
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    • pp.197-203
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    • 2012
  • Purpose: In this study, we considerate our radiation therapy process for the breast cancer patient implanted a pacemaker applying the machine movement surgery, shielding, beam selection. Materials and Methods: We perform radiation therapy to a 54 years old, breast cancer patient implanted a pacemaker. The patient underwent a surgery to move the position of a pacemaker to right side breast after consultation with cardiology department. Prescribed dose was 5,040 cGy and daily dose 180 cGy for 28 fractions. The 10 MV photon energy, field size 0/$9.5{\times}20$ cm, half beam and opposing portal irradiation are used. To find out appropriate thickness of shielding board, we carried out an experiment using a solid water phantom ($30{\times}30{\times}7$ cm), a Farmer-type chamber (TN30013, PTW, Germany) and a shielding board (Pb $28{\times}27{\times}0.1$ cm). We calculated expected absorbed dose to te pacemaker with absorb ratio and shielding ratio. In the PTP system (Eclipse, Varian, USA), we figured out how much radiation would be absorbed to the machine with and without shielding. First day of the radiation therapy, we measured head scatter to the pacemaker with MOSFET Dose Verification System (TN-RD-70-W, Medical Canada Ltd., Canada). Results: In the phantom measurement, we found out appropriate thickness was 2 mm of shielding board. In the RTP, when using 2 mm shielding the pacemaker will be absorbed 11.5~38.2 cGy and DVH is 77.3 cGy. In the first day of the therapy, 4.3 cGy was measured so 120.4 cGy was calculated during total therapy. The patient was free from any side effects, and the machine also normally functioned. Conclusion: As the report of association which have public confidence became superannuated, there is lack of data about new machine. We believe that radiation therapy to thiese kind of patients could be done successfully with co-operation, patient-suitable planning, accurate QA, frequent in-vivo dosimetry and monitoring.

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Food habits, health behaviors related to the personality in Korean college students (대학생의 성격요인과 식습관 및 건강관련행태)

  • Kim, Nahyeon;Kim, Jinhee;Kye, Seunghee
    • Journal of Nutrition and Health
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    • v.53 no.1
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    • pp.13-26
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    • 2020
  • Purpose: This study identified the relationship between dietary habits and health-related behaviors depending on the Big Five personality factors (extraversion, openness, agreeableness, conscientiousness, neuroticism). Methods: The NEO-II test was administered to 337 male and female college students in Seongnam City, Gyeonggi Province, and their dietary habits and health-related behaviors were surveyed. Results: The male participants showed higher scores for extraversion, openness, agreeableness, and conscientiousness compared to that of their female counterparts, while the female participants showed higher scores for neuroticism. As for the results of multivariate logistic regression analysis, in the case of men, higher scores for extraversion were related to a lower intake of instant/fast foods and a higher intake of vegetables; higher agreeableness scores were related to a lower intake of fruit; and higher neuroticism scores were related to a heavy intake of high-cholesterol foods. It was found that higher openness scores were associated with a higher intake of burnt fish/meat and a lower intake of animal fat, while higher agreeableness scores were related to a lower intake of burnt fish/meat in women. Also, those subjects with higher openness and agreeableness scores were found to better consider the nutritional balance when having a meal. In the case of the male participants, higher openness scores were related to increased physical activity, while higher neuroticism scores were related to increased smoking and a lack of sleep. As for the women, those with higher extraversion scores smoked more, while those who recorded higher agreeableness scores were involved in more physical activities. Conclusion: Differences were observed in dietary habits and health-related behaviors between men and women depending on personality factors, and the analysis results of some dietary habits according to personality factors were inconsistent with those of the overseas studies. Therefore, to provide customized nutritional counseling when considering each individual's personality factors, more research results from domestic samples should be collected and accumulated.

Analysis of Serum Antioxidant Materials Concentration and Their Relation with Blood Lipids and Anthropometric Indices in Middle-Aged Adults in Korea (중년기 성인의 혈중 항산화 물질 분석 및 혈중 지질과 신체계측치와의 상관성)

  • Lee, Hyun-Jung;Lee, Duk-Hee;Kim, Kwang-Ok;Kim, Yoo-Jung;Lee, Hye-Sung
    • Journal of Nutrition and Health
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    • v.42 no.5
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    • pp.464-473
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    • 2009
  • The serum levels of antioxidant materials (${\alpha}$-carotene, ${\beta}$-carotene, ${\beta}$-cryptoxanthin, lutein, lycopene, ${\alpha}$-tocopherol, ${\gamma}$-tocopherol, retinol) of the healthy Korean middle-aged adults (n = 373) were measured and their relationships with the serum lipids and anthropometric indices were analyzed. The serum levels of ${\beta}$-cryptoxanthin, ${\beta}$-carotene, lutein were higher than those of lycopene and ${\alpha}$-carotene. The levels of all measured carotenoids except lutein were significantly higher in females than in males, but retinol level was vice versa. There was a tendency of increase in serum levels of antioxidant vitamins with increasing age. The serum carotenoid levels had a positive correlation with serum cholesterol and a negative correlation with serum triglyceride. The serum levels of tocopherols or retinol showed a significantly positive relationship with blood cholesterol or triglyceride. In overall, anthropometric indices showed negative relations with serum carotenoids levels, but vice versa with serum tocopherol or retinol levels. Particularly, ${\beta}$-carotene and lutein levels showed a significantly negative relation with blood pressure in male subjects. The serum levels of ${\alpha}$-carotene, ${\beta}$-carotene and ${\beta}$-cryptoxanthin had significantly negative relations with body fat-related indices in female subjects. The results demonstrated that blood antioxidants levels differed by sex and age, and had significant relations with blood lipid levels and anthropometric indices. Therefore, the rationale and significance of the relationships need to be elucidated in the future study related to dietary intakes and life style.

Dose Rate of Restroom in Facilities using Radioisotope (방사성동위원소 사용시설(내/외) 화장실의 외부선량률)

  • Cho, Yong-Gwi;An, Seong-Min
    • Journal of radiological science and technology
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    • v.39 no.2
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    • pp.237-246
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    • 2016
  • This study is therefore aimed at measuring the surface dose rate and the spatial dose rate in and outside the radionuclide facility in order to ensure safety of the patients, radiation workers and family care-givers in their use of such equipment and to provide a basic framework for further research on radiation protection. The study was conducted at 4 restrooms in and outside the radionuclide facility of a general hospital in Incheon between May 1 and July 31, 2014. During the study period, the spatial contamination dose rate and the surface contamination dose rate before and after radiation use were measured at the 4 places-thyroid therapy room, PET center, gamma camera room, and outpatient department. According to the restroom use survey by hospitals, restrooms in the radionuclide facility were used not only by patients but also by family care-givers and some of radiation workers. The highest cumulative spatial radiation dose rate was 8.86 mSv/hr at camera room restroom, followed by 7.31 mSv/hr at radioactive iodine therapy room restroom, 2.29 mSv/hr at PET center restroom, and 0.26 mSv/hr at outpatient department restroom, respectively. The surface radiation dose rate measured before and after radiation use was the highest at toilets, which are in direct contact with patient's excretion, followed by the center and the entrance of restrooms. Unsealed radioactive sources used in nuclear medicine are relatively safe due to short half lives and low energy. A patient who received those radioactive sources, however, may become a mobile radioactive source and contaminate areas the patient contacts-camera room, sedation room, and restroom-through secretion and excretion. Therefore, patients administered radionuclides should be advised to drink sufficient amounts of water to efficiently minimize radiation exposure to others by reducing the biological half-life, and members of the public-family care-givers, pregnant women, and children-be as far away from the patients until the dose remains below the permitted dose limit.

Cost Analysis of Home Nursing Care Patients in Rural Hospital (농촌 지역 중소병원의 가정간호사업소 등록환자의 방문비용분석)

  • Kim, Jin-Soon;Kum, Ran;HwangBo, Soo-Ja
    • Journal of agricultural medicine and community health
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    • v.24 no.1
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    • pp.91-101
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    • 1999
  • The home nursing care system is an integral part of the health care delivery system in order to meet the various needs of consummer, in particular, early discharge patient from the hospital, patient with long term care needed and the elderly. To find out the cost of home nursing care services, the home nursing care records of patients registered by home nursing care units established in public hospital with 150beds during the period of 1996 - 1997 were analyzed. The subjects were 102patients, 45 of male patients and 57 of female patients, those who live in a rural area in Kymiggi - Do The results obtained are as follows : 1. The male patients accounted for 44.1% of the total, with 45cases : group aged 60 years and more was the largest group, accounting for 79.5%. 2. The most frequent disease revealed was the osteoporosis which constitute 35.3% of the total registered patients, followed, in order, by malignant tumor, cerebrovascular disease. 3. It revealed that the cost per visit for the male was 47,764won ; the female, 46,078 won per visit. Noteworthy the cost per visit was high in the older patient. It was clearly that the gender, years of age and the cost per visit were statistically significant at 0.01 level and 0.05 level. 4. The cost per visit for the non complicated disease was slightly higher than the complicated disease, but it is not statistically significant, the cost per visit by type of disease varied, the cost per visit for COPD was the highest, followed, in order, by in malignant tumor, cancer, diabetes, osteoporosis etc. 5. It revealed that home nursing care cost for a eligible disease for home nursing care was less than the cost for hospitalization of the same disease, therefore, we expect that the home nursing care is cost efficiency. In conclusion, the home nursing care costs are needed to analyze further in comparison with the hospitalization costs for a certain disease.

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Cardiac Intracoronary Stenting vs CABG: Prevention of Medical Accident (심장 스텐트 시술과 의료사고 예방)

  • Kim, Kyoung Reay;Park, Kook Yang
    • The Korean Society of Law and Medicine
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    • v.18 no.2
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    • pp.163-194
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    • 2017
  • Coronary artery disease has increased in Korea as the country enters the aged society. It is well known that the incidence of coronary artery disease is related to aging, hypertension, diabetes, hyperlipidemia, and dietary habit. For effective treatment of significant coronary stenosis, close coordination between cardiac surgery and cardiology team is essential. Especially cardiologists' decision whether to do the stent placement or CABG is very important because the cardiologists usually start to consult the patients for their treatment. Recently, non-surgical interventions(that is stent placement) in cardiology field have dramatically increased as the national insurance system removed the limitation of the number of stents deployed. However, accidents are often caused by inappropriate use of stents, especially in patients with triple coronary disease or left main disease with heavy coronary calcifications. Another aspect of stent placement is to cope with an emergency case in the event of coronary rupture or pericardial tamponade during coronary interventions without cardiac surgeons. In the past two years, the Korea Consumer Agency (Consumer Dispute Coordination Committee) analyzed eight cases of medical dispute settlement. Only two hospitals were manned with both cardiologists and cardiac surgeons. Seven patients died of procedures of stenting and five patients died on the day of the procedure. Among the 8 cases, 5 cases showed 3 vessel disease and the rest of the cases had either severe calcification, complete occlusion or poor coronary antomies for stenting According to a 2017 national data registry of coronary stenting, less than 3 drug-eluting stents were implanted in 98% of all patients. In 2015, the number of stent procedures was 38,922, and approximately in 800 (2%) cases, more than four stents were used per patient. We emphasize that it is necessary to seriously consider the cost-benefit analysis between stent and CABG. The patient has the right to choose the right procedure by asking the liability of 'instruction explanation obligation'. He should be well informed of the pros and cons of both procedures to avoid overuse of stent. It can be solved by intimate discussion of individual cases with the cardiac surgeon and the patient. Unilateral dialogue with the patient, forceful restriction on the number of stenting, lack of surgeon's backup in difficult cases should all be avoided. It is also necessary to solve the problem not only at the hospital level, such as multidisciplinary integrated medical care, but also a nationwide solution such as expanding cardiac surgeons as essential personnel to public officials.

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A study on Establishment and Management of the CCTV in Operating Room (수술실 CCTV 설치 및 운영에 대한 고찰)

  • Kim, Minji
    • The Korean Society of Law and Medicine
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    • v.20 no.1
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    • pp.109-132
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    • 2019
  • Recently, medical accidents related to surgical procedures have increased. In addition, the media reported that some of these accidents were involved in health crimes. Patient-advocate groups have called for mandatory establishment and management of CCTV in operating rooms. There is a lot of discussion among the interested parties, so it is necessary to review the relevant laws and regulations. The purpose of this study is to identify the characteristics of CCTV in operating rooms and to review legislations related to establishment and management of the CCTV in operating rooms. Medical institutions use CCTV for management of facilities and patient safety and install it in operating rooms optionally. The Constitution guarantees the privacy and the privacy of correspondence of every citizen, but it can be limited by the law for public welfare. Currently, however, there is no existing law about establishment and management of the CCTV in operating rooms and it can be defect of legal system. Under the current legislations, it is likely that the Self-determination can be violated due to the characteristic of healthcare provider when CCTV is mandatorily installed in operating room. In addition, the regulations on access and leakage of confidential information known by operator are insufficient. So that, the safety of the visual data might be threatened. Furthermore, unless the period and the place of storage of the visual data are clearly defined, it is highly unlikely to meet the original purpose of patient safety and prevention of medical accidents. This study is meaningful as there is few previous study on this topic although the need for legal review about this is growing and several bills are being proposed. It is expected that the results of this study can be utilized as basic data for enactment or amendment of the laws and regulations about establishment and management of CCTV in operating rooms.